臺灣性別少數族群之預期性污名、性別角色與情緒調節對生活品質與心理症狀之影響

Abstract

前言：過去研究指出預期性污名為性別少數族群之重大壓力源之一，卻少有研究探討此族群之預期性污名及其對心理健康後果之影響。探討不同族群於心理健康後果之表現、不同人際關係來源之預期性污名與情感調節如何影響性別少數族群之心理健康為本研究重點。目的：藉檢驗不同人際關係來源之預期性污名、情感調節策略、性別角色傾向，瞭解性別少數族群可能之少數族群壓力模式，以思索未來臨床可能介入途徑。方法：本研究採617名成人為樣本，異性戀與性別少數族群各佔311名與306名。首先，以兩隨機分派之同質次樣本交叉驗證中文版反應風格量表短版與中文版正負向性別角色量表的心理計量特性與因素結構。再者，檢驗不同性傾向、性別角色間於心理健康程度之差異。最後檢驗性別少數族群之不同人際來源之預期性污名、反芻反應風格對心理健康後果之影響，並驗證本研究提出之序列中介模式，探索不同親疏關係之預期性污名對社會關係品質與心理症狀之影響。結果：（1）中文版反應風格量表短版與中文版正負向性別角色量表皆具良好心理計量特性。（2）相對於異性戀組與同性戀組，雙性戀組呈現較差之心理健康結果。（3）正向性別角色具較高之生活品質水準；負向雙性化與負向女性化具較高程度的苦惱自責式反芻，且有較多心理症狀。（4）不論預期性污名來源，苦惱自責式反芻可顯著正向預測心理症狀。（5）朋友、親戚及職場之預期性污名可顯著正向預測社交互動焦慮症狀。（6）家人之預期性污名、社會關係品質在親戚之預期性污名與心理症狀間具序列中介效果。討論：探討華人社會下不同族群於心理健康指標之差異來源，與不同人際來源之預期性污名、反芻反應風格對於性別少數族群之影響。最後，說明研究結果在臨床應用上的啟發，與未來可行介入途徑與研究方向。

Introduction: Previous research points out that anticipated stigma is one of the major stressors of the gender minority group, but few studies have investigated the anticipated stigma and its influences on mental health outcomes of gender minority group. The study focused on mental health outcomes of different gender preference groups, and examined the differences of anticipated stigma emerged from different relationships and explored how emotional regulation strategies influence mental health of the gender minorities. Purpose: By testing the anticipated stigma from different interpersonal relationships, emotional regulation strategies, and gender role tendency, the present study aimed to realize the possible minority stress model of the gender minorities in order to provide possible ways for clinical intervention. Methods: The present study recruited 617 adults, with 311 heterosexuals and 306 gender minorities. First, the study used two equivalent and randomized subsamples to cross validate the psychometric properties of the Response Style Questionnaire-10 (RSQ-10) and Positive-Negative Sex Role Inventory (PN-SRI). Next, the differences of mental health were examined among subsamples classified based on participants’ sex orientation and gender role tendency. Last, the study examined the influences of anticipated stigma from different interpersonal relationships and rumination styles on mental health of the gender minorities. In addition, the serial mediation model was proposed and tested to explore the influences of anticipated stigma from different relationships with different degrees of intimacy on quality of life and psychological symptoms. Results: The results indicate that: (1) The RSQ-10 and PN-SRI yielded good psychometric properties. (2) Bisexual group displayed poorer mental health than heterosexual group and homosexual group. (3) Those who held more positive gender roles reported significantly better quality of life, while those who held more negative androgyny and negative femininity displayed significantly higher levels of brooding rumination and more psychological symptoms. (5) The anticipated stigma from friends and relative as well as the workplace significantly positively predicted social interaction anxiety symptoms. (6) The anticipated stigma from family and the social relationship domain of quality of life showed serial mediation effects between anticipated stigma from relatives and psychological symptoms respectively. Discussion: Under the situation in Taiwan, the possible sources of differences in different gender preference groups, and the impacts of anticipated stigma from different interpersonal relationships and rumination styles on gender minority were discussed. Possible clinical applications and directions for future research are also addressed.