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Sonu S, Mann K, Potter J, Rush P, Stillerman A. Toward Integration of Trauma, Resilience, and Equity Theory and Practice: A Narrative Review and Call for Consilience. Perm J 2024; 28:151-168. [PMID: 38206776 PMCID: PMC10940235 DOI: 10.7812/tpp/23.105] [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: 01/13/2024]
Abstract
Investigating the roots of health and illness has inspired unprecedented growth in research on trauma and adversity across academic and scientific disciplines. Can this science achieve its potential? How? Much of this research remains siloed and fragmented, limiting integrative approaches to translating science into a unified paradigm. From age-old traditions to the health, social, and basic sciences, this established and rapidly growing body of work has overwhelmingly found that experiences, both positive and negative, profoundly influence life course health. Such convergence across disciplines highlights the complex, intersectional nature and impact of experiences and reveals consilience: agreement of findings across diverse fields. This narrative review explored 400 sources to curate a representative sample of 98 tracing the evolution of trauma theory and practice from the 19th century to the present. It emphasizes research from 1970 to 2022, with a specific focus on adverse childhood experiences, everyday discrimination, sexual and gender minority stress, acculturative stress, and positive childhood experiences. This research reveals how experiences are a cause, catalyst, and key ingredient of health or of illness, disability, and disparities. The review also proposes steps toward a unified paradigm and showcases innovative integrated models and applications. These examples provide a more comprehensive and nuanced understanding and lead to more effective solutions. Recognition of consilience can connect multidimensional insights on trauma, resilience, and equity to spark further cross-sector innovations toward health, prevention, and justice. Realizing the promise of consilience will require a new era of radical intentionality, ongoing dialogue, and interdisciplinary collaboration to achieve necessary system transformation.
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Affiliation(s)
- Stan Sonu
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Patricia Rush
- The Center for Collaborative Study of Trauma, Health Equity, and Neurobiology, Chicago, IL, USA
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2
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Garey L, Smit T, Clausen BK, Redmond BY, Obasi EM, Businelle MS, Zvolensky MJ. Anxiety Sensitivity and Distress Tolerance in Relation to Smoking Abstinence Expectancies Among Black Individuals Who Smoke. J Stud Alcohol Drugs 2024; 85:244-253. [PMID: 38095261 PMCID: PMC10941823 DOI: 10.15288/jsad.23-00176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/19/2023] [Indexed: 03/12/2024] Open
Abstract
OBJECTIVE Black individuals who smoke in the United States experience significant tobacco-related disparities. Although prior work has established that smoking abstinence expectancies play an important role in smoking-related outcomes, few studies have examined potential individual difference factors that may be relevant to smoking abstinence expectancies among Black individuals who smoke. The present study investigated anxiety sensitivity and distress tolerance in relation to smoking abstinence expectancies among a sample of Black individuals who smoke. METHOD Participants were 86 Black adults who smoke cigarettes daily (M age = 46.07 years, SD = 10.37; 26.7% female). Four separate linear regression analyses were conducted to evaluate the relation between anxiety sensitivity, distress tolerance, and their interaction with each of the four smoking abstinence expectancies (i.e., somatic symptoms, positive consequences, harmful consequences, and negative mood). RESULTS Results indicated that higher anxiety sensitivity was related to higher somatic symptoms, harmful consequences, and negative mood abstinence expectancies, whereas distress tolerance was related to higher positive consequences. Further, anxiety sensitivity and distress tolerance interacted to confer greater expectancies for the positive consequences of quitting. CONCLUSIONS The current findings are among the first to document that anxiety sensitivity and distress tolerance are clinically relevant factors to consider when tailoring smoking cessation treatments for Black individuals who smoke. Future research is needed to examine distress tolerance and anxiety sensitivity as longitudinal predictors of smoking abstinence expectancies among Black individuals who smoke.
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Affiliation(s)
- Lorra Garey
- Department of Psychology, University of Houston, Houston, Texas
- HEALTH Research Institute, University of Houston, Houston, Texas
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, Texas
| | | | | | - Ezemenari M. Obasi
- HEALTH Research Institute, University of Houston, Houston, Texas
- Psychological, Health, & Learning Sciences, University of Houston, Houston, Texas
| | - Michael S. Businelle
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, Oklahoma
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, Texas
- HEALTH Research Institute, University of Houston, Houston, Texas
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
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3
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Parker VL, Liechty JM, Cantoni NP. Associations Between Trauma and Health Behaviors and Outcomes Among Sexual Minoritized Adults: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241233270. [PMID: 38415318 DOI: 10.1177/15248380241233270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Sexual minoritized (SM) adults experience health disparities and report higher rates of trauma history compared to heterosexual adults. This scoping review synthesizes the extant literature that investigates associations between trauma and physical health among SM adults. It also describes research instruments utilized to assess trauma in relation to health outcomes among SM adults. We searched CINAHL, LGBT+ Life, PsycINFO, and PubMed to identify studies meeting inclusion criteria: peer-reviewed, English, assessed trauma as an independent variable, and assessed health behaviors or outcomes among SM adults. From 587 nonduplicate articles, 69 full texts were reviewed; 18 met criteria and were included in this review. To enhance rigor, we utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Scoping Reviews checklist. Most (n = 12) of the included studies were cross-sectional. Trauma was assessed 16 different ways, including 9 validated measures, in relation to 5 health behaviors and 17 health conditions. Trauma was operationalized by history of childhood sexual abuse, adverse childhood experiences, lifetime rape, current symptoms of post-traumatic stress disorder, and lifetime victimization among SM adults. All but one study found associations between trauma and one or more unfavorable health behaviors or outcomes. Studies used widely heterogeneous instruments to assess trauma, health, and SM identity. Greater specification and standardization of measurement is needed, along with contextualized assessments of trauma and its impact on health such as sexual minority stress-related victimization and resilience, and post-traumatic growth and recovery processes.
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Affiliation(s)
| | - Janet M Liechty
- University of Illinois, Urbana-Champaign, USA
- Carle-Illinois College of Medicine, University of Illinois, Urbana-Champaign, USA
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4
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Roldán P, Matijczak A, Goffnett J. Negative Associations between Minority Stressors and Self-Reported Health Status among Sexual Minority Adults Living in Colombia. Healthcare (Basel) 2024; 12:429. [PMID: 38391805 PMCID: PMC10887566 DOI: 10.3390/healthcare12040429] [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: 11/30/2023] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 02/24/2024] Open
Abstract
Colombia has extensive laws prohibiting discrimination against sexual minority people. However, violence and discrimination toward sexual minorities are still frequent. While a growing body of research shows that sexual minority people experience elevated rates of discrimination and domestic abuse globally, little research has been conducted on these issues affecting sexual minorities in Colombia specifically. Using minority stress theory as a conceptual framework, this paper aims to fill this gap by examining the prevalence of experiencing intimate partner violence (IPV) and witnessed discrimination and the relationship of these stressors to self-reported health among a national sample of sexual minority Colombians. We found that bisexual individuals experienced higher rates of physical and sexual IPV, compared to lesbian and gay individuals. Additionally, sexual minority Colombians who experienced IPV and witnessed discrimination were more likely to report having poorer health, compared to those who had not. We discuss the implications of our findings for future research and clinicians working with sexual minority clients.
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Affiliation(s)
- Paola Roldán
- School of Social Work, Virginia Commonwealth University, Richmond, VA 23220, USA
| | - Angela Matijczak
- School of Social Work, Virginia Commonwealth University, Richmond, VA 23220, USA
| | - Jacob Goffnett
- School of Social Work, Virginia Commonwealth University, Richmond, VA 23220, USA
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5
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Marchi M, Travascio A, Uberti D, De Micheli E, Quartaroli F, Laquatra G, Grenzi P, Pingani L, Ferrari S, Fiorillo A, Converti M, Pinna F, Amaddeo F, Ventriglio A, Mirandola M, Galeazzi GM. Microaggression toward LGBTIQ people and implications for mental health: A systematic review. Int J Soc Psychiatry 2024; 70:23-35. [PMID: 37638668 DOI: 10.1177/00207640231194478] [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] [Indexed: 08/29/2023]
Abstract
BACKGROUND Research suggests that microaggressions detrimentally impact the mental health of members of marginalized social groups. AIMS The aim of this systematic review was to assess the exposure to microaggressions and related implications on mental health of Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ) people. METHOD Medline, Scopus, PsycINFO, CINAHL, and EMBASE were searched until January 2023. Studies reporting data on the exposure to microaggressions toward LGBTIQ people were identified. Meta-analyses of rates of exposure to microaggression and of the association between microaggressions and mental health outcomes were based on odds ratio (OR) and standardized mean difference (SMD) with 95% confidence intervals (95% CI), estimated through inverse variance models with random effects. RESULTS The review process led to the selection of 17 studies, involving a total of 9036 LGBTIQ people, of which 6827 identifying as cisgenders, and 492 as heterosexuals, were included in the quantitative synthesis. Overall, LGBTIQ people showed an increased risk of microaggression (SMD: 0.89; 95% CI [0.28, 1.50]), with Transgender people having the highest risk (OR: 10.0; 95% CI [3.08, 32.4]). Microaggression resulted associated with risk of depression (SMD: 0.21; 95% CI [0.05, 0.37]), anxiety (SMD: 0.29; 95% CI [0.17, 0.40]), suicide attempts (OR: 1.13; 95% CI [1.08, 1.18]), alcohol abuse (OR: 1.32; 95% CI [1.13, 1.54]), but not to suicidal ideation (OR: 1.56; 95% CI [0.64, 3.81]) and cannabis abuse (OR: 1.44; 95% CI [0.82, 2.55]). The quality of the evidence was limited by the small number of studies. CONCLUSIONS LGBTIQ people are at higher risk of microaggressions compared with their cisgender/heterosexual peers, which may lead to mental health consequences. This evidence may contribute to public awareness of LGBTIQ mental health needs and suggest supportive strategies as well as preventive interventions (e.g., supportive programs and destigmatizing efforts) as parts of tailored health-care planning aimed to reduce psychiatric morbidity in this population.
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Affiliation(s)
- Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Antonio Travascio
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Uberti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Edoardo De Micheli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabio Quartaroli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giuseppe Laquatra
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Pietro Grenzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Luca Pingani
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | | | - Federica Pinna
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari, Italy
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Massimo Mirandola
- WHO Collaborating Centre for Sexual Health and Vulnerable Populations, Epidemiology Unit - Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- School of Health Sciences, University of Brighton, Brighton, UK
| | - Gian M Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Clark KA, Pachankis JE, Dougherty LR, Katz BA, Hill KE, Klein DN, Kujawa A. Adolescents' Sexual Orientation and Behavioral and Neural Reactivity to Peer Acceptance and Rejection: The Moderating Role of Family Support. Clin Psychol Sci 2024; 12:115-132. [PMID: 38288008 PMCID: PMC10824405 DOI: 10.1177/21677026231158574] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Sexual-minority adolescents frequently endure peer rejection, yet scant research has investigated sexual-orientation differences in behavioral and neural reactions to peer rejection and acceptance. In a community sample of adolescents approximately 15 years old (47.2% female; same-sex attracted: n = 36, exclusively other-sex attracted: n = 310), we examined associations among sexual orientation and behavioral and neural reactivity to peer feedback and the moderating role of family support. Participants completed a social-interaction task while electroencephalogram data were recorded in which they voted to accept/reject peers and, in turn, received peer acceptance/rejection feedback. Compared with heterosexual adolescents, sexual-minority adolescents engaged in more behavioral efforts to ingratiate after peer rejection and demonstrated more blunted neural reactivity to peer acceptance at low, but not medium or high, levels of family support. By using a simulated real-world social-interaction task, these results demonstrate that sexual-minority adolescents display distinct behavioral and neural reactions to peer acceptance and rejection.
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Affiliation(s)
- Kirsty A. Clark
- Department of Medicine, Health, and Society, Vanderbilt University
- Department of Psychology and Human Development, Vanderbilt University
| | - John E. Pachankis
- Department of Social and Behavioral Sciences, Yale School of Clinical Psychological Science Public Health
| | | | | | - Kaylin E. Hill
- Department of Psychology and Human Development, Vanderbilt University
| | | | - Autumn Kujawa
- Department of Psychology and Human Development, Vanderbilt University
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Ouellette MJ, Mutschler C, Roth SL, McCabe RE, Tissera T, Patel H, Boyd JE, Nicholson AA, Hewitt J, Lopes J, Jeffs L, Schneider MA, McKinnon MC, Hatchard T. The Transcending Protocol: A Cognitive-Behavioral Approach for Addressing the Psychosocial Impact of Minority Stress in Transgender and Gender Diverse Individuals. JOURNAL OF LGBTQ ISSUES IN COUNSELING 2023. [DOI: 10.1080/26924951.2022.2096168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Mélise J. Ouellette
- Youth Wellness Centre, St. Joseph’s Healthcare Hamilton, Hamilton, Canada
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Canada
| | | | - Sophia L. Roth
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Canada
| | - Randi E. McCabe
- Youth Wellness Centre, St. Joseph’s Healthcare Hamilton, Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Talia Tissera
- Youth Wellness Centre, St. Joseph’s Healthcare Hamilton, Hamilton, Canada
| | - Herry Patel
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Jenna E. Boyd
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Andrew A. Nicholson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Jennifer Hewitt
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Jillian Lopes
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Canada
| | - Lisa Jeffs
- Youth Wellness Centre, St. Joseph’s Healthcare Hamilton, Hamilton, Canada
| | - Maiko A. Schneider
- Youth Wellness Centre, St. Joseph’s Healthcare Hamilton, Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Margaret C. McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Taylor Hatchard
- Youth Wellness Centre, St. Joseph’s Healthcare Hamilton, Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
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8
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Trombetta T, Balocco V, Santoniccolo F, Paradiso MN, Rollè L. Internalized Homonegativity, Emotion Dysregulation, and Isolating Behaviors Perpetration among Gay and Lesbian Couples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1593. [PMID: 36674347 PMCID: PMC9863614 DOI: 10.3390/ijerph20021593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Same-sex intimate partner violence (SSIPV) is a serious health concern and may manifest in various forms. Nevertheless, controlling behaviors of isolation are still poorly investigated. Due to their marginalized status, sexual minorities can face SSIPV-specific risk factors, such as internalized homonegativity, as well as general psychological stress factors, such as emotion dysregulation. While the literature is growing, there is still a lack of understanding of the complex pathways linking sexual minorities and minority stress to IPV and isolating controlling behavior. To fill this gap, we explored the relation between internalized homonegativity and controlling behaviors of isolation, assessing the mediating role of emotion dysregulation. In total, 120 gay and lesbian people (mean age = 33.8, SD = 11.5) involved in a same-sex relationship participated in the study. Results showed a direct and positive association between internalized homonegativity and difficulties in emotion regulation and a direct and positive association between emotion dysregulation and controlling behaviors of isolation; the mediating role of emotion dysregulation in the relation between internalized homonegativity and isolating controlling behaviors was supported as well. Emerging results can provide valuable information at the clinical level, although further studies are needed to confirm these preliminary findings.
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9
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Correro AN, Hinrichs KLM, Krishnan MC, Cottingham ME, Trittschuh EH, Parmenter BA, Kang J, Stelmokas J. Neuropsychological assessment with lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals: Practice, education, and training survey. Clin Neuropsychol 2022:1-43. [PMID: 36458596 DOI: 10.1080/13854046.2022.2148379] [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: 07/12/2022] [Accepted: 11/11/2022] [Indexed: 12/04/2022]
Abstract
Objective: We sought to describe the LGBTQ + related education, training, and clinical practice of independently licensed neuropsychologists in the United States and to identify factors that predict affirmative neuropsychological practices. We hypothesized that LGBTQ + identity, female gender, more recent training, and extent of LGBTQ + education/training would predict use of LGBTQ + practice guidelines. Method: A workgroup of clinical psychologists with experience in LGBTQ + psychology and neuropsychology developed a survey to identify personal and professional factors that predict affirmative neuropsychological testing practices. The survey was distributed through professional organizations and listservs between August and September 2021 with 118 responses meeting inclusionary criteria. Results: The majority of participants identified as heterosexual (70.3%) and cisgender (97.5%), and most (48-63%) received LGBTQ + training post-licensure. Between 19% and 32% of participants reported never completing LGBTQ + specific education. Consistent with our hypotheses, factors predicting affirmative clinical practice behaviors were LGBTQ + education/training, and personal background (sexual minority status, female/feminine gender, and years since degree). Other significant factors included prior experience with LGBTQ + patients and primary patient population (child vs. adult). Qualitative responses indicated varying values, attitudes, and knowledge regarding collection of LGBTQ + information and modification of clinical practice. Conclusions: Neuropsychologists underutilize affirming practices as evidenced by low rates of querying pronouns, knowing whether LGBTQ + health information is available at their institutions, and adjusting evaluation and feedback approaches. We provide specific training and education recommendations to increase knowledge and skills and to address beliefs about LGBTQ + health that can serve to promote affirmative neuropsychological practice.
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Affiliation(s)
- Anthony N Correro
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Psychiatry, Michigan Medicine, University of Michigan Health, Ann Arbor, Michigan, USA
| | - Kate L M Hinrichs
- Mental Health Service, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Mira C Krishnan
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | | | - Emily H Trittschuh
- Geriatric Research Education and Clinical Center (GRECC), VA Puget Sound Healthcare System, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Brett A Parmenter
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
- Mental Health Service, American Lake Division, VA Puget Sound Healthcare System, Tacoma, Washington, USA
- Olympic Psychology Services, Tacoma, Washington, USA
| | - Jinkyung Kang
- Department of Internal Medicine-Geriatric and Palliative Medicine, Michigan Medicine, University of Michigan Health, Ann Arbor, Michigan, USA
| | - Julija Stelmokas
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Psychiatry, Michigan Medicine, University of Michigan Health, Ann Arbor, Michigan, USA
- Mental Health Service, Brooklyn Campus, VA New York Harbor Healthcare System, Brooklyn, New York, USA
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Edmiston EK, Juster RP. Refining Research and Representation of Sexual and Gender Diversity in Neuroscience. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1251-1257. [PMID: 35940568 DOI: 10.1016/j.bpsc.2022.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/13/2022] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
There are opportunities to improve neuroscience that include lesbian, gay, bisexual, and transgender (LGBT) people. In this review, we briefly describe how the history of LGBT people in psychiatry has influenced neuroimaging approaches; how these attitudes have shifted over time; and what we can do to ensure that our future work is rigorous, ethical, and in service of the LGBT community. We suggest ways to refine neuroimaging methodologies to improve our understanding of marginalization and stigma while shifting away from research that focuses solely on the "etiology" or origins of LGBT identities. We also offer suggestions for conducting representative research that is LGBT-inclusive, regardless of the population of interest.
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Affiliation(s)
- Elliot Kale Edmiston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Robert-Paul Juster
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada; Research Center of the Montreal Mental Health University Institute, Montreal, Quebec, Canada
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11
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Siegel M, Legler M, Neziraj F, Goldberg AE, Zemp M. Minority Stress and Positive Identity Aspects in Members of LGBTQ+ Parent Families: Literature Review and a Study Protocol for a Mixed-Methods Evidence Synthesis. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9091364. [PMID: 36138673 PMCID: PMC9497922 DOI: 10.3390/children9091364] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 05/01/2023]
Abstract
BACKGROUND Parents and children in LGBTQ+ parent families face unique stressors (i.e., minority stress), but also possess unique resources (i.e., positive identity aspects) related to their family identity. Empirical evidence and theory suggest that these minority stressors and positive identity aspects are situated on the individual, couple, and family level and may be associated with key outcomes, including parent and child health, family functioning, and school-related outcomes. A systematic evidence synthesis and a theoretical placement are currently lacking. The aims of the systematic review outlined in this protocol are thus to (1) map minority stressors and positive identity aspects according to multiple levels in the family system, and (2) to synthesize evidence on their associations with key outcomes. METHODS We will conduct a PRISMA-conform mixed-methods systematic review. Studies will be retrieved using a multi-tiered search strategy, including database searches (PsycInfo, PubMed, Scopus, Web of Science), cited literature searches, authors' publication lists, and study requests. The mixed-methods synthesis will follow a parallel-results convergent synthesis design, where quantitative results will be synthesized via meta-analysis and qualitative results via thematic synthesis. CONCLUSIONS Our proposed systematic review may add to the theoretical understanding of LGBTQ+ parent family functioning and advance social inclusion of LGBTQ+ parent families.
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Affiliation(s)
- Magdalena Siegel
- Department of Clinical and Health Psychology, University of Vienna, 1010 Vienna, Austria
- Correspondence: ; Tel.: +43-1-4277-47285
| | - Muriel Legler
- Department of Clinical and Health Psychology, University of Vienna, 1010 Vienna, Austria
| | - Fortese Neziraj
- Department of Clinical and Health Psychology, University of Vienna, 1010 Vienna, Austria
| | - Abbie E. Goldberg
- Department of Psychology, Clark University, Worcester, MA 01610-1477, USA
| | - Martina Zemp
- Department of Clinical and Health Psychology, University of Vienna, 1010 Vienna, Austria
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12
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Manca R, Correro AN, Gauthreaux K, Flatt JD. Divergent patterns of cognitive deficits and structural brain alterations between older adults in mixed-sex and same-sex relationships. Front Hum Neurosci 2022; 16:909868. [PMID: 36118969 PMCID: PMC9479099 DOI: 10.3389/fnhum.2022.909868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022] Open
Abstract
Background Sexual minority (SM) older adults experience mental health disparities. Psychiatric disorders and neuropsychiatric symptoms (NPS) are risk factors for cognitive decline. Although older people in same-sex (SSR) compared to mixed-sex relationships (MSR) perform more poorly on cognitive screening tests, prior studies found no differences in rates of dementia diagnosis or neuropsychological profiles. We sought to explore the role of NPS on neurocognitive outcomes for SM populations. We compared cognitive performance and structural brain parameters of older adults in SSR and MSR. Methods Data were originally collected at Alzheimer's Disease Research Centers (ADRCs). Inclusion criteria were: age of 55+ years, a study partner identified as a spouse/partner, and availability of T1-MRI brain volumes/thickness. Participants were labeled as either SSR or MSR based on their/their co-participant's reported sex. We identified 1,073 participants (1,037 MSR−555 cognitively unimpaired [CU]; 36 SSR−23 CU) with structural MRI data, Mini-Mental State Exam (MMSE), and Neuropsychiatric Inventory Questionnaire (NPI-Q) scores. A subset of the overall sample completed comprehensive neuropsychological assessment (n = 939; 908 MSR−494 CU; 31 SSR−22 CU). Covariates included in statistical models were age, sex, education, total intracranial volume, and apolipoprotein E genotype. Results Multivariate general linear models showed significant diagnosis-by-relationship interaction effects on the left parahippocampal gyrus volume. After stratification by relationship group, only cognitively impaired (CI) MSR had significantly smaller left parahippocampal volumes than MSR-CU. The SSR group showed better episodic memory performance. Severity of neuropsychiatric symptoms was negatively associated with volume/thickness of bilateral fronto-temporal areas and with MMSE scores, predominantly in the MSR group. Conclusion In our study, MSR participants presented with a more compromised cognitive profile than SSR participants. MSR-CI participants showed significantly smaller left medio-temporal volumes, a neural signature of AD. Neuropsychiatric symptoms predicted smaller fronto-temporal volumes in the MSR more consistently than in the SSR group. These findings may be due to unexplored protective factors against cognitive decline in SM elders. Indeed, social support has been proposed as a protective factor warranting future investigation.
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Affiliation(s)
- Riccardo Manca
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Anthony N. Correro
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan Health, Ann Arbor, MI, United States
- *Correspondence: Anthony N. Correro II
| | - Kathryn Gauthreaux
- National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Jason D. Flatt
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, United States
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