1
|
Chang CJ, Livingston NA, Rashkovsky KT, Harper KL, Kuehn KS, Khalifian C, Harned MS, Tucker RP, Depp CA. A Scoping Review of Suicide Prevention Interventions for Lesbian, Gay, Bisexual, Transgender, Queer, and Other Sexual and Gender Minority Individuals. LGBT Health 2024. [PMID: 38722250 DOI: 10.1089/lgbt.2023.0262] [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] [Indexed: 05/12/2024] Open
Abstract
Purpose: This scoping review summarizes the literature on suicide-specific psychological interventions among lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) people to synthesize existing findings and support future intervention research and dissemination. Methods: Electronic databases PsycInfo and PubMed were searched for reports of psychological intervention studies with suicide-related outcome data among LGBTQ+ people. A total of 1269 articles were screened, and 19 studies met inclusion criteria (k = 3 examined suicide-specific interventions tailored to LGBTQ+ people, k = 4 examined nontailored suicide-specific interventions, k = 11 examined minority stress- or LGBTQ+ interventions that were not suicide-specific, and k = 1 examined other types of interventions). Results: Synthesis of this literature was made challenging by varied study designs, and features limit confidence in the degree of internal and external validity of the interventions evaluated. The only established suicide-specific intervention examined was Dialectical Behavior Therapy, and minority stress- and LGBTQ-specific interventions rarely targeted suicidal thoughts and behaviors (STBs). Nevertheless, most interventions reviewed demonstrated support for feasibility and/or acceptability. Only five studies tested suicide-related outcome differences between an LGBTQ+ group and a cisgender/heterosexual group. These studies did not find significant differences in STBs, but certain subgroups such as bisexual individuals may exhibit specific treatment disparities. Conclusion: Given the dearth of research, more research examining interventions that may reduce STBs among LGBTQ+ people is critically needed to address this public health issue.
Collapse
Affiliation(s)
- Cindy J Chang
- Veterans Affairs San Diego Healthcare System, U.S. Department of Veterans Affairs, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Nicholas A Livingston
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Katerine T Rashkovsky
- Veterans Affairs San Diego Healthcare System, U.S. Department of Veterans Affairs, San Diego, California, USA
| | - Kelly L Harper
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Kevin S Kuehn
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - Chandra Khalifian
- Veterans Affairs San Diego Healthcare System, U.S. Department of Veterans Affairs, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Melanie S Harned
- VA Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Raymond P Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Colin A Depp
- Veterans Affairs San Diego Healthcare System, U.S. Department of Veterans Affairs, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| |
Collapse
|
2
|
Terrell KR, Zeglin RJ, Palmer RE, Niemela DRM, Quinn N. The Tsunamic Model of LGBTQ+ Deaths of Despair: A Systemic Review to Identify Risk Factors for Deaths of Despair Among LGBTQ+ People. JOURNAL OF HOMOSEXUALITY 2022; 69:2167-2187. [PMID: 34085902 DOI: 10.1080/00918369.2021.1935620] [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: 06/12/2023]
Abstract
The term Deaths of Despair (DOD) was introduced to capture the phenomenon of mortality associated with suicide, drug overdose, and alcoholic liver disease. The LGBTQ+ population consistently evidences disproportionately high rates of DOD. This study reviewed the literature on DOD within this community to create a conceptual model that identifies risk factors that work together to potentiate DOD in the LGBTQ+ community. Ten DOD-Related Factors were identified and used to create The Tsunamic Model of LGBTQ+ Deaths of Despair. DOD-Related Factors include: (1) Stigma, (2) Demographics, (3) Identity Development, (4) Internalized Homophobia, (5) Depression, (6) Victimization, (7) Isolation/Rejection, (8) Sensation Seeking, (9) Risky Behavior, and (10) Uninformed Care. Each factor is associated with increased risk for DOD among the LGBTQ+ community. This model can help health professionals by providing a framework for prevention and early intervention programs.
Collapse
Affiliation(s)
- Kassie R Terrell
- Department of Public Health, University of North Florida, Jacksonville, Florida, USA
| | - Robert J Zeglin
- Department of Public Health, University of North Florida, Jacksonville, Florida, USA
| | - Reagan E Palmer
- Department of Public Health, University of North Florida, Jacksonville, Florida, USA
| | - Danielle R M Niemela
- Department of Public Health, University of North Florida, Jacksonville, Florida, USA
| | - Nathan Quinn
- Department of Public Health, University of North Florida, Jacksonville, Florida, USA
| |
Collapse
|
3
|
Dunlop BJ, Coleman SE, Hartley S, Carter LA, Taylor PJ. Self-injury in young bisexual people: A microlongitudinal investigation (SIBL) of thwarted belongingness and self-esteem on non-suicidal self-injury. Suicide Life Threat Behav 2022; 52:317-328. [PMID: 34890052 DOI: 10.1111/sltb.12823] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/25/2021] [Accepted: 11/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bisexual people are at an elevated risk for non-suicidal self-injury (NSSI). Psychological factors including self-esteem and thwarted belongingness may help explain this risk. The aim of the current study was to investigate associations between self-esteem, thwarted belongingness and NSSI urges and behavior in young bisexual people. METHODS Participants aged 16-25 from 25 countries took part in this microlongitudinal online survey study (N = 207). Mixed-effects linear and logistic regression were used for analysis, given the nested structure of data. Analysis examined the relationship between self-esteem and thwarted belongingness on NSSI urges and behavior at the same point in time, and lagged by one week. RESULTS At the same timepoint, self-esteem and thwarted belongingness both had significant between- and within-person associations with NSSI urges and behavior. For lagged models, self-esteem had significant between-person effects on urges, and thwarted belongingness had significant within-person effects. For NSSI behavior, both variables were only associated with between-person effects. CONCLUSION Findings support previous research suggesting the importance of self-esteem in explaining NSSI among sexual minorities. Preventative and intervention strategies to improve self-esteem may help reduce NSSI risk. Future studies should focus upon the experiences of bisexual people with intersecting identities and ensure that studies are statistically powered from inception to detect effects.
Collapse
Affiliation(s)
- Brendan J Dunlop
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Sophie E Coleman
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Samantha Hartley
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, UK.,Pennine Care NHS Foundation Trust, Ashton-Under-Lyne, UK
| | - Lesley-Anne Carter
- Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK
| | - Peter J Taylor
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, UK
| |
Collapse
|
4
|
Chang CJ, Fehling KB, Feinstein BA, Selby EA. Unique risk factors for suicide attempt among bisexual/pansexual versus gay/lesbian individuals. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2021. [DOI: 10.1080/19359705.2021.1943733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Cindy J. Chang
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
| | | | - Brian A. Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Edward A. Selby
- Department of Psychology, Rutgers University, Piscataway, New Jersey, USA
| |
Collapse
|
5
|
Hatch SG, Rothman K, Roddy MK, Dominguez RM, Le Y, Doss BD. Heteronormative Relationship Education for Same-Gender Couples. FAMILY PROCESS 2021; 60:119-133. [PMID: 32449947 DOI: 10.1111/famp.12548] [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: 11/26/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 06/11/2023]
Abstract
In recent years, same-gender group-based relationship education has emerged as a viable intervention to prevent relationship distress among same-gender couples. However, many of these programs are conducted in metropolitan areas and lack the ability to reach rural populations. The current study sought to investigate whether two wide-reaching web-based heteronormative relationship education programs could positively impact same-gender relationships. In a sample of 49 same-gender couples, heteronormative relationship education had small (Cohen's d = 0.16-0.39) but reliably positive effects on key areas of relationship functioning and perceived stress relative to a waitlist control group. Additionally, when same-gender couples were matched with different-gender individuals with similar baseline characteristics, no reliable differences between the two groups emerged even though the program effects were sometimes half as large for same-gender couples. Finally, same-gender participants were as satisfied with the program as the matched different-gender individuals. Though the results of the present study indicate that heteronormative relationship education can be helpful for same-gender couples, additional tailoring should be undertaken to ensure that same-gender couples experience as much benefit as possible. Estimates from the current study could be used in future studies to detect what might be small-sized differences.
Collapse
Affiliation(s)
- S Gabe Hatch
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Karen Rothman
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - McKenzie K Roddy
- Department of Psychiatry and Behavioral Sciences, The Baylor College of Medicine, Houston, TX, USA
| | | | - Yunying Le
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Brian D Doss
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| |
Collapse
|
6
|
Livingston NA, Berke D, Scholl J, Ruben M, Shipherd JC. Addressing Diversity in PTSD Treatment: Clinical Considerations and Guidance for the Treatment of PTSD in LGBTQ Populations. ACTA ACUST UNITED AC 2020; 7:53-69. [PMID: 32421099 PMCID: PMC7223966 DOI: 10.1007/s40501-020-00204-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose of review Trauma exposure is widespread but is especially common among lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. LGBTQ individuals also experience higher rates of discrimination, victimization, and minority stress which can complicate posttraumatic stress disorder (PTSD) treatment but also represent independent intervention targets. In this review, we highlight existing evidence-based practices, current limitations, and provide recommendations for care in the absence of established guidelines for treatment PTSD among LGBTQ patients. Recent findings Trauma-focused therapies (e.g., CPT, PE) and medications (e.g., SSRIs, SNRIs) have shown benefit for people with PTSD. However, evaluations of these interventions have failed to examine the role of LGBTQ identities in recovery from trauma, and existing PTSD treatments do not account for ongoing threat to safety or the pervasive minority stress experienced by LGBTQ patients. In addition, many LGBTQ patients report negative experiences with healthcare, necessitating increased education and cultural awareness on the part of clinicians to provide patient-centered care and, potentially, corrective mental health treatment experiences. Summary Providers should routinely assess trauma exposure, PTSD, and minority stress among LGBTQ patients. We provide assessment and screening recommendations, outline current evidence-based treatments, and suggest strategies for integrating existing treatments to treat PTSD among LGBTQ patients.
Collapse
Affiliation(s)
- Nicholas A Livingston
- National Center for PTSD, Behavioral Science Division, Boston, MA USA.,2Department of Psychiatry, Boston University School of Medicine, Boston, MA USA.,3VA Boston Healthcare System, Boston, MA USA
| | - Danielle Berke
- 4Hunter College of the City University of New York, New York City, NY USA.,5The Graduate Center, City University of New York, New York City, NY USA
| | - James Scholl
- 2Department of Psychiatry, Boston University School of Medicine, Boston, MA USA.,3VA Boston Healthcare System, Boston, MA USA
| | - Mollie Ruben
- 6Department of Psychology, University of Maine, Orono, ME USA
| | - Jillian C Shipherd
- National Center for PTSD, Behavioral Science Division, Boston, MA USA.,National Center for PTSD, Women's Health Sciences Division, Boston, MA USA.,8Lesbian, Gay, Bisexual, and Transgender (LGBT) Health Program, Veterans Health Administration, Washington, DC USA
| |
Collapse
|