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Wilson LC, Newins AR, Kassing F, Casanova T. Gender Minority Stress and Resilience Measure: A Meta-Analysis of the Associations with Mental Health in Transgender and Gender Diverse Individuals. TRAUMA, VIOLENCE & ABUSE 2024; 25:2552-2564. [PMID: 38160246 DOI: 10.1177/15248380231218288] [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: 01/03/2024]
Abstract
Transgender and gender diverse (TGD) individuals are more likely to experience mental health difficulties than cisgender individuals due to unique stressors related to their stigmatized gender identity and/or expression. This meta-analysis examined the associations between gender minority stressors and resilience factors, as measured by the Gender Minority Stress and Resilience Measure (GMSR; Testa et al., 2015), and two types of mental health symptoms (i.e., depression and anxiety). A comprehensive literature search and study inclusion process following PRISMA guidelines identified 69 sources, representing 47 unique samples. Mean effect sizes revealed significant positive associations between all GMSR minority stress subscales and anxiety and depression symptoms (rs = .22 to .40) with larger correlations for proximal stressors compared to distal stressors. The GMSR resilience subscales were significantly negatively correlated with anxiety and depression symptoms (rs = -.07 to -.16). These findings highlight the robust relationship between gender minority stressors and mental health symptoms among TGD individuals and indicate a need for addressing these stressors both by reducing exposure to external stressors and by addressing the internalization of those stressors in clinical settings. The small effects for the resilience subscales suggest a need to examine additional resilience factors that may be more pertinent to mental health among TGD individuals.
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Mittertreiner EJ, Ng-Cordell E, McVey AJ, Kerns CM. Research methods at the intersection of gender diversity and autism: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241245595. [PMID: 38661070 DOI: 10.1177/13623613241245595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
LAY ABSTRACT Research has increasingly focused on the intersection between gender diversity and autism. To better understand this literature, this scoping review systematically searched five databases for peer-reviewed literature on gender diversity and autism published between 2018 and 2023. Included studies (N = 84) were of English language, featured original qualitative or quantitative findings, and examined a psychosocial connection between autism and gender spectra variables. Most studies focused on measuring prevalence of autism among gender-diverse individuals. While the overall study rigor was acceptable, weaknesses in measurement, sample selection, and definition of key terms were noted. Promisingly, studies in this area appear to be shifting away from a pathologizing lens and towards research methods that engage in meaningful collaboration with the autistic, gender-diverse community to investigate how to best enhance the quality of life and wellbeing of this population.
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Affiliation(s)
| | | | - Alana J McVey
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Autism Center, Seattle Children's Hospital, Seattle, WA, United States
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Goldstein Ferber S, Weller A, Hayes AM, Vannorsdall TD, Ajlouni Y, Qudah M, Zalsman G, Shoval G, Jannini TB, Fiedler R, Chen LX, Shayani DR, Kachuki Dory E, Stolowicz-Melman D, Evans C, Trow M, Di Lorenzo G, Rossi R. International study of the Complex Stress Reaction Syndrome: Implications for transdiagnostic clinical practice. World J Psychiatry 2023; 13:803-815. [PMID: 38058684 PMCID: PMC10696285 DOI: 10.5498/wjp.v13.i10.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/25/2023] [Accepted: 09/11/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND The debate regarding diagnostic classification systems in psychiatry (categorial vs dimensional systems) has essential implications for the diagnosis, prevention and treatment of stress reactions. We previously found a unique pattern of stress reaction in a study executed during the coronavirus disease 2019 pandemic using large representative samples in two countries, and termed it the Complex Stress Reaction Syndrome (CSRS). AIM To investigate CSRS, Type A (psychiatric symptoms, spanning anxiety, depression, stress symptoms, and post-traumatic stress disorder (PTSD)), with or without long-coronavirus disease (COVID) residuals (CSRS, Type B, neuropsychiatric symptoms spanning cognitive deficits and fatigue, excluding systemic symptoms). Our two-tailed hypothesis was that CSRS is a condition related to an unrecognized type of stress reaction in daily life in the general population (Type A) or that it is related to the severe acute respiratory syndrome coronavirus 2 infection and its long-COVID residuals (Type B). METHODS 977 individuals in four continents (North America, Europe, Australia and the Middle East) completed the online study questionnaire in six languages using the Qualtrics platform. The study was managed by six teams in six countries that promoted the study on social media. The questionnaire assessed anxiety, depression, stress symptoms and PTSD (CSRS, Type A), cognitive deficits and fatigue (CSRS, Type B). The data were analyzed using Proportion Analyses, Multivariate Analysis of Co-Variance (MANCOVA), linear regression analyses and validated clinical cutoff points. RESULTS The results of the Proportion Analyses showed that the prevalence of 4 symptoms spanning anxiety, depression, stress symptoms, and PTSD was significantly higher than the most prevalent combinations of fewer symptoms across 4 continents, age groups, and gender. This supports the transdiagnostic argument embedded in the CSRS (Type A). The same pattern of results was found in infected/recovered individuals. The prevalence of the 4 psychiatric symptoms combination was significantly greater than that of 5 and 6 symptoms, when adding cognitive deficits and fatigue, respectively. MANCOVA showed a significant three-way interaction (age × gender × continent). Further analyses showed that the sources of this three-way interaction were threefold relating to two sub-populations at-risk: (1) Individuals that self-identified as non-binary gender scored significantly higher on all 4 psychiatric symptoms of the CSRS, Type A at young age groups (< 50 years old) in North America compared to (self-identified) women and men located in the 4 continents studied, and to other ages across the adult life span; and (2) This pattern of results (CSRS, Type A) was found also in women at young ages (< 40 years old) in North America who scored higher compared to men and women in other continents and other ages. Linear regression analyses confirmed the MANCOVA results. CONCLUSION These results show a combined mental health risk factor related to stress reactivity, suggesting that the CSRS is sensitive to populations at risk and may be applied to future identification of other vulnerable sub-populations. It also supports the transdiagnostic approach for more accurate prevention and treatment. Time will tell if such transdiagnostic syndromes will be part of the discussions on the next revisions of the traditional classification systems or whether the crisis in psychiatry further evolves.
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Affiliation(s)
- Sari Goldstein Ferber
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, United States
- Department of Psychology, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Aron Weller
- Department of Psychology and The Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Adele M Hayes
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, United States
| | - Tracy D Vannorsdall
- Department of Psychiatry and Behavioral Sciences, Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | | | - Mo'nes Qudah
- Jordan Health Aid-International, Amman 1234, Jordan
| | - Gil Zalsman
- Geha Mental Health Center, Petah Tiqva, Israel and Faculty of Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel
- Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY 10032, United States
| | - Gal Shoval
- Geha Mental Health Center, Petah Tiqva, Israel and Faculty of Medicine, Tel Aviv University, Ramat Aviv 6997801, Israel
- Department of Neuroscience, Princeton University, Princeton, NJ 08544, United States
| | | | - Racquel Fiedler
- Department of Psychology and The Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Lily X Chen
- UNSW School of Psychology, UNSW Sydney, Sydney 2052, Australia
| | - Danielle R Shayani
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, United States
| | - Elin Kachuki Dory
- Department of Psychology and The Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Dana Stolowicz-Melman
- Department of Psychology and The Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Connor Evans
- Department of Biology, Pacific University, Forest Grove, OR 97116, United States
| | - Megan Trow
- Oregon Chapter of Fulbright Association, Oregon, OR 97045, United States
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, Tor Vergata University of Rome, Rome 00179, Italy
- IRCCS, Fondazione Santa Lucia, Rome 00179, Italy
| | - Rodolfo Rossi
- Department of Systems Medicine, Tor Vergata University of Rome, Rome 00133, Italy
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