A new study directly links homophobic attitudes with people who also have higher levels of psychoticism and inappropriate coping mechanisms.

The study says that people who are homophobic are more likely to also have psychological issues in comparison to those that embrace homosexuality, according to CBS.

“The study is opening a new research avenue, where the real disease to study is homophobia,” lead researcher Emmanuele Jannini said.

In prior research about homophobia, some data has linked negative feelings toward gay people to same-sex desire of the person. There have also been other factors affecting homophobic behavior such as religion, sensitivity to disgust, hypermasculinity and misogyny.

But the new study is reaching further. It is taking a deeper look at mental health and psychopathology in relation to homophobic views. The researchers in this study asked 551 Italian students ages 18 to 30 to complete surveys on levels of homophobia.

The questionnaires also included questions on depression, anxiety and psychoticism among participants. They were all asked how strongly they agreed or disagreed with 25 statements that included: “Gay people make me nervous; I think homosexual people should not work with children; I tease and make jokes about say people.”

The students were also evaluated on attachment tendencies in terms of how people approach relationships. They were also questioned on their coping strategies.

They found that the better the mental health, the less likely the person was to convey any homophobic views. The students that said they were uncomfortable with close relationships with others also showed significantly higher homophobic views compared to those that were more secure. And those with a pattern of immature defense mechanisms were much more homophobic than those who dealt with mattes in clearly more mature ways.

Researchers also found high levels of hostility and anger in those that were homophobic whereas those with health issues like depression and hypochondria were linked to lower levels of homophobia.

In order to strengthen their findings, the research team is expanding the study to other participants in order to completely evaluate how personality and culture relate to homophobia.