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Mo PKH, Hu H, Ip M, Dong W, Lau JTF, Wang Z. Effect of stress and avoidant coping on depression and the moderating role of age among men who have sex with men: Findings from a 6-month prospective cohort study. J Affect Disord 2021; 283:310-316. [PMID: 33578343 DOI: 10.1016/j.jad.2021.01.072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/06/2021] [Accepted: 01/30/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Men who have sex with men (MSM) are at increased risk of mental health problems. Few studies have examined the risk factors for mental health problems of Chinese MSM and identified potential moderators using a longitudinal design. OBJECTIVES The present study examined the effect of stress and avoidant coping on depression among MSM, and the moderating role of age on such relationship. METHODOLOGY A 6-month observational prospective cohort study was conducted among Chinese MSM. Respectively 592 and 402 MSM completed a survey at baseline and 6-month follow-up. RESULTS The prevalence of probable depression was 36.1% at baseline and 34.1% at 6-month follow-up. After adjusting for background characteristics and baseline depression score, both stress (β = .22, p<.05) and avoidant coping (β = .14, p<.05) showed significant positive relationship with depression at 6-month follow-up. The interaction effect of age and stress / avoidant coping was also significant. The effect of stress on depression was stronger among younger MSM, and the effect of avoidant coping on depression was significant among younger MSM but non-significant among older MSM. CONCLUSIONS Mental health promotion for MSM should reduce stress and avoidant coping, and specific intervention should be designed for younger MSM.
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Affiliation(s)
- Phoenix K H Mo
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Huahua Hu
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Mary Ip
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Willa Dong
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, North Carolina, US.
| | - Joseph T F Lau
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Zixin Wang
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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Kim S, Choi-Kwon S. Physical and Mental Health Related Quality of Life and Their Influencing Factors on Sexual Minority Women in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2115. [PMID: 33671565 PMCID: PMC7926774 DOI: 10.3390/ijerph18042115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/14/2021] [Accepted: 02/18/2021] [Indexed: 11/17/2022]
Abstract
Korean sexual minority women (SMW) often experience discrimination, but their health-related quality of life (HRQoL) remains to be investigated. Therefore, we aimed to assess the levels of mental and physical HRQoL of Korean SMW and their influencing factors using data from the Korean Sexual Minority Women's Health Study (2017) in a cross-sectional study, which included lesbian and bisexual females (N = 736; age ≥19 years). The HRQoL was measured using SF-36v2®; moreover, separate multiple linear regression analyses were conducted to identify the factors influencing mental and physical HRQoL. The physical and mental HRQoL scores were average (52.38 ± 7.65) and low (38.33 ± 12.64), respectively. Significant factors influencing the physical HRQoL were bisexuality, minority stress, perceived social support, and physical activity. The same factors-apart from physical activity-were associated with mental HRQoL. Therefore, to improve the HRQoL of SMW, it is necessary to lower their minority stress and increase social support. Moreover, special attention is needed regarding bisexual women in Korea.
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Affiliation(s)
- Ssirai Kim
- College of Nursing, Seoul National University, Seoul 03080, Korea;
- Department of Healthcare Administration, Seoul National University Hospital, Seoul 03080, Korea
| | - Smi Choi-Kwon
- College of Nursing, Seoul National University, Seoul 03080, Korea;
- The Research Institute of Nursing Science, Seoul National University, Seoul 03080, Korea
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Petruzzella A, Feinstein BA, Davila J, Lavner JA. Gay-Specific and General Stressors Predict Gay Men's Psychological Functioning Over Time. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1755-1767. [PMID: 32146605 DOI: 10.1007/s10508-020-01672-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/25/2020] [Accepted: 02/27/2020] [Indexed: 06/10/2023]
Abstract
Gay men experience various stressors, including gay-specific stressors such as discrimination and internalized homonegativity as well as general stressors such as occupational and financial strain. While a robust literature has examined how gay-specific stressors are associated with negative mental health outcomes among gay men, less attention has been paid to the association between general stress and gay men's psychological functioning or to how different types of stressors may interact to affect functioning. The current study sought to address this gap by examining the unique and combined associations between gay-specific external stress (discrimination), gay-specific internal stress (rejection sensitivity, internalized homonegativity, sexual identity concealment), and general stressors (e.g., academic difficulties) and negative affect and alcohol use over time. A total of 147 self-identified gay men living in the greater New York City area participated in a baseline assessment and a 7-week diary study. Univariate and multivariate results revealed that gay-specific external stress, gay-specific internal stress, and general stress were each positively and uniquely associated with higher mean levels of and greater fluctuations in negative affect over time, and general stress was positively associated with greater fluctuations in alcohol use over time. Multiplicative analyses indicated that individuals reporting high levels of stress in multiple domains experienced particularly high mean levels of negative affect. These findings highlight the unique contribution of general stress to gay men's functioning over time and underscore the importance of considering multiple forms of stress (i.e., gay-specific and general stress) and their interactions to better understand gay men's psychological functioning.
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Affiliation(s)
- Antonio Petruzzella
- Department of Psychology, University of Georgia, 125 Baldwin Street, Psychology Building, Athens, GA, 30602, USA.
| | - Brian A Feinstein
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Joanne Davila
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Justin A Lavner
- Department of Psychology, University of Georgia, 125 Baldwin Street, Psychology Building, Athens, GA, 30602, USA
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Li MJ, Takada S, Okafor CN, Gorbach PM, Shoptaw SJ, Cole SW. Experienced homophobia and gene expression alterations in Black and Latino men who have sex with men in Los Angeles County. Brain Behav Immun 2020; 83:120-125. [PMID: 31563693 PMCID: PMC6906252 DOI: 10.1016/j.bbi.2019.09.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/20/2019] [Accepted: 09/25/2019] [Indexed: 01/17/2023] Open
Abstract
Men who have sex with men (MSM) experience high rates of homophobic victimization, which is linked to myriad chronic physical and mental health disparities. Social adversity such as rejection, isolation, and racial discrimination can induce a conserved transcriptional response to adversity (CTRA) involving upregulation of proinflammatory genes and downregulation of type I interferon and antibody synthesis genes. This study specifically examines whether homophobic victimization is associated with expression of CTRA profiles in Black and Latino MSM living in Los Angeles. Analyses linked behavioral survey data with quantified RNA from leukocytes from blood samples of 70 participants over 12 months. CTRA gene expression was increased by 3.1-fold in MSM who experienced homophobic victimization while adjusting for major leukocyte subsets and sociodemographics. Accounting for all these factors, CTRA gene expression was significantly enhanced in MSM who identified as Black compared to Latino. Our findings identify experiences of homophobic victimization as drivers of inflammatory and type I interferon gene expression profiles, which can contribute to physical and mental health challenges in Black and Latino MSM.
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Affiliation(s)
- Michael J. Li
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles,Center for Behavioral and Addiction Medicine, Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles,Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Sae Takada
- National Clinician Scholars Program UCLA, Division of General Internal Medicine and Health Services Research, Department of Medicine, Los Angeles, CA,Veterans Affairs, Health Services Research & Development, Center for the Study of Healthcare Innovation, Implementation, & Policy, Los Angeles, CA
| | - Chukwuemeka N. Okafor
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles,Center for Behavioral and Addiction Medicine, Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles,Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Pamina M. Gorbach
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles,Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles
| | - Steven J. Shoptaw
- Center for Behavioral and Addiction Medicine, Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles,Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Steven W. Cole
- Division of Hematology-Oncology, Department of Medicine, University of California, Los Angeles,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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