Differences in emotion regulation components underlie the sexual orientation disparity in depressive symptoms: a prospective, Population-based study of young adults

Hatzenbuehler's psychological mediation framework proposes that difficulties in emotion regulation (ER), which are driven in part by excess exposure to stigma-related experiences, contribute to sexual orientation-related mental health disparities. However, existing research on the framework has largely focused on a small number of ER variables in non-probability samples. To address these limitations, we examined whether a large complement of ER components mediates the prospective association between sexual minority status and depressive symptoms, using longitudinal data from a population-based sample of 1,208 Swedish young adults (aged 18-35). Data were collected in 2020 (ER, depressive symptoms) and 2021 (depressive symptoms). Participants completed 12 measures of ER, spanning a diverse array of ER constructs (e.g., emotional awareness, cognitive reappraisal, access to ER strategies). Sexual minorities exhibited significantly more ER difficulties on nine out of the 12 ER components, and higher depressive symptoms, compared to heterosexuals. Eight of the 12 ER components independently mediated the association between sexual minority status and increases in depressive symptoms one year later, and two components (brooding rumination, difficulty identifying positive emotions) mediated this relationship when all 12 ER components were entered into the model simultaneously. These findings provide evidence from a population-based, longitudinal study that a wide range of ER factors underlie sexual orientation-related disparities in depressive symptoms during a developmental period of heightened risk.