Associations of racial/ethnic identities and religious affiliation with suicidal ideation among lesbian, gay, bisexual, and questioning individuals

Emotional Distress Disparities Across Multiple Intersecting Social Positions: The Role of Bias-Based Bullying

OBJECTIVES

To apply an intersectional lens to disparities in emotional distress among youth, including multiple social positions and experiences with bias-based bullying.

METHODS

Data are from the 2019 Minnesota Student Survey (n = 80 456). Social positions (race and ethnicity, sexual orientation, gender) and 2 forms of bias-based bullying (racist, homophobic or transphobic) were entered into decision tree models for depression, anxiety, self-injury, suicidal ideation, and suicide attempts. Groups with the highest prevalence are described. Rates of emotional distress among youth with matching social positions but no bias-based bullying are described for comparison.

RESULTS

LGBQ identities (90%) and transgender, gender diverse, and questioning identities (54%) were common among the highest-prevalence groups for emotional distress, often concurrently; racial and ethnic identities rarely emerged. Bias-based bullying characterized 82% of the highest-prevalence groups. In comparable groups without bias-based bullying, emotional distress rates were 20% to 60% lower (average 38.8%).

CONCLUSIONS

Findings highlight bias-based bullying as an important point for the intervention and mitigation of mental health disparities, particularly among lesbian, gay, bisexual, transgender, gender-diverse, queer, and questioning adolescents. Results point to the importance of addressing bias-based bullying in schools and supporting lesbian, gay, bisexual, transgender, gender-diverse, queer, and questioning students at the systemic level as a way of preventing emotional distress.

Sexual orientation disparities in the prevalence of suicidal ideation among U.S adults aged 20 to 59 years: Results from NHANES 2005-2016

Existing studies have been limited in providing nationally representative data on the relationship between sexual orientation and suicidal ideation (SI) among adults in the U.S. particularly in terms of gender and racial differences. To fill this research gap, we conducted a study using data from the NHANES conducted between 2005 and 2016. Survey-weighted logistic regression models were used to investigate the relationship between sexual orientation and SI risk. Additionally, we performed further analysis by stratifying the data based on demographic variables and performed sensitivity analysis to ensure the reliability of our findings. This study included a weighted sample of 16,564 adults, representing a noninstitutionalized U.S population of 840.1 million. The overall age-adjusted prevalence of SI was found to be 3.5 %. After adjusting for relevant covariates, the study revealed that individuals who identified as something else, homosexual, and bisexual had a higher prevalence risk of suicidal ideation (SI) compared to heterosexual participants. Additionally, the study found that heterosexual participants were 74.4 % less likely to experience SI compared to bisexual individuals. These findings highlight the urgent requirement for inclusive and supportive prevention strategies to effectively address SI among adult sexual minorities in the U.S.

Mental health at religious and non-religious universities: Examining the role of student religiousness and sexual/gender minority identity

BACKGROUND

Religiousness is often related to positive mental health for university students. Yet this may not hold for sexual and gender minority (SGM) students at religious universities. Some studies find religiousness protective for SGM students, some find no relationship, and some find religiousness a risk.

METHODS

Using the Healthy Minds data (n = 135,344) student mental health (suicide ideation and anxiety) was compared across religious universities (Catholic, evangelical, and "Other Christian") and nonreligious universities, examining moderation by student religiousness and SGM identity.

RESULTS

Overall, there were no anxiety or ideation differences across religious and nonreligious universities except that students at "Other Christian" universities had slightly higher ideation than those at nonreligious universities. However, moderation analysis found SGMs at nonreligious universities at higher risk for anxiety compared to those at "Other Christian" universities. Student religious importance predicted lower ideation and anxiety across universities: though students for whom religion was unimportant were at greater risk for anxiety at nonreligious versus Catholic universities. Compared to SGMs at nonreligious universities, SGMs at evangelical universities who did not participate in extracurricular religious activities were at risk for ideation, but risk was low for SGMs who did participate.

LIMITATIONS

Data were cross-sectional. Analyses were unable to control for whether students dropped out of a university.

CONCLUSIONS

There were few overall differences between religious and nonreligious universities. Though moderation found attending a religious university either a protective or risk factor for some groups. The relations between being SGM and mental health should be considered concert with religiousness.

Neighborhood cohesion and psychological distress across race and sexual orientation

Introduction

Method

Result

Conclusion

•

Lesbian, gay, and bisexual (LGB) people are more likely to meet the criteria for psychological distress than non-LGB people.

•

Neighborhood cohesion (NC) has differing impact on psychological distress by race and sexual orientation.

•

NC provides greater protection against moderate distress for non-LGB groups and severe psychological distress for LGB groups.

Sexual minority status, religiosity, and suicidal behaviors among college students in the United States

BACKGROUND

Religiosity has been protective against suicidal behaviors, though it is unclear whether the protective effects extend to the high-risk group of sexual minorities.

METHODS

We analyzed data from the Healthy Minds Study, which was administered to college students enrolled in one of 140 campuses across the United States (N = 104,463) from September through December 2020, and from January to June 2021. We limited the sample to emerging adulthood (i.e., ages 18-30). We calculated the prevalence of suicidal behaviors and the mean of importance of religion, stratifying by sexual minority status. We used multivariable logistic regression to examine the associations between predictors (sexual minority status, importance of religion) and outcomes (suicidal ideation, suicide plan, and suicide attempt), adjusting for age, gender, and race/ethnicity. We then tested to see whether the association between importance of religion and suicidal behaviors was conditional on sexual minority status.

RESULTS

Significantly larger proportions of sexual minority students reported suicidal behaviors than heterosexual students. A larger proportion of heterosexual students viewed religion to be very important in their lives when compared with sexual minority students. Being a sexual minority was associated with greater odds of all suicidal behaviors, and greater importance of religion was associated with lower odds. The importance of religion was significantly associated with lower odds of suicidal behaviors for heterosexual students when compared with sexual minority students.

CONCLUSION

The association between importance of religion and suicidal behaviors was conditional on sexual minority status.

A mixed-methods study of social identities in mental health care among LGBTQ young adults of color

Social identities have been shown to reflect normative beliefs and practices that can impact important health behaviors. A better understanding of how this process unfolds among young people with marginalized identities can help inform strategies to decrease mental health disparities and improve their overall health outcomes. A mixed method, convergent parallel design was used to examine identity centrality, mental health treatment history, and cultural experiences of a purposeful sample, consisting of 31 Black and Latinx young adults (Mage = 22.16) who identified as sexual and gender minorities in New York City. Data from validated measures and in-depth interviews were triangulated to strengthen and add context to findings. Participants with higher social identity centrality scores, particularly on community belonging and sexual identity, were more likely to continuously use mental health services. Seven social identities were prominent in qualitative data: Sexual, Ethnic-racial, Religious, Socioeconomic, Gender, Family, and Generational. These social identities were described as interconnected, and as both significant barriers and facilitators to participants' involvement in treatment. Results suggested that young lesbian, gay, bisexual, transgender, queer (LGBTQ) people of color seeking mental health care might need more support to navigate experiences related to intersecting identities. Interventions to improve services and maintain these youth in treatment should employ strategies to assess and support positive minority identity development, while also addressing self-stigma and discrimination experienced through culture, family, and mental health professionals. Considering social identity development is conceptually useful for adapting services for diverse youth because it is a major focus of transitioning to adulthood and calls attention to multiple minority identities impacting individual clients. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Suicidal Behavior and Coming Out Milestones in Three Cohorts of Sexual Minority Adults

Purpose: We describe the timing of suicidality across the life span in three cohorts of sexual minority adults. We hypothesized that suicide attempts coincide with the coming out period and that younger sexual minority people, who grew up in more accepting social environments, will have lower prevalence of suicide attempts than older generations. Methods: A U.S. national probability sample of 1518 sexual minority adults in three age cohorts of 18-25, 34-41, and 52-59 years (collected 2016-2018) completed a self-administered survey. Results: Sexual minority adults had high prevalence of lifetime suicidal thoughts, plans, and attempts, with the highest attempted suicides in the younger cohort (30.8%, 95% confidence interval [CI] = 26.8-35.1) compared with the middle (23.7%, 95% CI = 19.0-29.1) and older (20.3%, 95% CI = 16.3-25.1) cohorts. There were no differences in suicidal behavior by race and ethnicity or between men and women, but gender nonbinary people had higher prevalence of suicidal thoughts. The mean age at suicidal thoughts, plans, and attempts tracked closely with age of first realization of sexual minority identity. Most suicide attempts (60.9%) occurred within 5 years of realizing one's sexual minority identity, but a significant proportion of attempts (39.1%) occurred outside this range. Conclusion: Our findings are contrary to the hypothesis that younger cohorts of sexual minority people are at lower risk of suicidality.

Promoting Sexual Health Knowledge through a Social Workers' Mentorship Programme: A Study of Gay Young Adults

Mentorship of counselling for men who have sex with other men and gay youths is understudied. The purpose of this study was to explore the effectiveness of how the Mentor Modelling Programme may increase the sexual health knowledge and practices of gay youths. As an expansion of a previous study with the application of the conceptual framework, this study mapped a sexual health promotion plan and the six-month-long Mentor Modelling Programme with the coordination of eight health and social care professionals and 40 gay youths. The researcher found positive and supportive feedback of how the Mentor Modelling Programme could increase sexual health knowledge, promote long-term relationships, and encourage referral of other vulnerable people. The results indicated two directions. The first solicited the perspectives of health and social care professionals and gay youths on how they would describe the relationship, application to, and experience of the Mentor Modelling Programme and second, assessed how this Mentor Modelling Programme influenced and changed the ideas and senses about counselling services and mentorship. This study reflected the current limited sexual promotion between traditional and inclusive sexual health materials. It further indicated the necessary concerns and areas of attention needed to upgrade the materials and host inclusive sexual health materials for both youths and adults in the communities.

Religious affiliation and suicidality among college students in China: A cross-sectional study across six provinces

BACKGROUND

Several past studies indicated that religious beliefs, orientation, and practice are protective of suicide. Findings from recent studies in China suggest that religiosity may contribute to increased suicidality. However, few studies have examined the associations between religious affiliation across different faiths and suicidality in China.

OBJECTIVE

The current study examines the association between religious affiliation and suicidality among college students in six provinces in China.

METHODS

We conducted a cross-sectional study involving 11,407 college students from six universities in Ningxia, Shandong, Shanghai, Jilin, Qinghai, and Shaanxi. We collected the data between October 2017 and March 2018 using self-report questionnaires. They included self-report measures of depression, psychache, hopelessness, self-esteem, social support, and life purpose.

RESULTS

Participants with a Christian affiliation had 1.5 times (95% CI: 1.14, 1.99, p = 0.004) higher odds of indicating an elevated suicide risk, 3.1 times (95% CI: 1.90, 5.04, p<0.001) higher odds of indicating a previous suicide attempt, and increased overall suicidality (B = 0.105, p < 0.001) after accounting for demographic and risk/protective factors. Christians also scored the highest in depression, psychache, hopelessness, and the lowest social support, self-esteem, and purpose in life. Muslims reported decreased suicidality (B = -0.034, p = 0.031). Buddhism/Daoism yielded non-significant results in the multivariate analyses.

CONCLUSIONS

Christian college students reported increased suicidality levels, perhaps due to public policies on religion. The decreased suicidality levels among Muslims may be attributed to higher perceived social support. The associations between religious affiliation and suicidality, depression, and hopelessness contrast sharply with US samples. This finding may be influenced by interactions between the religious denomination, individual, and social/political factors. This conclusion includes the possibility of anti-religious discrimination, which this paper did not investigate as a possible mediator and therefore remains a conjecture worthy of future investigation.

Suicide thought and behaviors, non-suicidal self-injury, and perceived life stress among sexual minority Mexican college students

BACKGROUND

Sexual minority college students are at a higher risk for suicidal thoughts and self-injurious behaviors compared to heterosexual students. Minority stress theory proposes sexual minority individuals experience higher stress due to stigma. Using a sample of Mexican college students, this study tested perceived life stress as a mediator of suicide and self-injury outcomes across various sexual orientation groups.

METHODS

The sample of college students (N=7882) was recruited from nine Mexican universities as part of the WHO World Mental Health International College Student (WMH-ICS) initiative. Participants completed an online survey including demographic questions, measure of perceived life stress, suicide outcomes, and non-suicidal self-injury (NSSI) in the past 12 months.

RESULTS

Logistic regression analyses revealed identifying as a sexual minority significantly predicted a higher likelihood of suicide ideation (ORs 2.05-3.00), suicide attempts (ORs 2.48-8.73), and NSSI (ORs 2.92-4.18) compared to heterosexual students reporting no same-gender attraction. Significant indirect effects from mediation path analyses showed perceived life stress mediated the relationship between a sexual minority identity and suicide ideation (range of proportion mediated 10.48-31.48%), attempts (10.48-31.48%), and NSSI (7.69-20.09%) across each group except among asexual students.

LIMITATIONS

The cross-sectional nature of the survey design precludes drawing causal inferences.

CONCLUSION

Findings from this study contribute to minority stress theory by elucidating the role of perceived life stress as a mediator of suicide ideation and attempts and NSSI among sexual minority college students. Clinical interventions may benefit in focusing on experiences of stress across various life areas when supporting sexual minority college students.

Questions of faith: Religious affiliations and suicidal ideation among sexual minority young adults

OBJECTIVE

To examine how the associations of specific religious affiliations with recent suicidal ideation vary by sexual orientation among young adults.

METHOD

This project was a cross-sectional secondary analysis of data from the 2006 and 2011 surveys of the National Research Consortium of Counseling Centers in Higher Education. The analytic sample was restricted to persons between the ages of 18-29 (n = 40,150). Multiple logistic regression analyses were used to examine associations of religious affiliations with recent suicidal ideation between heterosexual and sexual minority (e.g., gay, lesbian, bisexual, questioning) young adults.

RESULTS

Approximately 6.7% of the sample self-identified as sexual minority. Compared to heterosexuals, sexual minorities were more likely to report recent suicidal ideation (aOR = 4.52, 95% CI = 3.97-5.16). Among heterosexuals, Unspecified Christian and Catholic denominations were associated with 24% and 37% reduced odds of recent suicidal ideation compared to agnostic/atheist heterosexuals. However, among sexual minorities, Unspecified Christian and Catholic denominations were associated with 68% and 77% increased odds of recent suicidal ideation compared to agnostic/atheist sexual minorities. Unspecified Christian and Catholic sexual minorities had 184% and 198% increased odds of recent suicidal ideation compared to Unitarian/Universalist sexual minorities.

CONCLUSIONS

Although protective for heterosexuals, religious affiliation may not be globally protective against suicidal ideation among sexual minorities.

Internalizing Symptoms and Externalizing Behaviors in Latinx Adolescents with Same Sex Behaviors in Miami

Sexual minorities report poorer mental health relative to heterosexual counterparts, but this is underexplored in Latinx youth. This study compares internalizing symptoms and externalizing behaviors in Latinx adolescents with Same Sex Behaviors (LASSB) to their Latinx adolescent peers who did not report same sex behaviors (non-LASSB). It also explores the moderating role of biculturalism on the relationship between internalizing symptoms and externalizing behaviors, and same-sex behaviors. Individual-level baseline data (Total N=1,634; LASSB n=195) from five trials of a preventive intervention for Latinx adolescents were synthesized. Normal and clinical levels of internalizing symptoms and externalizing behaviors were determined, and logistic regression models were conducted to determine the odds of LASSB reporting these behaviors relative to non-LASSB. Additional adjusted models tested for the moderating effect of biculturalism. LASSB reported significantly higher odds of normal levels of all externalizing behaviors and clinical levels of anxious/depressed compared to non-LASSB. Biculturalism significantly moderated the association between same-sex behavior and clinical levels of internalizing behaviors; however, in subgroup analyses among LASSB, biculturalism did not significantly predict any of these behaviors. Latinx adolescents exhibited mental health disparities by same-sex behavior. Biculturalism may be an important indicator for describing these disparities in LASSB and should be further explored.

Sexual Orientation Change Efforts, Adverse Childhood Experiences, and Suicide Ideation and Attempt Among Sexual Minority Adults, United States, 2016-2018

Objectives. To examine how sexual orientation change efforts (SOCE) are associated with suicide morbidity after controlling for adverse childhood experiences (ACEs).Methods. Cross-sectional survey data are from the Generations survey, a nationally representative sample of 1518 nontransgender sexual minority adults recruited between March 28, 2016, and March 30, 2018, in the United States. Self-identified transgender individuals were included in a separate, related TransPop study. We used weighted multiple logistic regression analyses to assess the independent association of SOCE with suicidal ideation and suicide attempt while controlling for demographics and ACEs.Results. Approximately 7% experienced SOCE; of them, 80.8% reported SOCE from a religious leader. After adjusting for demographics and ACEs, sexual minorities exposed to SOCE had nearly twice the odds of lifetime suicidal ideation, 75% increased odds of planning to attempt suicide, and 88% increased odds of a suicide attempt with minor injury compared with sexual minorities who did not experience SOCE.Conclusions. Over the lifetime, sexual minorities who experienced SOCE reported a higher prevalence of suicidal ideation and attempts than did sexual minorities who did not experience SOCE.Public Health Implications. Evidence supports minimizing exposure of sexual minorities to SOCE and providing affirming care with SOCE-exposed sexual minorities. (Am J Public Health. Published online ahead of print May 21, 2020: e1-e7. doi:10.2105/AJPH.2020.305637).

Help-seeking behaviors and attitudes of emerging adults: How college students reporting recent suicidal ideation utilize the internet compared to traditional resources

Objective: Suicide is the second leading cause of death among emerging adults, yet little is known regarding their online help-seeking. Participants: The National Research Consortium of Counseling Centers in Higher Education's dataset (N=26,292). Methods: Students across the United States were recruited from 73 four-year institutions to participate during the 2010-2011 school year. Results: Observed the effectiveness of online and traditional help-seeking stratified by recent suicidal ideation related to their most distressful period in the past year. Females and younger students endorsed both types of help-seeking, yet those with recent ideation were less likely to disclose any help-seeking. Among those reporting recent ideation, only females reported that traditional supports were more than moderately helpful. Regardless of whether students endorsed ideation, students who were younger, engaged in risky behaviors and identified as females reported that online resources were more than moderately helpful. Conclusions: Online resources could potentially bridge barriers to traditional help-seeking for those reluctant to seek out care, yet traditional resources were reported to be the most effective among this sample.

Characterizing the phenomenology of passive suicidal ideation: a systematic review and meta-analysis of its prevalence, psychiatric comorbidity, correlates, and comparisons with active suicidal ideation

BACKGROUND

Compared to active ideation, passive ideation remains relatively understudied and its clinical importance poorly defined. The weight that should be accorded passive ideation in clinical risk assessment is therefore unclear.

METHODS

We conducted a systematic review and meta-analysis of the prevalence of passive ideation, its psychiatric comorbidity, associated sociodemographic characteristics, as well as psychological and environmental correlates. For reference, pooled effects were also calculated for direct comparisons of passive and active ideation with respect to potential correlates. Relevant articles published since inception to 9 September 2019 were identified through a systematic search of MEDLINE and PsycINFO.

RESULTS

A total of 86 studies were included in this review. The prevalence of passive ideation was high across sample types, ranging from 5.8% for 1-year prevalence to 10.6% for lifetime prevalence in the general population. Passive ideation was strongly associated with sexual minority status, psychiatric comorbidity, psychological characteristics implicated in risk, and suicide attempts. Preliminary evidence exists for a large association with suicide deaths. The effect sizes for individual correlates of passive and active ideation were largely equivalent and mostly non-significant in head-to-head comparisons.

CONCLUSIONS

Passive ideation is a prevalent clinical phenomenon associated with significant psychiatric comorbidity. Current evidence also suggests notable similarities exist between passive and active ideation in terms of psychiatric comorbidity and psychological and other characteristics traditionally associated with risk.

Race/Ethnicity and Sexual Orientation Disparities in Mental Health, Sexism, and Social Support among Women Veterans

OBJECTIVE

To identify patterns of risk and resilience by the intersections of race/ethnicity and sexual orientation in mental health symptom severity, sexism, and social support among U.S. women veterans.

METHODS

A national sample of women veterans (n = 648, 38% sexual minority, 15% racial/ethnic minority) was recruited online in 2013 using social networking websites and listservs. Using cross-sectional survey data, we evaluated main and interactive associations between race/ethnicity and sexual orientation on depression, anxiety, posttraumatic stress, unhealthy alcohol use, sexism, and social support. Models were adjusted for other demographic characteristics.

RESULTS

Across depression, anxiety, and sexism, White heterosexual women reported the least distress and racial/ethnic minority heterosexual women the most distress (race/ethnicity x sexual orientation interactions p < .05). Among White women, sexual minority women reported greater levels of depression, anxiety, and sexism than heterosexual women. The effects were the opposite among racial/ethnic minority women, where heterosexual women reported similar or worse depression, anxiety, and sexism than sexual minority women. There were no race/ethnicity or sexual orientation interaction effects on posttraumatic stress symptoms or unhealthy alcohol use and marginally significant effects on social support.

CONCLUSIONS

Among women veterans, race/ethnicity and sexual orientation were associated with mental health and sexism, alone and in combination. Findings suggest that those who were both racial/ethnic and sexual minorities may develop resilience from their lived experience. On the other hand, women veterans with a minority race/ethnicity or a minority sexual orientation appeared more vulnerable to adverse outcomes and may need targeted care.

Association of Religiosity With Sexual Minority Suicide Ideation and Attempt

INTRODUCTION

The purpose of this study is to explore how the associations between importance of religion and recent suicide ideation, recent suicide attempt, and lifetime suicide attempt vary by sexual orientation.

METHODS

Survey data were collected from the 2011 University of Texas at Austin's Research Consortium data from 21,247 college-enrolled young adults aged 18-30 years. Respondents reported sexual identity as heterosexual, gay/lesbian, bisexual, or questioning. Two sets of multivariable models were conducted to explore the relations of religious importance and sexual orientation with the prevalence of suicidal behavior. The first model was stratified by sexual orientation and the second model was stratified by importance of religion. To explore potential gender differences in self-directed violence, the models were also stratified by gender identity. The main outcome measures were recent suicidal ideation, recent suicide attempt, and lifetime suicide attempt.

RESULTS

Overall, increased importance of religion was associated with higher odds of recent suicide ideation for both gay/lesbian and questioning students. The association between sexual orientation and self-directed violence were mixed and varied by strata. Lesbian/gay students who viewed religion as very important had greater odds for recent suicidal ideation and lifetime suicide attempt compared with heterosexual individuals. Bisexual and questioning sexual orientations were significantly associated with recent suicide ideation, recent attempt, and lifetime attempt across all strata of religious importance, but the strongest effects were among those who reported that religion was very important.

CONCLUSIONS

Religion-based services for mental health and suicide prevention may not benefit gay/lesbian, bisexual, or questioning individuals. Religion-based service providers should actively assure their services are open and supportive of gay/lesbian, bisexual, or questioning individuals.

Anxiety and Related Disorders and Concealment in Sexual Minority Young Adults

Sexual minorities face greater exposure to discrimination and rejection than heterosexuals. Given these threats, sexual minorities may engage in sexual orientation concealment in order to avoid danger. This social stigma and minority stress places sexual minorities at risk for anxiety and related disorders. Given that three fourths of anxiety disorder onset occurs before the age of 24, the current study investigated the symptoms of generalized anxiety disorder, social phobia, panic disorder, posttraumatic stress disorder, and depression in sexual minority young adults relative to their heterosexual peers. Secondarily, the study investigated sexual orientation concealment as a predictor of anxiety and related disorders. A sample of 157 sexual minority and 157 heterosexual young adults matched on age and gender completed self-report measures of the aforementioned disorders, and indicated their level of sexual orientation concealment. Results revealed that sexual minority young adults reported greater symptoms relative to heterosexuals across all outcome measures. There were no interactions between sexual minority status and gender, however, women had higher symptoms across all disorders. Sexual minority young women appeared to be at the most risk for clinical levels of anxiety and related disorders. In addition, concealment of sexual orientation significantly predicted symptoms of social phobia. Implications are offered for the cognitive and behavioral treatment of anxiety and related disorders in this population.