1
|
Samek DR, Akua BA, Crumly B, Duke-Marks A. Increasing mental health issues in college students from 2016-2019: Assessing the intersections of race/ethnicity, gender, and sexual orientation. J Affect Disord 2024; 354:216-223. [PMID: 38484884 DOI: 10.1016/j.jad.2024.03.068] [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: 10/19/2023] [Revised: 02/27/2024] [Accepted: 03/09/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND This study aimed to evaluate how trends in mental health (e.g., diagnosis/treatment of depression, anxiety, suicidal ideation) varied across intersections of gender, race/ethnicity, and sexual orientation in a large, national sample of undergraduate students. METHODS Data from the American College Health Association, and National College Health Assessment II: 2016-2019 were analyzed (N = 228,640 undergraduate students from 442 campuses, ages 18-24; 67.8 % female, 40.4 % BIPOC, 3.0 % non-binary (trans/non-conforming), 19.4 % LGBQ+). We used logistic regression to predict each mental health indicator; covariates included year, gender, BIPOC, LGBQ+ status, and their interactions, as well as other covariate controls (e.g., region, year in school). RESULTS There were significant and steady increases in the odds of each mental health indicator by year (ORs = 1.12-1.13), which were significantly greater in magnitude for LGBQ+ students (ORs = 1.20-1.23). Increases did not vary by gender, race/ethnicity, or intersections between these groups and LGBQ+ status. There were significant interactions between identity groups that aligned with intersectional and minority stress theories (which did not vary by year). Non-Hispanic White students had significantly greater odds of past-year treatment/diagnosis of depression and anxiety compared to BIPOC students; however, BIPOC students had significantly greater odds of past-year suicidal ideation and this was pronounced for BIPOC women. Being non-binary x LGBQ+ was associated with significantly greater odds of each indicator. DISCUSSION Results affirm the importance of promoting mental health among college students, with a particular focus on how to better serve and support BIPOC, non-binary, and LGBQ+ students.
Collapse
|
2
|
Smith MS, Sarno EL, Price C, Sajwani A, Mustanski B, Newcomb ME. Dyadic Moderators of the Minority Stress-HIV Risk Association in Male Couples. AIDS Behav 2024; 28:2023-2033. [PMID: 38489139 DOI: 10.1007/s10461-024-04303-4] [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] [Accepted: 02/22/2024] [Indexed: 03/17/2024]
Abstract
Minority stressors have been linked to HIV risk behaviors among gay, bisexual, queer, and other men who have sex with men (MSM). Committed partnerships are a key context for new HIV infections and coping with minority stress among MSM, but very little work has tested the minority stress-HIV risk link among male couples, and little is known about how processes within one's relationship may exacerbate or buffer this association. The present study examined links between minority stress (i.e., internalized stigma, microaggressions) and HIV transmission risk behaviors (i.e., condomless anal sex with outside partners, breaks in relationship agreements) among male couples, as well as relationship-based moderators (i.e., social support, dyadic coping) of these associations. An analytic sample of male couples from a large cohort study (analytic N = 410 individuals, 205 dyads) completed self-report measures of minority stress, relationship-based moderators, and HIV transmission risk behaviors which were submitted to moderated actor-partner interdependence models (APIMs). In many cases, coping with stress with one's partner buffered the minority stress-HIV transmission link risk. However, findings also suggested situations in which partners may overburden one another with coping, thus exacerbating HIV-related risk behaviors.
Collapse
Affiliation(s)
- Madison Shea Smith
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Elissa L Sarno
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Cole Price
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Afiya Sajwani
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA.
| | - Michael E Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| |
Collapse
|
3
|
DeSon JJ, Andover MS. Microaggressions Toward Sexual and Gender Minority Emerging Adults: An Updated Systematic Review of Psychological Correlates and Outcomes and the Role of Intersectionality. LGBT Health 2024; 11:249-268. [PMID: 37906109 DOI: 10.1089/lgbt.2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023] Open
Abstract
Purpose: Quantitative data on the psychological effects of microaggressions toward sexual and gender minority individuals have grown substantially. Sexual orientation-based and transgender and gender-diverse (trans+) identity-based microaggressions have been thematically identified in prior research. In addition, combined lesbian, gay, bisexual, transgender and gender-diverse, queer/questioning, and other non-heterosexual (LGBTQ) microaggressions can be examined intersectionally with other marginalized identities. This systematic review synthesizes research on the relationships among these microaggressions and psychological correlates and outcomes. Methods: Forty-five quantitative studies examining sexual orientation-, trans+ identity-, or intersectional identity-based microaggressions and various psychological outcomes were identified from systematic searches of PsycINFO, PsycARTICLES, MEDLINE, and PubMed databases. Data regarding microaggressions were extracted, synthesized, and grouped by mental health outcome or correlate. Results: Sexual orientation-based microaggressions were risk factors for depression, anxiety, and internalized stigma and were positively associated with psychological distress, traumatic stress symptoms, alcohol use and abuse, cannabis use and problems, suicidal ideation, and suicide attempt. Trans+ identity-based microaggressions were positively associated with depression, suicide attempt, and cannabis use. LGBTQ intersectional identity-based microaggressions concerning race/ethnicity were associated with depression, anxiety, and suicidal ideation. Research on other intersectional identity-based microaggressions is scarce. Conclusion: These findings emphasize the psychological harm inflicted by various microaggressions on LGBTQ late adolescents and early adults. Future work should focus on microaggressions toward individuals with trans+ and intersectional identities and protective factors for these experiences. This review also highlights the distinct need for community-based research on implementing microintervention strategies in family, school, and work environments to mitigate the harmful effects of these microaggressions.
Collapse
Affiliation(s)
- Joshua J DeSon
- Department of Psychology, Fordham University, Bronx, New York, USA
| | | |
Collapse
|
4
|
Caba AE, Christophe NK, Renley BM, Simon KA, Feinstein BA, Eaton LA, Watson RJ. Measurement invariance of the LGBT People of Color Microaggressions Scale among LGBTQ+ youth. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024. [PMID: 38616300 DOI: 10.1111/jora.12937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 10/16/2023] [Accepted: 03/15/2024] [Indexed: 04/16/2024]
Abstract
The LGBT People of Color Microaggressions Scale (LGBT-PCMS) is a widely used measure of intersectional microaggression experiences among sexual and gender minority people of color. Although it is widely used-and increasingly used in adolescent and young adult samples-it is unknown whether the LGBT-PCMS demonstrates similar measurement properties across subgroups of sexual and gender minority youth of color (SGMYOC). Among 4142 SGMYOC (ages 13-17) we found evidence for either partial or full scalar invariance (item loadings and intercepts were generally equal) across sexual orientation, race-ethnicity, and gender identity groups for all three subscales. Specific patterns of invariance and noninvariance across groups, as well as implications for the use of the LGBT-PCMS and its subscales among SGMYOC are discussed.
Collapse
Affiliation(s)
- Antonia E Caba
- Department of Human Development and Family Sciences, University of Connecticut, Storrs Mansfield, Connecticut, USA
| | | | - Benton M Renley
- Department of Human Development and Family Sciences, University of Connecticut, Storrs Mansfield, Connecticut, USA
| | - Kay A Simon
- Department of Family Social Science, University of Minnesota, Minneapolis, Minnesota, USA
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Lisa A Eaton
- Department of Human Development and Family Sciences, University of Connecticut, Storrs Mansfield, Connecticut, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs Mansfield, Connecticut, USA
| |
Collapse
|
5
|
Pharr JR, Chien LC, Gakh M, Flatt JD, Kittle K, Terry E. Moderated Mediation Analysis of Structural Stigma and Suicidal Ideation and Behaviors Among Sexual and Gender Minority Adults. LGBT Health 2024; 11:239-248. [PMID: 38285526 DOI: 10.1089/lgbt.2022.0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024] Open
Abstract
Purpose: This study aimed to conduct a moderated mediation analysis to understand further the complex pathways through which structural stigma in the form of transgender sports bans was associated with suicidal ideation and behaviors among sexual and gender minority (SGM) adults. Methods: A cross-sectional survey of 1033 adults who identified as SGM from across the 50 U.S. states and Washington, DC was conducted between January 28 and February 7, 2022. Distal discrimination distress was the mediation variable; individual resilience and social resources were the moderation variables. Familiarity with transgender sports bans represented structural stigma. The conditional process analysis was applied to build a moderated mediation model. Both conditional direct and indirect effects were computed by estimated coefficients. All models were based on linear regression. Results: Our final model explained nearly half (46%) of the variation in suicidal ideation and behaviors between those SGM adults familiar and those not familiar with transgender sports bans. Social resources significantly moderated the conditional indirect effect of distal discrimination distress (adjusted estimate = -0.23; 95% confidence interval = -0.37 to -0.08). Conclusion: Both discrimination distress and social resources influenced the association between structural stigma as measured by familiarity with transgender sports bans and suicidal ideation and behaviors among SGM adults. Findings support the need for future research examining the pathway between structural stigma and suicidal ideation and behaviors among SGM adults and how minority stress, social safety, and other constructs shape this pathway.
Collapse
Affiliation(s)
- Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Maxim Gakh
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jason D Flatt
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Krystal Kittle
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| |
Collapse
|
6
|
Craig A, Walsh J, Quinn K. Intersectional Microaggressions, Sexual Identity Concealment, and Mental Health of Young Black Sexual Minority Men and Transgender Women. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1245-1254. [PMID: 38114872 DOI: 10.1007/s10508-023-02777-2] [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: 06/20/2022] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/21/2023]
Abstract
Previous research has demonstrated associations between experiences of microaggressions and negative mental and physical health outcomes, and national organizations such as the Centers for Disease Control and Prevention have acknowledged racism as a public health issue. Individuals with multiple marginalized identities, such as young Black men who have sex with men and transgender women, are commonly affected by discrimination and stigma, contributing to health disparities. One possible path by which microaggressions are linked to negative health outcomes for these groups is their impact on individuals' decisions to conceal their sexual identity, in some cases leading to increased stress and use of maladaptive coping strategies. We surveyed 280 young Black male (86%) and transgender or non-binary (14%) individuals between the ages of 16-25 years old (M = 21.68, SD = 2.73) who reported being recently sexually active with men about their experiences with intersectional microaggressions, concealment of their sexual identity, psychological distress, and substance use before and during sexual activity. Structural equation modeling revealed that experiences of microaggressions were associated with greater sexual identity concealment, and concealment partially mediated the relationship between microaggressions and psychological distress. While microaggressions were associated with greater substance use, sexual identity concealment did not mediate this relationship. Findings have implications for addressing health disparities among this population.
Collapse
Affiliation(s)
- Amber Craig
- Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Wauwatosa, WI, 53226, USA.
| | - Jennifer Walsh
- Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Wauwatosa, WI, 53226, USA
- The Center for AIDS Intervention Research, The Medical College of Wisconsin, Wauwatosa, WI, USA
| | - Katherine Quinn
- Department of Psychiatry and Behavioral Medicine, The Medical College of Wisconsin, Wauwatosa, WI, 53226, USA
- The Center for AIDS Intervention Research, The Medical College of Wisconsin, Wauwatosa, WI, USA
| |
Collapse
|
7
|
Adzrago D, Thapa K, Rajbhandari-Thapa J, Sulley S, Williams F. Influence of biopsychosocial factors on self-reported anxiety/depression symptoms among first-generation immigrant population in the U.S. BMC Public Health 2024; 24:819. [PMID: 38491362 PMCID: PMC10941619 DOI: 10.1186/s12889-024-18336-w] [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] [Received: 06/19/2023] [Accepted: 03/12/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Despite increasing studies on mental health among immigrants, there are limited studies using nationally representative samples to examine immigrants' mental health and its potential biopsychosocial contributing factors, especially during the COVID-19 pandemic. We explored and estimated the influence of life satisfaction, social/emotional support, and other biopsychosocial factors on self-reported anxiety/depression symptoms among a nationally representative sample of first-generation immigrants in the U.S. METHODS We conducted a secondary data analysis using the 2021 National Health Interview Survey among first-generation adults aged ≥ 18 years (n = 4295). We applied survey weights and developed multivariable logistic regression model to evaluate the study objective. RESULTS The prevalence of daily, weekly, or monthly anxiety/depression symptoms was 10.22% in the first-generation immigrant population. There were 2.04% daily, 3.27% weekly, and 4.91% monthly anxiety/depression among the population: about 8.20%, 9.94%, and 9.60% experienced anxiety symptoms, whereas 2.49%, 3.54%, and 5.34% experienced depression symptoms daily, weekly, and monthly, respectively. The first-generation population aged 26-49 years were less likely to experience anxiety/depression daily, weekly, or monthly compared to those aged 18-25. Females (versus males) were more likely to experience anxiety/depression daily, weekly, or monthly. Those who identified as gay/lesbian had higher odds of experiencing anxiety/depression daily, weekly, or monthly compared to heterosexual persons. Relative to non-Hispanic White individuals, non-Hispanic Asian, Black/African American, and Hispanic individuals had lower odds, while other/multi-racial/ethnic groups were more likely to experience anxiety/depression daily, weekly, or monthly. A higher life satisfaction score was associated with lower odds of experiencing anxiety/depression daily, weekly, or monthly. Having social/emotional support sometimes/rarely or using healthcare within the past one/two years was associated with experiencing anxiety/depression daily, weekly, or monthly. CONCLUSIONS The findings reveal significant burden of anxiety and depression among first-generation population in the U.S., with higher risks among subgroups like young adults, females, sexual minorities, and non-Hispanic White and other/multi-racial individuals. Additionally, individuals with lower life satisfaction scores, limited social/emotional support, or healthcare utilization in the past one or two years present increased risk. These findings highlight the need for personalized mental health screening and interventions for first-generation individuals in the U.S. based on their diversity and health-related risks.
Collapse
Affiliation(s)
- David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 20852, Bethesda, MD, USA.
| | - Kiran Thapa
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | | | - Saanie Sulley
- National Healthy Start Association, Washington, DC, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 20852, Bethesda, MD, USA
| |
Collapse
|
8
|
Oh H, Winn JG, Li Verdugo J, Bañada R, Zachry CE, Chan G, Okine L, Park J, Formigoni M, Leaune E. Mental health outcomes of multiracial individuals: A systematic review between the years 2016 and 2022. J Affect Disord 2024; 347:375-386. [PMID: 38008291 DOI: 10.1016/j.jad.2023.11.040] [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: 10/21/2022] [Revised: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Emerging evidence suggests that multiracial individuals are at high risk for mental health problems. Systematic and ongoing synthesis of literature is necessary to understand mental health among multiracial individuals. METHODS We conducted a systematic review of scholarly articles published during the years 2016-2022. Studies must have focused explicitly on mental health outcomes of biracial/multiracial individuals using quantitative methods. A total of 22 articles met criteria for this review. RESULTS Studies were mainly from the United States, with one study from the United Kingdom and one from the Netherlands. Sample sizes ranged from 57 to 393,681. Findings revealed a complicated picture between multiracial identity and mental health, which may be a function of how multiracial identity is defined and empirically examined. Among studies comparing multiracial individuals with monoracial groups, multiracial individuals tended to have worse mental health, with notable exceptions depending on the multiracial subgroup, the mental health outcome, and the reference group. Among studies that only examined multiracial individuals, discrimination and ethno-racial identity emerged as complex explanatory factors that can shape mental health, though each of these constructs can be explored more deeply across social milieu. LIMITATIONS The review focused on studies explicitly examining multiracial mental health, published during a limited time frame. CONCLUSION Multiracial individuals tended to have worse mental health outcomes compared to their monoracial counterparts, with variations depending on the outcomes, populations/subgroups, contexts, and reference groups. Racial discrimination and ethno-racial identity may shape mental health trajectories of multiracial people, calling for more research to inform targeted interventions.
Collapse
Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, USA.
| | | | | | - Ronna Bañada
- Suzanne Dworak Peck School of Social Work, University of Southern California, USA.
| | - Corinne E Zachry
- Suzanne Dworak Peck School of Social Work, University of Southern California, USA.
| | - Gloria Chan
- Suzanne Dworak Peck School of Social Work, University of Southern California, USA.
| | - Lucinda Okine
- Suzanne Dworak Peck School of Social Work, University of Southern California, USA.
| | - Juyoung Park
- Suzanne Dworak Peck School of Social Work, University of Southern California, USA.
| | - Marco Formigoni
- Suzanne Dworak Peck School of Social Work, University of Southern California, USA.
| | - Edouard Leaune
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France.
| |
Collapse
|
9
|
Hascher K, Jaiswal J, LoSchiavo C, Ezell J, Duffalo D, Greene RE, Cox A, Burton WM, Griffin M, John T, Grin B, Halkitis PN. Lack of Informed and Affirming Healthcare for Sexual Minority Men: A Call for Patient-Centered Care. J Gen Intern Med 2024:10.1007/s11606-024-08635-8. [PMID: 38308157 DOI: 10.1007/s11606-024-08635-8] [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: 04/04/2023] [Accepted: 01/16/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Sexual minority men (SMM) face severe health inequities alongside negative experiences that drive avoidance of medical care. Understanding how SMM experience healthcare is paramount to improving this population's health. Patient-centered care, which emphasizes mutual respect and collaboration between patients and providers, may alleviate the disparaging effects of the homophobia that SMM face in healthcare settings. OBJECTIVE To explore how SMM perceive their experiences with healthcare providers and how care can most effectively meet their needs. DESIGN Semi-structured qualitative interviews focused on healthcare experiences, pre-exposure prophylaxis (PrEP), and HIV-related beliefs were conducted between July and November 2018. PARTICIPANTS The study included a sample of 43 young adult SMM (ages 25-27), representing diverse socioeconomic, racial, and ethnic backgrounds, in New York City. APPROACH Researchers utilized a multiphase, systematic coding method to identify salient themes in the interview transcripts. KEY RESULTS Analyses revealed three main themes: (1) SMM perceived that their clinicians often lack adequate skills and knowledge required to provide care that considers participants' identities and behaviors; (2) SMM desired patient-centered care as a way to regain agency and actively participate in making decisions about their health; and (3) SMM felt that patient-centered care was more common with providers who were LGBTQ-affirming, including many who felt that this was especially true for LGBTQ-identified providers. CONCLUSIONS SMM expressed a clear and strong desire for patient-centered approaches to care, often informed by experiences with healthcare providers who were unable to adequately meet their needs. However, widespread adoption of patient-centered care will require improving education and training for clinicians, with a focus on LGBTQ-specific clinical care and cultural humility. Through centering patients' preferences and experiences in the construction of care, patient-centered care can reduce health inequities among SMM and empower healthcare utilization in a population burdened by historic and ongoing stigmatization.
Collapse
Affiliation(s)
- Kevin Hascher
- Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Jessica Jaiswal
- Department of Family and Community Medicine, University of Alabama, Birmingham School of Medicine, Birmingham, AL, 35294, USA.
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, 06510, USA.
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, 07102, USA.
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
| | - Caleb LoSchiavo
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, 07102, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, 08854, USA
| | - Jerel Ezell
- Department of Community Health Sciences, UC Berkeley, Berkeley, CA, 94720, USA
- Center for Cultural Humility, UC Berkeley, Berkeley, CA, 94720, USA
| | - Danika Duffalo
- School of Medicine, Creighton University, Phoenix, AZ, USA
| | - Richard E Greene
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, 10001, USA
| | - Amanda Cox
- Culverhouse College of Business, University of Alabama, Tuscaloosa, AL, USA
| | - Wanda M Burton
- Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, 35401, USA
| | - Marybec Griffin
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, 08854, USA
| | - Tejossy John
- Department of Family and Community Medicine, University of Alabama, Birmingham School of Medicine, Birmingham, AL, 35294, USA
| | - Benjamin Grin
- Department of Primary Care, Kansas City University College of Osteopathic Medicine, Kansas City, MO, 64106, USA
| | - Perry N Halkitis
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, 07102, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, 08854, USA
- Department of Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ, 07102, USA
| |
Collapse
|
10
|
Yang W, Craig SL, Anderson JAE, Ross LE, Muntaner C. Sexual orientation and cognition in aging populations: Results from the Canadian Longitudinal Study on Aging. Acta Psychol (Amst) 2024; 242:104117. [PMID: 38134682 DOI: 10.1016/j.actpsy.2023.104117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
The current study utilized the Canadian Longitudinal Study on Aging (CLSA) data to investigate the relationship between sexual orientation and cognitive health of the aging population. Cognitive flexibility and verbal fluency were examined as outcome variables in the study. A total of 45,993 respondents were included in the analyses. Each model had social support or social participation as a mediator. A series of mediation analysis, stratified by gender, revealed that aging gay men performed better in cognitive tasks related to cognitive flexibility when compared to their heterosexual counterparts. The results also indicated that social support is a protective factor for cognitive health in aging lesbian women. This study provides an opportunity to consider how clinical and social services can strategize to build inclusive environments for the aging sexual minority population.
Collapse
Affiliation(s)
- Wook Yang
- Rongxiang Xu College of Health and Human Services, California State University Los Angeles, 5151 State University Drive, Los Angeles, CA 90032, USA
| | - Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada
| | - John A E Anderson
- Department of Cognitive Science, Carleton University, 2202A Dunton Tower, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada
| | - Lori E Ross
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada
| | - Carles Muntaner
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada
| |
Collapse
|
11
|
Green NA. Beyond gender: The biological impacts of inequality through the lens of intersectionality. Proc Natl Acad Sci U S A 2024; 121:e2319314121. [PMID: 38252834 PMCID: PMC10835038 DOI: 10.1073/pnas.2319314121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024] Open
Affiliation(s)
- Natalie A Green
- The Center for Health and Aging Innovation, Silver School of Social Work, New York University, New York, NY 10003
| |
Collapse
|
12
|
Bochicchio L, Porsch L, Zollweg S, Matthews AK, Hughes TL. Health Outcomes of Sexual Minority Women Who Have Experienced Adverse Childhood Experiences: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:764-794. [PMID: 37070743 PMCID: PMC10582204 DOI: 10.1177/15248380231162973] [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] [Indexed: 06/19/2023]
Abstract
Sexual minority women (SMW; e.g., lesbian, bisexual) report higher rates of almost every negative physical health (e.g., asthma, arthritis, cardiovascular disease), mental health (e.g., depression, anxiety), and substance use outcome compared to heterosexual women. Adverse Childhood Experiences (ACEs) have been identified as risk factors for negative health outcomes. Despite this, no study to date has synthesized existing literature examining ACEs and health outcomes among SMW. This gap is important because SMW are significantly more likely than heterosexual women to report every type of ACE and a higher total number of ACEs. Therefore, using a scoping review methodology, we sought to expand understanding of the relationship between ACEs and health outcomes among SMW. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for. Scoping Reviews protocol, we searched five databases: Web of Science, PsycInfo, CINAHL, PubMed, and Embase for studies published between January 2000 and June 2021 that examined mental health, physical health, and/or substance use risk factors and outcomes among adult cisgender SMW who report ACEs. Our search yielded 840 unique results. Studies were screened independently by two authors to determine eligibility, and 42 met full inclusion criteria. Our findings provide strong evidence that ACEs are an important risk factor for multiple negative mental health and substance use outcomes among SMW. However, findings were mixed with respect to some health risk behaviors and physical health outcomes among SMW, highlighting the need for future research to clarify these relationships.
Collapse
Affiliation(s)
| | - Lauren Porsch
- Columbia University School of Nursing, New York, NY, USA
| | - Sarah Zollweg
- Columbia University School of Nursing, New York, NY, USA
| | | | | |
Collapse
|
13
|
Hsieh C, Charak R, Razo G, Tabler J, Schmitz RM. Associations between Sexual Minority Identities, Heterosexism, Identity Concealment, and Depression in Lesbian, Gay, and Bisexual Emerging Adults: Adjusting for the Effects of General Stressors. South Med J 2023; 116:923-929. [PMID: 38051164 DOI: 10.14423/smj.0000000000001625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVES Lesbian, gay, and bisexual (LGB) individuals experience stressors distinctively tied to their sexual identities, such as externalized and internalized heterosexism and identity concealment, which are correlated with increased psychological distress, including depression. The present study examined the variance in depression scores resulting from heterosexism, LGB identity concealment, and minority sexual identities, after adjusting for race/ethnicity and interpersonal violence victimization experiences. METHODS Participants were 277 LGB emerging adults 18 to 29 years old (mean 25.39, standard deviation 2.77; 46 lesbian women, 71 gay men) recruited from an online platform. RESULTS Nearly 41% reported moderate to severe depression symptoms. A two-step hierarchical regression model examining the effect of sexual minority stressors, heterosexism, LGB identity concealment, and minority sexual identity on depression after controlling for childhood maltreatment and face-to-face intimate partner violence types was significant. Bisexual women (vs gay men), those with greater exposure to heterosexism, and those with a greater degree of identity concealment experienced significantly higher scores on depression. In addition, being a person of color (including identifying as Hispanic), exposure to childhood maltreatment, and experiencing psychological intimate partner violence significantly predicted increases in depression scores. CONCLUSIONS Findings emphasize the importance of assessing minority stressors and taking them into account when providing clinical interventions to LGB individuals.
Collapse
Affiliation(s)
- Claire Hsieh
- From the Department of Psychological Science, the University of Texas Rio Grande Valley, Edinburg
| | - Ruby Charak
- From the Department of Psychological Science, the University of Texas Rio Grande Valley, Edinburg
| | - Gisselle Razo
- From the Department of Psychological Science, the University of Texas Rio Grande Valley, Edinburg
| | - Jennifer Tabler
- Department of Criminal Justice and Sociology, University of Wyoming, Laramie
| | | |
Collapse
|
14
|
Lei C, Qu D, Liu K, Chen R. Ecological Momentary Assessment and Machine Learning for Predicting Suicidal Ideation Among Sexual and Gender Minority Individuals. JAMA Netw Open 2023; 6:e2333164. [PMID: 37695580 PMCID: PMC10495869 DOI: 10.1001/jamanetworkopen.2023.33164] [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] [Received: 05/13/2023] [Accepted: 08/03/2023] [Indexed: 09/12/2023] Open
Abstract
Importance Suicidality poses a serious global health concern, particularly in the sexual and gender minority population. While various studies have focused on investigating chronic stressors, the precise prediction effect of daily experiences on suicide ideation remains uncertain. Objective To test the extent to which mood fluctuations and contextual stressful events experienced by sexual and gender minority individuals may predict later short- and long-term suicide ideation. Design, Setting, and Participants This diagnostic study collected twice-daily data on mood states and stressful events from sexual and gender minority individuals over 25 days throughout 3 waves of the Chinese Lunar New Year (before, during, and after), and follow-up surveys assessing suicidal ideation were conducted 1, 3, and 8 months later. Online recruitment advertisements were used to recruit young adults throughout China. Eligible participants were self-identified as sexual and gender minority individuals aged 18 to 29 years. Those who were diagnosed with psychotic disorders (eg, schizophrenia spectrum or schizotypal disorder) or prevented from objective factors (ie, not having a phone or having an irregular sleep rhythm) were excluded. Data were collected from January to October 2022. Main Outcomes and Measures To predict short-term (1 month) and longer-term (3 and 8 months) suicidal ideation, the study tested several approaches by using machine learning including chronic stress baseline data (baseline approach), dynamic patterns of mood states and stressful events (ecological momentary assessment [EMA] approach), and a combination of baseline data and dynamic patterns (EMA plus baseline approach). Results A total of 103 sexual and gender minority individuals participated in the study (mean [SD] age, 24.2 [2.5] years; 72 [70%] female). Of these, 19 (18.4%; 95% CI, 10.9%-25.9%), 25 (24.8%; 95% CI, 16.4%-33.2%), 30 (29.4%; 95% CI, 20.6%-38.2%), and 32 (31.1%; 95% CI, 22.2%-40.0%) reported suicidal ideation at baseline, 1, 3, and 8 months follow-up, respectively. The EMA approach showed better performance than the baseline and baseline plus EMA approaches at 1-month follow-up (area under the receiver operating characteristic curve [AUC], 0.80; 95% CI, 0.78-0.81) and slightly better performance on the prediction of suicidal ideation at 3 and 8 months' follow-up. In addition, the best approach predicting suicidal ideation was obtained during Lunar New Year period at 1-month follow-up, which had a mean AUC of 0.77 (95% CI, 0.74-0.79) and better performance at 3 and 8 months' follow-up (AUC, 0.74; 95% CI, 0.72-0.76 and AUC, 0.72; 95% CI, 0.69-0.74, respectively). Conclusions and Relevance The findings in this study emphasize the importance of contextual risk factors experienced by sexual and gender minority individuals at different stages. The use of machine learning may facilitate the identification of individuals who are at risk and aid in the development of personalized process-based early prevention programs to mitigate future suicide risk.
Collapse
Affiliation(s)
- Chang Lei
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Kunxu Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| |
Collapse
|
15
|
Yang W, Craig SL, Ross LE, Anderson JAE, Muntaner C. Impact of Neighborhood Deprivation on Aging Sexual Minority People's Depression: Results from the CANUE and CLSA data. Arch Gerontol Geriatr 2023; 112:105013. [PMID: 37058815 DOI: 10.1016/j.archger.2023.105013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023]
Abstract
As the aging population grows across the world, exploring the impact of social environment on minority populations' aging and well-being would be an essential step towards building an inclusive society. Using the Canadian Longitudinal Study on Aging (CLSA) and Canadian Urban Environmental Health Research Consortium (CANUE) data, the study investigated the relationship between deprivation and depression level in aging sexual minority people to examine how neighborhood level social and material deprivation influence mental health. 48,792 survey respondents were included in our analyses and the average age was 62.9. The study had 47,792 heterosexual, 760 gay/lesbian, and 240 bisexual individuals (23,977 men and 24,815 women). Regression analyses were conducted while controlling for age in each model. Results revealed that neighborhood material deprivation has a significant impact on mental health outcomes of aging lesbian women and bisexual men. The study provides an opportunity for intervention considerations for materially deprived neighborhoods to serve the aging sexual minority people residing in such areas.
Collapse
Affiliation(s)
- Wook Yang
- Rongxiang Xu College of Health and Human Services, California State University, Los Angeles, 5151 State University Drive, Los Angeles, California, USA 90032.
| | - Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, Canada M5S 1V4
| | - Lori E Ross
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, Canada M5T 3M7
| | - John A E Anderson
- Department of Cognitive Science, Carleton University, 2202A Dunton Tower, 1125 Colonel By Drive, Ottawa, Ontario, Canada K1S 5B6
| | - Carles Muntaner
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, Canada M5T 3M7; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, Ontario, Canada M5T 3M7
| |
Collapse
|
16
|
Barbee H, McKay T. Do supportive work environments matter for minority aging? Work stress and subjective cognitive impairment among middle-age and older lesbian, gay, bisexual, transgender, and queer adults. Acta Psychol (Amst) 2023; 237:103949. [PMID: 37267881 PMCID: PMC11089649 DOI: 10.1016/j.actpsy.2023.103949] [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] [Received: 07/15/2022] [Revised: 04/08/2023] [Accepted: 05/21/2023] [Indexed: 06/04/2023] Open
Abstract
Research has documented how people's experiences at work affect their cognitive health outcomes, but how these processes unfold for minority groups, particularly lesbian, gay, bisexual, transgender, and queer (LGBTQ+) populations, is unclear. This study builds on the nascent literature by employing generalized structural equation models to test how experiencing major problems at work and working with LGBTQ+ supportive coworkers affect subjective cognitive impairment among middle-age and older LGBTQ+ adults. We also test for mediated and indirect effects of support and problems at work operating via vascular disease, sleep problems, and depression symptoms. Experiencing major problems at work is associated with a higher likelihood of reporting cognitive symptoms consistent with mild cognitive impairment, but this relationship is mediated by depression symptoms and sleep problems. Having LGBTQ+ supportive coworkers does not have direct effects on mild cognitive impairment, but does operate indirectly by decreasing problems at work and, in turn, decreases the likelihood of reporting cognitive symptoms consistent with mild cognitive impairment. Overall, we find that workplace stressors contribute to cognitive health directly and through mediated and indirect pathways and that supportive contexts reduce exposure to problems at work. We conclude with suggested possibilities to reorganize workplaces to improve long-term cognitive health outcomes for older adults, especially those who are LGBTQ+-identified.
Collapse
Affiliation(s)
- Harry Barbee
- Johns Hopkins University, United States of America.
| | - Tara McKay
- Vanderbilt University, United States of America.
| |
Collapse
|
17
|
Behler AC, George N, Collibee C, Hamilton L, Oleson EB, Thamotharan S. A conceptual framework for queer, black womxn sexual assault survivors: an adaptation of the minoritised stress model. CULTURE, HEALTH & SEXUALITY 2023; 25:791-802. [PMID: 35900895 DOI: 10.1080/13691058.2022.2089734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 06/10/2022] [Indexed: 06/02/2023]
Abstract
Queer, Black womxn experience sexual assault at an alarming rate in the USA leading to adverse mental and physical health outcomes in survivors. A synthesis of the literature was conducted to understand their unique lived experiences and needs. This article proposes an adapted Meyer's Minoritised Stress framework to understand salient clinical factors impacting Queer, Black womxn sexual assault survivors, including those associated with multiple minoritised identities: Queer-based trauma, race-based trauma, cultural betrayal trauma, and misogynoir. Given the high rates of victimisation, marginalisation and discrimination, psychologists and others working with members of this population should engage with and address these factors to provide culturally responsive, sexually affirming and effective mental health treatment and care.
Collapse
Affiliation(s)
| | - Nevita George
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Charlene Collibee
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Lindsey Hamilton
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Erik B Oleson
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Sneha Thamotharan
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| |
Collapse
|
18
|
Weeks SN, Renshaw TL, Vinal SA. Minority Stress as a Multidimensional Predictor of LGB+ Adolescents' Mental Health Outcomes. JOURNAL OF HOMOSEXUALITY 2023; 70:938-962. [PMID: 34806974 DOI: 10.1080/00918369.2021.2006000] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The minority stress model has been used to explain added daily stressors that non-heterosexual (LGB+) individuals experience. While the emphasis of minority stress research is frequently broad (global minority stress) or narrow (specific stressors) in focus, the literature often refers to specific stressors at the domain level as either distal (external) or proximal (internal). This study found that, compared with broad and narrow levels, a domain level approach may be best for understanding the predictive value of minority stress. Multiple regression analyses with a sample of 152 LGB+ adolescents found that distal stress predicted substance misuse (p < .001) and suicidality (p = .002) and was a stronger predicter than proximal stress for psychological inflexibility. This study might contribute to an evidence base that could guide measurement approaches for assessing minority stress and using related results to inform the prediction of-and, ultimately, intervention with-LGB+ adolescents' mental health outcomes.
Collapse
Affiliation(s)
- Sean N Weeks
- Department of Psychology, Utah State University, Logan, Utah, USA
| | - Tyler L Renshaw
- Department of Psychology, Utah State University, Logan, Utah, USA
| | | |
Collapse
|
19
|
Parra LA, Spahr CM, Goldbach JT, Bray BC, Kipke MD, Slavich GM. Greater lifetime stressor exposure is associated with poorer mental health among sexual minority people of color. J Clin Psychol 2023; 79:1130-1155. [PMID: 36459589 PMCID: PMC10010942 DOI: 10.1002/jclp.23463] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/25/2022] [Accepted: 11/04/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Research has shown that sexual minority people of color experience pervasive and sometimes severe life stressors that increase their risk of experiencing mental health problems, and that can contribute to lifelong health disparities. However, no studies in this population have investigated stressor exposure occurring over the entire lifespan. Moreover, it remains unknown whether these stressor-health effects differ based on the timing or types of stressors experienced. PURPOSE The purpose of this study is to examine how cumulative lifetime stressor exposure is associated with mental health among Black, Latinx, and biracial Black-Latinx sexual minority persons. METHOD Participants were 285 ethnic/racial minority young adults (Mage = 25.18 years old, SD = 1.94, age range = 19-29 years), who completed the Stress and Adversity Inventory for Adults to assess for retrospective reports of lifetime stressor count and severity. The Brief Symptom Inventory was used to assess participants' symptoms of anxiety, depression, and somatization, which were the main outcomes. Most participants identified as cisgender male (94.7%) and gay (74.2%), with the remaining participants identifying as transgender or genderqueer/nonbinary for gender and bisexual/pansexual, queer, or another sexual orientation. RESULTS Multiple regression analyses indicated that experiencing more-and more severe-stressors across the lifespan was related to greater anxiety, depressive, and somatization symptoms. These effects were robust while controlling for race/ethnicity, sexual orientation, education, and employment status, and they differed based on stressor exposure timing, type, primary life domain, and core social-psychological characteristic. CONCLUSION Greater cumulative lifetime stressor exposure is related to poorer mental health among sexual minority people of color. Screening for lifetime stressors may thus help identify at-risk persons and provide an opportunity to intervene to help mitigate or prevent mental health disparities in multiply stigmatized adults.
Collapse
Affiliation(s)
- Luis A. Parra
- School of Nursing, University of Michigan, Ann Arbor, MI USA
| | - Chandler M. Spahr
- Department of Psychology, University of California, Riverside, CA, USA
| | | | - Bethany C. Bray
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, USA
| | - Michele D. Kipke
- Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Departments of Pediatrics and Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| |
Collapse
|
20
|
Han M, Wang Y, Zhang Y, Wang Y, Ou J, Ren D, Cai C, Liu K, Li R, Han J, Chen R. A multicomponent digital intervention to promote help-seeking for mental health problems and suicide in sexual and gender diverse young adults: A randomized controlled trial. PLoS Med 2023; 20:e1004197. [PMID: 36877740 PMCID: PMC10027204 DOI: 10.1371/journal.pmed.1004197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 03/20/2023] [Accepted: 02/10/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND LGBTQ+ community's higher susceptibility to worse mental health outcomes and more help-seeking barriers compared to the cis-heterosexual population. Despite the LGBTQ+ population facing higher mental health risks, there has been a dearth of research focusing on developing tailored interventions targeting them. This study aimed to assess the effectiveness of a digital multicomponent intervention in promoting help-seeking for mental health issues in LGBTQ+ young adults. METHODS AND FINDINGS We recruited LGBTQ+ young adults aged between 18 and 29 who scored moderate or above on at least 1 dimension of the Depression Anxiety Stress Scale 21 and did not have help-seeking experiences in the past 12 months. Participants (n = 144) were stratified by gender assigned at birth (male/female) and randomly allocated (1:1 ratio) to the intervention or active control parallel condition by generating a random number table, so they were blinded to the intervention condition. All participants received online psychoeducational videos, online facilitator-led group discussions, and electronic brochures in December 2021 and January 2022, with the final follow-up in April 2022. The contents of the video, discussion, and brochure are help-seeking for the intervention group and general mental health knowledge for the control group. The primary outcomes were help-seeking intentions for emotional problems and suicidal ideation and attitudes toward seeking help from mental health professionals at the 1-month follow-up. The analysis was performed by including all participants based on their randomized group regardless of adherence to the protocol. A linear mixed model (LMM) was used for analysis. All models were adjusted for baseline scores. Chinese Clinical Trial Registry: ChiCTR2100053248. A total of 137 (95.1%) participants completed a 3-month follow-up, and 4 participants from the intervention condition and 3 from the control condition did not complete the final survey. Compared with the control group (n = 72), a significant improvement was found in help-seeking intentions for suicidal ideation in the intervention group (n = 70) at post-discussion (mean difference = 0.22, 95% CI [0.09, 0.36], p = 0.005), 1-month (mean difference = 0.19, 95% CI [0.06, 0.33], p = 0.018), and 3-month follow-ups (mean difference = 0.25, 95% CI [0.11, 0.38], p = 0.001). There was also a significant improvement in the intervention condition on the help-seeking intention for emotional problems at 1-month (mean difference = 0.17, 95% CI [0.05, 0.28], p = 0.013) and 3-month follow-ups (mean difference = 0.16, 95% CI [0.04, 0.27], p = 0.022) compared with the control group. Participants' depression and anxiety literacy and help-seeking encouragement related knowledge in intervention conditions showed significant improvements. There were no significant improvements in actual help-seeking behaviors, self-stigma toward seeking professional assistance, depression, and anxiety symptoms. No adverse events or side effects were observed. However, the follow-up time point was limited to 3 months which might not be long enough for drastic mindset and behavioral changes in help-seeking to occur. CONCLUSIONS The current intervention was an effective approach in promoting help-seeking intentions, mental health literacy, and help-seeking encouragement-related knowledge. Its brief yet integrated intervention format could also be utilized in treating other imminent concerns confronted by LGBTQ+ young adults. TRIAL REGISTRATION Chictr.org.cn, ChiCTR2100053248.
Collapse
Affiliation(s)
- Meng Han
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yinzhe Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Yanwen Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Jianjun Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Daixi Ren
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Chengxi Cai
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kunxu Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Runan Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Jin Han
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| |
Collapse
|
21
|
Gillin LE, Signorella ML. Attitudes Toward Sexual Orientation and Gender Identity in Online Multiplayer Gaming Spaces. Psychol Rep 2023:332941231153798. [PMID: 36688329 DOI: 10.1177/00332941231153798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Online video game communities can provide a sense of belonging and support for marginalized people, while at the same time, can be rife with prejudice and discrimination. This study aimed to assess the prevalence of both positive and negative comments about sexual orientation and gender identity during online gaming, and to test the hypothesis that LGBTQ+ people witness or experience more prejudice than do heterosexual and cisgender persons. An online survey, distributed on social media sites and a psychology subject pool, included rating scales and open-ended questions on game-related conversations. Respondents (N = 185) provided negative examples made by others more frequently than positive ones and attributed serious comments to themselves versus jokes and offhand comments to others. Across all respondent gender identities, the targets of the negative comments by others were almost always LGBTQ+ persons. These results bolster critiques of online gaming environments as hostile to members of marginalized groups.
Collapse
Affiliation(s)
- Laura E Gillin
- Department of Psychology, 52501The Pennsylvania State University, Brandywine, Media, USA
| | - Margaret L Signorella
- Department of Psychology, 52501The Pennsylvania State University, Brandywine, Media, USA
| |
Collapse
|
22
|
Kirakosian N, Stanton AM, McKetchnie SM, King D, Dolotina B, O'Cleirigh C, Grasso C, Potter J, Mayer KH, Batchelder AW. Suicidal Ideation Disparities Among Transgender and Gender Diverse Compared to Cisgender Community Health Patients. J Gen Intern Med 2023; 38:1357-1365. [PMID: 36650322 PMCID: PMC9844943 DOI: 10.1007/s11606-022-07996-2] [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: 04/13/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Transgender and gender diverse (TGD) individuals experience more severe psychological distress and may be at higher risk for suicide compared to cisgender individuals. The existing literature largely consists of small-sample studies that do not assess subgroup differences. OBJECTIVE To examine rates of self-reported suicidal ideation among four TGD groups compared to cisgender individuals. DESIGN Data were extracted from the electronic health records of patients receiving primary care at a community health center specializing in sexual and gender minority health. A logistic regression was used to examine the relationship between sociodemographic variables and the presence of current suicidal ideation. PARTICIPANTS 29,988 patients receiving care at a community health center in Northeastern US between 2015 and 2018. MAIN MEASURES Demographic questionnaire, 9-item Patient Health Questionnaire KEY RESULTS: Younger age, sexual and gender minority identity, and public/grants-based insurance were associated with significantly higher odds of suicidal ideation. Relative to cisgender men, transgender men (OR=2.08; 95% CI=1.29-3.36; p=.003), transgender women (OR=3.08; 95% CI=2.05-4.63; p<.001), nonbinary (NB) individuals assigned male at birth (AMAB; OR=3.55; 95% CI=1.86-6.77; p<001), and NB individuals assigned female at birth (AFAB; OR=2.49; 95% CI=1.52-4.07; p<001) all endorsed significantly higher odds of current suicidal ideation, controlling for age, race, ethnicity, sexual orientation, and insurance status. Larger proportions of transgender women (23.6%) and NB AMAB individuals (26.7%) reported suicidal ideation not only compared to cisgender men (6.1%) and women (6.6%), but also compared to transgender men (17.4%; χ2[5, n=25,959]=906.454, p<0.001). CONCLUSIONS TGD patients were at significantly increased risk of suicidal ideation, even after accounting for age, race, ethnicity, sexual orientation, and insurance status. Findings suggest distinct risk profiles by assigned sex at birth. Consistent assessment of and intervention for suicidal ideation should be prioritized in settings that serve TGD patients.
Collapse
Affiliation(s)
- Norik Kirakosian
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Amelia M Stanton
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Samantha M McKetchnie
- School of Social Work, Boston College, Newton, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Dana King
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Brett Dolotina
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Conall O'Cleirigh
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Chris Grasso
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Jennifer Potter
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Abigail W Batchelder
- The Fenway Institute, Fenway Health, Boston, MA, USA.
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
23
|
Shepherd BF, Maki JL, Zelaya DG, Warner Ş, Wilson A, Brochu PM. Development and Validation of the Gay-Specific Intraminority Stigma Inventory (G-SISI): Initial Evidence Underpinned by Intraminority Stress Theory. Eur J Investig Health Psychol Educ 2023; 13:170-186. [PMID: 36661763 PMCID: PMC9858161 DOI: 10.3390/ejihpe13010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
There is currently a lack of measures testing intraminority stress within gay men. Therefore, the current study sought to develop and psychometrically test the Gay-Specific Intraminority Stigma Inventory (G-SISI). Based on a content review of the literature and a panel of experts, a pool of items assessing gay men's perceived exposure to a range of discriminatory attitudes from other gay men was generated. Utilizing a randomly split sample of 1723 gay men between the ages of 19 and 79 years, an exploratory factor analysis was first performed (n = 861). The remaining unexamined data were then used to conduct a confirmatory factor analysis (n = 862). The results support a six-factor model: (1) Age Stigma, (2) Socioeconomic Stigma, (3) Gay Non-Conformity Stigma, (4) Racial Stigma, (5) Gender Expression Stigma, and (6) Body Stigma. Cronbach's alpha for the total scale was 0.90 and for the subscales ranged from 0.60 to 0.85. Sociodemographic factors and measures of community involvement were differentially associated with the G-SISI subscales, providing evidence of construct validity. The findings demonstrate initial support for the dimensionality and validity of the G-SISI, which targets modifiable factors (e.g., identity-based stigma) that may increase stress and reduce community coping resources among gay men with diverse identities.
Collapse
Affiliation(s)
- Benjamin F. Shepherd
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Correspondence:
| | - Justin L. Maki
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
| | - David G. Zelaya
- School of Public Health, Brown University, Providence, RI 02903, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Şeniz Warner
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
| | - Adriana Wilson
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
| | - Paula M. Brochu
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
| |
Collapse
|
24
|
Kler S, Shepherd BF, Renteria R. Community Connectedness as a Moderator of the Association between Intersectional Microaggressions and Alcohol Use among Sexual and Gender Minoritized People of Color. Subst Use Misuse 2023; 58:129-138. [PMID: 36440902 DOI: 10.1080/10826084.2022.2149246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background: Researchers have documented associations between discrete conceptualizations of microaggressions (e.g., sexual identity, gender identity, and racial identity microaggressions) and alcohol use among sexual and gender minoritized people of color (SGM-POC). However, little is known about the association between intersectional microaggressions and alcohol use among SGM-POC. Moreover, protective factors such as community connectedness have been examined via similar discrete conceptualizations instead of examining SGM-POC community connectedness with other SGM-POC individuals. Objectives: The purpose of this study was to explore the association between intersectional microaggressions and alcohol use among SGM-POC and test whether different types of community connectedness moderated this association. Methods: Cross-sectional data were collected from a sample of 267 SGM-POC individuals. Four moderation analyses were done to analyze whether different types of community connectedness (sexual identity, racial identity, gender identity, and SGM-POC identity community connectedness) were moderators of the association of intersectional microaggressions and alcohol use. Results: Intersectional microaggressions were significantly positively correlated with alcohol use. Furthermore, SGM-POC community connectedness moderated this association such that the association was stronger for individuals with higher levels of SGM-POC community connectedness, but not lower levels of SGM-POC community connectedness. Conclusions: These findings showcase the importance of assessing for intersectional microaggressions as a risk factor for alcohol use. Similarly, the findings suggest that SGM-POC community connectedness may be a protective factor against alcohol use for SGM-POC.
Collapse
Affiliation(s)
- Satveer Kler
- Southern Illinois University, Carbondale, IL, USA
| | - Benjamin F Shepherd
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Roberto Renteria
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| |
Collapse
|
25
|
Goldbach JT, Parra LA, O’Brien RP, Rhoades H, Schrager SM. Explaining behavioral health differences in urban and rural sexual minority adolescents: A longitudinal investigation of minority stress in a diverse national sample of sexual minority adolescents: A longitudinal investigation of minority stress in a diverse national sample of sexual minority adolescents. J Rural Health 2023; 39:262-271. [PMID: 35977886 PMCID: PMC9771913 DOI: 10.1111/jrh.12706] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE Experiences of sexuality-based discrimination (ie, minority stressors) against youth who identify as nonheterosexual (ie, sexual minority) have been associated with increased symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD) for sexual minority adolescents (SMA; ages 14-17). However, little is known about the experiences of SMA living in rural communities across the United States. Thus, the present study sought to examine differences in mental health patterns between urban and rural dwelling SMA, and to see whether these differences are, at least in part, explained by experiences of lifetime minority stress. METHODS A nationwide sample of SMA residing in the United States (N = 2,558; aged 14-17, M = 15.90 years, SD = 0.98) was recruited through purposive social media and respondent-driven sampling methods to complete a cross-sectional survey online. Measures included those of minority stress, urbanicity, and symptoms of anxiety, depression, and PTSD. Parallel multiple mediation (PMM) analysis was employed to test whether urbanicity was associated with anxiety, depressive, and PTSD symptoms through reported lifetime minority stress. FINDINGS On average, SMA living in rural areas significantly reported more lifetime minority stress, depressive, and PTSD symptoms than SMA living in urban settings. Results from our PMM analysis indicated that heightened experiences of lifetime minority stress indirectly linked the effects of living in rural areas on anxiety (b = -0.288, 95% CI = [-0.491, -0.085]), depressive (b = -0.158, 95% CI = [-0.270, -0.047), and PTSD symptoms PTSD (b = -0.349, 95% CI = [-0.596, -0.105]). The model accounted for 16.8%, 18%, and 24.1% of the variability in anxiety symptoms, depressive symptoms, and PTSD symptoms, respectively. CONCLUSIONS SMA in our study who reside in rural areas reported elevated minority stress, depressive, and PTSD symptoms as compared to their urban dwelling peers. Our study found that lifetime experiences of minority stress fully mediated the relationship between urbanicity and both depressive and PTSD symptoms, and partially mediated the relationship between urbanicity and anxiety. These findings highlight the need to increase support for rural youth who are growing into adulthood and may find continuing challenges in their family, peer, and community relationships.
Collapse
Affiliation(s)
- Jeremy T. Goldbach
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Luis A. Parra
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Rory P. O’Brien
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Harmony Rhoades
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | | |
Collapse
|
26
|
Ronzón-Tirado R, Charak R, Cano-Gonzalez I, Karsberg S, Schnarrs PW. Latent Classes of Bidirectional Face-to-Face and Cyber Intimate Partner Violence Among Lesbian, Gay, and Bisexual Emerging Adults: The Role of Minority Stressors. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP21092-NP21118. [PMID: 34839733 PMCID: PMC10704391 DOI: 10.1177/08862605211055158] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The rates of intimate partner violence have been found to be higher among lesbian, gay, and bisexual (LGB) individuals when compared with heterosexual populations. However, lesser is known about the impact of specific minority stressors experienced by LGB populations on their face-to-face intimate partner violence (IPV) and cyber IPV experiences. Using a three-step latent class approach, the present study investigated (i) the latent classes of self-reported types of face-to-face IPV and cyber IPV perpetration and victimization and (ii) their associations with LGB distal and proximal minority stressors (i.e., vicarious trauma, discrimination, family rejection, and LGB-identity disclosure). Participants were 288 LGB emerging adults in the age range of 18-29 years (bisexual: n = 168, gay: n = 72, and lesbian: n = 48). Findings showed the presence of four latent classes, namely, face-to-face IPV (n = 32; 37.5% gay, 18.8% lesbian, and 43.8% bisexual individuals), cyber IPV (n = 66; 33.3% gay, 12.1% lesbian, and 54.5% bisexual individuals), psychological and stalking cyber IPV (n = 89; 15.7% gay, 15.7% lesbian, and 68.5% bisexual individuals), and low IPV (n = 101; 23.8% gay, 19.8% lesbian, and 56.4% bisexual individuals). Furthermore, multinomial logistic regressions indicated that greater exposure to the minority stressors such as exposure to heterosexism, namely, discrimination and harassment, rejection from one's family of origin, and exposure to vicarious trauma, as well as a lower degree of LGB-identity disclosure, largely predicted latent classes with greater probabilities of IPV exposure, namely, cyber IPV, face-to-face IPV classes, and psychological and stalking cyber IPV. Findings suggest the importance of addressing the role of minority stressors in IPV interventions and the creation of competent LGB-related services and training modules for clinicians.
Collapse
Affiliation(s)
- Roman Ronzón-Tirado
- Department of Biological and Health Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Ruby Charak
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Ines Cano-Gonzalez
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Sidsel Karsberg
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Phillip W. Schnarrs
- Department of Population Health, The University of Texas at Austin, Austin, TX, USA
| |
Collapse
|
27
|
Weeks SN, Renshaw TL, Serang S. Validating the Structure of Proximal and Distal Factors within the Sexual Minority Adolescent Stress Inventory. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2022. [DOI: 10.1177/07342829221133172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Minority stress theory is a model for understanding health disparities among sexual minorities, defined as those who experience a level of same-sex attraction, identity, or behavior. Methods for assessing minority stress among youth included only adult measures until the development of the Sexual Minority Adolescent Stress Inventory (SMASI). The SMASI appears to be a robust scale in its ability to measure specific stressors and global minority stress among adolescents; however, it does not measure the domain-level constructs of proximal and distal stress, which are integral features of the underlying theory. This study tests the psychometric defensibility of including these domain-level factors within an updated SMASI measurement model. Results provide evidence for the structural validity of the proximal and distal domains within the SMASI measurement model and suggest this updated model has more informational value than the original model for capturing minority stress.
Collapse
|
28
|
Kittiteerasack P, Matthews AK, Steffen AD. Loneliness mediates the association of minority stress and depression in sexual and gender minority populations in Thailand. Res Nurs Health 2022; 45:580-591. [DOI: 10.1002/nur.22255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/26/2022] [Accepted: 07/16/2022] [Indexed: 11/09/2022]
Affiliation(s)
| | - Alicia K. Matthews
- College of Nursing The University of Illinois at Chicago Chicago Illinois USA
| | - Alana D. Steffen
- College of Nursing The University of Illinois at Chicago Chicago Illinois USA
| |
Collapse
|
29
|
Jaspal R. Chemsex, Identity and Sexual Health among Gay and Bisexual Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12124. [PMID: 36231424 PMCID: PMC9564711 DOI: 10.3390/ijerph191912124] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
This article focuses on some of the social, cultural and psychological aspects of drug use in sexualized settings in gay and bisexual men (referred to as "chemsex"). Using a narrative review approach, the article examines previous empirical research in this area and presents a novel theoretical approach for understanding and predicting chemsex behavior. Tenets of identity process theory from social psychology are drawn upon to offer an integrative theoretical framework within which the social, cultural and psychological underpinnings of chemsex can be collectively examined. Existing empirical research suggests that gay and bisexual men may experience sexuality-related stressors that can undermine feelings of self-esteem, self-efficacy, continuity and positive distinctiveness. Identity process theory examines how individuals react to threats to identity brought about by these stressors. In response to identity threat, gay and bisexual men may engage in chemsex as a coping response that encompasses and facilitates various, largely maladaptive, coping strategies and tactics. The more chemsex is perceived as enhancing identity processes and as averting identity threat, the more central it is likely to be to the identities of participants. The centrality of chemsex to one's identity may preclude self-withdrawal from the practice. Several directions for future research are presented based on existing work on chemsex viewed through the lens of identity process theory. These should form the basis of future empirical research in the sphere of sexual health among gay and bisexual men and the outcomes of this research should inform policy and practice in this area.
Collapse
Affiliation(s)
- Rusi Jaspal
- Vice-Chancellor's Office, University of Brighton, Brighton BN2 4GJ, UK
| |
Collapse
|
30
|
Kler S, Arora S, Le TP. Validation of the Multidimensional Scale of Perceived Social Support (MSPSS) Among LGBTQ+ People of Color. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2022. [DOI: 10.1080/07481756.2022.2109174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Satveer Kler
- School of Psychological and Behavioral Sciences, Southern Illinois University, Carbondale, IL, USA
| | - Saumya Arora
- Department of Psychology, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Thomas P. Le
- Department of Psychology, University of Maryland-College Park, College Park, MD, USA
| |
Collapse
|
31
|
Veldhuis CB, Juster RP, Corbeil T, Wall M, Poteat T, Hughes TL. Testing whether the combination of victimization and minority stressors exacerbate PTSD risks in a diverse community sample of sexual minority women. PSYCHOLOGY & SEXUALITY 2022; 14:252-278. [PMID: 38549608 PMCID: PMC10978045 DOI: 10.1080/19419899.2022.2106147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 07/19/2022] [Indexed: 10/16/2022]
Abstract
Informed by minority stress and intersectionality frameworks, we examined: 1) associations of sexual identity and race/ethnicity with probable diagnosis of post-traumatic stress disorder (PTSD-PD) among sexual minority women (SMW; e.g., lesbian, bisexual); and 2) potential additive and interactive associations of minority stressors (discrimination, stigma consciousness, and internalized homonegativity) and potentially traumatic childhood and adulthood events (PTEs) with PTSD-PD. Data come from a large and diverse community sample of SMW (N = 662; age range: 18-82; M = 40.0, SD = 14.0). The sample included 35.8% Black, 23.4% Latinx, and 37.2% White participants. Logistic regressions tested associations of sexual identity and race/ethnicity, minority stressors, and PTEs with PTSD-PD. More than one-third of SMW (37.2%) had PTSD-PD with significantly higher prevalence among bisexual, particularly White bisexual women, than lesbian women. Discrimination, stigma consciousness, and internalized homonegativity were each associated with higher odds of PTSD-PD, but only internalized homonegativity was additively associated with PTSD-PD in mutually adjusted models above and beyond effects of PTEs. No evidence for interactive effects between PTEs and minority stressors was found. In a diverse community sample of sexual minority women, PTSD is strongly associated with potentially traumatic childhood events and with minority stressors above and beyond the associations with other potentially traumatic events and stressors in adulthood. Our findings suggest a strong need for therapists to address the effects of stigma and homophobia in treatment for PTSD, as these minority stressors likely maintain and exacerbate the effects of past traumas.
Collapse
Affiliation(s)
| | | | - Thomas Corbeil
- Mental Health Data Science, New York State Psychiatric Institute
| | - Melanie Wall
- Mental Health Data Science, New York State Psychiatric Institute
| | - Tonia Poteat
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill
| | | |
Collapse
|
32
|
Hammack PL, Grecco B, Wilson BDM, Meyer IH. "White, Tall, Top, Masculine, Muscular": Narratives of Intracommunity Stigma in Young Sexual Minority Men's Experience on Mobile Apps. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2413-2428. [PMID: 34820783 PMCID: PMC9293832 DOI: 10.1007/s10508-021-02144-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 05/03/2023]
Abstract
What forms of intracommunity stigma do young sexual minority men narrate as they participate in communities through mobile apps? In a content analysis of 32 interviews with a racially diverse sample of young sexual minority men (ages 19-25; 84.4% non-White) from four regions of the USA, a majority of men (62.5%) spontaneously discussed mobile apps (e.g., Grindr, Scruff) when asked about their experience of community more broadly. Men's narratives revealed engagement with intracommunity stigma related to body size, race/ethnicity, gender expression, and sexual position (e.g., bottom). Stigma related to HIV status, substance use, and social class were not spontaneously narrated in response to questions about men's experience in communities. Expressions of stigma were frequently experienced intersectionally, particularly regarding racialized stereotype expectations (e.g., "Asian men are twinks, effeminate"). We discuss the ways in which sexual minority men reproduce dominant ideologies related to racism, misogyny, and masculine body ideals as they engage with one another on mobile apps. To the extent that many young men rely on mobile apps for community connection, their experiences of community might serve to exacerbate, rather than ameliorate, the deleterious impact of stigma.
Collapse
Affiliation(s)
- Phillip L Hammack
- Department of Psychology, University of California, Santa Cruz, 1156 High Street, Santa Cruz, CA, 95054, USA.
| | - Brock Grecco
- Social Science Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Ilan H Meyer
- Williams Institute, UCLA School of Law, Los Angeles, CA, USA
| |
Collapse
|
33
|
Hinton JDX, de la Piedad Garcia X, Kaufmann LM, Koc Y, Anderson JR. A Systematic and Meta-Analytic Review of Identity Centrality among LGBTQ Groups: An Assessment of Psychosocial Correlates. JOURNAL OF SEX RESEARCH 2022; 59:568-586. [PMID: 34448656 DOI: 10.1080/00224499.2021.1967849] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The degree to which an identity is an important aspect of one's self-concept (i.e., identity centrality) relates to both health and prejudice experiences of minority groups. Individuals with greater levels of identity centrality view their world through the lens of that identity. This allows them to engage in more positive identity-relevant experiences. However, it could also heighten their perceptions of in-group threat. Among LGBTQ groups, the relationship between identity centrality and psychosocial outcomes is yet to be established. In this paper, we investigated the relationship between LGBTQ identity centrality and psychosocial outcomes via a comprehensive systematic (k = 89, N = 35,950) and meta-analytic (k = 57, N = 26,704) literature review. Results indicated that greater levels of LGBTQ centrality relates to more positive identity-relevant affirmations (.155 ≤ r's ≤ .419), but also greater prejudice/discrimination perceptions and experiences (-.271 ≤ r's ≤ -.128). We found no evidence of a relationship between LGBTQ centrality and health outcomes (-.052 ≤ r's ≤ .040). Importantly, we found that these relationships are more beneficial for some LGBTQ groups (gay men), than for others (bisexual/transgender individuals). Findings from this review provide important and necessary insights on the role of LGBTQ identity centrality and identify crucial gaps in the literature that should be addressed.
Collapse
Affiliation(s)
- Jordan D X Hinton
- School Of Behavioural And Health Sciences, Australian Catholic University
| | | | - Leah M Kaufmann
- School Of Behavioural And Health Sciences, Australian Catholic University
| | - Yasin Koc
- Department Of Social Psychology, University Of Groningen
| | - Joel R Anderson
- School Of Behavioural And Health Sciences, Australian Catholic University
- Australian Research Centre In Sex, Health, & Society, La Trobe University
| |
Collapse
|
34
|
Inventor BR, Paun O, McIntosh E. Mental Health of LGBTQ Older Adults. J Psychosoc Nurs Ment Health Serv 2022; 60:7-10. [PMID: 35353662 DOI: 10.3928/02793695-20220303-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
More than 54 million people in the United States are aged ≥65 years, including an estimated 2.4 million people who identify as lesbian, gay, bi-sexual, transgender, or queer (LGBTQ). As a group, LGBTQ older adults experienced criminalization, discrimination, and social stigma the majority of their lives, with rates of victimization and stigma increasing with age. LGBTQ older adults continue to experience social and health disparities compared to heterosexual individuals. To meet the needs of LGBTQ older adults, it is necessary to understand the impact of politics, culture, and social norms as they came of age. Unique mental health needs, such as social isolation, loneliness, disenfranchised grief, and long-term social support, are discussed through the lens of the minority stress model. Implications and recommendations for health care, research, and policy, such as creating a safe and welcoming environment and providing culturally competent care for LGBTQ older adults, are discussed. [Journal of Psychosocial Nursing and Mental Health Services, 60(4), 7-10.].
Collapse
|
35
|
Limas JC, Corcoran LC, Baker AN, Cartaya AE, Ayres ZJ. The Impact of Research Culture on Mental Health & Diversity in STEM. Chemistry 2022; 28:e202102957. [PMID: 35075707 DOI: 10.1002/chem.202102957] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Indexed: 11/07/2022]
Abstract
The onset of COVID-19, coupled with the finer lens placed on systemic racial disparities within our society, has resulted in increased discussions around mental health. Despite this, mental health struggles in research are still often viewed as individual weaknesses and not the result of a larger dysfunctional research culture. Mental health interventions in the science, technology, engineering, and mathematics (STEM) academic community often focus on what individuals can do to improve their mental health instead of focusing on improving the research environment. In this paper, we present four aspects of research that may heavily impact mental health based on our experiences as research scientists: bullying and harassment; precarity of contracts; diversity, inclusion, and accessibility; and the competitive research landscape. Based on these aspects, we propose systemic changes that institutions must adopt to ensure their research culture is supportive and allows everyone to thrive.
Collapse
Affiliation(s)
- Juanita C Limas
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Ana E Cartaya
- Department of Surgery, Center for Nanotechnology in Drug Delivery, Department of Pharmacology, McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | |
Collapse
|
36
|
Pellicane MJ, Ciesla JA. Associations between minority stress, depression, and suicidal ideation and attempts in transgender and gender diverse (TGD) individuals: Systematic review and meta-analysis. Clin Psychol Rev 2022; 91:102113. [PMID: 34973649 DOI: 10.1016/j.cpr.2021.102113] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 02/07/2023]
Abstract
Minority stress theory posits that transgender and gender diverse (TGD) individuals exhibit greater rates of depression and suicidality due to internal (proximal) and external (distal) stressors related to their TGD identity. Yet, the magnitude of the relationship between minority stress processes and mental health outcomes has not been quantitatively summarized. The current research meta-analyzed the relationship between minority stress constructs and depression, suicidal ideation, and suicide attempt. Results from 85 cross-sectional quantitative studies indicate that distal stress, expectations of rejection, internalized transphobia, and concealment are significantly associated with increased depression, suicidal ideation, and suicide attempt. Greater effect sizes were observed for expectations of rejection and internalized transphobia when compared to distal stress and concealment. Future research on the relationship between minority stress, depression, and suicide would benefit from longitudinal designs and more diverse and representative samples of TGD individuals.
Collapse
|
37
|
Truong NL, Zongrone AD. The role of GSA participation, victimization based on sexual orientation, and race on psychosocial well‐being among LGBTQ secondary school students. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
38
|
Mereish EH, Parra LA, Watson RJ, Fish JN. Subtle and Intersectional Minority Stress and Depressive Symptoms Among Sexual and Gender Minority Adolescents of Color: Mediating Role of Self-Esteem and Sense of Mastery. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:142-153. [PMID: 34482516 PMCID: PMC9802675 DOI: 10.1007/s11121-021-01294-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 01/03/2023]
Abstract
Little research has examined subtle, intersectional, and everyday minority stress, such as microaggressions specific to being a queer person of color, and its associations with depressive symptoms among sexual and gender minority adolescents (SGMA) of color. Moreover, research is needed to identify mechanisms that might explain the associations between minority stress and depression. This study examined the associations between subtle and intersectional minority stress (i.e., SGMA of color-specific microaggressions) and depressive symptoms among SGMA of color and tested self-concept factors (i.e., self-esteem and sense of mastery) as mediators of these associations. A large national US sample of SGMA of color (N = 3398; 31.8% transgender; 55.7% plurisexual) ages 13 to 17 years (M = 15.56, SD = 1.27) were recruited online. Participants' race/ethnicity were Asian/Pacific Islander (12.2%), Black/African American (13.2%), Hispanic/Latina(o)/x (30%), Native American/Alaska Native (1.2%), Middle Eastern (1.9%), Biracial or Multiracial (40%), and other racial/ethnic minority groups (1.7%). Over and above the effects of racism and SGM-based victimization, subtle intersectional minority stressors were associated with greater depressive symptoms and lower self-esteem and sense of mastery. Mediation analyses indicated that subtle intersectional minority stressors had indirect effects on depressive symptoms through lower self-esteem and sense of mastery for the aggregate sample of SGMA of color and most racial/ethnic groups in the sample. The results demonstrate that subtle and intersectional minority stress is a unique and significant form of minority stress that is a risk factor for depressive symptoms for SGMA of color. Moreover, our findings underscore self-concept mechanisms as targets for prevention and intervention.
Collapse
Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Health Studies, American University, 4400 Massachusetts Avenue NW, DC, Washington, USA.
| | - Luis A Parra
- Brown School of Social Work, Washington University in Saint Louis, Saint Louis, USA
| | - Ryan J Watson
- Human Development & Family Sciences, University of Connecticut, Storrs, USA
| | - Jessica N Fish
- Department of Family Science, University of Maryland, College Park, USA
| |
Collapse
|
39
|
Heinonen E, Orlinsky DE, Willutzki U, Rønnestad MH, Schröder T, Messina I, Löffler-Stastka H, Hartmann A. Psychotherapist Trainees' Quality of Life: Patterns and Correlates. Front Psychol 2022; 13:864691. [PMID: 35401345 PMCID: PMC8988184 DOI: 10.3389/fpsyg.2022.864691] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/21/2022] [Indexed: 02/05/2023] Open
Abstract
While psychotherapists are trained to improve their clients' quality of life, little work has examined the quality of life experienced by psychotherapist trainees themselves. Yet their life satisfactions and stresses would plausibly affect both their ability to learn new skills and conduct psychotherapy. Therefore, in the Society for Psychotherapy Research Interest Section on Psychotherapist Development and Training study, we investigated the patterns of self-reported life quality and their correlates in a multinational sample of 1,214 psychotherapist trainees. A comprehensive questionnaire was used at the outset of trainings to assess trainees' professional background, current life situation, personal characteristics, family background, and social and national origin. The findings indicated 54.3% of trainees' lives could be characterized as fortunate or happy (i.e., experiencing great life satisfaction and not much stress), whereas 14.3% could be characterized as clearly distressed or troubled (i.e., experiencing great life stress and not much satisfaction). The strongest correlates of high life stress, a contributor to poor life quality, were economic insecurity, self-protectiveness, and attachment-related anxiety in relationships, and economic or psychological hardship in childhood. In turn, greater wellbeing was most strongly associated with a warm and open interpersonal style, being married, having sufficient economic means, and material and emotional security in childhood. While the results indicate the majority of therapists experience a relatively good quality of life, the findings also suggest potential targets for increasing trainees' life quality when it may be deficient, such as those on a societal level (e.g., availability of low-cost student loans), training program level (e.g., promoting supportive supervision, positive between-trainee relationships and group collaboration), and individual level (e.g., personal therapy and learning self-care), in order to promote effective learning and therapy practice.
Collapse
Affiliation(s)
- Erkki Heinonen
- Department of Psychology, University of Oslo, Oslo, Norway
- Finnish Institute for Health and Welfare, Helsinki, Finland
- *Correspondence: Erkki Heinonen,
| | - David E. Orlinsky
- Department of Comparative Human Development, University of Chicago, Chicago, IL, United States
| | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, University of Witten/Herdecke, Witten, Germany
| | | | - Thomas Schröder
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| | | | | | - Armin Hartmann
- Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Medical Center – University of Freiburg, Freiburg im Breisgau, Germany
| |
Collapse
|
40
|
Ji CG, Cochran B. The Availability of Sexual and Gender Minority (SGM) Specific Substance Use Services. Subst Use Misuse 2022; 57:2126-2133. [PMID: 36352538 DOI: 10.1080/10826084.2022.2137812] [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] [Indexed: 11/11/2022]
Abstract
Background: In 2007, Cochran, Peavy, and Robohm conducted a study of treatment programs that indicated that they provided specialized services for gay and lesbian clients; however, phone calls to these agencies revealed that over 90% of these agencies actually did not provide services that were discernibly different from the agencies' general services. Objectives: Given the progress and development since 2007 regarding awareness of SGM (sexual and gender minority) rights and an increased understanding of the impact of health disparities on SGM individuals, the current study aimed to gain a renewed understanding of the state of SGM-specific substance treatment using a similar methodology. Results: agencies reporting that they provide SGMTitle specific services since 2007, fewer than 1 in 5 agencies who indicated offering SGM-specific treatment on the National Survey of Substance Abuse Treatment Services (N-SSAT S) survey actually provided such services (17.4%) in 2021. Conclusions/Importance: The current study reinforces the already observed need for specialized substance treatment services for the SGM population. Despite having hundreds more SGM-specific substance treatment services in existence today compared to 2007, our findings point to a strong need to address the discrepancies between self-reported and existing availabilities of SGM-specific services in substance treatment. Actions that can potentially close this gap might be two-fold: standardizing the definition of and criteria for SGM-specific services and increasing funding and resources that could expand the availability of such services, particularly in rural regions.
Collapse
Affiliation(s)
| | - Bryan Cochran
- Department of Psychology, University of Montana, Missoula, MT, USA
| |
Collapse
|
41
|
DiGuiseppi GT, Davis JP, Srivastava A, Layland EK, Pham D, Kipke MD. Multiple Minority Stress and Behavioral Health Among Young Black and Latino Sexual Minority Men. LGBT Health 2021; 9:114-121. [PMID: 34918974 DOI: 10.1089/lgbt.2021.0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Young Black and Latino sexual minority men may experience multiple minority stressors, which may negatively impact behavioral health. To investigate this, longitudinal associations between multiple minority stressors and behavioral health outcomes were examined over a 2-year period. Methods: Data were from the Healthy Young Men's Cohort Study. The present study used five waves of data collected every 6 months from 2016 to 2019. Participants were young Black and/or Latino sexual minority men in Los Angeles, California (n = 448; aged 16-24). Participants self-reported their experiences of racial and homonegative discrimination, internalized homonegativity, alcohol use, and depressive symptoms. Latent growth curve models with time-varying covariates examined contemporaneous associations between minority stressors as well as general life stress and behavioral health measures. Results: After accounting for general life stress and demographic characteristics, racial discrimination was persistently associated with unhealthy alcohol use. Internalized homonegativity was associated with unhealthy alcohol use initially, but this association became non-significant over time. In models predicting depressive symptoms, racial discrimination was a significant predictor at early waves, and homonegative discrimination and internalized homonegativity emerged as significant predictors at later waves. Conclusion: These results help clarify which multiple minority stressors are more prominent in their relationship to young Black and Latino sexual minority men's unhealthy alcohol use and depressive symptoms. Interventions targeting multiple minority stressors may be needed at different times during young adulthood.
Collapse
Affiliation(s)
- Graham T DiGuiseppi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Jordan P Davis
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.,Center for Artificial Intelligence in Society, University of Southern California, Los Angeles, California, USA.,Center for Mindfulness Science, University of Southern California, Los Angeles, California, USA.,Institute of Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Ankur Srivastava
- Raymond A. Kent School of Social Work, University of Louisville, Louisville, Kentucky, USA
| | - Eric K Layland
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, Connecticut, USA
| | - Duyen Pham
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Michele D Kipke
- Division of Adolescent Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
| |
Collapse
|
42
|
Waters AR, Tennant K, Cloyes KG. Cultivating LGBTQ+ Competent Cancer Research: Recommendations from LGBTQ+ Cancer Survivors, Care Partners, and Community Advocates. Semin Oncol Nurs 2021; 37:151227. [PMID: 34753639 DOI: 10.1016/j.soncn.2021.151227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Sexual and gender minority (SGM) or LGBTQ+ communities were designated as a National Institutes of Health (NIH) disparity population in 2016, yet research exploring SGM cancer disparities is still limited. Thus, we sought the insight of LGBTQ+ cancer survivors, care partners, and community advocates to learn their recommendations for cultivating competent and inclusive cancer research for LGBTQ+ individuals. DATA SOURCES We conducted a focus group with LGBTQ+ survivors and care partners of LGBTQ+ survivors who were 18 years or older (N = 8) and interviews with community advocates who are leaders in LGBTQ+ cancer (N = 8). The focus group and interviews were recorded, transcribed, and qualitatively analyzed using an inductive thematic analysis. CONCLUSION Qualitative analysis elicited an overarching theme of cultivating competent research for LGBTQ+ individuals, including three subthemes: (i) Cisheteronormativity: An inhospitable ecosystem for LGBTQ+ patients, survivors, and care partners, (ii) Study design: Shifting from invasive 'othering' to a sustainable community-driven climate, and (iii) Recruitment and data collection: Ways to cultivate ecosystem health. Cultivating inclusive, competent research with SGM populations is crucial for addressing health disparities and improving cancer survivors' and care partners' health. IMPLICATIONS FOR NURSING PRACTICE Recommendations from LGBTQ+ survivors, care partners, and community advocates ranged from small alterations to systemic changes, highlighting the multifaceted yet feasible process of cultivating LGBTQ+ competent cancer research. The process of cultivating competent research for LGBTQ+ populations will take substantial investment from researchers, providers, and health systems.
Collapse
Affiliation(s)
- Austin R Waters
- Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, Utah.
| | - Karrin Tennant
- College of Nursing, University of Utah, Salt Lake City, Utah
| | | |
Collapse
|
43
|
Grassau P, Stinchcombe A, Thomas R, Wright DK. Centering sexual and gender diversity within Compassionate Communities: insights from a community network of LGBTQ2S+ older adults. Palliat Care Soc Pract 2021; 15:26323524211042630. [PMID: 34589707 PMCID: PMC8474303 DOI: 10.1177/26323524211042630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 08/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background and Rationale: The Compassionate Communities movement emphasizes the importance of
illness, disability, dying, caregiving, and grief across the
lifespan and highlights the communal responsibility of caring
for one another. There is a need to recognize and incorporate
the needs of diverse communities within this movement and
research on dying, caregiving and grief. An important axis of
this diversity is related to individuals’ sexual orientation and
gender identity. Methods: As part of the early phases of Healthy End of Life Project Ottawa,
a Compassionate Communities, community-based, participatory
action research project, we held focus groups with older members
of lesbian, gay, bisexual, transgender, queer, and two-spirit
communities. Nine older lesbian, gay, bisexual, transgender,
queer, and two-spirit people participated in the focus groups
(mean age = 72 years). Data were analysed using an inductive,
reflexive thematic approach. Results: Through an iterative analysis process, we identified themes related
to lifecourse experiences of trauma, the need for safety within
care contexts, the importance of relationships and connection,
as well as participants’ ability to ask for and receive help. A
core tenet of Compassionate Communities involves responding to
the needs of diverse communities with respect to aging,
end-of-life, and grief. Our findings emphasize the importance of
incorporating the voices of diverse sexual and gender identities
and promoting health equity within Compassionate Community
initiatives.
Collapse
Affiliation(s)
- Pamela Grassau
- School of Social Work, Carleton University, Ottawa, ON K1S 5B6, Canada
| | | | - Roanne Thomas
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | |
Collapse
|
44
|
Spanierman LB, Clark DA, Kim Y. Reviewing Racial Microaggressions Research: Documenting Targets' Experiences, Harmful Sequelae, and Resistance Strategies. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2021; 16:1037-1059. [PMID: 34498519 DOI: 10.1177/17456916211019944] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this article, we review the theoretical and empirical literature on racial microaggressions from 2007 to 2020 (N = 138 articles). First, we refine racial microaggressions theory and update the definition to address mischaracterizations in the literature and clarify the term (i.e., "micro" refers to microlevel interactions rather than degree of harm). Next, we used four superordinate categories (i.e., pathologizing differences, denigrating and pigeonholing, excluding or rendering invisible, and perpetuating color-blind racial attitudes) in which to situate racial microaggression themes from the extant literature. Moreover, we consolidated and renamed existing themes to privilege targets' perspectives (e.g., facing assumptions of inferior status and enduring exoticization). We then synthesized qualitative and quantitative research that shows harmful sequelae of racial microaggressions (i.e., psychological and physiological symptoms). Extending prior research on coping with gendered racial microaggressions, we describe empirical findings on collective, resistance, and self-protective strategies to mitigate the harmful impact of racial microaggressions. We conclude with directions for future research.
Collapse
Affiliation(s)
| | - D Anthony Clark
- Interdisciplinary Humanities and Communication, Arizona State University
| | - Yeeun Kim
- Counseling and Counseling Psychology, Arizona State University
| |
Collapse
|
45
|
Cusack CE, Cooper M, Libbey N, Galupo MP. Rumination & eating psychopathology among trans and nonbinary individuals: A path analysis integrating minority stress. Eat Behav 2021; 42:101544. [PMID: 34358854 DOI: 10.1016/j.eatbeh.2021.101544] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/29/2022]
Abstract
UNLABELLED Ruminative thought patterns, defined as repetitive negative self-focused attention, are considered an avoidant coping strategy for managing stress. As trans and nonbinary (TNB) individuals commonly experience prejudice and discrimination in response to their gender identities (i.e. minority stressors), rumination over these stressors may contribute to heightened risk of psychopathology in these groups. Although rumination is a general risk factor for eating disorder (ED) psychopathology, no studies to date have examined whether eating- or gender-related ruminative patterns relate to maintenance of ED psychopathology for TNB individuals. This cross-sectional study investigated whether levels of rumination (both gender-related and ED-specific) mediated the relationship between minority stress and ED psychopathology. METHOD Participants were 242 TNB adults (Mage = 24.92, SD = 6.5, Range = 18-70) recruited online, who completed measures of minority stress, gender-related rumination, ED-specific rumination, and ED psychopathology. We used Preacher-Hayes' approach to examine the parallel mediation model, with gender-related and ED-specific rumination as potential mediators. RESULTS Gender-related rumination did not mediate the relation between gender minority stress and ED psychopathology, Indirect B = -0.00 [95% BCa CI: -0.01, 0.00]; however, ED-specific rumination was significant, indicating partial mediation, Indirect B = 0.01 [95% BCa CI: 0.00, 0.02]. CONCLUSION As gender minority stress and ED-specific rumination relate to ED psychopathology, it is essential that clinicians adopt an intersectional minority stress framework in understanding ED psychopathology among TNB individuals.
Collapse
|
46
|
Tshisa N, van der Walt F. Discrimination challenges and psychological well-being of black African queer employees. SA JOURNAL OF INDUSTRIAL PSYCHOLOGY 2021. [DOI: 10.4102/sajip.v47i0.1835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
47
|
Frequency and perceived effectiveness of mental health providers' coping strategies during COVID-19. CURRENT PSYCHOLOGY 2021; 40:5753-5762. [PMID: 33867779 PMCID: PMC8041948 DOI: 10.1007/s12144-021-01683-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 01/22/2023]
Abstract
There has been an emphasis on understanding the detrimental effects of coronavirus disease (COVID-19) on individuals’ wellbeing. Healthcare workers, including mental health providers, may experience increased emotional and behavioral health concerns to a greater degree than the general public. The objective of the present study was to examine the frequency and the perceived effectiveness of various coping strategies implemented by mental health practitioners during the COVID-19 pandemic, as well as differences across career stages (i.e., trainees versus licensed practitioners [LPs]). Survey data were collected from mental health practitioners (N = 888) assessing the strategies they used to manage COVID-19-associated anxiety/distress and the perceived effectiveness of these strategies. Bonferroni-adjusted chi-square tests and t-tests were conducted to assess differences by career stage. Overall, respondents used various coping strategies, most commonly behavioral strategies such as distraction/engaging in an enjoyable activity (88.63%), spending time with loved ones (77.82%), and exercise (72.64%). Over one-quarter reported using alcohol to cope (28.27%). Respondents generally perceived their coping strategies as somewhat to very effective; no strategies were generally perceived as ineffective. Compared to LPs, trainees were significantly more likely to manage COVID-19-related anxiety/distress using supervision (p < .001) and substances other than alcohol or tobacco (p < .001). There were no significant differences in how effective trainees and LPs perceived each strategy. U.S. mental health practitioners’ use of predominantly behavioral coping strategies, which were generally perceived as effective, during the first months of COVID-19 offers implications for interventions as the pandemic progresses.
Collapse
|
48
|
Lim G, Waling A, Lyons A, Pepping CA, Brooks A, Bourne A. The experiences of lesbian, gay and bisexual people accessing mental health crisis support helplines in Australia. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2021.1904274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Gene Lim
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia
- School of Social Sciences, Monash University, Melbourne, Australia
| | - Andrea Waling
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia
| | | | - Anna Brooks
- Lifeline Research Foundation, Canberra, Australia
| | - Adam Bourne
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia
| |
Collapse
|
49
|
Mo PKH, Hu H, Ip M, Dong W, Lau JTF, Wang Z. Effect of stress and avoidant coping on depression and the moderating role of age among men who have sex with men: Findings from a 6-month prospective cohort study. J Affect Disord 2021; 283:310-316. [PMID: 33578343 DOI: 10.1016/j.jad.2021.01.072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/06/2021] [Accepted: 01/30/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Men who have sex with men (MSM) are at increased risk of mental health problems. Few studies have examined the risk factors for mental health problems of Chinese MSM and identified potential moderators using a longitudinal design. OBJECTIVES The present study examined the effect of stress and avoidant coping on depression among MSM, and the moderating role of age on such relationship. METHODOLOGY A 6-month observational prospective cohort study was conducted among Chinese MSM. Respectively 592 and 402 MSM completed a survey at baseline and 6-month follow-up. RESULTS The prevalence of probable depression was 36.1% at baseline and 34.1% at 6-month follow-up. After adjusting for background characteristics and baseline depression score, both stress (β = .22, p<.05) and avoidant coping (β = .14, p<.05) showed significant positive relationship with depression at 6-month follow-up. The interaction effect of age and stress / avoidant coping was also significant. The effect of stress on depression was stronger among younger MSM, and the effect of avoidant coping on depression was significant among younger MSM but non-significant among older MSM. CONCLUSIONS Mental health promotion for MSM should reduce stress and avoidant coping, and specific intervention should be designed for younger MSM.
Collapse
Affiliation(s)
- Phoenix K H Mo
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Huahua Hu
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Mary Ip
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Willa Dong
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, North Carolina, US.
| | - Joseph T F Lau
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Zixin Wang
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| |
Collapse
|
50
|
Kim S, Choi-Kwon S. Physical and Mental Health Related Quality of Life and Their Influencing Factors on Sexual Minority Women in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2115. [PMID: 33671565 PMCID: PMC7926774 DOI: 10.3390/ijerph18042115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/14/2021] [Accepted: 02/18/2021] [Indexed: 11/17/2022]
Abstract
Korean sexual minority women (SMW) often experience discrimination, but their health-related quality of life (HRQoL) remains to be investigated. Therefore, we aimed to assess the levels of mental and physical HRQoL of Korean SMW and their influencing factors using data from the Korean Sexual Minority Women's Health Study (2017) in a cross-sectional study, which included lesbian and bisexual females (N = 736; age ≥19 years). The HRQoL was measured using SF-36v2®; moreover, separate multiple linear regression analyses were conducted to identify the factors influencing mental and physical HRQoL. The physical and mental HRQoL scores were average (52.38 ± 7.65) and low (38.33 ± 12.64), respectively. Significant factors influencing the physical HRQoL were bisexuality, minority stress, perceived social support, and physical activity. The same factors-apart from physical activity-were associated with mental HRQoL. Therefore, to improve the HRQoL of SMW, it is necessary to lower their minority stress and increase social support. Moreover, special attention is needed regarding bisexual women in Korea.
Collapse
Affiliation(s)
- Ssirai Kim
- College of Nursing, Seoul National University, Seoul 03080, Korea;
- Department of Healthcare Administration, Seoul National University Hospital, Seoul 03080, Korea
| | - Smi Choi-Kwon
- College of Nursing, Seoul National University, Seoul 03080, Korea;
- The Research Institute of Nursing Science, Seoul National University, Seoul 03080, Korea
| |
Collapse
|