Contending with disability-based minority stressors: Adapting the minority stress model to people with disabilities

Rehabil Psychol. 2025 Jul 28. doi: 10.1037/rep0000633. Online ahead of print.

Abstract

Purpose/objective: People with disabilities (PWDs) are at elevated risk for depression compared to their nondisabled peers (Okoro et al., 2021). Experiences of ableism and emotion dysregulation are identified risk factors for depression among disabled adults (Almeida et al., 2017; Wang et al., 2022). This study applies a minority stress lens, originally developed among sexual minorities, to a sample of PWDs, specifically, by examining distal (i.e., interpersonal and structural ableism) and proximal (i.e., internalized ableism and disability concealment) minority stressors as predictors of emotion dysregulation and depressive symptoms in a cross-disability sample.

Research method/design: U.S. adults (N = 162) with a range of disabilities completed an online survey in Fall 2022 assessing all model variables. A cross-sectional mediation analysis examined emotion dysregulation as a mechanism linking distal and proximal minority stressors to depressive symptoms. The model controlled for comorbid disability status to account for differences in depression among participants with multiple disabilities.

Results: As hypothesized, emotion dysregulation mediated the relationships between proximal minority stressors, internalized ableism, B = 0.12, 95% confidence interval (CI) [0.02, 0.23], and disability concealment (B = 0.13, 95% CI [0.03, 0.23]) and depressive symptoms. Ableist discrimination had a significant direct effect on depressive symptoms (B = 0.08, p = .008) but not a significant indirect effect through emotion dysregulation.

Conclusion/implications: Findings highlight emotion dysregulation as a mechanism through which proximal minority stressors are associated with depressive symptoms among PWDs, underscoring the need to target minority stressors in mental health interventions for disabled adults. (PsycInfo Database Record (c) 2025 APA, all rights reserved).