Psychometric Properties of the Nungesser Homosexual Attitudes Inventory and its Relation to Health Risks Among Gay Men

Abstract

Sexual minority men are at an increased risk for negative outcomes, including mental health disorders, suicide, substance abuse, and sexual risk behaviors. Internalized Homophobia (IH), roughly defined as sexual orientation-related self-hatred among gay men, has been linked to these outcomes. Since its publication in 1983, the predominant measure of IH used in psychological research has been the Nungesser Homosexual Attitudes Inventory (Nungesser, 1983). The scale is potentially dated, and there is a relative paucity of investigation into its psychometric properties; findings derived through its use may be in question. The current effort describes two studies designed to address these concerns. Study I includes a principal components analysis of the scale using data obtained from an internet sample (N = 486), resulting in suggested revisions for the broader scale, and proposed brief versions of the Self and Disclosure subscales. Study II used data obtained from a second internet sample (N = 884) to further evaluate scale structure and properties. Analyses include confirmatory factor analyses of the original scale, Shidlo's revised version (1994), the suggested alternative, and the Brief Self and Disclosure scales proposed in Study I. Of the three versions of the overall scale, the suggested alternative proposed in Study I exhibited the most favorable fit and highest item loadings. Internal consistency for the suggested alternative was equal to that of the larger NHAI and Shidlo-revised scales. External validity was evaluated through correlations with mental health and suicide, substance use, sexual risk, and orientation-based victimization. Strong results in the expected direction were found only in the instance of mental health, with negative attitudes towards homosexuality being associated with increases in depression and anxiety scores as measured by the Hospital Anxiety and Depression Scale. The suggested scale alternative and Brief Self and Disclosure scales performed similarly to the more extensive NHAI and Shidlo-revised scales, leading to a recommendation for their use in research. Finally, findings from the current effort are discussed in relation to the broader social context impacting the lives and development of sexual minority men.