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Wright T, Solmi F, Ajnakina O, Ingram E, Kandola A, Lee S, Iob E, Steptoe A, Thomas B, Lewis G. The role of loneliness in the association between sexual orientation and depressive symptoms among older adults: A prospective cohort study. J Affect Disord 2024; 356:137-144. [PMID: 38593941 DOI: 10.1016/j.jad.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 03/13/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND This study aims to understand the mechanisms contributing to the elevated risk of depression among sexual minority older adults compared to heterosexuals. Specifically, the role of loneliness as a potential mediator is investigated to inform targeted interventions for preventing depression in sexual minority populations. METHODS Data from the English Longitudinal Study of Ageing, focusing on adults aged over 50, were analysed. Sexual orientation (sexual minority or heterosexual) and loneliness scores (UCLA scale) were assessed at wave six (2010-2011), while depressive symptoms (CESD) were assessed at wave seven (2013-14). Linear regression models and mediation analyses, using g-computation formula and adjusted for confounders, were conducted. RESULTS The sample included 6794 participants, with 478 (7.0 %) identifying as sexual minorities. After adjustments, sexual minorities scored higher on depressive symptoms at wave seven (mean difference): 0.23, 95 % CI 0.07 to 0.39) and loneliness at wave six (MD: 0.27, 95 % CI 0.08 to 0.46). Loneliness was positively associated with depressive symptoms (coefficient: 0.27, 95 % CI 0.26 to 0.29). In mediation analyses, loneliness explained 15 % of the association between sexual orientation and subsequent depressive symptoms. LIMITATIONS The dataset used sexual behaviour rather than desire and identity, potentially skewing representation of sexual minorities. Additionally, transgender older adults were not included due to limited gender diversity reported within the ELSA dataset. CONCLUSIONS Loneliness appears to be a significant modifiable mechanism contributing to the heightened risk of depressive symptoms in sexual minority older adults compared with their heterosexual counterparts.
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Affiliation(s)
- Talen Wright
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, United Kingdom.
| | - Francesca Solmi
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, United Kingdom
| | - Olesya Ajnakina
- Institute of Psychiatry, Psychology & Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, United Kingdom
| | - Elizabeth Ingram
- Department of Applied Health Research, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom
| | - Aaron Kandola
- MRC Unit for Lifelong Health and Ageing, University College London, 1-19 Torrington Place, London, United Kingdom
| | - Stephen Lee
- Opening Doors, Unit 4.1b Resource for London, 356 Holloway Road, London N7 6PA, United Kingdom
| | - Eleonora Iob
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Ben Thomas
- Opening Doors, Unit 4.1b Resource for London, 356 Holloway Road, London N7 6PA, United Kingdom
| | - Gemma Lewis
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, United Kingdom
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2
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Elmer EM, van Tilburg TG, Fokkema T. Age and Gender Identity in the Relationship Between Minority Stress and Loneliness: A Global Sample of Sexual and Gender Minority Adults. JOURNAL OF SEX RESEARCH 2024:1-20. [PMID: 38861488 DOI: 10.1080/00224499.2024.2339511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
Loneliness is prevalent among sexual minority adults and is associated with minority stress. Yet there is limited understanding of how loneliness and minority stress vary across key demographic variables. This cross-sectional study explored age and gender differences in a minority stress model linking sexual orientation marginalization to social and emotional loneliness via proximal stress (internalized homonegativity, concealment, and stigma preoccupation) and via social anxiety and inhibition. The study also assessed age and gender differences in the protective influence of LGBTQ community involvement. 7,856 sexual minority adults from 85 countries completed an online survey. They were categorized as emerging adults (18-24, n = 3,056), young adults (25-34, n = 2,193), midlife adults (35-49, n = 1,243), and older adults (50-88, n = 1,364). Gender identity groups were cisgender men (n = 4,073), cisgender women (n = 3,017), and transgender individuals (n = 766). With each successive age group, there was a lower prevalence of sexual orientation marginalization, proximal stress, social anxiety, inhibition, and emotional loneliness, along with more community involvement. Sexual orientation marginalization was more pronounced among cisgender women and, especially, transgender individuals. The latter also exhibited the most social anxiety, inhibition, loneliness, and community involvement. Proximal stress was more prevalent among cisgender men than cisgender women and transgender individuals. Multiple group structural equation modeling supported the applicability of the loneliness model across age and gender groups, with only a few variations; these mainly related to how strongly community involvement was linked to marginalization, internalized homonegativity, and social loneliness.
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Affiliation(s)
- Eddy M Elmer
- Department of Sociology, Vrije Universiteit Amsterdam
| | | | - Tineke Fokkema
- Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW/University of Groningen
- Department of Public Administration and Sociology, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam
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3
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Paciente R, Pranoto EP, Woolard A, Munro E, Lombardi K. The queers are all right: a content analysis of LGBTQIA + mental health on TikTok. CULTURE, HEALTH & SEXUALITY 2024; 26:778-789. [PMID: 37729467 DOI: 10.1080/13691058.2023.2253882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/28/2023] [Indexed: 09/22/2023]
Abstract
The formation of online communities instils a sense of connectedness which can ameliorate the mental health concerns that result from minority stressors for lesbian, gay, queer, intersex, asexual, and other diverse genders/sexualities (LGBTQIA+). The aim of this study was to explore how LGBTQIA + people communicate social and mental health concerns on TikTok. It was anticipated that factors affecting mental health, such as minority stressors and community connectedness, would be addressed by the videos collected. Engagement statistics, demographics and content analysis were used to describe the 50 most-viewed videos across the top five related hashtags: #genderidentity, #lgbtqawareness, #sexualidentity, #lgbtmentalhealth, and #transmentalhealth. The content analysis indicates that TikTok is used as a way for members of the LGBTQIA + community to connect with each other and enhance feelings of community connectedness, which research shows may buffer the effects of minority stressors. Engagement with social media can be especially beneficial for those who may not be able to connect in the real-world. Further interactions, such as analysis of the comment section, should be investigated to develop a fuller understanding of how LGBTQIA + TikTok users respond to these contents.
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Affiliation(s)
- Rigel Paciente
- Youth Mental Health, Telethon Kids Institute, Nedlands, Australia
- School of Psychology, The University of Western Australia, Perth, Australia
| | | | - Alix Woolard
- Youth Mental Health, Telethon Kids Institute, Nedlands, Australia
- School of Psychology, The University of Western Australia, Perth, Australia
| | - Emily Munro
- Youth Mental Health, Telethon Kids Institute, Nedlands, Australia
| | - Karen Lombardi
- Youth Mental Health, Telethon Kids Institute, Nedlands, Australia
- School of Medical and Health Sciences, Edith Cowan University, Edith Cowan University, Australia
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Ross EJ, Jimenez DE, Ghanooni D, Mendez A, Hirshfield S, Horvath KJ, DeVries B, Dilworth SE, Carrico AW, Martinez CA. Loneliness, Methamphetamine Use, and Cardiovascular Risk Factors Among Sexual Minority Men in the COVID-19 Era. Int J Behav Med 2024:10.1007/s12529-024-10288-0. [PMID: 38684565 DOI: 10.1007/s12529-024-10288-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Important gaps exist in our understanding of loneliness and biobehavioral outcomes among sexual minority men (SMM), such as faster HIV disease progression. At the same time, SMM who use methamphetamine are approximately one-third more likely than non-users to develop cardiovascular disease. This study examined associations of loneliness, stimulant use, and cardiovascular risk in SMM with and without HIV. METHOD Participants were enrolled from August 2020 to February 2022 in a 6-month prospective cohort study. The study leveraged self-report baseline data from 103 SMM, with a subset of 56 SMM that provided a blood sample to measure markers of cardiovascular risk. RESULTS Loneliness showed negative bivariate associations with total cholesterol and LDL cholesterol in the cardiometabolic subsample (n = 56). SMM with methamphetamine use (t(101) = 2.03, p < .05; d = .42) and those that screened positive for a stimulant use disorder (t(101) = 2.07, p < .05; d = .46) had significantly higher mean loneliness scores. In linear regression analyses, negative associations of loneliness with LDL and total cholesterol were observed only among SMM who used methamphetamine. CONCLUSION We observed lower cholesterol in SMM reporting loneliness and methamphetamine use. Thus, in addition to the observed associations of loneliness with cholesterol, there are important medical consequences of methamphetamine use including cardiovascular risk, higher HIV acquisition risk and progression, as well as stimulant overdose death. This cross-sectional study underscores the need for clinical research to develop and test interventions targeting loneliness among SMM with stimulant use disorders.
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Affiliation(s)
- Emily J Ross
- Department of Public Health Sciences, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Daniel E Jimenez
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1436, Miami, FL, 33136, USA
| | - Delaram Ghanooni
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Armando Mendez
- Division of Endocrinology, Diabetes and Metabolism and the Diabetes Research Institute, Department of Medicine, University of Miami Miller School of Medicine, 1450 NW 10 Ave, Miami, FL, 33136, USA
| | - Sabina Hirshfield
- Department of Medicine, STAR Program, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | - Keith J Horvath
- Department of Psychology, San Diego State University, Alvarado Court, San Diego, 6363, CA, USA
| | - Britt DeVries
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Samantha E Dilworth
- Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, 550 16 Street, San Francisco, CA, 94158, USA
| | - Adam W Carrico
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Claudia A Martinez
- Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA.
- Department of Cardiology and Interventional Cardiology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA.
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Nicholas J, Bresin K. Everyday Sexual and Gender Minority Stress and Health: A Systematic Review of Experience Sampling Studies. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1221-1243. [PMID: 38172351 DOI: 10.1007/s10508-023-02779-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024]
Abstract
Sexual and gender minority stress is associated with negative physical and mental health outcomes, such as hypertension and depression. Expanding on previous reviews of the literature on cross-sectional and long-term prospective associations between sexual and gender minority stress and health outcomes, the current systematic review synthesizes the evidence on how everyday sexual and gender minority stress relates to momentary changes in health. The findings of 53 experience sampling studies published between 2007 and 2022 suggest that daily and momentary within-persons fluctuations in minority stressors are associated with cognitive-emotional (e.g., affect, suicidality), behavioral (e.g., substance use), social (e.g., relationship satisfaction), and physical health outcomes (e.g., somatic symptoms). These findings suggest that sexual and gender minority stress is a dynamic process that can vary within individuals over time and significantly impact everyday mental and physical health. We discuss the implications of these findings for minority stress theory, LGBTQ+ health research, LGBTQ+ affirming therapy, and prevention initiatives. The current experience sampling literature is limited by a lack of attention to gender minority stress and a focus on a limited range of health outcomes. Methodological and theoretical considerations for future experience sampling research are discussed in light of these limitations.
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Affiliation(s)
- Julia Nicholas
- Department of Psychological and Brain Sciences, University of Louisville, 317 Life Sciences Building, Louisville, KY, 40292, USA.
| | - Konrad Bresin
- Department of Psychological and Brain Sciences, University of Louisville, 317 Life Sciences Building, Louisville, KY, 40292, USA
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6
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Heu LC. The Loneliness of the Odd One Out: How Deviations From Social Norms Can Help Explain Loneliness Across Cultures. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023:17456916231192485. [PMID: 37819246 DOI: 10.1177/17456916231192485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Loneliness is an important health risk, which is why it is important to understand what can cause persistent or severe loneliness. Previous research has identified numerous personal or relational risk factors for loneliness. Cultural predictors, however, have been considered less. The new framework of norm deviations and loneliness (NoDeL) proposes that social norms, which are defining features of culture, can help explain loneliness within and across cultural contexts. Specifically, people who deviate from social norms are suggested to be at an increased risk for feeling lonely because they are more likely to experience alienation, inauthenticity, lower self-worth, social rejection, relationship dissatisfaction, and/or unfulfilled relational needs. Given that social norms vary by social, geographical, and temporal context, they can furthermore be considered cultural moderators between individual-level risk factors and loneliness: Personal or relational characteristics, such as shyness or being single, may increase the risk for loneliness particularly if they do not fit social norms in a specific environment. Integrating previous quantitative and qualitative findings, I hence offer a framework (NoDeL) to predict loneliness and cultural differences in risk factors for it. Thus, the NoDeL framework may help prepare culture-sensitive interventions against loneliness.
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Affiliation(s)
- Luzia Cassis Heu
- Faculty of Behavioural and Social Sciences, Department of Interdisciplinary Social Science, Utrecht University
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7
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Firk C, Großheinrich N, Scherbaum N, Deimel D. The impact of social connectedness on mental health in LGBTQ + identifying individuals during the COVID-19 pandemic in Germany. BMC Psychol 2023; 11:252. [PMID: 37644578 PMCID: PMC10466739 DOI: 10.1186/s40359-023-01265-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/26/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Recent studies report that LGBTQ + people have experienced high levels of mental health problems during COVID-19-related social distancing. Given the well-established association between social isolation and mental health, the main aim of the current study was to investigate differences in mental health and (perceived) social isolation and social support in LGBTQ + individuals compared to heterosexual, cisgender people and to explore whether the hypothesized higher mental health burden in LGBTQ + individuals is (partly) mediated by (perceived) social isolation or social support. METHODS N = 531 participants indicating belonging to the LGBTQ + community and N = 1826 not identifying as LGBTQ + participated in a cross-sectional online survey during the initial COVID-19-related lockdown in Germany. Standardized questionnaires were used to assess depression, anxiety, suicidality, loneliness and social support. Further, perceived social isolation and face-to-face communication during the lockdown were assessed. RESULTS LGBTQ + people had higher levels of depression, anxiety and suicidal thought, were lonelier and experienced less social support than non-LGBTQ + identifying individuals. Mediation analysis showed that the higher levels of mental health burden in LGBTQ + people were (partly) mediated by reduced social connectedness. Further face-to-face contact positively affected mental health by reducing feelings of loneliness. CONCLUSION Given the high impact of loneliness on mental health, governmental actions should be taken to promote social connectedness particularly among LGBTQ + identifying individuals to ensure that the COVID-19 pandemic does not exacerbate the health inequalities that already exist between LGBTQ+-identifying and heterosexual, cisgender people.
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Affiliation(s)
- Christine Firk
- Catholic University of Applied Sciences North Rhine-Westphalia, Robert-Schuman- Str. 25, 52066, Aachen, Germany.
- Institute of Health Research and Social Psychiatry, Catholic University of Applied Sciences North Rhine-Westphalia, Robert-Schuman-Str. 25, 52066, Aachen, Germany.
| | - Nicola Großheinrich
- Institute of Health Research and Social Psychiatry, Catholic University of Applied Sciences North Rhine-Westphalia, Robert-Schuman-Str. 25, 52066, Aachen, Germany
- Catholic University of Applied Sciences of North Rhine-Westphalia, Wörthstraße 10, 50668, Cologne, Germany
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Daniel Deimel
- Catholic University of Applied Sciences North Rhine-Westphalia, Robert-Schuman- Str. 25, 52066, Aachen, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Institute for Addiction and Prevention Research, Catholic University of Applied Sciences North Rhine-Westphalia, Konrad-Adenauer-Ufer 79-81, 50668, Cologne, Germany
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8
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Wootton AR, Soled KRS, Puckett JA, Garrett-Walker JJ, Hill AP, Delucio K, Veldhuis CB. Community (dis)connectedness and identity among LGBTQIA+ people during the COVID-19 pandemic: A qualitative cross-sectional and longitudinal trajectory study. PSYCHOLOGY & SEXUALITY 2023; 15:170-192. [PMID: 38800743 PMCID: PMC11114605 DOI: 10.1080/19419899.2023.2241868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/27/2023] [Indexed: 05/29/2024]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic and associated shelter-in-place ordinances passed in the first year of the pandemic rapidly limited access to in-person social interactions, raising concerns of diminishing social support and community cohesion while psychological stressors increased. For LGBTQIA+ people, connectedness to the LGBTQIA+ community is known to buffer against the harmful effects of stressors and decrease risks for poor psychological and behavioral health outcomes. The current study uses qualitative cross-sectional and trajectory analysis methods to characterize how LGBTQIA+ people's perceptions of community connectedness shifted during the first year of the pandemic. A convenience sample of LGBTQIA+-identified people in the U.S. completed an initial online survey in September 2020 (n = 298 and a follow-up survey in September 2021 (n = 129). The survey included changes in connectedness to the LGBTQIA+ community since the pandemic's beginning. Thus, we used both cross-sectional (between-person analyses) and longitudinal trajectory (within-person analyses) qualitative approaches to understanding changes in LGBTQIA+ people's sense of connection to the LGBTQIA+ community across the first two years of the COVID-19 pandemic. Eight cross-cutting themes (related to identity shifts/exploration, disconnection, online connections, and increased awareness of social justice issues) were identified and then organized within each level of the Social-Ecological Model of LGBTQIA+ wellbeing (i.e., the individual-, couple-, interpersonal-, organizational-, community-, and chronosystem- level). Given the importance of social support for LGBTQIA+ wellbeing, more longitudinal research is needed to determine whether these changes persist after the resolution of the acute phase of the pandemic.
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Affiliation(s)
- Angie R Wootton
- School of Social Welfare, University of California, Berkeley, California, USA
| | - Kodiak R S Soled
- Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Jae A Puckett
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - J J Garrett-Walker
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
| | - Aaron Perry Hill
- School of Social Welfare, University of California, Berkeley, California, USA
| | - Kevin Delucio
- Fairhaven College of Interdisciplinary Studies, Western Washington University, Bellingham, WA, USA
| | - Cindy B Veldhuis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
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Cisek A, Rogowska AM. The Relationship between Minority Stress and Depressive Symptoms in the LGBTQA Population from Poland. Eur J Investig Health Psychol Educ 2023; 13:1000-1014. [PMID: 37366780 DOI: 10.3390/ejihpe13060076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023] Open
Abstract
The cross-sectional study examines minority stress and depression symptoms regarding various sexual and gender minority (SGM) identities in lesbian, gay, bisexual, transgender, queer, and asexual (LGBTQA) individuals from Poland. The online survey was conducted among 509 people. Participants aged between 18 and 47 (M = 22.39, SD = 4.78). Gender identity included 262 cisgender women, 74 cisgender men, 31 transgender women, 53 transgender men, and 89 nonbinary individuals. Sexual identity comprises 197 bisexual, 150 homosexual, 78 pansexual, 33 asexual, 21 undefined, 14 heterosexual, 9 demisexuals, 6 queer, and 1 sapiosexual individual. The Daily Heterosexist Experiences Questionnaire (DHEQ) and the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) were used to measure minority stress and depression symptoms, respectively. Among LGBTQA participants, 99.80% declared minority stress at least once during the past year. In particular, vicarious trauma was experienced in 99.80% of participants, vigilance in 95.87%, harassment and discrimination in 80.35%, stress related to the family of origin in 69.16%, and to gender expression in 68.76% of respondents. Depression symptoms were found in 62.50% of respondents. Significantly higher rates of depression and minority stress were presented in dual than single SGM individuals. Binomial logistic regression showed that such sources of minority stress as vigilance, harassment, and gender expression could predict depression symptoms. Therefore, prevention and intervention programs should be designed for the LGBTQA population focusing on coping with these sources of minority stress, especially among those of dual SGM identity.
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Affiliation(s)
- Aleksandra Cisek
- Institute of Psychology, University of Opole, 45-052 Opole, Poland
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10
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Ünsal BC, Demetrovics Z, Reinhardt M. Stronger together: community participation, structural stigma, and depression among sexual and gender minority adults in 28 European countries. Soc Psychiatry Psychiatr Epidemiol 2023; 58:657-669. [PMID: 36434298 PMCID: PMC10066166 DOI: 10.1007/s00127-022-02385-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Although discriminatory laws, policies, and public attitudes (i.e., structural stigma) are linked to adverse mental health outcomes among sexual and gender minority (SGM) populations, little attention has been paid to protective factors, such as community participation, about which inconsistencies exist whether it ameliorates or exacerbates mental health burdens. Thus, we examined the mediator roles of identity disclosure and victimization and the moderator role of structural stigma in the association of community participation with depression. METHODS Data from the EU-LGBTI-II survey assessing community participation, identity disclosure, victimization, and depression among sexual minority men (n = 62,939), women (n = 38,976), and gender minority adults (n = 15,845) in 28 European countries were used. Structural stigma was measured as discriminatory legislation, policies, and societal attitudes using publicly available data. RESULTS Findings showed that community participation predicted lower and higher levels of depression through identity disclosure and victimization, respectively. For sexual minority men and women, structural stigma moderated the indirect effect through identity disclosure, with a larger effect in higher structural stigma countries. Only for sexual minority men, the indirect effect through victimization was also moderated, with a larger effect in high-stigma countries. For gender minorities, no moderation effect was found. CONCLUSIONS Community participation is differentially linked to depression through identity disclosure and victimization, and as a function of structural stigma. It can be a double-edged sword, especially for sexual minority men in high-stigma countries, who are expected to pay the price while enjoying its benefits, highlighting the targets and considerations for interventions.
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Affiliation(s)
- Berk C Ünsal
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Melinda Reinhardt
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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11
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Chang CC, Lu HY, Chang YP, Tsai CS, Yen CF. Perceived attitudes of family and peers toward same-sex marriage as a distal sexual minority stressor for gay and bisexual men in Taiwan. BMC Public Health 2022; 22:2143. [PMID: 36414933 PMCID: PMC9682646 DOI: 10.1186/s12889-022-14604-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To investigate whether perceived attitudes of family and peers toward same-sex marriage (SSM) is a type of distal sexual minority stressor, as defined in minority stress theory, this cross-sectional study examined the associations of perceived attitudes of family and peers toward SSM with perceived sexual stigma from family and peers, internalized homonegativity, and mental health problems (e.g., depression, loneliness, anxiety) among gay and bisexual men in Taiwan. METHODS We recruited 400 gay and bisexual men and assessed their perceived attitudes of family and peers toward SSM; perceived sexual stigma from family and peers; internalized homonegativity; and severity of depression, loneliness, and anxiety. RESULTS Perceived attitudes of family and peers toward SSM (1) significantly correlated with various aspects of perceived sexual stigma from family and peers and (2) were significantly associated with internalized homonegativity, depression, loneliness, and anxiety. CONCLUSIONS Perceived attitudes of family and peers toward SSM matched the characteristics of a distal sexual minority stressor, and as a new type of distal sexual minority stressor for lesbian, gay, and bisexual individuals, these perceived attitudes and related stress warrant greater attention from mental health professionals for the development of intervention programs.
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Affiliation(s)
- Chih-Cheng Chang
- grid.411209.f0000 0004 0616 5076Department of Psychiatry, Chi Mei Medical Center, and Department of Health Psychology, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan
| | - Hsin-Yu Lu
- grid.412027.20000 0004 0620 9374Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- grid.273335.30000 0004 1936 9887School of Nursing, The State University of New York, University at Buffalo, New York, NY USA
| | - Ching-Shu Tsai
- grid.145695.a0000 0004 1798 0922Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung and School of Medicine, Chang Gung University, 32 Dapi Rd. Niaosong Dist., Kaohsiung, 83341 Taiwan
| | - Cheng-Fang Yen
- grid.412027.20000 0004 0620 9374Department of Psychiatry, Kaohsiung Medical University Hospital, and School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung; College of Professional Studies, National Pingtung University of Science and Technology, 100 Tzyou 1St Road, Kaohsiung, 80708 Taiwan
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12
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Televantos M, Strauss SM. “I wasn’t feeling like I belonged in my skin”: How self‐identified gay men in the
UK
experience unhelpful incidents in talking therapy
1. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lin CY, Tsai CS, Fan CW, Griffiths MD, Chang CC, Yen CF, Pakpour AH. Psychometric Evaluation of Three Versions of the UCLA Loneliness Scale (Full, Eight-Item, and Three-Item Versions) among Sexual Minority Men in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138095. [PMID: 35805754 PMCID: PMC9265606 DOI: 10.3390/ijerph19138095] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
The UCLA Loneliness Scale, with different short versions, is widely used to assess levels of loneliness. However, whether the scale is valid in assessing loneliness among sexual-minority men is unknown. Additionally, it is unclear whether the 8-item and 3-item short versions are comparable to the full 20-item version. The present study compared the validity of the three versions of the UCLA Loneliness Scale (i.e., 20-item, 8-item, and 3-item versions) among gay and bisexual men in Taiwan. The participants comprised 400 gay and bisexual men in Taiwan who completed a cross-sectional online survey, which included the UCLA Loneliness Scale, Center for Epidemiological Studies Depression Scale (CES-D) and State–Trait Anxiety Inventory (STAI). Confirmatory factor analysis was used to evaluate factorial validity. Convergent validity was examined between the three versions of the UCLA Loneliness Scale and the CES-D and STAI. Known-group validity was investigated with participants’ sexual orientation and educational levels. The unidimensional construct was supported in all three versions of the UCLA Loneliness Scale tested in the present study. Convergent validity was supported as the level of loneliness was correlated with the level of depression and anxiety for all three versions. There were no significant differences between gay and bisexual men, although significant differences were found across different educational levels. The study confirmed that all three versions of the UCLA Loneliness Scale were comparable with satisfactory reliability and validity in Taiwanese sexual-minority men.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Orlando, FL 32803, USA;
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK;
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 70246, Taiwan
- Department of Health Psychology, Chang Jung Christian University, Tainan 71101, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2228116 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2228116 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
| | - Amir H. Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, SE-551 11 Jönköping, Sweden;
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Sattler FA, Franke GH, Zeyen J, Jagla-Franke M. Mental health disparities between German lesbian and bisexual women and a population-based sample. JOURNAL OF LESBIAN STUDIES 2022; 27:60-73. [PMID: 35699301 DOI: 10.1080/10894160.2022.2087343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Lesbians are at greater risk of mental health problems than heterosexual women, and bisexual individuals are even more likely to report mental health problems. No study has yet tested whether there are any mental health differences between German lesbians, bisexual women, and female controls. We tested for mental health differences between matched groups of 161 lesbian and bisexual women and 161 women in the general population, as well as between matched groups of 79 lesbians and 79 bisexual women. Lesbian and bisexual women reported more mental health problems than population-based women. In contrast, bisexual women did not differ in mental health from lesbians. Therefore, German lesbian and bisexual women constitute a risk group for mental health problems. To improve lesbian and bisexual women's mental health, attempts should be made to lower the frequency of minority stressors, and best-practice mental health interventions made available.
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Affiliation(s)
| | - Gabriele H Franke
- Psychology of Rehabilitation, University of Applied Sciences Magdeburg-Stendal, Stendal, Germany
| | - Johanna Zeyen
- Psychiatric Clinic, Vitos Gießen-Marburg, Marburg, Germany
| | - Melanie Jagla-Franke
- Health, Nursing, Administration, University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany
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