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Hoskin JM, Erekson DM, June H, Parker A, McMurray M, Hannan CR, Spjut K, Merrill B, Davis B, Ross M, Jorgensen A, Papenfuss K, Damm A, Goates-Jones M. "I Just Want to be Acknowledged": Suicidal Ideation Experiences among Sexual Minority Students at a Religiously Affiliated University. JOURNAL OF HOMOSEXUALITY 2024; 71:2217-2242. [PMID: 37405701 DOI: 10.1080/00918369.2023.2230603] [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: 07/06/2023]
Abstract
Research finds that sexual minority university students experience considerable psychological and emotional distress. Furthermore, a recent study at Brigham Young University (BYU)-a university affiliated with The Church of Jesus Christ of Latter-day Saints-found that suicidality prevalence and severity were twice as high among sexual minority students compared to their heterosexual peers. To better understand this finding, we interviewed ten sexual minority students at BYU who reported clinically significant current or previous suicidality. A coding team and auditors then analyzed and categorized the transcripts of these interviews using the Consensual Qualitative Research methodology. Five domains emerged related to suicidality among sexual minority students: deterrents from suicidal ideation and intent; contributors to suicidal ideation and intent; religious and spiritual experiences; experiences with BYU; and suggested improvements. We found patterns consistent with previous literature, including relational and belonging factors contributing to suicidality; we also found that certain doctrinal interpretations were related to increased suicidality. The primary improvement requested by participants was feeling better understood and accepted (rather than ignored or marginalized). We discuss study limitations (including small sample size and low generalizability,), future directions for research, and implications for religious university campuses.
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Affiliation(s)
- Jason M Hoskin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - David M Erekson
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Haylie June
- Department of Sociology, Brigham Young University, Provo, Utah, USA
| | - Audrey Parker
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Matthew McMurray
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Corinne R Hannan
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Kersti Spjut
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Brett Merrill
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Brad Davis
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - McKay Ross
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Anna Jorgensen
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Kyrie Papenfuss
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Annie Damm
- Department of Psychology, Brigham Young University, Provo, Utah, USA
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Boyd DT, Sterrett-Hong E, Scott ED, Allen JL, Smith B, Quinn CR. Family as a Pathway to Suicidal Behaviors Through Depression Symptoms and Internalized Homophobia. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01956-8. [PMID: 38443741 DOI: 10.1007/s40615-024-01956-8] [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: 10/02/2023] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/07/2024]
Abstract
Research consistently highlights how systemic and social factors can adversely impact mental health, and the potential buffering effects of family support, yet raced sexual minorities are vastly underrepresented among these studies. As rates of suicide increase among Black people and remain high among men and those in gender and sexually diverse communities, this study sought to examine to relationships between family dynamics and suicidality among young Black men who have sex with men (MSM) in young adulthood. We used an online survey to conduct a logistic regression to examine family factors (family support, open family communication, other adult support, and other adult value), depression symptoms, and internalized homophobia on suicide attempts. The conceptualization of the study's design and interpretation of the results were informed by minority stress theory and the phenomenological variant of ecological systems theory. The results indicate that higher levels of family support and open family communication were associated with lower levels of suicidality. Implications for future research and applications for healthcare providers and human services professionals who support young Black MSM in emerging adulthood are discussed.
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Affiliation(s)
- Donte T Boyd
- College of Social Work, The Ohio State University, Columbus, USA.
- Center for Equitable, Family and Community Wellbeing, Ann Arbor, USA.
| | - Emma Sterrett-Hong
- Raymond A. Kent School of Social Work and Family Science, University of Louisville, Louisville, USA
| | - Edward D Scott
- Graduate College of Social Work, University of Houston, Houston, USA
| | - Junior L Allen
- School of Social Work, Wayne State University, Detroit, USA
| | - Brianna Smith
- College of Social Work, The Ohio State University, Columbus, USA
| | - Camille R Quinn
- Center for Equitable, Family and Community Wellbeing, Ann Arbor, USA
- School of Social Work, University of Michigan, Ann Arbor, USA
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Brewer K, Mantey DS, Thomas PB, Romm KF, Kong AY, Alexander AC. Identifying disparities in suicidal thoughts and behaviors among US adolescents during the COVID-19 pandemic. Prev Med 2023; 177:107791. [PMID: 38035944 PMCID: PMC10842713 DOI: 10.1016/j.ypmed.2023.107791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/24/2023] [Accepted: 11/26/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Suicidal thoughts and behaviors (STBs) became more common among racial and ethnic minorities and sexual and gender minorities (SGM) during the COVID-19 pandemic relative to White and non-SGM adolescents. This study examines associations between pandemic-related stressors and STBs among a nationally representative sample of adolescents to identify vulnerable subpopulations. METHODS We analyzed data from 6769 high school students using the 2021 Adolescent Behaviors and Experiences Survey. Pandemic-related stressors were assessed via seven items related to negative experiences (e.g., parent job loss; food insecurity) during the COVID-19 pandemic. Logistic regression analyses estimated the association between pandemic-related stressors and four outcomes: (1) sadness/hopelessness; (2) suicidal ideation; (3) suicide planning; and (4) recent suicide attempt (i.e., past 12 months). Interactions were modeled by sex, race/ethnicity, and sexual identity. RESULTS A greater number of pandemic-related stressors was associated with higher odds for sadness and hopelessness (aOR: 1.55; 95% CI:1.44-1.67), suicidal ideation (aOR: 1.48; 95% CI:1.39-1.57), suicide planning (aOR:1.47; 95% CI: 1.36-1.59), and recent suicide attempt (aOR: 1.64; 95% CI:1.42-1.88). Pandemic-related stressors were also more strongly associated with some types of STBs in males (relative to females) and SGM females (relative to heterosexual females). CONCLUSION Study findings indicate that pandemic-related stressors are associated with STBs within the US adolescent population, particularly among male and SGM female adolescents. Researchers are encouraged to use this knowledge to ensure nationwide suicide prevention efforts adequately address inequities in suicide risk.
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Affiliation(s)
- Khandis Brewer
- TSET Health Promotion Research Center, Stephenson Cancer Center, the University of Oklahoma Health Science Centers, Oklahoma City, OK, USA
| | - Dale S Mantey
- Department of Health Promotion & Behavioral Sciences, the University of Texas Health Science Center, School of Public Health, Austin, TX, USA; Department of Epidemiology, Human Genetics, & Environmental Sciences, the University of Texas Health Science Center, School of Public Health, Austin, TX, USA; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, TX, USA
| | - Priya B Thomas
- Department of Epidemiology, Human Genetics, & Environmental Sciences, the University of Texas Health Science Center, School of Public Health, Austin, TX, USA
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, the University of Oklahoma Health Science Centers, Oklahoma City, OK, USA; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Amanda Y Kong
- TSET Health Promotion Research Center, Stephenson Cancer Center, the University of Oklahoma Health Science Centers, Oklahoma City, OK, USA; Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Adam C Alexander
- TSET Health Promotion Research Center, Stephenson Cancer Center, the University of Oklahoma Health Science Centers, Oklahoma City, OK, USA; Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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Vrouenraets LJJJ, de Vries ALC, Arnoldussen M, Hannema SE, Lindauer RJL, de Vries MC, Hein IM. Medical decision-making competence regarding puberty suppression: perceptions of transgender adolescents, their parents and clinicians. Eur Child Adolesc Psychiatry 2023; 32:2343-2361. [PMID: 36115898 PMCID: PMC10576681 DOI: 10.1007/s00787-022-02076-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 08/31/2022] [Indexed: 11/30/2022]
Abstract
According to international transgender care guidelines, transgender adolescents should have medical decision-making competence (MDC) to start puberty suppression (PS) and halt endogenous pubertal development. However, MDC is a debated concept in adolescent transgender care and little is known about the transgender adolescents', their parents', and clinicians' perspectives on this. Increasing our understanding of these perspectives can improve transgender adolescent care. A qualitative interview study with adolescents attending two Dutch gender identity clinics (eight transgender adolescents who proceeded to gender-affirming hormones after PS, and six adolescents who discontinued PS) and 12 of their parents, and focus groups with ten clinicians was conducted. From thematic analysis, three themes emerged regarding transgender adolescents' MDC to start PS: (1) challenges when assessing MDC, (2) aspects that are considered when assessing MDC, and (3) MDC's relevance. The four criteria one needs to fulfill to have MDC-understanding, appreciating, reasoning, communicating a choice-were all, to a greater or lesser extent, mentioned by most participants, just as MDC being relative to a specific decision and context. Interestingly, most adolescents, parents and clinicians find understanding and appreciating PS and its consequences important for MDC. Nevertheless, most state that the adolescents did not fully understand and appreciate PS and its consequences, but were nonetheless able to decide about PS. Parents' support of their child was considered essential in the decision-making process. Clinicians find MDC difficult to assess and put into practice in a uniform way. Dissemination of knowledge about MDC to start PS would help to adequately support adolescents, parents and clinicians in the decision-making process.
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Affiliation(s)
- Lieke Josephina Jeanne Johanna Vrouenraets
- Department of Medical Psychology, Willem Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands.
- Department of Medical Ethics and Health Law, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
| | - Annelou L C de Vries
- Department of Child and Adolescent Psychiatry, Emma Children's Hospital, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Marijn Arnoldussen
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Sabine E Hannema
- Department of Paediatric Endocrinology, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Ramón J L Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centers, Location AMC, University of Amsterdam and Levvel, Amsterdam, The Netherlands
| | - Martine C de Vries
- Department of Medical Ethics and Health Law, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
- Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Irma M Hein
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centers, Location AMC, University of Amsterdam and Levvel, Amsterdam, The Netherlands
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Lăzărescu G, Karner-Hutuleac A, Maftei A. Modern homophobia among heterosexual Romanian adults: the roles of sexual orientation beliefs, religiosity, perceived social roles, and social media use. Front Psychol 2023; 14:1219442. [PMID: 37809294 PMCID: PMC10556666 DOI: 10.3389/fpsyg.2023.1219442] [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: 05/09/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
The present study aimed to examine some potential predictors of homophobia against lesbians and gay individuals. Our sample comprised 722 heterosexual participants aged 18-74, mostly women (self-reported gender; 224 men and 498 women) with various educational backgrounds (i.e., High School, Bachelor's, and Master's degrees). Participants filled in self-reported scales measuring sexual orientation beliefs (incremental vs. entity views), religiosity, social media use, and perceived gender-transcendent social roles. Correlation analyses and multiple regression models were computed separately for men and women. For all participants, homophobia against lesbians (HAL) was negatively associated with participants' age, religiosity, and gender-transcendent social roles and positively with incremental views about sexuality. However, only in the case of women was HAL positively related to social media use. Next, for both men and women, homophobia against gay individuals (HAG) was negatively related to age, religiosity, and gender-transcendent social roles. However, only in the case of women, HAG was positively related to social media use online and incremental views about sexuality. In the case of men, the most significant predictor of HAL was the perceived gender-transcendent social roles and HAG - perceived gender-linked social roles. For women, perceived gender-linked social roles were the most significant predictor of both HAL and HAG. Results are discussed regarding their use for interventions aimed at reducing homophobia among heterosexual individuals.
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Agrawal KR, Bohn J, Mathre K, Buzzanell PM, O'Connell A, Salinas-Miranda A. Assessing Communicative Resilience in Suicide Prevention for LGBTQ+ Communities: A Qualitative Analysis of Community Conversations. Am J Health Promot 2023; 37:975-981. [PMID: 37466383 DOI: 10.1177/08901171231190598] [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: 07/20/2023]
Abstract
PURPOSE Since LGBTQ + communities experience disproportionate rates of suicidality; it is important to identify strategies for suicide prevention. Research shows that supportive interpersonal communication and identity affirmation helps prevent suicide. The purpose of this analysis is to explore the role of communicative resilience in suicide prevention among LGBTQ + communities. APPROACH This analysis is part of a community-based participatory research project. SETTING In November 2021, a Community-Academic Partnership hosted a virtual town hall, via Zoom, immediately followed by five Community Conversation (CC) groups. PARTICIPANTS Participants were aged 18 years or older and identified as an LGBTQ + community member or active ally. We define active ally as an individual who, through their personal relationships, service to the community, or professional work, actively advocates for and supports members of LGBTQ + communities. METHOD CC groups were audio-recorded and transcribed (n= 25 participants). Transcripts were inductively coded for thematic analysis and identified themes were deductively coded using Communication Theory of Resilience (CTR) to identify observations of communicative resilience (MaxQDA2020). RESULTS Themes aligned with CTR, including importance of peer and professional support, affirming identities, reducing stigma, cultivating hope, and advocating for equitable policies. CONCLUSION Findings demonstrate that through communication, members of LGBTQ + communities enact processes of resilience that support and promote suicide prevention. These findings support community mobilization, communicative resilience, and advocacy to help save lives.
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Affiliation(s)
- Kelli R Agrawal
- The Harrell Center, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Joe Bohn
- The Harrell Center, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Kristin Mathre
- Zero Suicide Partners of Pinellas, Suncoast Center, St. Petersburg, FL, USA
| | - Patrice M Buzzanell
- Department of Communication, College of Arts and Sciences, University of South Florida, Tampa, FL, USA
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White J, Borgia S, Rehkopf DH. Socioeconomic inequalities in the risk of suicide attempts among sexual minority adolescents: Findings from the UK's Millennium Cohort Study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 26:100570. [PMID: 36619211 PMCID: PMC9813783 DOI: 10.1016/j.lanepe.2022.100570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022]
Abstract
Background Both sexual minority and socioeconomically deprived young people are at an increased risk of making a suicide attempt. Intersectionality theory predicts these risk factors will interact synergistically to create unique vulnerabilities. We investigated the risk of suicide attempts in sexual minority socioeconomically deprived young people in a contemporary national cohort. Methods The Millennium Cohort Study (MCS) is a birth cohort study in the UK following children born 2000-2002. Children in the MCS have been followed up over seven sweeps to date at ages 9 months, 3, 5, 7, 11, 14 and 17 years. The relative risk (RR) of self-reported suicide attempts at 17 years by sexual minority status and parental unemployment was estimated using multivariable log-binomial regression. Additive interaction, representing the synergistic effect, was estimated using the relative excess risk due to interaction (RERI). Findings Between January, 2018 and March, 2019, 10,247 adolescents provided their sexuality and parents their employment status. 758 (7.4%) of 10,247 adolescents had made a suicide attempt. Relative to heterosexual young people living with no unemployed parents, the RR for sexual minorities living with no unemployed parents/carers was 2.93 (95% CI 2.26-3.79), one unemployed was 4.46 (95% CI 2.94-6.77), and two was 6.35 (95% CI 3.62-11.14). There was evidence of a positive additive interaction. The RERI for having one unemployed parent was 1.08 (95% CI -0.54 to 2.69) and two was 3.10 (95% CI -1.58 to 7.78). Sensitivity analyses using housing tenure and in a sample with no missing data generated comparable results. Interpretation To our knowledge, this is the first evidence that socioeconomically deprived sexual minority adolescents are uniquely vulnerable to making a suicide attempt. Health and educational practitioners need to be aware of the increased risk of suicide attempts in socioeconomically deprived sexual minority adolescents. Funding Economic and Social Research Council (ESRC).
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Affiliation(s)
- James White
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Sophie Borgia
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - David H. Rehkopf
- Department of Epidemiology and Population Health, Department of Medicine, Department of Sociology, Center for Population Health Sciences, Stanford University, Stanford, USA
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Preventing Youth Suicide: Potential "Crossover Effects" of Existing School-Based Programs. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:382-392. [PMID: 36484887 PMCID: PMC9734872 DOI: 10.1007/s11121-022-01473-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 12/13/2022]
Abstract
Notable increases in youth mental health problems combined with strains on the already stretched mental health workforce raise concerns that there will be an ensuing increase in youth suicide thoughts, behaviors, and even deaths. Schools are recognized as crucial settings for youth mental health support and suicide prevention activities, yet schools also face staff shortages and ever-increasing responsibilities for student well-being. Evidence is emerging that prevention programs originally designed to improve problem-solving skills and social-emotional functioning in youth have demonstrated downstream, "crossover effects," that is, unanticipated benefits, on youth suicidal behavior. Relatively little research on crossover effects has been conducted within school settings, despite the strong potential for commonly administered programs to have an impact on later suicide risk. We review key suicide risk factors and their proposed mechanisms of action; we also discuss factors that may protect against suicide risk. We then identify upstream prevention programs targeting the same factors and mechanisms; these programs may hold promise for downstream, crossover effects on youth suicide risk. This paper is intended to provide a framework to help researchers, practitioners, and policymakers as they consider how to prevent youth suicide using existing school-based resources. Rigorous investigation of upstream prevention programs is urgently needed to determine ideal approaches schools and communities can deploy to prevent youth suicide.
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Aivadyan C, Slavin MN, Wu E. Inclusive State Legislation and Reduced Risk of Past-Year Suicide Attempts Among Lesbian, Gay, Bisexual, and Questioning Adolescents in the United States. Arch Suicide Res 2023; 27:63-79. [PMID: 34427167 PMCID: PMC8866533 DOI: 10.1080/13811118.2021.1967237] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study examines the relationship between state legislation relevant to equality for sexual minorities and past-year suicide attempts among lesbian, gay, bisexual, and questioning (LGBQ) adolescents in the United States. METHODS Data were aggregated from 24 states that participated in the 2017 Youth Risk Behavior Surveillance System (N = 70,599). We utilized multilevel logistic regression to determine whether observed positive associations between sexual minority identity and past-year suicide attempts differ as a function of 2016 State Equality Index (SEI), an objective measure of state laws and policies affecting equality for sexual minorities. RESULTS LGBQ adolescents were significantly more likely to report having made a suicide attempt in the past year than heterosexual youth (adjusted odds ratio [AOR]: 3.82; 95% confidence interval [CI]: 3.29-4.44). The 2016 SEI moderated the positive association between sexual minority identity and suicide attempts, with odds of past-year suicide attempts significantly reduced in states with more inclusive legislation (AOR: 0.91; CI: 0.85-0.97). Among sexual minority subgroups, significant effect modifications were found for bisexual (AOR: 0.88; CI: 0.77-0.99) and questioning (AOR: 0.87; CI: 0.78-0.96) - but not gay or lesbian (AOR: 1.10; CI: 0.97-1.24) - adolescents. The effect modification was strongest for bisexual males (AOR: 0.68; CI: 0.47-0.99). CONCLUSIONS State legislation relevant to equality for sexual minorities differentially affected associations between sexual minority identity and suicide attempts, such that past-year suicide attempts were substantially lower in states with more inclusive legislation. Inclusive state legislation may exert a protective effect on risk for suicide attempts among sexual minority youth.
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Morrison J, Williams MO, Fox JRE. Negative childhood events and the development of the anorexic voice: A grounded theory. Psychol Psychother 2022; 95:1018-1035. [PMID: 35894418 PMCID: PMC9796900 DOI: 10.1111/papt.12416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/14/2022] [Accepted: 06/25/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Many individuals diagnosed with anorexia nervosa (AN) describe their disorder as being represented by an internal 'anorexic voice' (AV). Previous studies have identified associations between eating psychopathology and multifarious forms of adverse life experiences. AIMS This study explores the relationship between adverse experiences in childhood and the development of the AV. MATERIALS AND METHODS Twelve women who had the experience of the AV in the context of a diagnosis of AN took part in semi-structured interviews. The interview data were analysed using a constructivist grounded theory methodology. RESULTS Participants recalled feeling unsafe in a variety of relationships and a theory was constructed in which the AV provides a sense of conditional safety, becoming increasingly hostile and belittling when it is disobeyed, revealing similar characteristics to abusers and bullies in childhood. DISCUSSION Findings are related to the broader literature on the link between trauma and eating disorders, and to existing theories of internal voices. CONCLUSIONS The findings have implications for a trauma-focused approach when working with the AV.
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Tie B, Tang C, Ren Y, Cui S, He J. Internalized Homophobia, Body Dissatisfaction, Psychological Distress, and Nonsuicidal Self-Injury Among Young Sexual Minority Men in China. LGBT Health 2022; 9:555-563. [PMID: 35708638 DOI: 10.1089/lgbt.2022.0007] [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: 01/06/2023] Open
Abstract
Purpose: Sexual minority men (SMM) have been shown to be at high risk of nonsuicidal self-injury (NSSI). Internalized homophobia, body dissatisfaction, and psychological distress have been found to be related to NSSI among SMM, but few studies have focused on the mechanisms underlying these associations. Thus, the current study was conducted to examine the association between internalized homophobia and NSSI, and whether body dissatisfaction and psychological distress mediate this relationship among young SMM in China. Methods: In total, 264 young SMM (mean age, 22.00 ± 2.86 years) in Henan Province, China, participated in the study. A set of questionnaires were used to assess participants' internalized homophobia, body fat dissatisfaction, muscularity dissatisfaction, psychological distress, and NSSI. Correlation and mediation analyses were used to examine the data. Results: Internalized homophobia correlated positively with NSSI (r = 0.24, p < 0.001) among young SMM in China. This relationship was partly mediated by body fat dissatisfaction, muscularity dissatisfaction, and psychological distress. Conclusion: The study findings suggest that internalized homophobia is a risk factor for NSSI among young SMM in China, and that body fat and muscle dissatisfaction and psychological distress underlie the association between internalized homophobia and NSSI. In developing interventions targeting NSSI among SMM, the findings of the current study should be considered to improve intervention outcomes.
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Affiliation(s)
- Bijie Tie
- Department of Psychology, School of Education, Zhengzhou University, Zhengzhou, China
| | - Chanyuan Tang
- Department of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, China
| | - Yaoxiang Ren
- Department of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, China
| | - Shuqi Cui
- Department of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, China
| | - Jinbo He
- Department of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, China
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McGillivray L, Shand F, Calear AL, Batterham PJ, Chen NA, Rheinberger D, Rosebrock H, Torok M. Profiles of Passive and Active Suicidal Ideation and Attempts Among Secondary School Students in Australia: A Cross-Sectional Analysis. Arch Suicide Res 2022; 26:1880-1894. [PMID: 34223811 DOI: 10.1080/13811118.2021.1945983] [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] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Suicide is a leading cause of death among young people (aged 15-24 years), and as such, identifying targets for early intervention is essential to reducing this risk. Using baseline data from a school-based universal suicide prevention trial, we investigate factors associated with different types of suicidal ideation in secondary school students with implications for youth suicide preventive efforts. METHODS A self-report questionnaire was administered to students aged 13-16 years (Year 9) before program delivery in four regions across New South Wales, Australia (N = 556). Multinomial logistic regression was used to identify correlates of suicidal ideation type (passive vs. active). RESULTS Approximately half the total sample reported recent suicidal ideation (51.6% in the previous two weeks), which included almost one-third reporting active suicidal ideation (32.2% seriously considered suicide or made plans). Participants that were significantly more likely to report active suicidal ideation compared to passive suicidal ideation identified as female (OR = 1.91, 95% CI = 1.02-3.59), Indigenous (OR = 0.21, 95% CI = 0.05-0.80), as sexual minorities (OR = 0.36, 95% CI = 0.13-0.97), and had greater depression severity (OR = 1.11, 95% CI = 1.04-1.19). CONCLUSIONS Suicidal thoughts are prevalent among young people. Universal and indicated preventive interventions that address depression, as well as bullying and discrimination of minority groups would benefit all young people, particularly those more vulnerable to severe suicidal ideation and suicide attempts.HighlightsActive suicidal ideation (SI) was reported by 32.2% of our student sample aged 13-16 years.Active SI is linked to sex (female), Indigeneity status, sexual minority status, and greater depression severity.Improved bullying and discrimination policy within schools, and well-being programs targeting depression and promoting help-seeking, would benefit youth.
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Lin CY, Griffiths MD, Pakpour AH, Tsai CS, Yen CF. Relationships of familial sexual stigma and family support with internalized homonegativity among lesbian, gay and bisexual individuals: The mediating effect of self-identity disturbance and moderating effect of gender. BMC Public Health 2022; 22:1465. [PMID: 35915488 PMCID: PMC9344633 DOI: 10.1186/s12889-022-13815-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background The mediators of the association between familial attitudes toward sexual orientation and internalized homonegativity among lesbian, gay, and bisexual (LGB) individuals have not been well examined. Methods A cross-sectional survey study was carried out to examine the (i) associations of familial sexual stigma and family support with internalized homonegativity among young adult LGB individuals in Taiwan, and (ii) mediating effect of self-identity disturbance and the moderating effect of gender. Self-identified LGB individuals (N = 1000; 50% males and 50% females; mean age = 24.6 years) participated in the study. Familial sexual stigma, family support, self-identity disturbance, and internalized homonegativity were assessed. Structural equation modeling was used to examine relationships between the variables. Results The results indicated that familial sexual stigma was directly associated with increased internalized homonegativity, and indirectly associated with increased internalized homonegativity via the mediation of self-identity disturbance among LGB individuals. Family support was indirectly associated with decreased internalized homonegativity via the mediation of low self-identity disturbance. The direct association between family support and internalized homonegativity was only found among lesbian and bisexual women but not among gay and bisexual men. Conclusions Program interventions for familial sexual stigma, family support, and self-identity disturbance are warranted to help reduce internalized homonegativity among LGB individuals.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung and School of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 32 Dapi Rd. Niaosong Dist., Kaohsiung, 83341, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, and School of Medicine College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 80708, Taiwan. .,College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
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14
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Depa N, Desai S, Patel S, Silvi S, Hanif S, Rizvi S, Rahman F, Ortega G, Hsieh YC, Malik P, Pathrose RPM, Parikh T, Mansuri Z. Mental health disparities amongst sexual-minority adolescents of the US - A national survey study of YRBSS-CDC. Psychiatry Res 2022; 314:114635. [PMID: 35640323 DOI: 10.1016/j.psychres.2022.114635] [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: 07/02/2021] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We aimed to evaluate the prevalence and trend of identifying as a sexual minority among the American adolescent population. Additionally, we aimed to evaluate the prevalence and odds of substance abuse, hopelessness, and suicidality among the sexual minority adolescents compared to their heterosexual peers. METHODS We performed a retrospective cross-sectional study using Youth Risk Behavior Surveillance System (YRBSS) data from 2015 to 2019. YRBSS divides "Sexual identity" into three groups: heterosexuals, sexual minorities (gay or lesbian or bisexual), and unsure. We identified "hopelessness and suicidality" using the survey questions exploring if participants felt sad or hopeless for >2 weeks, considered suicide, made a suicide plan, and attempted suicide requiring medical care. Univariate and multivariable survey logistic regression analyses were performed to establish an association between hopelessness, suicidality, substance abuse, and identifying as a sexual minority. RESULTS Out of 41,377 adolescents, 4055 (9.8%) identified as a sexual minority. An increasing percentage of adolescents identified themselves as a sexual minority between 2015 to 2019 (8% to 11.2%) (pTrend<0.0001). The sexual minority had a higher prevalence of feeling sad and hopeless (63.4 vs. 28.6%), considering suicide (46 vs. 14.2%), planning suicide (38.9 vs. 11.5%), attempting suicide, and having injurious suicide attempts compared to heterosexuals. (p<0.0001) Amongst sexual minorities, the prevalence of substance abuse was higher compared to their heterosexual peers, which includes cigarettes (15 vs 7.8%), e-cigarette (27.2 vs 23.2%), inhalants (14.1 vs 5.3%), cocaine (8.4 vs 3.9%), marijuana (31.2 vs 20.2%), alcohol (36.9 vs 30.3%), steroids (6.4 vs 2.2%), heroin (4.4 vs 1.2%), and injectable drugs (4.0 vs 1.1%) (p<0.0001). In regression analysis, the sexual minority had higher odds of substance abuse, feeling sad and hopeless (aOR:4.6; 95%CI:4.0-5.2; p<0.0001), considering suicide (3.2; 2.8-3.7; p<0.0001), planning suicide (2.0; 1.7-2.3; p<0.0001) compared to heterosexual. CONCLUSION Sexual minorities not only have higher prevalence and odds of hopelessness and suicidality but also have higher prevalence and odds of substance abuse like cigarettes, marijuana, cocaine, heroin, inhalants, and steroids. Hence, early identification, risk stratification, and interventions to reduce mental health disparities are needed.
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Affiliation(s)
- Nishitha Depa
- St. George's University School of Medicine, St. George's, Grenada, West Indies
| | - Saral Desai
- Department of Psychiatry, Brookdale University Hospital Medical Center, Brooklyn, NY, United States.
| | - Shweta Patel
- Department, Government Medical College, Surat, Gujarat, India
| | - Suraiya Silvi
- Department of Psychiatry, Millwood Hospital, Arlington, TX, United States
| | - Sarah Hanif
- Department of Child and Adolescent Psychiatry, Tulane University School of Medicine, LA, United States
| | - Syeda Rizvi
- Department of Child and Adolescent Psychiatry, Bronx Care Health System, NY, United States
| | | | - Gizelle Ortega
- Centros de Integracion Juvenil A.C., Monterrey, Nuevo Leon, Mexico
| | - Ya-Ching Hsieh
- Department of Public Health, Icahn School of Medicine Mount Sinai, NY, United States
| | - Preeti Malik
- Department of Public Health, Icahn School of Medicine Mount Sinai, NY, United States
| | | | - Tapan Parikh
- Department of Psychiatry, Northwestern University Feinberg School of Medicine, IL, United States
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Brighton, MA, United States
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15
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Shattuck DG, Rasberry CN, Willging CE, Ramos MM. Positive Trends in School-Based Practices to Support LGBTQ Youth in the United States Between 2010 and 2018. J Adolesc Health 2022; 70:810-816. [PMID: 35165032 PMCID: PMC9038681 DOI: 10.1016/j.jadohealth.2021.11.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/25/2021] [Accepted: 11/23/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The present study tests the hypothesis that there has been a significant increase in the implementation of six LGBTQ-supportive school practices in US states between 2010 and 2018. METHODS Data were drawn from the publicly available School Health Profiles reports published by the Centers for Disease Control and Prevention, Division of Adolescent and School Health. We conducted unadjusted linear regression models separately for each practice to examine state-specific linear trends in the percentage of secondary schools reportedly engaging in six LGBTQ-supportive practices across all 50 states. In addition, we conducted an unadjusted linear regression on the trend to estimate changes in the median percentage of schools across all states engaging in each of the six practices through time. RESULTS In 2010, 5.7% of schools reported implementing all six practices, which increased to 15.3% in 2018. In the period from 2010 to 2018, the implementation of four of six key practices increased significantly in more than half of US states. Most states experienced a mix of either increases in practices or no change in practice prevalence, with no state experiencing a significant decrease. DISCUSSION There have been significant gains in the percentage of schools implementing LGBTQ-supportive practices. Yet, despite increases in the examined practices, the median percentage of schools in the United States that implement all six remains low. There is considerable room to improve on the use of these practices in schools across the United States, including increased attention to the quality of implementation and the barriers and facilitators to their instantiation.
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Affiliation(s)
- Daniel G Shattuck
- Pacific Institute for Research and Evaluation - Southwest Center, Albuquerque, New Mexico.
| | - Catherine N Rasberry
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia
| | - Cathleen E Willging
- Pacific Institute for Research and Evaluation - Southwest Center, Albuquerque, New Mexico
| | - Mary M Ramos
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
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Relationships of Homophobic Bullying Victimization during Childhood with Borderline Personality Disorder Symptoms in Early Adulthood among Gay and Bisexual Men: Mediating Effect of Depressive Symptoms and Moderating Effect of Family Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084789. [PMID: 35457655 PMCID: PMC9027503 DOI: 10.3390/ijerph19084789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023]
Abstract
This study investigated (1) the associations of homophobic bullying victimization in childhood with borderline personality disorder (BPD) symptoms in early adulthood among gay and bisexual men; (2) the mediating effect of depressive symptoms on the association between homophobic bullying victimization and BPD symptoms, and (3) the moderating effects of perceived family support on the association between homophobic bullying victimization and BPD symptoms. A total of 500 gay or bisexual men aged between 20 and 25 years were recruited into this study. The experiences of physical, verbal and social relationship bullying victimization during childhood were evaluated using the Mandarin Chinese version of the School Bullying Experience Questionnaire. The experiences of cyberbullying victimization during childhood were evaluated using the Cyberbullying Experiences Questionnaire. BPD symptoms were assessed using the Borderline Symptom List. Depressive symptoms were examined using the Center for Epidemiologic Studies Depression Scale. Perceived family support was evaluated using the Family Adaptation, Partnership, Growth, Affection, and Resolve index. The results of mediation analyses demonstrated that all the types of homophobic bullying victimization in childhood were directly associated with BDP symptoms in young adulthood as well as indirectly associated with BPD symptoms through the mediation of depressive symptoms. The results of moderation analyses demonstrated that the association between homophobic bullying victimization and BPD symptoms decreased when the individuals had more family support. Intervention programs to reduce homophobic bullying victimization and enhance family support for gay and bisexual men and their families are necessary. Interventions to improve depressive and BPD symptoms among gay and bisexual men are also necessary, especially for those who experienced homophobic bullying victimization during childhood.
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17
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Mendoza C, Poggi H, Flores M, Morales C, Martínez-Aguayo A. Quality of Life in Chilean Transgender Children and Adolescents. Horm Res Paediatr 2022; 94:333-342. [PMID: 34788756 DOI: 10.1159/000520606] [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] [Received: 05/09/2021] [Accepted: 11/01/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Transgender (TG) children and adolescents experience problems in school as well as with family and social relationships that can adversely affect their physical and psychosocial health and impair their quality of life (QoL). This study aimed to assess health-related quality of life (HRQoL) in TG children. METHODS We performed a cross-sectional study comparing HRQoL in gender non-conforming (Trans) and gender-conforming (CIS) children and adolescents using the Spanish version of KIDSCREEN-52 in 120 Chilean Trans and CIS children (aged 8-18 years) and their parents. All scores were standardized according to the KIDSCREEN manual. RESULTS Among the 100 questionnaires answered, 38 corresponded to children and adolescents aged 8.4-18 years. Twenty-one of them were TG (71% trans males) and 17 were CIS (76% females). Sixty-two parents answered the questionnaires: 33 from families of TG children (PTrans) and 29 from families of CIS children (PCis). Trans children had lower HRQoL scores in all domains than CIS children. The lowest-scoring domains for TG children were "Moods and Emotions," "Psychological Well-Being" and "Social Acceptance," and the highest-scoring domain was "School Environment." The PTrans group had significantly higher scores than the Trans group for 3 of the 10 domains: "Psychological Well-Being," "Moods and Emotions," and "Parent Relations and Home Life." CONCLUSION Our results revealed that TG children and adolescents have lower QoL than their CIS counterparts, especially regarding items related to mental health. Furthermore, their parents may underestimate their well-being, confirming the vulnerability of the TG population. This finding underlies the need to perform early assessments of QoL for early detection and intervention in aspects that could deteriorate their quality of life.
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Affiliation(s)
- Carolina Mendoza
- Paediatrics Division, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Helena Poggi
- Paediatrics Division, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Cristóbal Morales
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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18
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McGraw JS, Peer SO, McManimen S, Chinn J, Mahoney A. Comparison of Lifetime Suicide Attempts and Recent Suicidal/Self-Harming Thoughts Among Sexual Minority and Heterosexual Utahns: Results from a Population-Based Survey. Arch Suicide Res 2022; 26:961-967. [PMID: 32783705 DOI: 10.1080/13811118.2020.1806159] [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] [Indexed: 01/22/2023]
Abstract
OBJECTIVE We sought to be the first published article to report differences in population-representative prevalence of suicidal thoughts and attempts by sexual orientation. METHOD Data from Utah's Behavioral Risk Factor Surveillance System (BRFSS) collected for 2016 (N = 10,988) and 2017 (N = 10,251) were examined to determine differences in the prevalence of suicidal thoughts in the past 2 weeks and the lifetime prevalence of suicide attempts (i.e., any, single, and multiple) by sexual orientation. RESULTS 3.5% of heterosexuals Utahns reported recent suicidal/self-harming thoughts in the last 2 weeks compared to 14.7% of LGB Utahns (OR = 4.73 95% CI [2.67, 8.36]). 5.8% of heterosexuals reported a lifetime prevalence of any suicidal attempts compared to 37.2% of LGB folx (OR = 9.58 95% CI [7.16, 12.81]) with similar differences occurring for single and multiple attempts. Comparing LG versus B, there was no difference in ideation or prevalence of any attempt, but bisexuals reported higher rates of multiple suicide attempts. CONCLUSION LGB folx in Utah are drastically more likely to have thought about suicide/self-harming in the last 2 weeks and to have attempted suicide in their lifetime when compared to heterosexuals in Utah.
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19
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Kudinova A, Brick LA, Barthelemy C, MacPherson HA, Jenkins G, DeYoung L, Gilbert A, Radoeva P, Kim K, Armey M, Dickstein D. Sex and age moderate the trajectory of guilt among children and adolescents with and without recent suicidal ideation. Cogn Emot 2022; 36:512-526. [PMID: 35077324 PMCID: PMC9156530 DOI: 10.1080/02699931.2022.2029359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We aimed to examine whether the trajectories of ecologically derived guilt differ among a transdiagnostic sample of youth with and without recent suicidal ideation and whether sex and age moderated this association. We assessed guilt 3 times a day over a 2-week period via ecological momentary assessment (EMA) technology in 102 children recruited from the community, outpatient, and inpatient settings. The average age of children was 10.95 y.o. (SD = 2.26, range 8-16) and the majority were male (54.9%) and White (76.5%). We found that the real-world guilt during a two-week EMA period was higher among youth with greater suicidal ideation severity in the past six months. Moreover, there was a significant moderating effect of sex and age on this association, such that the association between suicidal ideation severity and guilt was particularly strong among females compared to males and youth who were 10 years old or older. The findings were maintained when we adjusted for the relevant demographic and clinical characteristics, including age, minority status, parental income, EMA response rate, and current internalising symptoms. These preliminary findings highlight the clinical relevance of assessing and targeting feelings of guilt in the day-to-day lives of youth, particularly for females and older youth.
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Affiliation(s)
- Anastacia Kudinova
- Bradley Hospital, Providence, RI, USA
- Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Leslie A. Brick
- Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Christine Barthelemy
- PediMIND Program at McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard University Medical School, Boston, MA, USA
| | | | - Gracie Jenkins
- PediMIND Program at McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard University Medical School, Boston, MA, USA
| | - Lena DeYoung
- PediMIND Program at McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard University Medical School, Boston, MA, USA
| | - Anna Gilbert
- Bradley Hospital, Providence, RI, USA
- Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Petya Radoeva
- Bradley Hospital, Providence, RI, USA
- Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Kerri Kim
- Bradley Hospital, Providence, RI, USA
- Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael Armey
- Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Daniel Dickstein
- PediMIND Program at McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard University Medical School, Boston, MA, USA
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20
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Jaspal R, Breakwell GM. Identity resilience, social support and internalised homonegativity in gay men. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2021.2016916] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Rusi Jaspal
- Vice-Chancellor’s Office, University of Brighton, Brighton, United Kingdom of Great Britain and Northern Ireland
| | - Glynis M Breakwell
- Department of Psychology, University of Bath, Bath, United Kingdom of Great Britain and Northern Ireland
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21
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Scheer JR, Clark KA, Talan A, Cabral C, Pachankis JE, Rendina HJ. Longitudinal associations between childhood sexual abuse-related PTSD symptoms and passive and active suicidal ideation among sexual minority men. CHILD ABUSE & NEGLECT 2021; 122:105353. [PMID: 34638046 PMCID: PMC8612966 DOI: 10.1016/j.chiabu.2021.105353] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Sexual minority men report high rates of childhood sexual abuse (CSA) and adulthood suicidality. However, mechanisms (e.g., PTSD symptoms) through which CSA might drive suicidality remain unknown. OBJECTIVE In a prospective cohort of sexual minority men, we examined: (1) associations between CSA and suicidal thoughts and behaviors; (2) prospective associations between CSA-related PTSD symptoms and suicidal ideation; and (3) interpersonal moderators of these associations. PARTICIPANTS AND SETTING Participants included 6305 sexual minority men (Mage = 33.2, SD = 11.5; 82.0% gay; 53.5% White) who completed baseline and one-year follow-up at-home online surveys. METHODS Bivariate analyses were used to assess baseline demographic and suicidality differences between CSA-exposed participants and non-CSA-exposed participants. Among CSA-exposed participants, multivariable logistic regression analyses were used to regress passive and active suicidal ideation at one-year follow-up on CSA-related PTSD symptoms at baseline. Interactions were examined between CSA-related PTSD symptoms and interpersonal difficulties. RESULTS CSA-exposed sexual minority men reported two-and-a-half times the odds of suicide attempt history compared to non-CSA-exposed men (95% CI = 2.15-2.88; p < 0.001). Among CSA-exposed sexual minority men, CSA-related PTSD symptoms were prospectively associated with passive suicidal ideation (adjusted odds ratio [aOR] = 1.38; 95% CI = 1.19; 1.61). Regardless of CSA-related PTSD symptom severity, those with lower social support and greater loneliness were at elevated risk of active suicidal ideation at one-year follow-up. CONCLUSIONS CSA-related PTSD symptom severity represents a psychological mechanism contributing to CSA-exposed sexual minority men's elevated suicide risk, particularly among those who lack social support and report loneliness.
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Affiliation(s)
- Jillian R Scheer
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse NY 13244, USA.
| | - Kirsty A Clark
- Department of Medicine, Health & Society, Vanderbilt University, Nashville, TN 37212, USA
| | - Ali Talan
- Whitman-Walker Institute, Inc., Washington, DC 20009, USA
| | - Cynthia Cabral
- Counseling and Wellness Center, St. Joseph's College, Brooklyn, NY 11205, USA
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, USA
| | - H Jonathon Rendina
- Whitman-Walker Institute, Inc., Washington, DC 20009, USA; Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
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22
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Protective Factors for LGBTI+ Youth Wellbeing: A Scoping Review Underpinned by Recognition Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111682. [PMID: 34770199 PMCID: PMC8583439 DOI: 10.3390/ijerph182111682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022]
Abstract
Considerable research has been undertaken regarding the mental health inequalities experienced by lesbian, gay, bisexual, transgender and intersex (LGBTI+) youth as a consequence of societal and individual prejudice, stigma and discrimination. Far less research has focussed on protective factors that promote wellbeing for this population. A scoping review was conducted using a six-stage methodological framework, and is reported in accordance with the PRISMA-ScR statement. This explored the extent, range and nature of the peer-reviewed, published, academic literature on what is known about the protective factors that promote LGBTI+ youth wellbeing. Six databases were systematically searched applying Population–Concept–Context key inclusion criteria, complemented by contact with authors to identify additional sources, reference checks and hand searches. Ninety-six individual research records were identified and analysed, drawing from Honneth’s Recognition Theory. Interpersonal relations with parents (n = 40), peers (n = 32) and providers (n = 22) were associated with indicators of enhanced wellbeing, as were LGBTI+ community relations (n = 32). Importantly, online (n = 10), faith (n = 10) and cultural (n = 5) communities were potentially protective. Content and thematic analysis highlighted the importance of Gay–Straight Alliances (GSAs) (n = 23) offering powerful protective opportunities through intersecting interpersonal, community and legal forms of recognition. GSAs enhance allyship by peers and providers (n = 21), facilitate access to LGBTI+ community networks (n = 11) and co-exist alongside inclusive policies (n = 12), curricular (n = 5) and extracurricular activities (n = 1). This scoping review underscores the need to move beyond the predominant focus on risk factors for LGBTI+ youth, which subsequently inform protectionist approaches. It concludes with an appeal to develop mechanisms to apply recognitive justice to policy, practice and, importantly, future research directions. This emphasises the salience of enhanced understandings of inclusion, which is rights-based, universally available and of potential benefit to all.
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23
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Scoggins D, Khan AS, Dai H. Hierarchical Analysis of Disparities in Suicidal Outcomes With Intersection of Sexual Minority and Gender Among U.S. Youth, 2017. HEALTH EDUCATION & BEHAVIOR 2021; 49:569-583. [PMID: 34628973 DOI: 10.1177/10901981211045933] [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: 11/16/2022]
Abstract
Sexual minority youth have a higher risk of suicidal behaviors than their straight peers. Despite this alarming trend, there is limited information on how health-risk factors are systematically associated with suicidal outcomes in relation to the intersection of sex and sexual orientation identity. Data from the 2017 Youth Risk Behavior Survey (Grades 9-12, N = 14,108) were analyzed to examine three distinct suicidal outcomes (i.e., suicidal ideation, suicide planning, and suicide attempt). Separate hierarchical logistic regression models were performed to gradually adjust for influencing factors in examining the association between suicidal outcomes and sexual orientation identity (i.e., heterosexual, gay/lesbian, bisexual, and unsure), stratified by self-reported sex. There exist significant differences in youth suicidal behaviors based on sexual orientation identity and sex: lesbians (adjusted odds ratio [AOR] = 2.7, 95% CI [1.5, 5.0]), bisexual girls (AOR = 1.9, 95% CI [1.3, 2.6]) and bisexual boys (AOR = 2.6, 95% CI [1.3, 5.2]) had higher odds of suicide attempts than their straight peers. Unsure boys and girls also reported higher risks of suicidal ideation and suicide plan as compared with their straight peers. Having a very short sleep duration, reporting ever use of illicit drugs, being bullied, and feeling sad/hopeless were associated with elevated risks of suicidality across males and females. This study identified potential disparities in suicidal outcomes by sexual orientation identity as well as factors that attenuate or strengthen this relationship in a representative sample of adolescents across the United States. An improved understanding of the differences in suicidal outcomes will serve as an opportunity to ameliorate any potential inequalities and improve sexual minority youth' health outcomes.
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Affiliation(s)
| | - Ali S Khan
- University of Nebraska Medical Center, Omaha, NE, USA
| | - Hongying Dai
- University of Nebraska Medical Center, Omaha, NE, USA
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24
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Luk JW, Goldstein RB, Yu J, Haynie DL, Gilman SE. Sexual Minority Status and Age of Onset of Adolescent Suicide Ideation and Behavior. Pediatrics 2021; 148:e2020034900. [PMID: 34580171 PMCID: PMC9446478 DOI: 10.1542/peds.2020-034900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine if sexual minority adolescents have earlier onset of suicidality and faster progressions from ideation to plan and attempt than heterosexual adolescents. METHODS A population-based longitudinal cohort of 1771 adolescents participated in the NEXT Generation Health Study. Participants reported sexual minority status (defined by sexual attraction) in 2010-2011 and retrospectively reported age at onset of suicidality in 2015-2016. RESULTS Sexual minority adolescents (5.8% of weighted sample) had higher lifetime risk of suicide ideation (26.1% vs 13.0%), plan (16.6% vs 5.4%), and attempt (12.0% vs 5.4%) than heterosexual adolescents. Survival analyses adjusted for demographic characteristics and depressive symptoms revealed positive associations of sexual minority status with time to first onset of suicide ideation (hazard ratio [HR] = 1.77; 95% confidence interval [CI] 1.03-3.06) and plan (HR = 2.69; 95% CI 1.30-5.56). The association between sexual minority status and age at onset of suicide attempt was stronger at age <15 (HR = 3.26; 95% CI 1.25-8.47) than age ≥15 (HR = 0.59; 95% CI 0.21-1.66). The association between sexual minority status and progression from ideation to plan was stronger in the same year of first ideation (HR = 2.01; 95% CI 1.07-3.77) than ≥1 year after first ideation (HR = 1.33; 95% CI 0.26-6.77). CONCLUSIONS Sexual minority adolescents had earlier onset of suicidality and faster progression from suicide ideation to plan than heterosexual adolescents. The assessment of sexual minority status in routine pediatric care has the potential to inform suicide risk screening, management, and intervention efforts among early sexual minority adolescents.
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Affiliation(s)
- Jeremy W Luk
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
| | - Risë B Goldstein
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Jing Yu
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Denise L Haynie
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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25
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Goldbach JT, Schrager SM, Mamey MR, Rhoades H. Confirming the Reliability and Validity of the Sexual Minority Adolescent Stress Inventory in a National Sample of Sexual Minority Adolescents. Front Psychol 2021; 12:720199. [PMID: 34531800 PMCID: PMC8438190 DOI: 10.3389/fpsyg.2021.720199] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Sexual minority adolescents (SMA) experience numerous behavioral health disparities, including depression, anxiety, substance use, non-suicidal self-injury, and suicidality. The primary framework to understand these disparities is minority stress theory, which frames this disproportionate burden as the result of discrimination, violence, and victimization in a homophobic culture. Empirical examinations of minority stress among SMA have been limited by lack of diverse samples or validated measures. This study engaged a national community sample of SMA to confirm reliability and validity of the Sexual Minority Adolescent Stress Inventory (SMASI). Method: A national sample of 2,310 SMA aged 14-17 was recruited in the United States through a hybrid social media and respondent-driven sampling approach. Item response theory and confirmatory factor analysis established the psychometric properties of the SMASI in this sample; minority stress was modeled as a latent variable in several regression models to verify criterion and divergent validity. Results: In this national sample (M age = 15.9; 64% female and 60% White), the factor structure of the SMASI and its 11 subscales was confirmed and shown to be invariant by demographic characteristics. Minority stress as measured by the SMASI was significantly associated with all mental and behavioral health outcomes. Conclusions: This study provides evidence that SMASI is a reliable, valid, and important tool for better understanding minority stress and subsequent health and mental health consequences among SMA.
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Affiliation(s)
- Jeremy T. Goldbach
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Sheree M. Schrager
- Department of Graduate Studies and Research, California State University, Dominguez Hills, Carson, CA, United States
| | - Mary Rose Mamey
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Harmony Rhoades
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
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Abstract
Homophobia is still a scourge in the modern era. Despite a greater acceptance of sexual variations and same-sex marriage in many countries, homophobia is widely sustained by religious, political and cultural values and beliefs at individual and social level. Most of homophobic attitudes are based on the principle of heteronormativity according to which heterosexuality is the standard for legitimating social and sexual relationships and homosexuality is considered as an abnormal variant. Homophobia may be also recognised at institutional level (state-sponsored homophobia, social homophobia) and supported by laws or religious beliefs. Moreover, internalised homophobia (IH) is defined as the inward direction of societal homophobic behaviours at individual level and refers to the subjective psychological impact of these negative attitudes. In fact, IH is significantly associated with a high prevalence of internalising mental disorders such as depression, anxiety, stress/trauma-related disorders, etc. We believe that a set of immediate actions are needed in order to contrast homophobia and its impact on mental health, in particular political initiatives, educational trainings and scientific research should be promoted with a specific focus on mental health needs of people target of homophobia.
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Kennedy A, Genç M, Owen PD. The Association Between Same-Sex Marriage Legalization and Youth Deaths by Suicide: A Multimethod Counterfactual Analysis. J Adolesc Health 2021; 68:1176-1182. [PMID: 33812751 DOI: 10.1016/j.jadohealth.2021.01.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 01/07/2021] [Accepted: 01/31/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To estimate the association between same-sex marriage legalization and deaths by suicide among youth. METHODS The study used country-level suicide data sourced from the Global Burden of Disease Study for all 36 Organisation for Economic Co-operation and Development countries for the period 1991-2017. We analyzed the suicide rates of all youth, male youth, and female youth aged 10-24 years using multiple policy-evaluation methods-difference-in-differences, matrix completion, and generalized synthetic control via expectation-maximization-to estimate the impact of same-sex marriage legalization at the country level. Secondary analysis considered several covariate specifications, evaluated the immediacy and persistence of the estimated associations, and assessed whether any observed association was limited to early adopters of same-sex marriage. RESULTS The state-of-the-art matrix completion analysis indicated that same-sex marriage legalization was associated with a decline in the youth suicide rate of 1.191 deaths per 100,000 individuals (95% CI = -1.66, -.64; p < .001), corresponding to a reduction of 17.90% compared to the youth suicide rate at the time of legalization. This decline was most pronounced in males for whom the suicide rate fell by 1.993 (CI = -2.76, -1.12; p < .001) compared to a decrease of .348 for female youth (CI = -.60, -.06; p = .02), corresponding to decreases of 19.98% and 10.90%, respectively. These associations persisted after legalization, but to differing degrees depending on model specification. CONCLUSIONS Developed countries that are yet to legalize same-sex marriage have an opportunity to put downward pressure on youth suicide.
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Affiliation(s)
- Andrew Kennedy
- Department of Economics, University of Otago, Dunedin, New Zealand
| | - Murat Genç
- Department of Economics, University of Otago, Dunedin, New Zealand
| | - P Dorian Owen
- Department of Economics, University of Otago, Dunedin, New Zealand.
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28
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Inderbinen M, Schaefer K, Schneeberger A, Gaab J, Garcia Nuñez D. Relationship of Internalized Transnegativity and Protective Factors With Depression, Anxiety, Non-suicidal Self-Injury and Suicidal Tendency in Trans Populations: A Systematic Review. Front Psychiatry 2021; 12:636513. [PMID: 34093262 PMCID: PMC8172993 DOI: 10.3389/fpsyt.2021.636513] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/08/2021] [Indexed: 11/24/2022] Open
Abstract
Discrimination heavily impacts the lives of trans populations and causes adverse mental health outcomes. As stated by the Gender Minority Stress Model self-stigmatization could play an important role in this process. The aim of this systematic review is to investigate whether there is a positive association between self-stigmatization and mental health and to identify mediation factors. Studies which quantitatively investigated the association between internalized transnegativity and selected mental health outcomes (depression, anxiety, non-suicidal self-injury, suicidal tendency) in self-identified trans populations were included. Comprehensive search of 5 large databases in June 2020 and the following screening and selection procedure, performed by two researchers separately, identified 14 studies which met criteria. The relationship to be studied was reported with correlation and/or mediation analysis of cross-sectional data. IT was directly positively associated with depression, anxiety and suicidal tendency in most of the reviewed studies. Data indicates links between self-stigmatization and other general mental health stressors such as rumination and thwarted belongingness. Community connectedness showed to be the strongest protective factor for mental health impairments. These results should be considered in transition counseling. More research is needed to better understand the underlying mechanisms of the GMSM and to address unsolved operationalization and measurement issues.
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Affiliation(s)
- Marc Inderbinen
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Kristin Schaefer
- Department of Plastic, Reconstructive and Aesthetic Surgery and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | | | - Jens Gaab
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - David Garcia Nuñez
- Center for Gender Variance, Basel University Hospital, University of Basel, Basel, Switzerland
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29
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Ancheta AJ, Bruzzese JM, Hughes TL. The Impact of Positive School Climate on Suicidality and Mental Health Among LGBTQ Adolescents: A Systematic Review. J Sch Nurs 2021; 37:75-86. [PMID: 33287652 PMCID: PMC8142116 DOI: 10.1177/1059840520970847] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) adolescents are more likely to report suicidality and worse mental health than their heterosexual peers. We conducted a systematic review to examine the relationship between positive school climate and suicidality and mental health among LGBTQ adolescents. We searched the literature using PubMed, PsycINFO, and CINAHL. Six studies met inclusion criteria, and all had low to moderate risks of bias. Results indicate that LGBTQ students in schools with more positive school climates were at lower risk of suicidality and reported fewer depressive symptoms compared to students in less positive school climates. Being at the forefront of health in schools, school nurses have the opportunity to advocate for changes in school environments that promote positive mental health for all youth, including LGBTQ adolescents.
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Affiliation(s)
- April J. Ancheta
- Program for the Study of LGBT Health, Columbia University School of Nursing, New York, NY, USA
| | | | - Tonda L. Hughes
- Program for the Study of LGBT Health, Columbia University School of Nursing, New York, NY, USA
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30
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Finlay-Jones A, Strauss P, Perry Y, Waters Z, Gilbey D, Windred MA, Murdoch A, Pugh C, Ohan JL, Lin A. Group mindful self-compassion training to improve mental health outcomes for LGBTQIA+ young adults: Rationale and protocol for a randomised controlled trial. Contemp Clin Trials 2021; 102:106268. [PMID: 33421648 DOI: 10.1016/j.cct.2021.106268] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/10/2020] [Accepted: 01/01/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Young adults who are lesbian, gay, bisexual, trans, queer or questioning, intersex, asexual and other diverse genders and sexualities (LGBTQIA+) are more likely to experience mental health difficulties and are at significantly elevated risk of substance abuse, self-harm and suicide, relative to their heterosexual, endosex and cisgender peers. There is a need for effective mental health interventions for LGBTQIA+ young adults. Mindful Self-Compassion training is a promising approach; among LGBTQIA+ individuals, self-compassion accounts for more variation in mental health outcomes than bullying, victimization, and adverse childhood experiences combined. Furthermore, LGBTQIA+ individuals with high self-compassion report more positive identity and happiness, less self-stigma, and lower suicidality than those with low self-compassion. METHOD This paper outlines the rationale and protocol for a single-blind CONSORT-compliant randomised controlled trial, comparing group Mindful Self-Compassion to a delayed-treatment waitlist control group, for improving mental health, decreasing self-criticism and increasing self-compassion in LGBTQIA+ young adults (age 18-25 years). Mindful Self-Compassion training is an 8-week group program that focuses on cultivating self-compassion and mindfulness. While typically delivered as a face-to-face program, the proposed trial will investigate efficacy of the program when provided via videoconferencing. DISCUSSION Videoconference Mindful Self-Compassion training has the potential to improve the mental health of Australian LGBTQIA+ young adults and provide a possible cost-effective, scalable intervention for this population. The proposed trial will be the first to determine its efficacy for LGBTQIA+ young adults and will provide the first data on the delivery of the program via videoconferencing.
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Affiliation(s)
- Amy Finlay-Jones
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia; School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
| | - Penelope Strauss
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia; School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
| | - Yael Perry
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia.
| | - Zoe Waters
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia; School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
| | - Dylan Gilbey
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia; School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
| | - Meg-An Windred
- Minus18, 81 Rupert St, Collingwood, VIC 3066, Australia.
| | - Adrian Murdoch
- Minus18, 81 Rupert St, Collingwood, VIC 3066, Australia.
| | - Charlotte Pugh
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia.
| | - Jeneva L Ohan
- School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
| | - Ashleigh Lin
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia; School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
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31
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Nydegger LA, Blanco L, Marti CN, Kreitzberg D, Quinn K. Evaluation of sexual minority identity as a moderator of the association between intimate partner violence and suicidal ideation and attempts among a national sample of youth. PLoS One 2020; 15:e0236880. [PMID: 32764776 PMCID: PMC7413515 DOI: 10.1371/journal.pone.0236880] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/15/2020] [Indexed: 12/28/2022] Open
Abstract
Sexual minority (SM) youth are at high risk for intimate partner violence (IPV) and suicidal ideation/attempts compared to their heterosexual peers. We examined whether SM identity enhanced the relationship between experiences of IPV and suicidal ideation/attempts. Weighted logistic regression models were run using the 2017 Youth Risk Behavior Survey. All main effects were significant; each SM identity and both physical and sexual IPV were significantly associated with suicidal ideation and suicide attempts. The interaction between bisexual identity and physical IPV was significant for suicidal ideation; as physical IPV experiences increased, the difference between bisexual identity and heterosexual youth was non-significant. Findings suggest exploring trauma and suicidal ideation by aggregate groups and increasing support for SM youth in schools and communities.
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Affiliation(s)
- Liesl A. Nydegger
- Health Behavior and Health Education, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States of America
| | - Lyzette Blanco
- Edith Neumann School of Health and Human Services, Department of Health Science, Touro University Worldwide, Los Alamitos, CA, United States of America
| | - C. Nathan Marti
- Abacist Analytics, LLC, Austin, TX, United States of America
| | - Daniel Kreitzberg
- Health Behavior and Health Education, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States of America
| | - Katherine Quinn
- Center for AIDS Intervention Research, Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI, United States of America
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32
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Quarshie ENB, Waterman MG, House AO. Prevalence of self-harm among lesbian, gay, bisexual, and transgender adolescents: a comparison of personal and social adversity with a heterosexual sample in Ghana. BMC Res Notes 2020; 13:271. [PMID: 32493429 PMCID: PMC7271418 DOI: 10.1186/s13104-020-05111-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/25/2020] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES We sought to estimate the prevalence of self-reported self-harm among adolescents identifying as lesbian, gay, bisexual, and transgender (LGBT) in Ghana, and compare self-reported personal and social adversities related to self-harm in this group to those in a random sample of heterosexual adolescents from the same locality. RESULTS A total of 444 adolescents aged 13-21 years, comprising 74 LGBT adolescents and 370 heterosexual adolescents, provided data. The lifetime prevalence estimate of self-harm was higher in the LGBT group (47%) than the heterosexual group (23%). The LGBT group reported a higher rate of self-harm during the previous 12 months (45%), compared to the heterosexual group (18%). LGBT adolescents reported more alcohol and substance use and more personal social adversities, including various forms of victimisation, than heterosexual adolescents. They were no more likely to report difficulty in making and keeping friends or schoolwork problems than were heterosexual adolescents.
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Affiliation(s)
| | | | - Allan O House
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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33
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Wiepjes CM, den Heijer M, Bremmer MA, Nota NM, de Blok CJM, Coumou BJG, Steensma TD. Trends in suicide death risk in transgender people: results from the Amsterdam Cohort of Gender Dysphoria study (1972-2017). Acta Psychiatr Scand 2020; 141:486-491. [PMID: 32072611 PMCID: PMC7317390 DOI: 10.1111/acps.13164] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/31/2020] [Accepted: 02/16/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study explored the overall suicide death rate, the incidence over time, and the stage in transition where suicide deaths were observed in transgender people. METHODS A chart study, including all 8263 referrals to our clinic since 1972. Information on death occurrence, time, and cause of death was obtained from multiple sources. RESULTS Out of 5107 trans women (median age at first visit 28 years, median follow-up time 10 years) and 3156 trans men (median age at first visit 20 years, median follow-up time 5 years), 41 trans women and 8 trans men died by suicide. In trans women, suicide deaths decreased over time, while it did not change in trans men. Of all suicide deaths, 14 people were no longer in treatment, 35 were in treatment in the previous two years. The mean number of suicides in the years 2013-2017 was higher in the trans population compared with the Dutch population. CONCLUSIONS We observed no increase in suicide death risk over time and even a decrease in suicide death risk in trans women. However, the suicide risk in transgender people is higher than in the general population and seems to occur during every stage of transitioning. It is important to have specific attention for suicide risk in the counseling of this population and in providing suicide prevention programs.
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Affiliation(s)
- C. M. Wiepjes
- Department of EndocrinologyAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands,Center of Expertise on Gender DysphoriaAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
| | - M. den Heijer
- Department of EndocrinologyAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands,Center of Expertise on Gender DysphoriaAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
| | - M. A. Bremmer
- Center of Expertise on Gender DysphoriaAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands,Department of PsychiatryAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
| | - N. M. Nota
- Department of EndocrinologyAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands,Center of Expertise on Gender DysphoriaAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
| | - C. J. M. de Blok
- Department of EndocrinologyAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands,Center of Expertise on Gender DysphoriaAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
| | - B. J. G. Coumou
- Center of Expertise on Gender DysphoriaAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands,Department of Medical PsychologyAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
| | - T. D. Steensma
- Center of Expertise on Gender DysphoriaAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands,Department of Medical PsychologyAmsterdam UMCVU University Medical CenterAmsterdamthe Netherlands
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34
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Clark H, Coll-Seck AM, Banerjee A, Peterson S, Dalglish SL, Ameratunga S, Balabanova D, Bhan MK, Bhutta ZA, Borrazzo J, Claeson M, Doherty T, El-Jardali F, George AS, Gichaga A, Gram L, Hipgrave DB, Kwamie A, Meng Q, Mercer R, Narain S, Nsungwa-Sabiiti J, Olumide AO, Osrin D, Powell-Jackson T, Rasanathan K, Rasul I, Reid P, Requejo J, Rohde SS, Rollins N, Romedenne M, Singh Sachdev H, Saleh R, Shawar YR, Shiffman J, Simon J, Sly PD, Stenberg K, Tomlinson M, Ved RR, Costello A. A future for the world's children? A WHO-UNICEF-Lancet Commission. Lancet 2020; 395:605-658. [PMID: 32085821 DOI: 10.1016/s0140-6736(19)32540-1] [Citation(s) in RCA: 391] [Impact Index Per Article: 97.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/10/2019] [Accepted: 09/19/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Helen Clark
- The Helen Clark Foundation, Auckland, New Zealand; Partnership for Maternal Newborn & Child Health, Geneva, Switzerland
| | | | - Anshu Banerjee
- Department of Maternal Newborn Child and Adolescent Health, Geneva, Switzerland
| | - Stefan Peterson
- UNICEF Headquarters, Programme Division, Health Section, New York, USA
| | - Sarah L Dalglish
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Shanthi Ameratunga
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Dina Balabanova
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, OT, Canada; Center of Excellence in Women and Child Health, the Aga Khan University, Karachi, Pakistan
| | - John Borrazzo
- Global Financing Facility, World Bank, Washington, DC, USA
| | - Mariam Claeson
- Global Financing Facility, World Bank, Washington, DC, USA
| | - Tanya Doherty
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Fadi El-Jardali
- Department of Health Management and Policy, Beirut, Lebanon; Knowledge to Policy Center American University of Beirut, Beirut, Lebanon
| | - Asha S George
- School of Public Health, University of Western Cape, Bellville, South Africa
| | | | - Lu Gram
- Institute for Global Health, London, UK
| | - David B Hipgrave
- UNICEF Headquarters, Programme Division, Health Section, New York, USA
| | - Aku Kwamie
- Health Policy and Systems Research Consultant, Accra, Ghana
| | - Qingyue Meng
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Raúl Mercer
- Program of Social Sciences and Health, Latin American School of Social Sciences, Buenos Aires, Argentina
| | - Sunita Narain
- Centre for Science and Environment, New Delhi, India
| | | | | | | | - Timothy Powell-Jackson
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Papaarangi Reid
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jennifer Requejo
- Division of Data, Analysis, Planning and Monitoring, Data and Analytics Section, New York, USA
| | - Sarah S Rohde
- Center of Excellence in Women and Child Health, the Aga Khan University, Karachi, Pakistan
| | - Nigel Rollins
- Department of Maternal Newborn Child and Adolescent Health, Geneva, Switzerland
| | | | - Harshpal Singh Sachdev
- Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Rana Saleh
- Knowledge to Policy Center American University of Beirut, Beirut, Lebanon
| | - Yusra R Shawar
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Jeremy Shiffman
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Jonathon Simon
- Department of Maternal Newborn Child and Adolescent Health, Geneva, Switzerland
| | - Peter D Sly
- Children's Health and Environment Program, The University of Queensland, Brisbane, QLD, Australia
| | - Karin Stenberg
- Department of Health Systems Governance and Financing, WHO, Geneva, Switzerland
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Rajani R Ved
- National Health Systems Resource Centre, New Delhi, India
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