Hypervigilance: An Understudied Mediator of the Longitudinal Relationship Between Stigma and Internalizing Psychopathology Among Sexual-Minority Young Adults

Abstract

Hypervigilance is often theoretically invoked as a psychological mechanism linking stigma to internalizing psychopathology among sexual minorities. Empirically, however, hypervigilance is rarely explicitly assessed but is instead commonly conflated with putatively related constructs, including sexual-orientation-related rejection sensitivity and rumination, hindering conceptual and mechanistic understandings of this process. We therefore embedded a hypervigilance measure in a longitudinal, population-based study of 811 Swedish sexual-minority young adults (ages 17–34). Hypervigilance—but neither sexual-orientation-related rejection sensitivity nor rumination, with which it was only weakly correlated (rs = .23–.24)—uniquely mediated prospective associations between perceived discrimination and internalizing symptoms 2 years later, explaining up to 40% of these effects. Sexual-orientation-related rejection sensitivity and rumination prospectively predicted hypervigilance on these paths. Findings suggest that hypervigilance represents a distinct construct and transdiagnostic mechanism through which stigma-related experiences and processes undermine sexual-minority mental health. We discuss implications for enhancing psychological interventions for sexual minorities by addressing hypervigilance.