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Weststrate NM, McLean KC, Fivush R. Intergenerational Storytelling and Positive Psychosocial Development: Stories as Developmental Resources for Marginalized Groups. PERSONALITY AND SOCIAL PSYCHOLOGY REVIEW 2024:10888683241259902. [PMID: 39068536 DOI: 10.1177/10888683241259902] [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: 07/30/2024]
Abstract
ACADEMIC ABSTRACT We articulate an intergenerational model of positive psychosocial development that centers storytelling in an ecological framework and is motivated by an orientation toward social justice. We bring together diverse literature (e.g., racial-ethnic socialization, family storytelling, narrative psychology) to argue that the intergenerational transmission of stories about one's group is equally important for elders and youth, and especially important for groups who are marginalized, because stories provide a developmental resource for resistance and resilience in the face of injustice. We describe how storytelling activities can support positive psychosocial development in culturally dynamic contexts and illustrate our model with a case study involving LGBTQ+ communities, arguing that intergenerational storytelling is uniquely important for this group given issues of access to stories. We argue that harnessing the power of intergenerational storytelling could provide a culturally safe and sustaining practice for fostering psychosocial development among LGBTQ+ people and other equity-seeking populations. PUBLIC ABSTRACT Understanding one's identity as part of a group with shared history and culture that has existed through time is important for positive psychological functioning. This is especially true for marginalized communities for whom identity-relevant knowledge is often erased, silenced, or distorted in mainstream public discourses (e.g., school curricula, news media, television, and film). To compensate for these limitations around access, one channel for the transmission of this knowledge is through oral storytelling between generations of elders and youth. Contemporary psychological science has often assumed that such storytelling occurs within families, but when families cannot or would not share such knowledge, youth suffer. We present a model of intergenerational storytelling that expands our ideas around who counts as "family" and how knowledge can be transmitted through alternative channels, using LGBTQ+ communities as a case example.
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Harvey TD, Watson RJ, Clark KA. Arrest History and Health Among U.S. Sexual and Gender Minority Youth, 2022. Am J Prev Med 2024:S0749-3797(24)00194-6. [PMID: 38878985 DOI: 10.1016/j.amepre.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 06/06/2024] [Accepted: 06/07/2024] [Indexed: 07/07/2024]
Abstract
INTRODUCTION Sexual and gender minority youth, who experience high mental and behavioral health needs, are overrepresented in the criminal legal system, which may exacerbate these needs. This study examined the associations between arrest history and mental and behavioral health among sexual and gender minority youth. METHODS Using cross-sectional survey data from the 2022 LGBTQ+ National Teen Survey, this study created a case-control sample of 287 sexual and gender minority youth with an arrest history and 1,148 propensity-matched sexual and gender minority youth without an arrest history. Associations between arrest history and sexual and gender minority developmental milestones, minority stressors, and mental and behavioral health outcomes were examined. Statistical analyses were conducted between 2022 and 2024. RESULTS Arrest history was significantly associated with several sexual and gender minority developmental milestones (e.g., earlier age of identity realization and disclosure) and minority stressors (e.g., greater bullying and parental rejection). Sexual and gender minority youth with an arrest history had poorer mental and behavioral health, including greater sleep disturbance (AOR=1.46; 95% CI=1.08, 2.00) and positive screenings for depression (AOR=1.60; 95% CI=1.20, 2.14), anxiety (AOR=1.35; 95% CI=1.01, 1.82), and risk for substance use disorder development (AOR=5.81; 95% CI=4.26, 7.94). CONCLUSIONS Arrest history is associated with the mental and behavioral health of sexual and gender minority youth, highlighting systemic inequities. Tailored public health interventions are needed to reduce criminal-legal contact in this population.
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Affiliation(s)
- Tyler D Harvey
- MD-PhD Program, Yale School of Medicine, New Haven, Connecticut.
| | - Ryan J Watson
- Department of Human Development and Family Sciences, College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut
| | - Kirsty A Clark
- Program in Public Policy Studies, Department of Medicine, Health, and Society, College of Arts and Sciences, Vanderbilt University, Nashville, Tennessee; Vanderbilt LGBTQ+ Policy Lab, Vanderbilt University, Nashville, Tennessee
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Juster RP, Rutherford C, Keyes K, Hatzenbuehler ML. Associations Between Structural Stigma and Allostatic Load Among Sexual Minorities: Results From a Population-Based Study. Psychosom Med 2024; 86:157-168. [PMID: 38345315 DOI: 10.1097/psy.0000000000001289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
OBJECTIVE Structural forms of stigma and discrimination are associated with adverse health outcomes across numerous stigmatized groups, including lesbian, gay, and bisexual (LGB) individuals. However, the biological consequences of structural stigma among LGB populations are understudied. To begin to address this gap, we assessed associations between indicators of structural stigma (i.e., state-level policies) targeting LGB individuals and allostatic load (AL) indices representing physiological dysregulations. METHODS Pooled data from the continuous 2001-2014 National Health and Nutritional Examination Survey were analyzed (LGB: n = 864; heterosexual: n = 20,310). Ten state-level LGB-related policies (e.g., employment nondiscrimination protections, same-sex marriage) were used to operationalize structural stigma. A sex-specific AL index representing 11 immune, metabolic, and cardiovascular biomarkers was estimated. Multilevel models were used to examine associations between structural stigma and AL, net of nine individual-level characteristics (e.g., education, race/ethnicity, age, and health behaviors). RESULTS Sexual minority men living in states with low levels of structural stigma experienced significantly lower AL ( β = -0.45, p = .02) compared with sexual minority men living in states with high structural stigma (i.e., fewer protective policies). There was no significant association between structural stigma and AL among sexual minority women. CONCLUSIONS By demonstrating direct associations between structural stigma and indices of physiological dysregulation, our findings provide a mechanistic understanding of how the social environment can "get under the skin and skull" for sexual minority men in the United States. Future research should explore whether these mechanisms generalize to other marginalized groups exposed to structural stigma.
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Affiliation(s)
- Robert-Paul Juster
- From the Department of Psychiatry and Addiction (Juster), University of Montreal; Research Center of the Montreal Mental Health University Institute (Juster), Montreal, Quebec, Canada; Department of Epidemiology, Mailman School of Public Health, Columbia University (Rutherford, Keyes), New York, New York; and Department of Psychology, Harvard University (Hatzenbuehler), Cambridge, Massachusetts
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DuBois LZ, Puckett JA, Jolly D, Powers S, Walker T, Hope DA, Mocarski R, Huit TZ, Lash BR, Holt N, Ralston A, Miles M, Capannola A, Tipton C, Eick G, Juster RP. Gender minority stress and diurnal cortisol profiles among transgender and gender diverse people in the United States. Horm Behav 2024; 159:105473. [PMID: 38190769 DOI: 10.1016/j.yhbeh.2023.105473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024]
Abstract
The field of behavioral neuroendocrinology has only begun to explore the lived experiences of transgender and gender diverse (TGD) people exposed to stigma. In light of escalating attacks and legislation targeting TGD people in the United States, it is crucial to examine the physiological pathways through which gender minority stressors become embodied, impact health, and contribute to health inequities. The Trans Resilience and Health Study included baseline data collection from fall 2019 to spring 2020 from a sample of 124 TGD people, reflecting a diversity of gender identities (e.g., trans masculine, trans feminine, and nonbinary) and ages (range = 19-70 years old; M = 34.10), living in Michigan, Nebraska, Oregon, and Tennessee. These analyses examine experiences of gender-related enacted stigma in association with hypothalamic-pituitary-adrenal (HPA)-axis functioning. Among those experiencing the highest levels of enacted stigma, findings show a blunted cortisol awakening response and sluggish daily decline that resulted in elevated concentrations at bedtime compared to those experiencing less enacted stigma. These results of flattened diurnal activity are consistent with an emergent literature on discrimination as a social determinant of potential stress pathophysiology. In contrast, community connectedness was associated with a larger, more dynamic cortisol awakening response. These findings emphasize the importance of incorporating gender-minority stress and resilience measures when studying HPA-axis functioning among TGD people.
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Affiliation(s)
- L Zachary DuBois
- Department of Anthropology, 1218 University of Oregon, Eugene, OR 97403, United States.
| | - Jae A Puckett
- Department of Psychology, Michigan State University, 316 Physics Road, East Lansing, MI 48824, United States.
| | - Dee Jolly
- Department of Anthropology, 1218 University of Oregon, Eugene, OR 97403, United States.
| | - Sally Powers
- Department of Psychological and Brain Sciences, University of Massachusetts at Amherst, 135 Hicks Way, Amherst, MA 01003, United States.
| | - Tian Walker
- Department of Anthropology, 1218 University of Oregon, Eugene, OR 97403, United States.
| | - Debra A Hope
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnette Hall, Lincoln, NE 68588, United States; Office of Graduate Studies, University of Nebraska-Lincoln, Lincoln, NE 68588, United States.
| | - Richard Mocarski
- Office of Research, San José State University, One Washington Square, San José, CA, United States.
| | - T Zachary Huit
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnette Hall, Lincoln, NE 68588, United States
| | - Brenna R Lash
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnette Hall, Lincoln, NE 68588, United States
| | - Natalie Holt
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnette Hall, Lincoln, NE 68588, United States
| | - Allura Ralston
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnette Hall, Lincoln, NE 68588, United States
| | - Makinna Miles
- College of Public Health and Human Sciences, Oregon State University, 160 SW 26th St, Corvallis, OR 97331, United States
| | - A Capannola
- Department of Child & Family Studies, The University of Tennessee at Knoxville, 1215 W. Cumberland Ave., Knoxville, TN 37996, United States.
| | - Clove Tipton
- Department of Sociology, The University of Tennessee at Knoxville, 901 McClung Tower, Knoxville, TN 37996, United States.
| | - Geeta Eick
- Department of Anthropology, 1218 University of Oregon, Eugene, OR 97403, United States
| | - Robert-Paul Juster
- Department of Psychiatry and Addiction, University of Montreal, Research Center of the Montreal Mental Health University Institute, 7331 Hochelaga, FS-145-12, Montreal, Quebec H1N 3V2, Canada.
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Patel-Syed Z, Moise IK, Bulotsky-Shearer R, Price M, Becker SJ, Jensen-Doss A. Conceptualizing Neighborhood Context in Youth Psychotherapy Research. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-7. [PMID: 38407998 DOI: 10.1080/15374416.2024.2303705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Affiliation(s)
- Zabin Patel-Syed
- Department of Psychiatry and Behavioral Sciences, Center for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine
| | - Imelda K Moise
- Department of Geography and Sustainable Development, University of Miami
| | | | | | - Sara J Becker
- Department of Psychiatry and Behavioral Sciences, Center for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine
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Price MA, Hollinsaid NL, McKetta S, Mellen EJ, Rakhilin M. Structural transphobia is associated with psychological distress and suicidality in a large national sample of transgender adults. Soc Psychiatry Psychiatr Epidemiol 2024; 59:285-294. [PMID: 37165214 PMCID: PMC10171731 DOI: 10.1007/s00127-023-02482-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 04/17/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE Transgender adults face increasingly discriminatory laws/policies and prejudicial attitudes in many regions of the United States (US), yet research has neither quantified state-level transphobia using indicators of both, nor considered their collective association with transgender adults' psychological wellbeing, hindering the identification of this potential social determinant of transgender mental health inequity. METHODS We therefore used factor analysis to develop a more comprehensive structural transphobia measure encompassing 29 indicators of transphobic laws/policies and attitudes at the state level, which we linked to individual-level mental health data from a large national sample of 27,279 transgender adults (ages 18-100) residing in 45 US states and the District of Columbia (DC). RESULTS Controlling for individual- (i.e., demographics), interpersonal- (i.e., perceived discrimination), and state- (i.e., income inequality, religiosity) level covariates, transgender adults from US states with higher (vs. lower) levels of structural transphobia reported more severe past-month psychological distress and were more likely to endorse past-year and lifetime suicidal thoughts, plans, and attempts. CONCLUSION Findings provide novel evidence that state-level transphobic laws/policies and attitudes collectively shape a range of important mental health outcomes among transgender adults in the US. Multilevel intervention strategies, such as affirming mental health treatments, provider-training interventions, and supportive legislation, are needed to address structural transphobia's multifaceted nature and negative mental health consequences.
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Affiliation(s)
- Maggi A Price
- School of Social Work, Boston College, McGuinn Hall 126, 275 Beacon St., Chestnut Hill, MA, 02467, USA.
- Department of Psychology, Harvard University, Cambridge, MA, USA.
| | | | - Sarah McKetta
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | - Emily J Mellen
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Marina Rakhilin
- School of Social Work, Boston College, McGuinn Hall 126, 275 Beacon St., Chestnut Hill, MA, 02467, USA
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7
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Eisenberg ME, Lawrence SE, Eadeh HM, Suresh M, Rider GN, Gower AL. Emotional Distress Disparities Across Multiple Intersecting Social Positions: The Role of Bias-Based Bullying. Pediatrics 2024; 153:e2023061647. [PMID: 38273773 PMCID: PMC10827645 DOI: 10.1542/peds.2023-061647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVES To apply an intersectional lens to disparities in emotional distress among youth, including multiple social positions and experiences with bias-based bullying. METHODS Data are from the 2019 Minnesota Student Survey (n = 80 456). Social positions (race and ethnicity, sexual orientation, gender) and 2 forms of bias-based bullying (racist, homophobic or transphobic) were entered into decision tree models for depression, anxiety, self-injury, suicidal ideation, and suicide attempts. Groups with the highest prevalence are described. Rates of emotional distress among youth with matching social positions but no bias-based bullying are described for comparison. RESULTS LGBQ identities (90%) and transgender, gender diverse, and questioning identities (54%) were common among the highest-prevalence groups for emotional distress, often concurrently; racial and ethnic identities rarely emerged. Bias-based bullying characterized 82% of the highest-prevalence groups. In comparable groups without bias-based bullying, emotional distress rates were 20% to 60% lower (average 38.8%). CONCLUSIONS Findings highlight bias-based bullying as an important point for the intervention and mitigation of mental health disparities, particularly among lesbian, gay, bisexual, transgender, gender-diverse, queer, and questioning adolescents. Results point to the importance of addressing bias-based bullying in schools and supporting lesbian, gay, bisexual, transgender, gender-diverse, queer, and questioning students at the systemic level as a way of preventing emotional distress.
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Affiliation(s)
- Marla E. Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Samantha E. Lawrence
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
- University of Connecticut, School of Social Work, Hartford, CT
| | - Hana-May Eadeh
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Malavika Suresh
- University of Minnesota Medical School, Minneapolis, Minnesota
| | - G. Nic Rider
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Amy L. Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
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Hatzenbuehler ML, McLaughlin KA, Weissman DG, Cikara M. A research agenda for understanding how social inequality is linked to brain structure and function. Nat Hum Behav 2024; 8:20-31. [PMID: 38172629 PMCID: PMC11112523 DOI: 10.1038/s41562-023-01774-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/01/2023] [Indexed: 01/05/2024]
Abstract
Consistent evidence documents powerful effects of social inequality on health, well-being and academic achievement. Yet research on whether social inequality may also be linked to brain structure and function has, until recently, been rare. Here we describe three methodological approaches that can be used to study this question-single site, single study; multi-site, single study; and spatial meta-analysis. We review empirical work that, using these approaches, has observed associations between neural outcomes and structural measures of social inequality-including structural stigma, community-level prejudice, gender inequality, neighbourhood disadvantage and the generosity of the social safety net for low-income families. We evaluate the relative strengths and limitations of these approaches, discuss ethical considerations and outline directions for future research. In doing so, we advocate for a paradigm shift in cognitive neuroscience that explicitly incorporates upstream structural and contextual factors, which we argue holds promise for uncovering the neural correlates of social inequality.
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Affiliation(s)
| | | | - David G Weissman
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Mina Cikara
- Department of Psychology, Harvard University, Cambridge, MA, USA
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Brooks BD, Kaniuka A, Job SA, Hodgkinson N, Kelliher Rabon J, Williams SL, Hirsch JK. Anticipated Sexual Minority Stress and Mental Health after the 2016 Presidential Election: Examining a Psychological Mediation Framework. JOURNAL OF HOMOSEXUALITY 2023; 70:3125-3148. [PMID: 35759638 DOI: 10.1080/00918369.2022.2087481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sexual minorities are at an increased risk for psychopathology, compared to heterosexual counterparts, in part due to stressors unique to their sexual minority identity. The greater socio-political climate may exacerbate sexual minority stress, and the context of the 2016 United States presidential election infringed upon the rights and well-being of LGBQ individuals. In our sample of sexual minorities (n = 253), we examined the association between anticipated stigma in response to the 2016 presidential election and symptoms of anxiety and depression, and the potential mediating role of self-compassion, hopelessness and social support. Greater anticipated stigma was associated with less self-compassion, less perceived social support, and greater hopelessness, and, in turn, greater symptoms of anxiety and depression. Anticipated stigma may erode feelings of environmental support and may be internalized as negative views of the self and future. From a public health perspective, policy-makers should be aware that the discussion and/or enactment of policies which discriminate against LGBQ persons may negatively impact mental health. Clinically, bolstering self-compassion and interpersonal functioning, and targeting hopelessness, through strategies such as Acceptance and Commitment Therapy and Compassion-Focused Therapy, may buffer the impact of minority stress among sexual minorities.
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Affiliation(s)
- Byron D Brooks
- Department of Psychology, Loyola University Chicago, Chicago, Illinios, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA
| | - Andrea Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Sarah A Job
- Department of Population Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Nicole Hodgkinson
- Department of Psychology, Loyola University Chicago, Chicago, Illinios, USA
| | - Jessica Kelliher Rabon
- Division of Pediatric Psychology, Prisma Health - Upstate, Greenville, South Carolina, USA
| | - Stacey L Williams
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Jameson K Hirsch
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
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Martino RM, Weissman DG, McLaughlin KA, Hatzenbuehler ML. Associations Between Structural Stigma and Psychopathology Among Early Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023:1-11. [PMID: 37916808 PMCID: PMC11063121 DOI: 10.1080/15374416.2023.2272936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Ample evidence demonstrates that structural stigma - defined as societal-level conditions, cultural norms, and institutional policies and practices that constrain opportunities, resources, and well-being of stigmatized populations - is associated with psychopathology in adults from marginalized groups. Yet there is limited research on whether structural stigma is similarly associated with internalizing and externalizing symptoms among youth. METHOD Structural stigma related to sex, sexual orientation, race, and Latinx ethnicity was measured using indicators of state-level policy and aggregated attitudes. Using data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,414; M age = 12 years, SD = 0.66; 48% female, 6.8% lesbian, gay, and bisexual (LGB), 13.4% Black, 20% Latinx), we examined associations of structural stigma with internalizing and externalizing symptoms among female, LGB, Black, and Latinx youth. RESULTS LGB youth living in higher (vs. lower) structural stigma states had elevated levels of internalizing and externalizing symptoms. In lower structural stigma states, there were no differences in externalizing symptoms between LGB and heterosexual youth. Similarly, Latinx youth and females living in higher (vs. lower) structural stigma states had elevated levels of externalizing symptoms. In lower structural stigma states, there were no differences in externalizing symptoms between Latinx youth and non-Latinx White youth. Structural stigma related to race was unrelated to internalizing or externalizing symptoms for Black youth. CONCLUSIONS This study provides novel evidence that macro-level social environments, in the form of structural stigma, contribute to adverse mental health outcomes for marginalized youth and partly explain disparities in externalizing symptoms.
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Baiden P, Onyeaka HK, Aneni K, Wood BM, LaBrenz CA, Hagedorn A, Muoghalu C, Gobodzo EC, Baiden JF, Adeku Y, Mets VE, Brown FA. Racial/ethnic differences in adolescents' non-response to suicide attempt: Findings from the Youth Risk Behavior Survey, 2015-2019. J Psychiatr Res 2023; 166:115-121. [PMID: 37757704 DOI: 10.1016/j.jpsychires.2023.09.015] [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: 01/11/2023] [Revised: 07/13/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
Racial/ethnic minority adolescents are at greater risk of attempting suicide compared to their White counterparts. Yet, racial/ethnic minority adolescents are more likely to not respond to questions on suicidal behaviors. The objective of this study was to investigate the association between race/ethnicity and missing response to suicide attempt among adolescents in the United States. Data for this study were obtained the 2015-2019 national Youth Risk Behavior Survey (n = 40,360). The outcome variable investigated in this study was missing response to suicide attempt and the main explanatory variable was race/ethnicity. Two hierarchical binary logistic regression models were fitted to examine the association between race/ethnicity and missing response to suicide attempt. Of the 40,036 adolescents, 13.4% had missing response to suicide attempt. Controlling for the effects of demographic factors and symptoms of depression, adolescents who self-identified as non-Hispanic Black had more than threefold higher odds of having missing response to suicide attempt when compared to their non-Hispanic White counterparts (AOR = 3.62, p < .001, 95% CI = 2.45-5.34). Adolescent males and adolescents questioning their sexual identity had higher odds of having missing response to suicide attempt. Adolescents with depressive symptoms had lower odds of having missing response to suicide attempt. Missing response to suicide attempt among adolescents continues to differ by race/ethnicity and other demographic factors. The use of a single item in assessing suicide attempt history may be inadequate in capturing national estimates of adolescent suicide metrics.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX, 76010, USA.
| | - Henry K Onyeaka
- Harvard Medical School, Department of Psychiatry, Boston, MA, 02115, USA; Massachusetts General Hospital, Department of Psychiatry, Boston, MA, 02115, USA; McLean Hospital, Department of Psychiatry, Boston, MA, 02478, USA
| | | | - Bethany M Wood
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX, 76010, USA
| | - Catherine A LaBrenz
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX, 76010, USA
| | - Aaron Hagedorn
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX, 76010, USA
| | | | | | - John F Baiden
- East Airport International School, P. O. Box KAPM 57, KIA, Accra, Ghana
| | - Yvonne Adeku
- Western University, Department of Sociology, Social Science Centre, Room 5306, London, Ontario, N6A 5C2, Canada
| | - Vera E Mets
- University of Ghana, Legon, Department of Social Work, P. O. Box LG 419, Legon, Accra, Ghana
| | - Fawn A Brown
- The University of Texas at Arlington, Department of Psychology, 501 Nedderman Dr., Box 19528, Arlington, TX, 76019, USA
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Abstract
Transgender and gender diverse (TGD) children and adolescents are an increasingly visible yet highly stigmatized group. These youth experience more psychological distress than not only their cisgender, heterosexual peers but also their cisgender, sexual minority peers. In this review, we document these mental health disparities and discuss potential explanations for them using a minority stress framework. We also discuss factors that may increase and decrease TGD youth's vulnerability to psychological distress. Further, we review interventions, including gender-affirming medical care, that may improve mental health in TGD youth. We conclude by discussing limitations of current research and suggestions for the future.
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Affiliation(s)
- Natalie M Wittlin
- Department of Psychology, Princeton University, Princeton, New Jersey, USA;
| | - Laura E Kuper
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Endocrinology, Children's Health Systems of Texas, Dallas, Texas, USA
| | - Kristina R Olson
- Department of Psychology, Princeton University, Princeton, New Jersey, USA;
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13
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Kapadia D. Stigma, mental illness & ethnicity: Time to centre racism and structural stigma. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:855-871. [PMID: 36738120 PMCID: PMC10946858 DOI: 10.1111/1467-9566.13615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/10/2023] [Indexed: 05/04/2023]
Abstract
This article critically reviews previous research in the field of stigma, mental illness and 'race' and ethnicity, and argues for a shift of focus from individual and community blame, as inferred by mental illness stigma, to a more comprehensive view of how stigma operates against a backdrop of structural and institutional racism. Ethnic minority people have poorer mental health outcomes compared with White majority populations. Dominant narratives of greater mental illness stigma in ethnic minority populations, due to religious, spiritual or traditional beliefs and leading to a lower use of services, have taken centre stage in the explanations for these consequent poorer outcomes. This article argues that this 'fact' has become taken for granted as knowledge without corresponding comparative research evidence. Research in the field has also failed to robustly consider how racism might operate in conjunction with different forms of mental illness stigma (particularly structural stigma) to exacerbate mental illness and influence pathways to mental health treatment. Future research should centre the role of racism and structural stigma in explaining the poorer mental health outcomes for ethnic minority people.
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Affiliation(s)
- Dharmi Kapadia
- Department of SociologyThe University of ManchesterManchesterUK
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14
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Ünsal BC, Demetrovics Z, Reinhardt M. Stronger together: community participation, structural stigma, and depression among sexual and gender minority adults in 28 European countries. Soc Psychiatry Psychiatr Epidemiol 2023; 58:657-669. [PMID: 36434298 PMCID: PMC10066166 DOI: 10.1007/s00127-022-02385-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Although discriminatory laws, policies, and public attitudes (i.e., structural stigma) are linked to adverse mental health outcomes among sexual and gender minority (SGM) populations, little attention has been paid to protective factors, such as community participation, about which inconsistencies exist whether it ameliorates or exacerbates mental health burdens. Thus, we examined the mediator roles of identity disclosure and victimization and the moderator role of structural stigma in the association of community participation with depression. METHODS Data from the EU-LGBTI-II survey assessing community participation, identity disclosure, victimization, and depression among sexual minority men (n = 62,939), women (n = 38,976), and gender minority adults (n = 15,845) in 28 European countries were used. Structural stigma was measured as discriminatory legislation, policies, and societal attitudes using publicly available data. RESULTS Findings showed that community participation predicted lower and higher levels of depression through identity disclosure and victimization, respectively. For sexual minority men and women, structural stigma moderated the indirect effect through identity disclosure, with a larger effect in higher structural stigma countries. Only for sexual minority men, the indirect effect through victimization was also moderated, with a larger effect in high-stigma countries. For gender minorities, no moderation effect was found. CONCLUSIONS Community participation is differentially linked to depression through identity disclosure and victimization, and as a function of structural stigma. It can be a double-edged sword, especially for sexual minority men in high-stigma countries, who are expected to pay the price while enjoying its benefits, highlighting the targets and considerations for interventions.
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Affiliation(s)
- Berk C Ünsal
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Melinda Reinhardt
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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15
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Cao B, Smith K. Gay Dating Apps in China: Do They Alleviate or Exacerbate Loneliness? The Serial Mediation Effect of Perceived and Internalized Sexuality Stigma. JOURNAL OF HOMOSEXUALITY 2023; 70:347-363. [PMID: 34613888 DOI: 10.1080/00918369.2021.1984751] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Gay dating apps have become increasingly popular and been intensively used. However, studies that closely examine the effects of gay dating app usage on mental health outcomes are few. This study tackles an unsolved question on whether gay dating apps alleviate or exacerbate loneliness through perceptions of sexuality stigma. A cross-sectional online survey from 371 Chinese gay or bisexual men found that the intensity of gay dating app usage is positively associated with loneliness. The association between gay dating app usage intensity and loneliness is sequentially mediated by perceived sexuality stigma and internalized sexuality stigma. That is, increased intensity of gay dating app usage strengthens perceived sexuality stigma, which in turn reinforces internalized sexuality stigma, further exacerbating loneliness. This study echoes the "alone together" phenomena and uncovers the feasibility of using stigma perceptions as a mechanism to understand the mental health of gay dating app users.
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Affiliation(s)
- Bolin Cao
- School of Media and Communication, Shenzhen University, Nanshan District, China
| | - Kumi Smith
- Division of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
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16
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Sheikhan NY, Henderson JL, Halsall T, Daley M, Brownell S, Shah J, Iyer SN, Hawke LD. Stigma as a barrier to early intervention among youth seeking mental health services in Ontario, Canada: a qualitative study. BMC Health Serv Res 2023; 23:86. [PMID: 36703119 PMCID: PMC9877499 DOI: 10.1186/s12913-023-09075-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/16/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Stigma associated with mental health challenges is a major barrier to service seeking among youth. Understanding how stigma impacts service-seeking decisions from the perspectives of youth remains underexplored. Such research is necessary to inform effective stigma reduction. OBJECTIVE This study aims to understand how stigma influences service seeking among youth with mental health challenges. METHODS Qualitative inquiry was taken using youth engagement, underpinned by pragmatism. Data were collected via 4 virtual focus groups with 22 purposively selected youth participants with lived experience of mental health challenges in Ontario, Canada. Focus group guides were developed collaboratively among research team members, including youth co-researchers. Data were analyzed inductively using reflexive thematic analysis. RESULTS Three main themes were constructed from the data: point of entry into the system, being biomedicalized or trivialized, and paving the way for non-stigmatizing services. Initial contact with the mental healthcare system was seen to be affected by stigma, causing participants to delay contact or be refused services if they do not fit with an expected profile. Participants described a constant negotiation between feeling 'sick enough' and 'not sick enough' to receive services. Once participants accessed services, they perceived the biomedicalization or trivialization of their challenges to be driven by stigma. Lastly, participants reflected on changes needed to reduce stigma's effects on seeking and obtaining services. CONCLUSION A constant negotiation between being 'sick enough' or 'not sick enough' is a key component of stigma from the perspectives of youth. This tension influences youth decisions about whether to seek services, but also service provider decisions about whether to offer services. Building awareness around the invisibility of mental health challenges and the continuum of wellness to illness may help to break down stigma's impact as a barrier to service seeking. Early intervention models of care that propose services across the spectrum of challenges may prevent the sense of stigma that deters youth from accessing and continuing to access services.
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Affiliation(s)
- Natasha Y. Sheikhan
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
| | - Jo L. Henderson
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
| | - Tanya Halsall
- grid.28046.380000 0001 2182 2255University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Mardi Daley
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
| | - Samantha Brownell
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
| | - Jai Shah
- grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1 Canada
| | - Srividya N. Iyer
- grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1 Canada
| | - Lisa D. Hawke
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
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17
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Woods-Giscombe CL, Yearwood EL, Wilson PR, Bravo L, Ngugi D, Minarik P, Brooks J, Rodney T, Starks S, Pasini M, Tatum ML, Martin VH. Honoring the past and charting the future: The International Society of Psychiatric Mental Health Nurses' commitment to advance diversity and equity in mental health care. Arch Psychiatr Nurs 2022; 41:354-358. [PMID: 36428072 DOI: 10.1016/j.apnu.2022.08.006] [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: 03/25/2022] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 11/02/2022]
Abstract
For more than two decades, the International Society of Psychiatric Nurses has dedicated its efforts to improving mental health care services worldwide, focusing on leveraging the psychiatric nursing workforce and advocating to eradicate systemic health disparities. Part of this labor included creating a culturally centered initiative, the Position Statement on Diversity, Cultural Competence and Access to Mental Health Care to fortify the cultural awareness of ISPN members to improve health-care quality delivered to diverse individuals, families, and communities across the life span and to improve these populations' access to mental health care.
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Affiliation(s)
- Cheryl L Woods-Giscombe
- The University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, S. Columbia Street, Chapel Hill, NC 27599, United States of America
| | - Edilma L Yearwood
- Georgetown University School of Nursing & Health Studies, 3700 Reservoir Rd NW, Washington, DC 20007, United States of America
| | - Patty R Wilson
- Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America.
| | - Lilian Bravo
- The University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, S. Columbia Street, Chapel Hill, NC 27599, United States of America
| | - Dave Ngugi
- The University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, S. Columbia Street, Chapel Hill, NC 27599, United States of America
| | - Pamela Minarik
- Samuel Merritt University School of Nursing, 3100 Telegraph Ave, Oakland, CA 94609, United States of America
| | - Jada Brooks
- The University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, S. Columbia Street, Chapel Hill, NC 27599, United States of America
| | - Tamar Rodney
- Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America
| | - Shaquita Starks
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA 30322, United States of America
| | - Mia Pasini
- Azusa Pacific University School of Nursing, 701 E. Foothill Blvd., Azusa, CA 91702, United States of America
| | - Mary Louise Tatum
- Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, United States of America
| | - Vicki Hines Martin
- University of Louisville School of Nursing, K-Wing 555 South Floyd Street Suite 3019, Louisville, KY 40202, United States of America
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18
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Xu W, Xue S, Huang Y, Zhang X, Tang W, Kaufman MR. Childhood abuse, left-behind status and mental health among lesbian, gay, and bisexual young adults in China. CHILD ABUSE & NEGLECT 2022; 134:105936. [PMID: 36327763 DOI: 10.1016/j.chiabu.2022.105936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 08/12/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Lesbian, gay, and bisexual (LGB) young adults are at increased risk of mental distress in China. To better carry out psychological intervention, it is essential to understand unique patterns of mental distress and their association with childhood abuse/neglect, including experiencing being left behind by migrating parents. OBJECTIVE In a sample of Chinese LGB young adults, we examined: (1) associations between childhood abuse and left-behind status and mental distress; (2) latent profiles of mental distress; and (3) associations between childhood abuse and left-behind status and latent profiles of mental distress. PARTICIPANTS AND SETTING A sample of 630 Chinese LGB young adults aged 18-30 years was recruited to complete an online survey. METHODS Participants provided demographic information and completed validated measures of childhood abuse experience and mental distress. Latent profile analysis (LPA) was used to identify patterns of mental distress, and logistic regression analysis was used to examine the relationships among these variables. RESULTS Results showed that all forms of childhood abuse and left-behind status were associated with all dimensions of adulthood mental distress. The LPA suggested a 3-group solution as optimal (no mental distress, mild mental distress, and moderate/severe mental distress). Participants who experienced any forms of childhood abuse were more likely to be members of both the mild mental distress and moderate/severe mental distress groups (all p's < 0.001). Also, participants who had left-behind status were more likely to be in the moderate/severe mental distress group (AOR = 1.61, p < .05). CONCLUSIONS Our findings highlight the need for interventions aimed at addressing childhood abuse/neglect among Chinese LGB young adults, as these experiences increase the risk for mental health issues in adulthood.
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Affiliation(s)
- Wenjian Xu
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China; Social Development and Risk Control Research Center, Sichuan University, Chengdu, China.
| | - Shuang Xue
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China
| | - Yuxia Huang
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China
| | - Xing Zhang
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Wanjie Tang
- Center for Educational and Health Psychology, Sichuan University, Chengdu, China.
| | - Michelle R Kaufman
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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19
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Clark KA, Harvey TD, Hughto JM, Meyer IH. Mental Health Among Sexual and Gender Minority Youth Incarcerated in Juvenile Corrections. Pediatrics 2022; 150:e2022058158. [PMID: 36385576 PMCID: PMC9724172 DOI: 10.1542/peds.2022-058158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/19/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This study examined differences by sexual and gender minority (SGM) and incarceration statuses in mental health indicators among youth. METHODS Population-based, cross-sectional data are from the 2019 Minnesota Student Survey (N = 72 324) and includes public school students (Mage = 15.49) and youth incarcerated in juvenile correctional facilities (Mage = 15.48). We categorized youth into 4 groups: (1) non-SGM youth in public schools, (2) non-SGM youth in correctional facilities, (3) SGM youth in public schools, and (4) SGM youth in correctional facilities. Multivariable regression models assessed associations among SGM and incarceration statuses and mental health indicators after controlling for sociodemographic characteristics and exposure to adverse childhood experiences. RESULTS More youth in juvenile correctional facilities identified as SGM (28.8%) compared with youth in public schools (20.4%, P = .002). SGM youth in correctional facilities reported a higher prevalence of suicidal ideation (42.2%), suicide attempt (37.5%), and self-harm (57.8%) compared with all other groups. Depressive symptom severity was similarly elevated among SGM youth in correctional facilities and SGM youth in public schools. SGM youth in correctional facilities, compared with non-SGM youth in public schools, demonstrated elevated odds of suicide ideation (adjusted odds ratio [aOR] = 2.2, 95% confidence interval [95% CI] = 1.3-3.9), suicide attempt (aOR = 6.3, 95% CI = 3.6-10.9), and self-harm (aOR = 3.6, 95% CI = 2.1-6.3). CONCLUSIONS Incarcerated SGM youth disproportionately experience negative mental health indicators. Findings suggest that tailored, intersectional, and responsive mental health interventions are needed to support incarcerated SGM youth.
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Affiliation(s)
- Kirsty A. Clark
- Department of Medicine, Health, and Society, Program in Public Policy Studies
- LGBTQ+ Policy Lab, Vanderbilt University, Nashville, Tennessee
| | - Tyler D. Harvey
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, Connecticut
| | - Jaclyn M.W. Hughto
- Departments of Behavioral and Social Sciences, and Epidemiology, School of Public Health
- Center for Health Promotion and Health Equity, Brown University, Providence, Rhode Island
| | - Ilan H. Meyer
- Williams Institute, UCLA School of Law, Los Angeles, California
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20
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Uddin LQ, De Los Reyes A. Developmental Considerations for Understanding Perceptions and Impacts of Identity-Related Differences: Focusing on Adolescence. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1209-1214. [PMID: 35525409 DOI: 10.1016/j.bpsc.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/06/2022] [Accepted: 04/25/2022] [Indexed: 12/24/2022]
Abstract
Biological psychiatry, similar to many other scientific fields, is grappling with the challenge of revising its practices with an eye toward promoting diversity, equity, and inclusivity. One arena in which much of this work will have significant impact is in developmental science generally and the study of adolescence specifically. Adolescence is a critical period during human development during which important social, neural, and cognitive maturation processes take place. It is also a time marked by risky behaviors and the onset of a range of mental disorders. Social and developmental research has provided insight into the cognitive and neural processes by which perceptions of identity-related differences emerge. Clinical research aimed at understanding how individuals from diverse backgrounds navigate the transition period of adolescence is critical for identifying the unique factors underlying risk and resilience in minoritized populations. Taking a developmental perspective, we review processes by which the brain understands group differences and how the developmental timing of this can influence antecedents of psychological distress. We close with a call to action, pointing to important understudied areas within the field of biological psychiatry that are critical for supporting mental health among diverse adolescent populations.
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Affiliation(s)
- Lucina Q Uddin
- Department of Psychiatry and Biobehavioral Sciences (LQU), University of California, Los Angeles, Los Angeles, California.
| | - Andres De Los Reyes
- Department of Psychology (ADLR), University of Maryland, College Park, Maryland.
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21
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Hollinsaid NL, Price MA, Hatzenbuehler ML. Transgender-Specific Adolescent Mental Health Provider Availability is Substantially Lower in States with More Restrictive Policies. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022:1-12. [PMID: 36369805 DOI: 10.1080/15374416.2022.2140433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Transgender adolescents experience adversity accessing mental healthcare, which is exacerbated by transgender-specific mental health provider shortages in the United States. Factors associated with variability in transgender-specific mental health provider availability across states - especially at the macro-social level - have yet to be identified, hindering efforts to address these shortages. To remedy this gap, we queried whether transgender-specific adolescent mental health provider availability varied by states' transgender-specific policy climate. METHOD We quantified states' policy climate by factor-analyzing tallies of the presence/absence of 33 transgender-specific state laws/policies in six domains: parental/relationship recognition, nondiscrimination, education, healthcare, criminal justice, and identity documentation. We then tested whether states' transgender-specific policy climate was associated with rates of transgender-specific adolescent mental health providers - identified via Psychology Today - per transgender adolescent in all 50 states and the District of Columbia. RESULTS Transgender-specific adolescent mental health provider availability was substantially lower in states with more restrictive laws/policies for transgender people (rate ratio = 0.65, 95% CI [0.52, 0.81], p = .00017), controlling for state-level conservatism, religiosity, and urbanicity. States' transgender-specific policy climate was unrelated to rates of adolescent Attention-Deficit/Hyperactivity Disorder-specialty providers, Oppositional Defiant Disorder-specialty providers, and youth mental health provider shortages broadly, providing evidence for result specificity. CONCLUSIONS Transgender adolescents appear to have access to considerably fewer transgender-specific mental health providers in states with more restrictive laws/policies for transgender people, which may compound their already high mental health burden in these contexts. Intervention and policy efforts are needed to address these shortages, particularly in states with increasingly prohibitive laws/policies targeting transgender adolescents.
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Affiliation(s)
| | - Maggi A Price
- Department of Psychology, Harvard University
- School of Social Work, Boston College
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22
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Lett E, Abrams MP, Moberg E, Benson GP, Perlson JE. Syndemic relationship of depressive symptoms, substance use, and suicidality in transgender youth: a cross-sectional study using the U.S. youth risk behavior surveillance system. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2293-2304. [PMID: 35962805 DOI: 10.1007/s00127-022-02348-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 08/02/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Syndemics are co-occurring epidemics that cluster within populations due to shared socio-structural factors and are often in populations with intersecting forms of vulnerability. Suicide, depression, and substance use all disproportionately affect transgender and gender diverse (TGD) youth. In this study, we test a syndemic model of the relationship between these three mental health conditions in the context of economic deprivation and interpersonal discrimination. METHODS We used data on substance use, depressive symptoms, suicidality, and social-structural factors from 2680 TGD youth captured in the 2017 and 2019 survey waves of the Youth Risk Behavior Surveillance System. We used a latent class analysis (LCA) to identify groups with distinct patterns of self-reported substance use and depressive symptoms, and regression models to characterize the relationship between substance-use, depressive symptoms, class membership, social-structural factors, and suicidality. RESULTS A three-class LCA solution identified a subset of student respondents in a "high use" latent class characterized by high self-reported substance use frequency and depressive symptoms compared with other classes. Online bullying (aOR: 1.58; 95% CI: 1.28-1.95) and housing insecurity (aOR: 8.78; 95% CI: 4.35-17.71) were associated with increased odds of "high use" class membership relative to the "no use" class membership. "High use" class membership was associated with increased odds of suicidal ideation (aOR: 2.26; 95% CI: 1.75-2.94), plans (aOR: 2.59; 95% CI: 2.01-3.36), and attempts (aOR: 6.85; 95% CI: 3.17-15.68). CONCLUSION The co-occurrence of substance use and depressive symptoms is associated with socio-structural factors and may drive risk for suicidality among TGD youth. Meaningful suicide prevention efforts that address disproportionate risk in this population must be attentive to and mitigate the shared determinants of mood symptoms and substance use behavior.
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Affiliation(s)
- Elle Lett
- Perelman School of Medicine, University of Pennsylvania, Blockley Hall, Philadelphia, PA, 19146, USA. .,Center for Applied Transgender Studies, Chicago, IL, USA.
| | - Matthew P Abrams
- Center for Emergency Care Policy and Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Penn Medicine Center for Digital Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Emery Moberg
- Unaffiliated Recent College Graduate, Los Angeles, CA, USA
| | - G Perusi Benson
- Department of Psychology, North Carolina State University, Raleigh, NC, USA
| | - Jacob E Perlson
- Department of Psychiatry, Columbia University, New York, NY, USA
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23
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Meanley S, Sexton Topper P, Listerud L, Bonett SK, Watson D, Choi SK, Teixeira Da Silva D, Flores DD, James R, Bauermeister JA. Leveraging Resilience-supportive Strategies to Enhance Protective Factors in Young Sexual Minority Men: A Scoping Review of HIV Behavioral Interventions Implemented in High-income Countries. JOURNAL OF SEX RESEARCH 2022; 59:957-983. [PMID: 35080999 DOI: 10.1080/00224499.2021.2024789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Behavioral HIV interventions focused on strengthening young sexual minority men's (SMM) internal (assets) and external (resources) protective factors are promising, yet their evaluation as resilience-supportive strategies to minimize or negate HIV-related risks remain understudied. The objective of this scoping review was to describe resilience-supportive intervention strategies that have been used to achieve desired HIV behavioral outcomes and to identify how these strategies have been evaluated using a resilience analytic framework. Our scoping review uncovered 271 peer-reviewed articles, of which 38 were eligible for inclusion based on our review criteria. The majority of interventions relied on social support strategies as their primary resilience-supportive strategy. A third of interventions reviewed analyzed their findings from a deficits-focused model, another third used compensatory resilience models, and the remaining interventions employed a hybrid (i.e., deficit and compensatory model) strategy. None of the interventions evaluated their intervention effects using a risk-protective model. From our synthesis regarding the current state of research around resilience-informed interventions, we propose strategies to inform the design of resilience-supportive approaches and make recommendations to move the field forward on how to develop, implement, and measure young SMM's resiliency processes.
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Affiliation(s)
- Steven Meanley
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Patrina Sexton Topper
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Louis Listerud
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Stephen K Bonett
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
- University of Pennsylvania Leonard Davis Institute of Health Economics
| | - Dovie Watson
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
- School of Medicine, Division of Infectious Diseases, University of Pennsylvania Perelman
| | - Seul Ki Choi
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Daniel Teixeira Da Silva
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
- University of Pennsylvania Leonard Davis Institute of Health Economics
- School of Medicine National Clinician Scholar, University of Pennsylvania Perelman
| | - Dalmacio D Flores
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | | | - José A Bauermeister
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
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24
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Price MA, Hollinsaid NL. Future Directions in Mental Health Treatment with Stigmatized Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:810-825. [PMID: 36007234 PMCID: PMC9835015 DOI: 10.1080/15374416.2022.2109652] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Stigma refers to societally-deemed inferiority associated with a circumstance, behavior, status, or identity. It manifests internally, interpersonally, and structurally. Decades of research indicate that all forms of stigma are associated with heightened risk for mental health problems (e.g., depression, PTSD, suicidality) in stigmatized youth (i.e., children, adolescents, and young adults with one or more stigmatized identities, such as youth of Color and transgender youth). Notably, studies find that stigmatized youth living in places with high structural stigma - defined as laws/policies and norms/attitudes that hurt stigmatized people - have a harder time accessing mental health treatment and are less able to benefit from it. In order to reduce youth mental health inequities, it is imperative for our field to better understand, and ultimately address, stigma at each of these levels. To facilitate this endeavor, we briefly review research on stigma and youth mental health treatment, with an emphasis on structural stigma, and present three future directions for research in this area: (1) directly addressing stigma in treatment, (2) training therapists in culturally responsive care, and (3) structural interventions. We conclude with recommendations for best practices in broader mental health treatment research.
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Affiliation(s)
- Maggi A. Price
- School of Social Work, Boston College, Boston, MA
- Department of Psychology, Harvard University, Cambridge, MA
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25
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Barksdale CL, Pérez-Stable E, Gordon J. Innovative Directions to Advance Mental Health Disparities Research. Am J Psychiatry 2022; 179:397-401. [PMID: 35599539 DOI: 10.1176/appi.ajp.21100972] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Disparities in mental health have persisted or worsened despite our awareness of their existence, increased understanding of their causes, and efforts at reduction and mitigation. Although much is known, there is still much to be done in mental health research to meaningfully impact disparities. In November 2020, the National Institute of Mental Health (NIMH) and the National Institute of Minority Health and Health Disparities (NIMHD) co-sponsored a virtual workshop to explore the complexities of mental health disparities, which revealed several gaps and opportunities for the field to pursue to advance mental health disparities research. This article, the introduction to a Special Issue on Mental Health Disparities, provides a frame for four articles that stem from and are inspired by the virtual NIMH/NIMHD workshop, all of which illustrate innovative research on understanding the complex mechanisms of disparities and how this knowledge can be translated into effective intervention development that advances mental health equity.
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Affiliation(s)
- Crystal L Barksdale
- Office for Disparities Research and Workforce Diversity, NIMH, Bethesda, Md. (Barksdale); National Institute on Minority Health and Health Disparities, NIH, Bethesda, Md. (Barksdale, Pérez-Stable); NIMH, Bethesda, Md. (Gordon)
| | - Eliseo Pérez-Stable
- Office for Disparities Research and Workforce Diversity, NIMH, Bethesda, Md. (Barksdale); National Institute on Minority Health and Health Disparities, NIH, Bethesda, Md. (Barksdale, Pérez-Stable); NIMH, Bethesda, Md. (Gordon)
| | - Joshua Gordon
- Office for Disparities Research and Workforce Diversity, NIMH, Bethesda, Md. (Barksdale); National Institute on Minority Health and Health Disparities, NIH, Bethesda, Md. (Barksdale, Pérez-Stable); NIMH, Bethesda, Md. (Gordon)
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Frost DM, Meyer IH, Lin A, Wilson BDM, Lightfoot M, Russell ST, Hammack PL. Social Change and the Health of Sexual Minority Individuals: Do the Effects of Minority Stress and Community Connectedness Vary by Age Cohort? ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2299-2316. [PMID: 35411489 PMCID: PMC9192485 DOI: 10.1007/s10508-022-02288-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
This study examined the extent to which social stress stemming from a stigmatized social status (i.e., minority stress) was associated with three domains of health in younger as compared with older age cohorts of sexual minority individuals. Data were analyzed from the Generations Study, a longitudinal study using a probability sample (N = 1518) of age cohorts of sexual minority individuals in the USA. Exposure to a variety of minority stressors was associated with poorer health for all age cohorts. We hypothesized that because of improved social and legal environments in recent years, the associations between minority stress and health would be diminished in the younger cohort. As expected, we found that the associations between some minority stressors and health outcomes were diminished in the younger cohort compared to older cohorts. Positive associations between community connectedness and mental health and social well-being were observed for all participants but were attenuated in the younger cohort. Findings demonstrate the continuing negative association between minority stress and health among sexual minorities, which, despite some attenuation, persists even for young cohorts of sexual minority individuals in a more equal and accepting social climate.
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Affiliation(s)
- David M Frost
- Social Research Institute, University College London, 27-28 Woburn Square, London, WC1H 0AA, UK.
| | - Ilan H Meyer
- The Williams Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Andy Lin
- The Williams Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bianca D M Wilson
- The Williams Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Marguerita Lightfoot
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Stephen T Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
| | - Phillip L Hammack
- Psychology Department, University of California, Santa Cruz, Santa Cruz, CA, USA
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Schmitz RM, Charak R. "I Went into This as One Person, and Then Came Out a Totally Different Person": Native LGBTQ2S+ Young Adults' Conceptions of Trauma. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP3293-NP3319. [PMID: 32779508 DOI: 10.1177/0886260520948523] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Intersecting sources of stigma influence harmful mental health outcomes for lesbian, gay, bisexual, transgender, queer, and Two-Spirit (LGBTQ2S+) young adults (YA) of color as they must manage multiple oppressions. Experiencing both mental health challenges and victimization, LGBTQ2S+ YA of color struggle with distinctive psychological traumas. There is a critical need to determine how certain groups of LGBTQ2S+ YA of color's marginalized social statuses shape trauma understandings. Native LGBTQ2S+ people in general endure diverse forms of oppression and trauma, such as histories of colonialism, contemporary racism, sexism, homophobia, and classism. Understanding the subjective interpretations of violence and trauma among Native LGBTQ2S+ YA is needed to best meet their mental health needs. Through in-depth interviews with 13 Native LGBTQ2S+ YA between 18 and 24 years old, this study delineates processes of how an underrepresented, underserved group of rurally embedded YA conceptualize violent and traumatic life experiences within the context of their mental health. First, participants described their traumatic experiences as shaping persistent harmful mental health outcomes throughout their lives. Second, YA conceptualized trauma as pivotal moments that were profound and influential in their significance as a turning point in their lives. Finally, YA underscored multiple traumas as cumulative and complex in how they interacted to create distinctively harmful mental health challenges. Expansive conceptualizations of trauma can better inform understandings of trauma etiology and promote inclusive health services.
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Affiliation(s)
| | - Ruby Charak
- The University of Texas Rio Grande Valley, Edinburg, USA
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28
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Nicholson AA, Siegel M, Wolf J, Narikuzhy S, Roth SL, Hatchard T, Lanius RA, Schneider M, Lloyd CS, McKinnon MC, Heber A, Smith P, Lueger-Schuster B. A systematic review of the neural correlates of sexual minority stress: towards an intersectional minority mosaic framework with implications for a future research agenda. Eur J Psychotraumatol 2022; 13:2002572. [PMID: 35251527 PMCID: PMC8890555 DOI: 10.1080/20008198.2021.2002572] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/18/2021] [Accepted: 10/29/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Systemic oppression, particularly towards sexual minorities, continues to be deeply rooted in the bedrock of many societies globally. Experiences with minority stressors (e.g. discrimination, hate-crimes, internalized homonegativity, rejection sensitivity, and microaggressions or everyday indignities) have been consistently linked to adverse mental health outcomes. Elucidating the neural adaptations associated with minority stress exposure will be critical for furthering our understanding of how sexual minorities become disproportionately affected by mental health burdens. METHODS Following PRISMA-guidelines, we systematically reviewed published neuroimaging studies that compared neural dynamics among sexual minority and heterosexual populations, aggregating information pertaining to any measurement of minority stress and relevant clinical phenomena. RESULTS Only 1 of 13 studies eligible for inclusion examined minority stress directly, where all other studies focused on investigating the neurobiological basis of sexual orientation. In our narrative synthesis, we highlight important themes that suggest minority stress exposure may be associated with decreased activation and functional connectivity within the default-mode network (related to the sense-of-self and social cognition), and summarize preliminary evidence related to aberrant neural dynamics within the salience network (involved in threat detection and fear processing) and the central executive network (involved in executive functioning and emotion regulation). Importantly, this parallels neural adaptations commonly observed among individuals with posttraumatic stress disorder (PTSD) in the aftermath of trauma and supports the inclusion of insidious forms of trauma related to minority stress within models of PTSD. CONCLUSIONS Taken together, minority stress may have several shared neuropsychological pathways with PTSD and stress-related disorders. Here, we outline a detailed research agenda that provides an overview of literature linking sexual minority stress to PTSD and insidious trauma, moral affect (including shame and guilt), and mental health risk/resiliency, in addition to racial, ethnic, and gender related minority stress. Finally, we propose a novel minority mosaic framework designed to inform future directions of minority stress neuroimaging research from an intersectional lens.
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Affiliation(s)
- Andrew A. Nicholson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
- Department of Medical Biophysics, Western University, London, Canada
- Homewood Research Institute, Guelph, Canada
| | - Magdalena Siegel
- Department of Developmental and Educational Psychology, University of Vienna, Vienna, Austria
- Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Jakub Wolf
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Sandhya Narikuzhy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Sophia L. Roth
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Taylor Hatchard
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Ruth A. Lanius
- Department of Psychiatry, Western University, London, Canada
| | - Maiko Schneider
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | | | - Margaret C. McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Homewood Research Institute, Guelph, Canada
| | | | - Patrick Smith
- The Centre of Excellence for PTSD, Royal Ottawa Hospital, Ottawa, Canada
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Madireddy S, Madireddy S. Supportive model for the improvement of mental health and prevention of suicide among LGBTQ+ youth. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2022. [DOI: 10.1080/02673843.2022.2025872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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30
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Clark M, Moe J, Chan CD, Best MD, Mallow LM. Social justice outcomes and professional counseling: An 11‐year content analysis. JOURNAL OF COUNSELING AND DEVELOPMENT 2022. [DOI: 10.1002/jcad.12427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Madeline Clark
- School of Intervention and Wellness The University of Toledo Toledo Ohio USA
| | - Jeffry Moe
- Department of Counseling and Human Services Old Dominion University Norfolk Virginia USA
| | - Christian D. Chan
- Department of Counseling and Educational Development The University of North Carolina at Greensboro Greensboro North Carolina USA
| | - Mihkaya D. Best
- School of Intervention and Wellness The University of Toledo Toledo Ohio USA
| | - Laura M. Mallow
- School of Intervention and Wellness The University of Toledo Toledo Ohio USA
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31
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Anderson RE, Heard-Garris N, DeLapp RCT. Future Directions for Vaccinating Children against the American Endemic: Treating Racism as a Virus. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:127-142. [PMID: 34605727 DOI: 10.1080/15374416.2021.1969940] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
For Black American youth and their families, the racial terror that claimed the life of George Floyd in May 2020 is nothing new, as stories of people who look just like them have been part and parcel of their lived experience in the United States. Beyond state-sanctioned murder, Black youth were also witnessing the disproportionate transmission, treatment, and travesty plaguing their community with COVID-19 - all predictable outcomes given the inequitable systems supporting the American pipeline from cradle to grave. Why, then, were so many White Americans just coming into awareness of this deadly disease of individual and systemic racism that has ravaged Black American communities for centuries? In this work, we seek to explain in what ways racism is tantamount to a social virus and how its permeation is endemic to the American body, rather than an emerging threat, like a pandemic. We will also address how better conceptualizing racism as a virus allows for more accurate, precise, and feasible treatments for transmitters and targets of racism with respect to prevention (e.g., inoculation) and intervention (e.g., healing and vaccination). Finally, we will describe clinical therapeutic trials that will help to decipher whether our treatment of this social disease is effective, including family-level interventions and systemic shifts in prevention through clinical training.
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Affiliation(s)
| | - Nia Heard-Garris
- Feinberg School of Medicine, Northwestern University.,Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago
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32
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Doom JR, Rozenman M, Fox KR, Phu T, Subar AR, Seok D, Rivera KM. The Transdiagnostic Origins of Anxiety and Depression During the Pediatric Period: Linking NIMH Research Domain Criteria (RDoC) Constructs to Ecological Systems. Dev Psychopathol 2021; 33:1599-1619. [PMID: 35281333 PMCID: PMC8916713 DOI: 10.1017/s0954579421000559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In the last decade, an abundance of research has utilized the NIMH Research Domain Criteria (RDoC) framework to examine mechanisms underlying anxiety and depression in youth. However, relatively little work has examined how these mechanistic intrapersonal processes intersect with context during childhood and adolescence. The current paper covers reviews and meta-analyses that have linked RDoC-relevant constructs to ecological systems in internalizing problems in youth. Specifically, cognitive, biological, and affective factors within the RDoC framework were examined. Based on these reviews and some of the original empirical research they cover, we highlight the integral role of ecological factors to the RDoC framework in predicting onset and maintenance of internalizing problems in youth. Specific recommendations are provided for researchers using the RDoC framework to inform future research integrating ecological systems and development. We advocate for future research and research funding to focus on better integration of the environment and development into the RDoC framework.
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33
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Sallabank G, Chavanduka TMD, Walsh AR, Sullivan P, Wolfe J, Filipowicz R, Bonar EE, Horvath KJ, Hailu B, Bauermeister J, Stephenson R. Mapping LGBTQ+ Youth Resource Density Across Four High HIV Prevalence Corridors in the US. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2021; 20:300-314. [PMID: 34703505 PMCID: PMC8532447 DOI: 10.1007/s13178-021-00660-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Studies using geospatial data to understand LGBTQ+-friendly sexual health and wellness resource availability have often focused on services catered to adults. While HIV rates have increased in adolescents in recent years, few studies have explored disparities in resource access for adolescent gay and bisexual men (AGBMSM). METHODS We used geospatial data of resources (collected and verified 2017-2018) from the iReach app to understand disparities in resource access for AGBMSM within and between 4 high HIV prevalence corridors in the US. RESULTS AGBMSM in non-metro areas had access to fewer resources and some rural counties had no LGBTQ+ -friendly resources. Corridors comprising states with legacies of punitive laws targeting sexual and gender minorities demonstrate stark geographic disparities across the US. CONCLUSIONS Policy-makers must understand the granularity of disparities within regions. Online resources may be able to surmount LGBTQ+ resource deserts. However, physical access to LGBTQ+ -friendly services must be improved as a fundamental strategy for reducing HIV among AGBMSM. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s13178-021-00660-0.
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Affiliation(s)
- Gregory Sallabank
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI USA
| | - Tanaka M. D. Chavanduka
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI USA
| | - Alison R. Walsh
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI USA
| | - Patrick Sullivan
- Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - James Wolfe
- School of Nursing, University of Pennsylvania, Philadelphia, PA USA
| | | | - Erin E. Bonar
- Dept of Psychiatry and Addiction Center, Injury Prevention Center, Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI USA
| | - Keith J. Horvath
- Department of Psychology, San Diego State University, San Diego, CA USA
| | - Benyam Hailu
- Division of Clinical & Health Services Research, National Institute On Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD USA
| | | | - Rob Stephenson
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI USA
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34
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Campbell C, Mena JA. LGBTQ+ Structural Stigma and College Counseling Center Website Friendliness. JOURNAL OF COLLEGE COUNSELING 2021. [DOI: 10.1002/jocc.12194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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35
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Reynolds A, Hamidian Jahromi A. Transgender Athletes in Sports Competitions: How Policy Measures Can Be More Inclusive and Fairer to All. Front Sports Act Living 2021; 3:704178. [PMID: 34337407 PMCID: PMC8316721 DOI: 10.3389/fspor.2021.704178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/22/2021] [Indexed: 01/18/2023] Open
Affiliation(s)
| | - Alireza Hamidian Jahromi
- Plastic and Reconstructive Surgery Department, Rush University Medical Center, Chicago, IL, United States
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36
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Homophobia is online: Sexual victimization and risks on the internet and mental health among bisexual, homosexual, pansexual, asexual, and queer adolescents. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106728] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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37
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Watson RJ, Fish JN, Denary W, Caba A, Cunningham C, Eaton LA. LGBTQ state policies: A lever for reducing SGM youth substance use and bullying. Drug Alcohol Depend 2021; 221:108659. [PMID: 33676075 PMCID: PMC8026721 DOI: 10.1016/j.drugalcdep.2021.108659] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Sexual and gender minority youth (SGMY) are more likely than their cisgender and heterosexual peers to use substances and to be bullied, yet it is unknown whether the absence/presence of youth- and LGBTQ-specific equity laws drive these disparities. The purpose of this study was to extend previous research focused on adult- and LGBTQ-specific structural factors (e.g., same-sex marriage laws) to determine whether the youths' structural environment (i.e., state-level LGBTQ youth-focused equity laws) was associated with bullying and recent alcohol use, binge drinking, and cigarette use among SGMY. PROCEDURES We utilized data from the LGBTQ National Teen Survey, collected in 2017 (N = 8,841 sexual and gender minority youth). Linear regression analyses examined the association between bullying and substance use and between state-level LGBTQ youth-focused equity laws (individually and as a composite variable) and bullying and substance use. FINDINGS SGMY living in states with LGBTQ equity laws were less likely to experience bullying. Findings regarding the relation between LGBTQ equity laws and substance use were mixed, such that LGBTQ equity laws were associated with a higher likelihood of binge drinking and alcohol use, and a lower likelihood of cigarette use. CONCLUSIONS Findings highlight the role of state-level equity laws in reducing bullying and substance use disparities for SGMY. Yet, given the finding that equity laws were associated with a higher likelihood of binge drinking, it is important to continue to explore how the structural environment shapes SGMY health.
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Affiliation(s)
- Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, United States.
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, United States
| | - Whitney Denary
- School of Public Health, Yale University, CT, United States
| | - Antonia Caba
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, United States
| | - Casey Cunningham
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, United States
| | - Lisa A Eaton
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, United States
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38
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De Los Reyes A. (Second) Inaugural Editorial: How the Journal of Clinical Child and Adolescent Psychology Can Nurture Team Science Approaches to Addressing Burning Questions about Mental Health. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2021; 50:1-11. [PMID: 33577356 DOI: 10.1080/15374416.2020.1858839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
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39
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van der Star A, Pachankis JE, Bränström R. Country-Level Structural Stigma, School-Based and Adulthood Victimization, and Life Satisfaction Among Sexual Minority Adults: A Life Course Approach. J Youth Adolesc 2021; 50:189-201. [PMID: 33196894 PMCID: PMC7815544 DOI: 10.1007/s10964-020-01340-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 10/21/2020] [Indexed: 02/05/2023]
Abstract
Country-level structural stigma, defined as prejudiced population attitudes and discriminatory legislation and policies, has been suggested to compromise the wellbeing of sexual minority adults. This study explores whether and how structural stigma might be associated with sexual minorities' school-based and adulthood experiences of victimization and adulthood life satisfaction. Using a sample of 55,263 sexual minority individuals (22% female; 53% 18-29 years old; 85% lesbian/gay, 15% bisexual) living across 28 European countries and a country-level index of structural stigma, results show that sexual minorities, especially men, reported school bullying in both higher- and lower-stigma countries. Higher rates of school bullying were found among sexual minorities living in higher-stigma countries when open about their identity at school. Past exposure to school bullying was associated with lower adulthood life satisfaction, an association partially explained by an increased risk of adulthood victimization. These findings suggest that sexual minorities living in higher-stigma countries might benefit from not being open about their sexual identity at school, despite previously established mental health costs of identity concealment, because of the reduced risk of school bullying and adverse adulthood experiences. These results provide one of the first indications that structural stigma is associated with sexual minority adults' wellbeing through both contemporaneous and historical experiences of victimization.
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Affiliation(s)
- Arjan van der Star
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA.
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Richard Bränström
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
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40
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Fish JN. Future Directions in Understanding and Addressing Mental Health among LGBTQ Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2020; 49:943-956. [PMID: 33074740 PMCID: PMC7736182 DOI: 10.1080/15374416.2020.1815207] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Today's LGBTQ youth come of age at a time of dynamic social and political change with regard to LGBTQ rights and visibility, yet remain vulnerable to compromised mental health. Despite advances in individual-level treatment strategies, school-based programs, and state-level policies that address LGBTQ mental health, there remains a critical gap in large-scale evidence-based prevention and intervention programs designed to support the positive development and mental health of LGBTQ youth. To spur advances in research and translation, I pose six considerations for future scholarship and practice. I begin by framing LGBTQ (mental) health disparities in a life course perspective and discuss how research focused on the timing of events could offer insight into the optimum targets and timing of prevention and intervention strategies. Next, I argue the importance of expanding notions of "mental health" to include perspectives of wellbeing, positive youth development, and resilience. I then consider how research might attend to the complexity of LGBTQ youths' lived experience within and across the various contexts they traverse in their day-to-day lives. Similarly, I discuss the importance of exploring heterogeneity in LGBTQ youth experiences and mental health. I also offer suggestions for how community partnerships may be a key resource for developing and evaluating evidence-informed programs and tools designed to foster the positive development and mental health of LGBTQ youth. Finally, I acknowledge the potentials of team science for advancing research and practice for LGBTQ youth health and wellbeing. Throughout, these future directions center the urgent needs of LGBTQ youth.
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Affiliation(s)
- Jessica N. Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, 4200 Valley Drive, Suite 1142, College Park, MD, 20742
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41
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Hopwood M, Cama E, de Wit J, Treloar C. Stigma, Anxiety, and Depression Among Gay and Bisexual Men in Mixed-Orientation Marriages. QUALITATIVE HEALTH RESEARCH 2020; 30:622-633. [PMID: 31315511 DOI: 10.1177/1049732319862536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The mental health of gay and bisexual men in mixed-orientation marriages is poorly understood. In this article, the authors explore the development of anxiety and depression among gay and bisexual men in heterosexual marriages. Sixteen men, living in the Australian states of New South Wales, Queensland, Victoria, and Tasmania were interviewed throughout 2016 and 2017. An analysis of interviews identified four main themes, namely, compulsory heterosexuality, existential distress, compartmentalization, and integration and resolution. Participants reported experiencing anxiety and depression, which were exacerbated by the stigmatization of same-sex attraction and by an overwhelming distress from feelings of shame and guilt regarding their marital infidelity. Findings indicate that gay and bisexual men in mixed-orientation marriages develop anxiety and depression in response to the exigencies of compulsory heterosexuality and the compartmentalizing of same-sex attraction and identity during heterosexual marriage. Coming-out as same-sex attracted resolved men's distress by facilitating an integrative self-structure.
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Affiliation(s)
- Max Hopwood
- UNSW Sydney, Sydney, New South Wales, Australia
| | - Elena Cama
- UNSW Sydney, Sydney, New South Wales, Australia
| | - John de Wit
- UNSW Sydney, Sydney, New South Wales, Australia
- Utrecht University, Utrecht, The Netherlands
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Bosse JD. Sexual and Gender Identity Development in Young Adults and Implications for Healthcare. CURRENT SEXUAL HEALTH REPORTS 2019. [DOI: 10.1007/s11930-019-00215-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Frost DM, Hammack PL, Wilson BDM, Russell ST, Lightfoot M, Meyer IH. The Qualitative Interview in Psychology and the Study of Social Change: Sexual Identity Development, Minority Stress, and Health in the Generations Study. ACTA ACUST UNITED AC 2019; 7:245-266. [PMID: 34095332 DOI: 10.1037/qup0000148] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Interviewing is considered a key form of qualitative inquiry in psychology that yields rich data on lived experience and meaning making of life events. Interviews that contain multiple components informed by specific epistemologies have the potential to provide particularly nuanced perspectives on psychological experience. We offer a methodological model for a multi-component interview that draws upon both pragmatic and constructivist epistemologies to examine generational differences in the experience of identity development, stress, and health among contemporary sexual minorities in the United States. Grounded in theories of life course, narrative, and intersectionality, we designed and implemented a multi-component protocol that was administered among a diverse sample of three generations of sexual minority individuals. For each component, we describe the purpose and utility, underlying epistemology, foundational psychological approach, and procedure, and we provide illustrative data from interviewees. We discuss procedures undertaken to ensure methodological integrity in process of data collection, illustrating the implementation of recent guidelines for qualitative inquiry in psychology. We highlight the utility of this qualitative multi-component interview to examine the way in which sexual minorities of distinct generations have made meaning of significant social change over the past half-century.
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Supportive Community Resources Are Associated with Lower Risk of Substance Use among Lesbian, Gay, Bisexual, and Questioning Adolescents in Minnesota. J Youth Adolesc 2019; 49:836-848. [PMID: 31446582 DOI: 10.1007/s10964-019-01100-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/30/2019] [Indexed: 12/28/2022]
Abstract
Research has indicated that lesbian, gay, bisexual, and queer/questioning (LGBQ) adolescents have disproportionately high rates of substance use compared to heterosexual peers; yet certain features of schools and communities have been associated with lower substance use rates in this population. To advance this field, research examining multiple levels of influence using measures developed with youth input is needed. With community, school, and student data, this study tested hypotheses that LGBQ students attending high schools and living in communities with more LGBQ-supportive environments (assessed with a novel inventory tool) have lower odds of substance use behaviors (cigarette smoking, alcohol use, marijuana use, prescription drug misuse, and other drug use) than their peers in less supportive LGBQ environments. Multilevel models using data from 2454 LGBQ students (54.0% female, 63.9% non-Hispanic white) in 81 communities and adjusting for student and school covariates found that LGBQ adolescents who lived in areas with more community support had lower odds of frequent substance use, particularly among females. Expanding and strengthening community resources (e.g., LGBQ youth-serving organizations, LGBQ events such as a Pride parade, and LGBQ-friendly services) is recommended to further support LGBQ adolescents and reduce substance use disparities.
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Johnson SE, O'Brien EK, Coleman B, Tessman GK, Hoffman L, Delahanty J. Sexual and Gender Minority U.S. Youth Tobacco Use: Population Assessment of Tobacco and Health (PATH) Study Wave 3, 2015-2016. Am J Prev Med 2019; 57:256-261. [PMID: 31326009 DOI: 10.1016/j.amepre.2019.03.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Tobacco use disparities by sexual identity are well characterized among adults, but relatively less is known about tobacco use disparities in sexual minority youth. Moreover, no national study has reported tobacco use behaviors among gender minority (e.g., transgender) youth. METHODS Data from Wave 3 (2015-2016) of the Population Assessment of Health Study from youth aged 14-17 years (n=7,772), analyzed in 2018, were stratified by transgender identity, sex, and sexual identity to describe tobacco product use. RESULTS Transgender youth (n=79) were more likely to report ever use of tobacco products compared with nontransgender youth (electronic nicotine products, 40.2% vs 23.0%; cigarettes, 33.9% vs 14.1%; and smokeless tobacco, 21.5% vs 6.0%, respectively) and more likely to report past 30-day use of these products. Similarly, female sexual minority youth, compared with straight female youth, were more likely to report ever use of electronic nicotine products (37.9% vs 20.1%); cigarettes (28.9% vs 12.0%); cigars (11.3% vs 5.2%); hookah (12.7% vs 7.6%); and past 30-day use of electronic nicotine products, cigarettes, and cigars. Among male youth, sexual minority youth were more likely to report ever use of cigarettes compared with straight youth (25.1% vs 13.5%), but they did not differ in ever or past 30-day use of any other tobacco products. CONCLUSIONS Sexual minority youth and transgender youth are more likely to use tobacco products compared with their nonminority peers. Similar to patterns among adults, this is especially true for female sexual minority youth. This information is useful for developing communication and education efforts to prevent youth tobacco initiation in these high-risk groups.
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Affiliation(s)
- Sarah E Johnson
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland.
| | - Erin Keely O'Brien
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Blair Coleman
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Greta K Tessman
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Leah Hoffman
- Office of Health Communication and Education, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Janine Delahanty
- Office of Health Communication and Education, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
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Fortenberry JD. Trust, Sexual Trust, and Sexual Health: An Interrogative Review. JOURNAL OF SEX RESEARCH 2019; 56:425-439. [PMID: 30289286 DOI: 10.1080/00224499.2018.1523999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Trust is experienced almost constantly in all forms of social and interpersonal relationships, including sexual relationships, and may contribute both directly and indirectly to sexual health. The purpose of this review is to link three aspects of trust to sexual health: (1) the role of trust in sexual relationships; (2) the role of trust in sexually transmitted infection (STI) prevention, particularly condom use; and (3) the relevance of trust in sexual relationships outside of the traditional model of monogamy. The review ends with consideration of perspectives that could guide new research toward understanding the enigmas of trust in partnered sexual relations in the context of sexual and public health.
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Beach L, Bartelt E, Dodge B, Bostwick W, Schick V, Fu TCJ, Friedman MR, Herbenick D. Meta-Perceptions of Others' Attitudes Toward Bisexual Men and Women Among a Nationally Representative Probability Sample. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:191-197. [PMID: 30446861 PMCID: PMC6467292 DOI: 10.1007/s10508-018-1347-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/03/2018] [Accepted: 11/07/2018] [Indexed: 05/12/2023]
Abstract
Researchers posit that negative attitudes, prejudice, and discrimination (i.e., binegativity) from heterosexual and gay/lesbian individuals may contribute to health disparities among bisexual individuals relative to heterosexual and gay/lesbian individuals. Recent studies have focused on gay, lesbian, and heterosexual people's (e.g., "others") attitudes toward bisexual people. No studies have investigated how bisexual individuals perceive others' attitudes toward bisexual people, which are generally known as "meta-perceptions." As part of the 2015 National Survey of Sexual Health and Behavior, we collected data from a nationally representative probability sample of 2999 adults, including from a subsample of 33 men and 61 women self-identified as bisexual. The Bisexualities: Indiana Attitudes Scale-bisexual (BIAS-b), a modified 5-item scale assessing bisexual people's perceptions of others' attitudes toward bisexual individuals, was included and was followed by an open-ended text box question. Quantitative scale data were analyzed using descriptive and gamma regression methods. Two coders thematically analyzed the open-ended text box data. The internal consistency of the BIAS-b was high (Cronbach's α = 0.85). An exploratory factor analysis supported a one-factor solution. Participants responded to statements regarding others' attitudes toward them as bisexual people, including the domains of confusion, HIV/STD risk, incapability of monogamy, promiscuity, and instability ("just a phase"). Participants' text box descriptions largely aligned with these five domains, with the exception of HIV/STD risk. Additionally, some participants reported others' positive perceptions of them as bisexual individuals. In sum, we observed a range of meta-perceptions, primarily neutral to negative, but also including some relatively positive. These results show the need for interventions to promote acceptance of bisexual individuals among heterosexual and gay/lesbian individuals.
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Affiliation(s)
- Lauren Beach
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Elizabeth Bartelt
- Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - Brian Dodge
- Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, 47405, USA.
| | - Wendy Bostwick
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Vanessa Schick
- Department of Management, Policy and Community Health, University of Texas Health Sciences Center, Houston, TX, USA
| | - Tsung-Chieh Jane Fu
- Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - M Reuel Friedman
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Debby Herbenick
- Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, 47405, USA
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Duby Z, Nkosi B, Scheibe A, Brown B, Bekker LG. 'Scared of going to the clinic': Contextualising healthcare access for men who have sex with men, female sex workers and people who use drugs in two South African cities. South Afr J HIV Med 2018; 19:701. [PMID: 29568645 PMCID: PMC5843994 DOI: 10.4102/sajhivmed.v19i1.701] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 10/30/2017] [Indexed: 11/24/2022] Open
Abstract
Background Men who have sex with men (MSM), sex workers (SW) and people who use drugs (PWUD) are at increased risk for HIV because of multiple socio-structural barriers and do not have adequate access to appropriate HIV prevention, diagnosis and treatment services. Objective To examine the context of access to healthcare experienced by these three ‘Key Populations’, we conducted a qualitative study in two South African cities: Bloemfontein in the Free State province and Mafikeng in the North West province. Method We carried out in-depth interviews to explore healthcare workers’ perceptions, beliefs and attitudes towards Key Populations. Focus group discussions were also conducted with members of Key Populations exploring their experiences of accessing healthcare. Results Healthcare workers described their own attitudes towards Key Populations and demonstrated a lack of relevant knowledge, skills and training to manage the particular health needs and vulnerabilities facing Key Populations. Female SW, MSM and PWUD described their experiences of stigmatisation, and of being made to feel guilt, shame and a loss of dignity as a result of the discrimination by healthcare providers and other community. members. Our findings suggest that the uptake and effectiveness of health services amongst Key Populations in South Africa is limited by internalised stigma, reluctance to seek care, unwillingness to disclose risk behaviours to healthcare workers, combined with a lack of knowledge and understanding on the part of the broader community members, including healthcare workers. Conclusion This research highlights the need to address the broader healthcare provision environment, improving alignment of policies and programming in order to strengthen provision of effective health services that people from Key Populations will be able to access.
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Affiliation(s)
- Zoe Duby
- Desmond Tutu HIV Centre, Department of Medicine, University of Cape Town, South Africa
| | - Busisiwe Nkosi
- Desmond Tutu HIV Centre, Department of Medicine, University of Cape Town, South Africa
| | - Andrew Scheibe
- Desmond Tutu HIV Centre, Department of Medicine, University of Cape Town, South Africa
| | - Ben Brown
- Desmond Tutu HIV Centre, Department of Medicine, University of Cape Town, South Africa
| | - Linda-Gail Bekker
- Desmond Tutu HIV Centre, Department of Medicine, University of Cape Town, South Africa
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De Los Reyes A. Inaugural Editorial: Making the Journal of Clinical Child & Adolescent Psychology Your "Home Journal". JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2017; 46:1-10. [PMID: 28169578 DOI: 10.1080/15374416.2016.1266649] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Andres De Los Reyes
- a Comprehensive Assessment and Intervention Program, Department of Psychology , University of Maryland at College Park
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