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Fedele E, Trousset V, Schalk T, Oliero J, Fovet T, Lefevre T. Identification of Psycho-Socio-Judicial Trajectories and Factors Associated With Posttraumatic Stress Disorder in People Over 15 Years of Age Who Recently Reported Sexual Assault to a Forensic Medical Center: Protocol for a Multicentric Prospective Study Using Mixed Methods and Artificial Intelligence. JMIR Res Protoc 2023; 12:e46652. [PMID: 37843900 PMCID: PMC10616743 DOI: 10.2196/46652] [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: 02/21/2023] [Revised: 06/29/2023] [Accepted: 07/31/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Sexual assault (SA) can lead to a range of adverse effects on physical, sexual, and mental health, as well as on one's social life, financial stability, and overall quality of life. However, not all people who experience SA will develop negative functional outcomes. Various risk and protective factors can influence psycho-socio-judicial trajectories. However, how these factors influence trauma adaptation and the onset of early posttraumatic stress disorder (PTSD) is not always clear. OBJECTIVE Guided by an ecological framework, this project has 3 primary objectives: (1) to describe the 1-year psycho-socio-judicial trajectories of individuals recently exposed to SA who sought consultation with a forensic practitioner; (2) to identify predictive factors for the development of PTSD during the initial forensic examination using artificial intelligence; and (3) to explore the perceptions, needs, and experiences of individuals who have been sexually assaulted. METHODS This longitudinal multicentric cohort study uses a mixed methods approach. Quantitative cohort data are collected through an initial questionnaire completed by the physician during the first forensic examination and through follow-up telephone questionnaires at 6 weeks, 3 months, 6 months, and 1 year after the SA. The questionnaires measure factors associated with PTSD, mental, physical, social, and overall functional outcomes, as well as psycho-socio-judicial trajectories. Cohort participants are recruited through their forensic examination at 1 of the 5 participating centers based in France. Eligible participants are aged 15 or older, have experienced SA in the last 30 days, are fluent in French, and can be reached by phone. Qualitative data are gathered through semistructured interviews with cohort participants, individuals who have experienced SA but are not part of the cohort, and professionals involved in their psycho-socio-judicial care. RESULTS Bivariate and multivariate analyses will be conducted to examine the associations between each variable and mental, physical, social, and judicial outcomes. Predictive analyses will be performed using multiple prediction algorithms to forecast PTSD. Qualitative data will be integrated with quantitative data to identify psycho-socio-judicial trajectories and enhance the prediction of PTSD. Additionally, data on the perceptions and needs of individuals who have experienced SA will be analyzed independently to gain a deeper understanding of their experiences and requirements. CONCLUSIONS This project will collect extensive qualitative and quantitative data that have never been gathered over such an extended period, leading to unprecedented insights into the psycho-socio-judicial trajectories of individuals who have recently experienced SA. It represents the initial phase of developing a functional artificial intelligence tool that forensic practitioners can use to better guide individuals who have recently experienced SA, with the aim of preventing the onset of PTSD. Furthermore, it will contribute to addressing the existing gap in the literature regarding the accessibility and effectiveness of support services for individuals who have experienced SA in Europe. This comprehensive approach, encompassing the entire psycho-socio-judicial continuum and taking into account the viewpoints of SA survivors, will enable the generation of innovative recommendations for enhancing their care across all stages, starting from the initial forensic examination. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46652.
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Affiliation(s)
- Emma Fedele
- Institute for Interdisciplinary Research on Social Issues (UMR 8156), Aubervilliers, France
- Department of Health, Medicine and Human Biology, Sorbonne Paris Nord University (Paris 13), Bobigny, France
| | - Victor Trousset
- Department of Legal and Social Medicine, Jean Verdier Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Bondy, France
| | - Thibault Schalk
- Department of Legal and Social Medicine, Jean Verdier Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Bondy, France
| | - Juliette Oliero
- Department of Legal and Social Medicine, Jean Verdier Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Bondy, France
| | - Thomas Fovet
- Lille Neuroscience & Cognition Research Center, Regional University Hospital of Lille, University of Lille, Lille, France
| | - Thomas Lefevre
- Institute for Interdisciplinary Research on Social Issues (UMR 8156), Aubervilliers, France
- Department of Health, Medicine and Human Biology, Sorbonne Paris Nord University (Paris 13), Bobigny, France
- Department of Legal and Social Medicine, Jean Verdier Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Bondy, France
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Xavier Hall CD, Harris R, Burns P, Girod C, Yount KM, Wong FY. Utilizing Latent Class Analysis to Assess the Association of Intersectional Stigma on Mental Health Outcomes Among Young Adult Black, Indigenous, and Sexual Minority Women of Color. LGBT Health 2023; 10:463-470. [PMID: 36951670 PMCID: PMC10468552 DOI: 10.1089/lgbt.2022.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
Purpose: Discrimination has detrimental effects on mental health, particularly among Black, Indigenous, and people of color who are also sexual minority women (BIPOC SMW); however, measurement of multiple intersecting forms of discrimination (e.g., race, gender, and sexual identity discrimination among BIPOC SMW) poses methodological challenges. This analysis uses latent class analysis (LCA) to examine the influences of discrimination on mental health in a convenience sample of BIPOC SMW. Methods: Online survey data from BIPOC SMW aged 18-29 years (n = 324) were used to estimate latent classes for discrimination type (race, gender, and sexual identity). Data for this study were collected from July to October 2018. Adjusted linear regressions examined the influences of discrimination profiles on perceived stress and depressive symptoms. Results: Utilizing LCA, the following four classes emerged: (1) low discrimination; (2) mid-level discrimination; (3) high racial, medium gender, and low sexual identity discrimination; (4) high discrimination. Classes 3 and 4 were positively associated with perceived stress and depressive symptoms relative to Class 1 in adjusted models. Conclusion: This analysis highlights the importance of intersectionality and the adverse impact of multiple forms of discrimination on mental health outcomes for BIPOC SMW. Respondents reporting higher levels of racial or multiple forms of discrimination had poorer mental health outcomes. LCA is a promising analytical tool for investigating intersectional stigma and discrimination. There is an urgent need to develop tailored, culturally appropriate intersectional mental health interventions to address the multiple identities and oppressions faced by BIPOC SMW.
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Affiliation(s)
- Casey D. Xavier Hall
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, Florida, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Rachel Harris
- College of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Paul Burns
- John D. Bower School of Population Health, Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | - Kathryn M. Yount
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Department of Sociology, Emory University, Atlanta, Georgia, USA
| | - Frankie Y. Wong
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, Florida, USA
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
- Department of Epidemiology, Fudan University, Shanghai, China
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Fedele E, Juster RP, Guay S. Stigma and Mental Health of Sexual Minority Women Former Victims of Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP22732-NP22758. [PMID: 35189737 PMCID: PMC9679572 DOI: 10.1177/08862605211072180] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
UNLABELLED Sexual minority women (SMW) are at high risk of experiencing stigma, mental health problems, and being victims of intimate partner violence (IPV). This vulnerability can be explained by the sexual and gender minority stress model, stating that sexual and gender minority people suffer from specific stress factors added to general stressors, leading to more mental health and relationships problems. OBJECTIVE The main goal of this study was to assess the impact of minority stress factors and former IPV victimization on the current mental health of Canadian SMW, as a function of their sexual and gender identity. METHOD In total, 209 individuals identifying as women (M age = 33.9), living in Canada and who lived in a past violent relationship with a woman responded to an online survey. Well-validated questionnaires assessed sexual orientation and gender identity, former IPV behaviors, minority stress factors, depression, and anxiety. RESULTS Hierarchical regressions showed that past psychological aggression was positively associated with anxiety symptoms and past sexual coercion with depressive symptoms. Not being monosexual was also associated more severe symptoms of depression and age was negatively associated with the severity of anxiety symptoms. After controlling for age, race/ethnicity, sexual and gender identity and former IPV victimization, having negative feelings about being a SMW was strongly associated with both depression and anxiety symptoms. CONCLUSION These results provide new information on the interconnected associations between former IPV, minority stress and SMW's mental health. Findings highlight the need to adapt clinical interventions to help buffer against victimization faced by IPV victims who identify as sexual and gender minorities.
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Affiliation(s)
- Emma Fedele
- Master’s candidate in Criminology,
School of Criminology, University of Montreal, Montreal, QC, Canada
- Emma Fedele, Montreal Mental Health
University Research Centre, 7331 rue Hochelaga, Montreal (QC) H1N 3V2.
| | - Robert-Paul Juster
- Assistant Research Professor,
Department of Psychiatry and Addiction, University of Montreal, Montreal, QC, Canada
| | - Stéphane Guay
- Tenured Professor, School of
Criminology and Department of Psychiatry and Addiction, University of Montreal, Montreal, QC, Canada
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Dyar C. A Review of Disparities in Cannabis Use and Cannabis Use Disorder Affecting Sexual and Gender Minority Populations and Evidence for Contributing Factors. CURRENT ADDICTION REPORTS 2022; 9:589-597. [PMID: 37637872 PMCID: PMC10449003 DOI: 10.1007/s40429-022-00452-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2022] [Indexed: 11/08/2022]
Abstract
Purpose of Review Sexual and gender minorities (SGM) appear to be at elevated risk for cannabis use (CU) and cannabis use disorder (CUD) compared to cisgender heterosexuals. However, risk factors remain understudied among SGM. This review aims to summarize evidence for disparities in CU and CUD affecting SGM and factors contributing to these disparities. Recent Findings We found strong evidence that sexual minorities are at elevated risk for CU and CUD is elevated for sexual minority women. Evidence supports a concurrent association between minority stress and CUD symptoms. There is robust support for coping motives as a mechanism linking minority stress to subsequent CU and CUD. Studies also point to CU norms and contexts as potential risk factors. Summary SGM are at high risk for CU and CUD, and minority stress, CU norms, and contextual factors are implicated. Additional research is needed on CU among gender minorities, prospective effects of risk factors, and interventions for SGM.
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Desjardins G, Caceres BA, Juster RP. Sexual minority health and allostatic load in the National Health and Nutrition Examination Survey: A systematic scoping review with intersectional implications. Psychoneuroendocrinology 2022; 145:105916. [PMID: 36115322 DOI: 10.1016/j.psyneuen.2022.105916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 09/02/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022]
Abstract
Understood largely from a minority stress framework, sexual minorities (SM) are hypothesized to suffer more physical and mental health burdens compared to their heterosexual counterparts. Several studies have used data from the National Health and Nutrition Examination Survey (NHANES) in the United States to assess SM health disparities and the 'wear and tear' of allostatic load. Because findings are generally mixed and sometimes contradictory with sexual minority stress theory, we endeavoured to explore existing NHANES studies of SM health. Our scoping review yielded a comprehensive analysis of all existing published articles (N = 43) that have used the NHANES to assess any outcome regarding SM health and well-being. Our synthesis confirms that SM sub-groups are significantly different from one another and from their heterosexual peers on several key health variables. Surprisingly, gay men appear to have the lowest allostatic load and no differences have yet been identified among women as a function of sexual identity/behavior. The existing literature suggests a need to use the NHANES more broadly and to include more psychosocial variables to better delineate sexual minority stress. This is especially important to consider at a physiological level in allostatic load research that should better include health behaviors available in NHANES and from other available datasets as moderators linking psychosocial exposures (e.g., minority stress) and health outcomes. Suggested future directions are proposed in an intersectional perspective that incorporates interactions among sex, gender, sexual identity/behaviors, race, ethnicity, age cohorts, socioeconomic status, and lived experiences.
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Affiliation(s)
- Gabriel Desjardins
- Center on Sex⁎Gender, Allostasis, and Resilience (CÉSAR), Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada.
| | - Billy A Caceres
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, NY, USA
| | - Robert-Paul Juster
- Center on Sex⁎Gender, Allostasis, and Resilience (CÉSAR), Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada; Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
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Miller GH, Marquez-Velarde G, Lindstrom ED, Keith VM, Brown LE. Neighborhood cohesion and psychological distress across race and sexual orientation. SSM Popul Health 2022; 18:101134. [PMID: 35655796 PMCID: PMC9152102 DOI: 10.1016/j.ssmph.2022.101134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 12/01/2022] Open
Abstract
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.
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Affiliation(s)
- Gabe H. Miller
- Mississippi State University, Department of Sociology, African American Studies Program, 456 Hardy Road, Mississippi State, MS, 39762, United States
- Corresponding author.
| | | | | | - Verna M. Keith
- University of Alabama at Birmingham, Department of Sociology Birmingham, Alabama, United States
| | - Lauren E. Brown
- Mississippi State University, Department of Sociology Mississippi State, Mississippi, United States
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