Date of Award:


Document Type:


Degree Name:

Master of Science (MS)



Committee Chair(s)

Tyler Renshaw


Tyler Renshaw


Melissa Tehee


Renee Galliher


Adolescence is a difficult time, especially for those who do not identify as heterosexual (e.g., gay, lesbian, bisexual, asexual, pansexual; LGB+). Increased rates of substance abuse and suicidality are well documented outcomes that tend to be worse in the LGB+ adolescent community than in mainstream groups. Minority stress, the effect of unique stressors experienced by those in the LGB+ community explained by external and societal influences, has been accepted within the research community as a theory used to explain the health disparities seen in this group. This study proposed a possible further explanation, in addition to minority stress, that helps clarify the relationship between minority stress and negative outcomes, and that is changeable through Acceptance and Commitment Therapy (ACT). Psychological inflexibility, a rigid reaction to life events that is inconsistent with values and often promotes avoidant behavior, and five of its six key sub-processes (experiential avoidance, cognitive fusion, lack of values, preoccupation with the past or future, and inaction) was posited as influencing the strength of the relationship between minority stress and substance misuse or suicidality.

Interactions with both global psychological inflexibility and its sub-processes were examined using statistical models to explore relationships between minority stress and both suicidality and substance misuse in the LGB+ adolescent community. A sample of 152 LGB+ adolescents participated. Significant interactions were found in models of substance misuse but not suicidality, with global psychological inflexibility, cognitive fusion, and obstruction of valued living as moderators that strengthened the relationship between minority stress and substance misuse.

Implications based on results suggest that psychological inflexibility as a mechanism of change in LGB+ adolescents is worth further study. Additional examination into the effectiveness of ACT in LGB+ populations struggling with minority stress’ effects and/or substance misuse should be conducted to advance the understanding of these results.