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Felton JW, Rabinowitz JA, Sadler RC, Hampton T, Sosnowski DW, Lejuez CW, Yi R. Environmental Support Moderates the association of Socioeconomic Distress and Delay Discounting across Adolescence. J Youth Adolesc 2024:10.1007/s10964-024-02051-1. [PMID: 39023841 DOI: 10.1007/s10964-024-02051-1] [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: 03/19/2024] [Accepted: 06/30/2024] [Indexed: 07/20/2024]
Abstract
Early exposure to socioeconomic distress is hypothesized to reinforce decision making that prioritizes immediate, relative to delayed, rewards (i.e., delay discounting); yet these relations have not been examined longitudinal across the vulnerable adolescent period. This study is one of the first to utilize objective and subjective measures to evaluate the relative effects of environmental disadvantage and the potential protective effects of perceived environmental support on delay discounting. A diverse (48.4% White; 46.7% female) sample of participants (N = 246) reported on their home addresses at baseline when they were, on average, 11.96 years old (SDage = 0.88); Youth then reported perceived environmental supports at baseline and delay discounting annually from ages 13 to 18. A socioeconomic distress index was derived from census tract rates of unemployment, income, educational attainment, and lone parenthood. Greater socioeconomic distress was associated with a greater propensity to discount delayed rewards at baseline. Findings also suggest greater perceived higher environmental support was associated with decreasing rates of delay discounting across adolescence for youth from highly socioeconomically distressed areas. These results highlight potential future avenues for preventative and intervention efforts to improve positive youth outcomes.
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Affiliation(s)
- Julia W Felton
- Center for Health Policy & Health Services Research, Henry Ford Health, Detroit, MI, USA.
| | - Jill A Rabinowitz
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Richard C Sadler
- Departments of Public Health and Family Medicine, College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Tessa Hampton
- Center for Health Policy & Health Services Research, Henry Ford Health, Detroit, MI, USA
| | - David W Sosnowski
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl W Lejuez
- Office of the Provost, Stony Brook University, Stony Brook, NY, USA
| | - Richard Yi
- Cofrin Logan Center for Addiction Research and Treatment and Department of Psychology, University of Kansas, Lawrence, KS, USA
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Dermody SS, Uhrig A, Moore A, Raessi T, Abramovich A. A narrative systematic review of the gender inclusivity of measures of harmful drinking and their psychometric properties among transgender adults. Addiction 2023; 118:1649-1660. [PMID: 37070479 DOI: 10.1111/add.16212] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/28/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND AND AIMS Experiencing higher rates of stigma, marginalization and discrimination puts transgender individuals at risk for alcohol use and associated harms. Measures of harmful drinking were designed with cisgender people in mind, and some rely on sex- and gender-based cut-offs. The applicability of these measures for gender diverse samples remains unknown. The present study had two aims: (i) identify gender-non-inclusive language and cut-offs in measures of harmful drinking, and (ii) systematically review research reporting psychometric properties of these measures in transgender individuals. METHODS We reviewed 22 measures of harmful drinking for gendered language and sex- and gender-based cut-off values and provided suggestions for revision when warranted. We also conducted a systematic narrative review, including eight eligible studies, summarizing the psychometric properties of measures of harmful drinking in transgender populations. RESULTS Six of 22 measures of harmful drinking were not gender inclusive, because of gendered language in the measure itself or use of sex- or gender-based cut-off scores. Only eight published studies reported psychometric data for these measures in transgender people. Apart from in one study, the Alcohol Use Disorders Identification Test (AUDIT) and Alcohol Use Disorders Identification Test Consumption (AUDIT-C) appear reliable for transgender adults (Cronbach's α: AUDIT [0.81-0.87] and AUDIT [0.72-0.8)]). There is initial support for using uniform cut-offs for transgender people for the AUDIT-C (≥3) and binge drinking (≥5 drinks in a sitting). CONCLUSIONS Most existing measures of harmful drinking appear to be gender inclusive (containing gender neutral language and uniform cut-off scores across sex and gender groups) and some that are not easily adapted to be gender inclusive.
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Affiliation(s)
- Sarah S Dermody
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Alexandra Uhrig
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Annabelle Moore
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Tara Raessi
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Alex Abramovich
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Kidd JD, Kaczmarkiewicz R, Kreski NT, Jackman K, George M, Hughes TL, Bockting WO. A qualitative study of alcohol use disorder psychotherapies for transgender and nonbinary individuals: Opportunities for cultural adaptation. Drug Alcohol Depend 2023; 248:109913. [PMID: 37182356 PMCID: PMC10330671 DOI: 10.1016/j.drugalcdep.2023.109913] [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: 11/28/2022] [Revised: 03/29/2023] [Accepted: 04/29/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Transgender and nonbinary (TGNB) populations experience high rates of hazardous drinking (HD) and alcohol use disorder (AUD) as well as unique treatment barriers. This is due, in-part, to discrimination and stigma within and outside of the healthcare system. Cultural adaptation of clinical interventions can improve outcomes for marginalized populations, but no such adapted interventions exist for AUD among TGNB individuals. This study sought to understand how TGNB individuals perceive currently available AUD psychotherapies and to generate knowledge about potential areas for cultural adaptation. METHODS As part of a qualitative study of HD among TGNB individuals (N=27), participants were asked to imagine that they were clients in psychotherapy vignettes corresponding to cognitive behavioral therapy, motivational enhancement therapy, and twelve step facilitation. Interviews were audio-recorded and professionally transcribed. A coding team used an iterative codebook to guide coding. Categories emerged from this process that reflected participants' perceptions and allowed for the identification of potential cultural-adaptation targets. RESULTS Across all three psychotherapies, participants wanted therapists to explicitly discuss gender identity and culturally salient HD risk factors for TGNB individuals (e.g., discrimination, stigma, gender dysphoria). There were also modality-specific recommendations to incorporate principles of trauma-informed care into cognitive behavioral therapy, avoid motivational enhancement therapy exercises that oversimplify decision-making, and recognize that the twelve-step-facilitation concept of "powerlessness" may conflict with how many TGNB people see themselves. CONCLUSIONS These findings highlight areas for cultural adaptation that can be evaluated in future intervention trials in an effort to improve psychotherapy acceptability and efficacy for TGNB individuals.
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Affiliation(s)
- Jeremy D Kidd
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY10032, USA.
| | - Roma Kaczmarkiewicz
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY10032, USA.
| | - Noah T Kreski
- Mailman School of Public Health, Columbia University, 722 W. 168th Street, New York, NY10032, USA.
| | - Kasey Jackman
- Columbia University School of Nursing, 560 W. 168th Street, New York, NY10032, USA; New York-Presbyterian Hospital, 622 W. 168th Street, New York, NY10032, USA.
| | - Maureen George
- Columbia University School of Nursing, 560 W. 168th Street, New York, NY10032, USA.
| | - Tonda L Hughes
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY10032, USA; Columbia University School of Nursing, 560 W. 168th Street, New York, NY10032, USA.
| | - Walter O Bockting
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY10032, USA; Columbia University School of Nursing, 560 W. 168th Street, New York, NY10032, USA.
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4
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Grocott LR, Schlechter TE, Wilder SMJ, O'Hair CM, Gidycz CA, Shorey RC. Social Support as a Buffer of the Association between Sexual Assault and Trauma Symptoms Among Transgender and Gender Diverse Individuals. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1738-NP1761. [PMID: 35466782 DOI: 10.1177/08862605221092069] [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: 06/14/2023]
Abstract
The prevalence of experiencing sexual assault is alarmingly high among Transgender and Gender Diverse people (TGD; people whose gender identities and/or expressions are not traditionally associated with their sex assigned at birth) and is associated with various mental health sequalae. Perceived social support has been shown to abate the negative outcomes of sexual assault among cisgender individuals, yet little is known about this association among TGD people, especially which provider of support (i.e., family, friends, or significant others) may be most beneficial. To that end, 191 TGD adults were recruited through Amazon's Mechanical Turk to examine perceived social support as a potential moderator of the association between sexual assault victimization and post-sexual assault trauma symptomology. Results showed an interaction trending toward significance between sexual assault and support from a significant other. Decomposition of this interaction demonstrated that sexual assault was associated with post-assault trauma symptoms when support from a significant other was low (ß = .25, p < .05) but not high (ß = .10, p = .089). The interaction between sexual assault and perceived social support was not significant for perceived support from friends (p = .133) or family (p = .954). Findings highlight the need for additional research on perceived social support as a potential buffering mechanism between sexual assault and post-assault symptomology in TGD people.
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Chakrapani V, Lakshmi PVM, Newman PA, Kaur J, Tsai AC, Vijin PP, Singh B, Kumar P, Rajan S, Kumar R. Syndemic violence victimization, alcohol and drug use, and HIV transmission risk behavior among HIV-negative transgender women in India: A cross-sectional, population-based study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000437. [PMID: 36962491 PMCID: PMC10021466 DOI: 10.1371/journal.pgph.0000437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/29/2022] [Indexed: 03/26/2023]
Abstract
Transgender women globally are disproportionately burdened by HIV. Co-occurring epidemics of adverse psychosocial exposures accelerate HIV sexual risk, including among transgender women; however, studies using additive models fail to examine synergies among psychosocial conditions that define a syndemic. We examined the impact of synergistic interactions among 4 psychosocial exposures on condomless anal sex (CAS) among transgender women in India. A national probability-based sample of 4,607 HIV-negative transgender women completed the Indian Integrated Biological and Behavioural Surveillance survey, 2014-2015. We used linear probability regression and logistic regression to assess 2-, 3-, and 4-way interactions among 4 psychosocial exposures (physical violence, sexual violence, drug use, and alcohol use) on CAS. Overall, 27.3% reported physical and 22.3% sexual violence victimization (39.2% either physical or sexual violence), one-third (33.9%) reported frequent alcohol use and 11.5% illicit drug use. Physical violence was associated with twofold higher odds of CAS in the main effects model. Statistically significant two- and three-way interactions were identified, on both the multiplicative and the additive scales, between physical violence and drug use; physical and sexual violence; physical violence, sexual violence, and alcohol use; and physical violence, alcohol use and drug use. Physical and sexual violence victimization, and alcohol and drug use are highly prevalent and synergistically interact to increase CAS among HIV-negative transgender women in India. Targeted and integrated multilevel initiatives to improve the assessment of psychosocial comorbidities, to combat systemic transphobic violence, and to provide tailored, trauma-informed alcohol and substance use treatment services may reduce HIV risk among transgender women.
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Affiliation(s)
- Venkatesan Chakrapani
- Centre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, India
- Postgraduate Institute of Medical Education and Research (PGIMER), School of Public Health, Chandigarh, India
| | - P V M Lakshmi
- Postgraduate Institute of Medical Education and Research (PGIMER), School of Public Health, Chandigarh, India
| | - Peter A Newman
- University of Toronto, Factor-Inwentash Faculty of Social Work, Toronto, Canada
| | - Jasvir Kaur
- Postgraduate Institute of Medical Education and Research (PGIMER), School of Public Health, Chandigarh, India
| | - Alexander C Tsai
- Massachusetts General Hospital and Harvard Medical School, Boston, United States of America
| | - P P Vijin
- Postgraduate Institute of Medical Education and Research (PGIMER), School of Public Health, Chandigarh, India
| | - Bhawani Singh
- National AIDS Control Organisation, New Delhi, India
| | - Pradeep Kumar
- National AIDS Control Organisation, New Delhi, India
| | - Shobini Rajan
- National AIDS Control Organisation, New Delhi, India
| | - Rajesh Kumar
- Postgraduate Institute of Medical Education and Research (PGIMER), School of Public Health, Chandigarh, India
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Reyes ME, Rossi JS, Thomas ED, C Goldstein S, Weiss NH. Posttraumatic Stress Disorder and Substance Misuse Among Black Emerging Adults: The Influence of Social Support. J Dual Diagn 2022; 18:42-51. [PMID: 34970948 PMCID: PMC9128832 DOI: 10.1080/15504263.2021.2017221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective: Black emerging adults are significantly impacted by substance misuse. Posttraumatic stress disorder (PTSD) is associated with heightened substance misuse among Black emerging adults. However, limited research has identified protective factors that may influence the strength of the relation between PTSD and substance misuse in this population. Addressing this important limitation, the present study examined the potential moderating role of perceived social support in the association between PTSD symptoms and substance (i.e., alcohol and drug) misuse. Methods: Participants were 182 trauma-exposed Black emerging adults (M age = 20.50; 71.3% women) who completed self-report measures assessing PTSD symptoms, alcohol and drug misuse, and perceived social support. Results: PTSD symptoms were significantly and positively correlated with both alcohol and drug misuse. Moderation analyses indicated that positive relations between PTSD symptoms and both alcohol and drug misuse were only significant among Black emerging adults with lower (but not higher) levels of perceived social support. Conclusions: These findings suggest the potential utility of addressing social support in the assessment and treatment of substance misuse in trauma-exposed Black emerging adults.
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Affiliation(s)
- Miranda E Reyes
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Joseph S Rossi
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Emmanuel D Thomas
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Silvi C Goldstein
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
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