{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T14:39:18Z","timestamp":1776695958809,"version":"3.51.2"},"reference-count":64,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2017,11,9]],"date-time":"2017-11-09T00:00:00Z","timestamp":1510185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 DE014320"],"award-info":[{"award-number":["T32 DE014320"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Stress may contribute to illness through the impaired recovery or sustained activity of stress-responsive biological systems. Rumination, or mental rehearsal of past stressors, may alter the body\u2019s stress-responsive systems by amplifying and prolonging exposure to physiological mediators, such as cortisol. The primary aim of the current investigation was to test the extent to which the tendency to ruminate on stress predicts diminished diurnal cortisol recovery (i.e., elevated evening cortisol) in a sample of sexual and gender minority young adults. Participants included 58 lesbian, gay, bisexual, and transgender young adults (Mage = 25.0, SD = 4.1) who completed an initial online survey that assessed trait rumination and current depressed mood. Participants completed daily evening questionnaires and provided salivary cortisol samples at wake, 45 min post-wake, 12 h post-wake, and at bedtime over seven consecutive days. Trait rumination predicted significantly higher cortisol concentrations at bedtime, but was unrelated to other cortisol indices (e.g., morning cortisol, diurnal slope, total output). The association with trait rumination was not accounted for by daily negative affect, and was largely independent of depressed mood. These results have implications for identifying and treating those who may be at risk for impaired diurnal cortisol recovery and associated negative health outcomes.<\/jats:p>","DOI":"10.3390\/ijerph14111365","type":"journal-article","created":{"date-parts":[[2017,11,9]],"date-time":"2017-11-09T11:33:02Z","timestamp":1510227182000},"page":"1365","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Trait Rumination Predicts Elevated Evening Cortisol in Sexual and Gender Minority Young Adults"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5709-0092","authenticated-orcid":false,"given":"Peggy","family":"Zoccola","sequence":"first","affiliation":[{"name":"Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4197-1295","authenticated-orcid":false,"given":"Andrew","family":"Manigault","sequence":"additional","affiliation":[{"name":"Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilson","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3346-7646","authenticated-orcid":false,"given":"Cari","family":"Hollenbeck","sequence":"additional","affiliation":[{"name":"Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA"},{"name":"Department of Social and Public Health, Ohio University, Grover Center W324, Athens, OH 45701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Mendlein","sequence":"additional","affiliation":[{"name":"Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Woody","sequence":"additional","affiliation":[{"name":"Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA"},{"name":"Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, 460 Medical Center Drive, Columbus, OH 43210, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrina","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA"},{"name":"Heritage College of Osteopathic Medicine, Ohio University, 35 W. Green Drive, Athens, OH 45701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5658-2095","authenticated-orcid":false,"given":"Matt","family":"Scanlin","sequence":"additional","affiliation":[{"name":"Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA"},{"name":"Department of Social and Public Health, Ohio University, Grover Center W324, Athens, OH 45701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2017,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.neubiorev.2013.11.005","article-title":"Biological and psychological markers of stress in humans: Focus on the Trier Social Stress Test","volume":"38","author":"Allen","year":"2014","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1111\/j.1749-6632.1999.tb08103.x","article-title":"Protective and damaging effects of mediators of stress: Elaborating and testing the concepts of allostasis and allostatic load","volume":"896","author":"McEwen","year":"1999","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1146\/annurev.physiol.67.040403.120816","article-title":"Endocrinology of the stress response","volume":"67","author":"Charmandari","year":"2005","journal-title":"Annu. Rev. Physiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/S0301-0511(01)00092-8","article-title":"Psychoneuroendocrinological contributions to the etiology of depression, posttraumatic stress disorder, and stress-related bodily disorders: The role of the hypothalamus-pituitary-adrenal axis","volume":"57","author":"Ehlert","year":"2001","journal-title":"Biol. Psychol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.physbeh.2011.02.027","article-title":"Allostatic load associations to acute, 3-year and 6-year prospective depressive symptoms in healthy older adults","volume":"104","author":"Juster","year":"2011","journal-title":"Physiol. Behav."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1988","DOI":"10.1016\/j.socscimed.2010.02.024","article-title":"Allostatic load is associated with chronic conditions in the Boston Puerto Rican Health Study","volume":"70","author":"Mattei","year":"2010","journal-title":"Soc. Sci. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1210\/jcem-33-1-14","article-title":"Twenty-four hour pattern of the episodic secretion of cortisol in normal subjects","volume":"33","author":"Weitzman","year":"1971","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1210\/jc.2010-2137","article-title":"Association of diurnal patterns in salivary cortisol with all-cause and cardiovascular mortality: Findings from the Whitehall II Study","volume":"96","author":"Kumari","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1093\/jnci\/92.12.994","article-title":"Diurnal cortisol rhythm as a predictor of breast cancer survival","volume":"92","author":"Sephton","year":"2000","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S163","DOI":"10.1016\/j.bbi.2012.07.019","article-title":"Diurnal cortisol rhythm as a predictor of lung cancer survival","volume":"30","author":"Sephton","year":"2013","journal-title":"Brain Behav. Immun."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1210\/jc.2015-2853","article-title":"Diurnal cortisol patterns, future diabetes, and impaired glucose metabolism in the Whitehall II Cohort Study","volume":"101","author":"Hackett","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1037\/0022-3514.85.5.909","article-title":"A multidimensional structure for repetitive thought: What\u2019s on your mind, and how, and how much?","volume":"85","author":"Segerstrom","year":"2003","journal-title":"J. Personal. Soc. Psychol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.cpr.2008.10.003","article-title":"A roadmap to rumination: A review of the definition, assessment, and conceptualization of this multifaceted construct","volume":"29","author":"Smith","year":"2009","journal-title":"Clin. Psychol. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jpsychores.2005.06.074","article-title":"The perseverative cognition hypothesis: A review of worry, prolonged stress-related physiological activation, and health","volume":"60","author":"Brosschot","year":"2006","journal-title":"J. Psychosom. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"435","DOI":"10.3109\/10253891003713765","article-title":"Salivary cortisol responses to a psychosocial laboratory stressor and later verbal recall of the stressor: The role of trait and state rumination","volume":"13","author":"Zoccola","year":"2010","journal-title":"Stress"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1037\/0021-843X.106.2.221","article-title":"The response styles theory of depression: Tests and an extension of the theory","volume":"106","author":"Just","year":"1997","journal-title":"J. Abnorm. Psychol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1037\/a0027349","article-title":"Eliciting and maintaining ruminative thought: The role of social-evaluative threat","volume":"12","author":"Zoccola","year":"2012","journal-title":"Emotion"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1037\/0021-843X.102.1.20","article-title":"Response styles and the duration of episodes of depressed mood","volume":"102","author":"Morrow","year":"1993","journal-title":"J. Abnorm. Psychol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jpsychores.2012.03.007","article-title":"Assessing the relationship between rumination and cortisol: A review","volume":"73","author":"Zoccola","year":"2012","journal-title":"J. Psychosom. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.psyneuen.2015.04.014","article-title":"Extending the recovery window: Effects of trait rumination on subsequent evening cortisol following a laboratory performance stressor","volume":"58","author":"Zoccola","year":"2015","journal-title":"Psychoneuroendocrinology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1080\/10615800802596378","article-title":"The effects of gender, long-term need for recovery and trait inhibition-rumination on morning and evening saliva cortisol secretion","volume":"22","author":"Rydstedt","year":"2009","journal-title":"Anxiety Stress Coping"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1002\/smi.2538","article-title":"The relationship between work-related rumination and evening and morning salivary cortisol secretion","volume":"31","author":"Cropley","year":"2015","journal-title":"Stress Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.psyneuen.2006.12.007","article-title":"Decreased cortisol response to awakening is associated with cognitive vulnerability to depression in a nonclinical sample of young adults","volume":"32","author":"Kuehner","year":"2007","journal-title":"Psychoneuroendocrinology"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Hilt, L.M., Sladek, M.R., Doane, L.D., and Stroud, C.B. (2016). Daily and trait rumination: Diurnal cortisol patterns in adolescent girls. Cogn. Emot., 1\u201311.","DOI":"10.1080\/02699931.2016.1262332"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2258","DOI":"10.1016\/j.psyneuen.2013.04.014","article-title":"Effects of mood and rumination on cortisol levels in daily life: An ambulatory assessment study in remitted depressed patients and healthy controls","volume":"38","author":"Huffziger","year":"2013","journal-title":"Psychoneuroendocrinology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1037\/0033-2909.129.5.674","article-title":"Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence","volume":"129","author":"Meyer","year":"2003","journal-title":"Psychol. Bull."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1037\/a0016059","article-title":"Perceived discrimination and health: A meta-analytic review","volume":"135","author":"Pascoe","year":"2009","journal-title":"Psychol. Bull."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1177\/2167696815626822","article-title":"Minority stress predicts depression in lesbian, gay, and bisexual emerging adults via elevated diurnal cortisol","volume":"4","author":"Parra","year":"2016","journal-title":"Emerg. Adulthood"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1097\/PSY.0b013e3182826881","article-title":"Sexual orientation and disclosure in relation to psychiatric symptoms, diurnal cortisol, and allostatic load","volume":"75","author":"Juster","year":"2013","journal-title":"Psychosom. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/s10508-006-9022-x","article-title":"Coming-out across the life course: Implications of age and historical context","volume":"35","author":"Floyd","year":"2006","journal-title":"Arch. Sex. Behav."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1037\/0033-2909.130.3.355","article-title":"Acute stressors and cortisol responses: A theoretical integration and synthesis of laboratory research","volume":"130","author":"Dickerson","year":"2004","journal-title":"Psychol. Bull."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1037\/0278-6133.27.1.116","article-title":"Negative social evaluation, but not mere social presence, elicits cortisol responses to a laboratory stressor task","volume":"27","author":"Dickerson","year":"2008","journal-title":"Health Psychol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1016\/S0191-8869(03)00206-X","article-title":"An exploration of shame, social rank and rumination in relation to depression","volume":"36","author":"Cheung","year":"2004","journal-title":"Personal. Individ. Differ."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1080\/13576500444000038","article-title":"Empathy and the self-absorption paradox II: Self-rumination and self-reflection as mediators between shame, guilt, and empathy","volume":"3","author":"Joireman","year":"2004","journal-title":"Self Identity"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1037\/a0016441","article-title":"How does sexual minority stigma \u201cget under the skin\u201d? A psychological mediation framework","volume":"135","author":"Hatzenbuehler","year":"2009","journal-title":"Psychol. Bull."},{"key":"ref_36","first-page":"226","article-title":"Rural location and exposure to minority stress among sexual minorities in the United States","volume":"3","author":"Swank","year":"2012","journal-title":"Psychol. Sex."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1080\/1364557032000081663","article-title":"Snowball sampling: Using social networks to research non-heterosexual women","volume":"8","author":"Browne","year":"2005","journal-title":"Int. J. Soc. Res. Methodol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1111\/j.1442-2018.2010.00541.x","article-title":"Recruitment of hard-to-reach population subgroups via adaptations of the snowball sampling strategy","volume":"12","author":"Sadler","year":"2010","journal-title":"Nurs. Health Sci."},{"key":"ref_39","unstructured":"MacArthur Research Network on Socioeconomic Status and Health (2017, September 28). Salivary Cortisol Measurement. Available online: http:\/\/www.macses.ucsf.edu\/research\/allostatic\/salivarycort.php."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1080\/00365510510025773","article-title":"Long-term stability of salivary cortisol","volume":"65","author":"Garde","year":"2005","journal-title":"Scand. J. Clin. Lab. Investig."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/S0306-4530(98)00031-6","article-title":"The relationship between salivary cortisol concentrations in frozen versus mailed samples","volume":"23","author":"Clements","year":"1998","journal-title":"Psychoneuroendocrinology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/0191-8869(89)90020-2","article-title":"The construction and validation of a new scale for measuring emotion control","volume":"10","author":"Roger","year":"1989","journal-title":"Personal. Individ. Differ."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1177\/089826439300500202","article-title":"Two shorter forms of the CES-D depression symptoms index","volume":"5","author":"Kohout","year":"1993","journal-title":"J. Aging Health"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1037\/0022-3514.54.6.1063","article-title":"Development and validation of brief measures of positive and negative affect: The PANAS scales","volume":"54","author":"Watson","year":"1988","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ijpsycho.2008.03.014","article-title":"The cortisol awakening response (CAR): Facts and future directions","volume":"72","author":"Fries","year":"2009","journal-title":"Int. J. Psychophysiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1097\/PSY.0b013e31814c405c","article-title":"Area under the curve and other summary indicators of repeated waking cortisol measurements","volume":"69","author":"Fekedulegn","year":"2007","journal-title":"Psychosom. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.psyneuen.2012.04.019","article-title":"Comparison of salivary cortisol as measured by different immunoassays and tandem mass spectrometry","volume":"38","author":"Miller","year":"2013","journal-title":"Psychoneuroendocrinology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1037\/bul0000036","article-title":"Physiological concomitants of perseverative cognition: A systematic review and meta-analysis","volume":"142","author":"Ottaviani","year":"2016","journal-title":"Psychol. Bull."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1097\/PSY.0b013e31817bbc77","article-title":"Rumination and cortisol responses to laboratory stressors","volume":"70","author":"Zoccola","year":"2008","journal-title":"Psychosom. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/1467-6494.00004","article-title":"Diurnal patterns of unpleasant mood: Associations with neuroticism, depression, and anxiety","volume":"66","author":"Rusting","year":"1998","journal-title":"J. Personal."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1016\/j.brat.2008.06.004","article-title":"Ruminative self-focus, negative life events, and negative affect","volume":"46","author":"Moberly","year":"2008","journal-title":"Behav. Res. Ther."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0749-3797(18)30622-6","article-title":"Screening for depression in well older adults: Evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale)","volume":"10","author":"Andresen","year":"1994","journal-title":"Am. J. Prev. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1097\/01.psy.0000195747.12404.aa","article-title":"The role of angry rumination and distraction in blood pressure recovery from emotional arousal","volume":"68","author":"Gerin","year":"2006","journal-title":"Psychosom. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.bbi.2015.10.011","article-title":"Trait reflection predicts interleukin-6 response to a social-evaluative stressor","volume":"52","author":"Woody","year":"2016","journal-title":"Brain Behav. Immun."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1037\/hea0000019","article-title":"Differential effects of poststressor rumination and distraction on cortisol and C-reactive protein","volume":"33","author":"Zoccola","year":"2014","journal-title":"Health Psychol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1016\/j.cpr.2013.08.004","article-title":"Assessing treatments used to reduce rumination and\/or worry: A systematic review","volume":"33","author":"Querstret","year":"2013","journal-title":"Clin. Psychol. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.psyneuen.2017.05.008","article-title":"Stigma and diurnal cortisol among transitioning transgender men","volume":"82","author":"DuBois","year":"2017","journal-title":"Psychoneuroendocrinology"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1207\/s15324796abm3003_10","article-title":"Gay and bisexual men who disclose their sexual orientations in the workplace have higher workday levels of salivary cortisol and negative affect","volume":"30","author":"Huebner","year":"2005","journal-title":"Ann. Behav. Med."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Stawski, R.S., Cichy, K.E., Piazza, J.R., and Almeida, D.M. (2013). Associations among daily stressors and salivary cortisol: Findings from the National Study of Daily Experiences. Psychoneuroendocrinology.","DOI":"10.1016\/j.psyneuen.2013.06.023"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2048","DOI":"10.2105\/AJPH.2006.087254","article-title":"Physical health complaints among lesbians, gay men, and bisexual and homosexually experienced heterosexual individuals: Results from the California Quality of Life Survey","volume":"97","author":"Cochran","year":"2007","journal-title":"Am. J. Public Health"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.2105\/AJPH.2013.301733","article-title":"Health and health risks among sexual minority women: An examination of 3 subgroups","volume":"104","author":"Przedworski","year":"2014","journal-title":"Am. J. Public Health"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.2105\/AJPH.2013.301258","article-title":"A population-based study of cardiovascular disease risk in sexual-minority women","volume":"103","author":"Farmer","year":"2013","journal-title":"Am. J. Public Health"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.2105\/AJPH.2009.174169","article-title":"A population-based study of sexual orientation identity and gender differences in adult health","volume":"100","author":"Conron","year":"2010","journal-title":"Am. J. Public Health"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.psyneuen.2014.07.022","article-title":"Variability and reliability of diurnal cortisol in younger and older adults: Implications for design decisions","volume":"49","author":"Segerstrom","year":"2014","journal-title":"Psychoneuroendocrinology"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/14\/11\/1365\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:48:45Z","timestamp":1760208525000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/14\/11\/1365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,9]]},"references-count":64,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2017,11]]}},"alternative-id":["ijerph14111365"],"URL":"https:\/\/doi.org\/10.3390\/ijerph14111365","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,9]]}}}