1
|
Epstein R, Aceret J, Giordani C, Zankich VR, Zhang L. A rank ordering and analysis of four cognitive-behavioral stress-management competencies suggests that proactive stress management is especially valuable. Sci Rep 2024; 14:19224. [PMID: 39160168 PMCID: PMC11333707 DOI: 10.1038/s41598-024-68328-4] [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: 05/26/2023] [Accepted: 07/22/2024] [Indexed: 08/21/2024] Open
Abstract
The main objective of this study was to determine the relative value of four cognitive-behavioral competencies that have been shown in empirical studies to be associated with effective stress management. Based on a review of relevant psychological literature, we named the competencies as follows: Manages or Reduces Sources of Stress, Manages Thoughts, Plans and Prevents, and Practices Relaxation Techniques. We measured their relative value by examining data obtained from a diverse convenience sample of 18,895 English-speaking participants in 125 countries (65.0% from the U.S. and Canada) who completed a new inventory of stress-management competencies. We assessed their relative value by employing a concurrent study design, which also allowed us to assess the validity of the new instrument. Regression analyses were used to rank order the four competencies according to how well they predicted desirable outcomes. Both regression and factor analyses pointed to the importance of proactive stress-management practices over reactive methods, but we note that the correlational design of our study has no implications for the possible causal effects of these methods. Questionnaire scores were strongly associated with self-reported happiness and also significantly associated with personal success, professional success, and general level of stress. Data were collected between 2007 and 2022, but we found no effect for time. The study supports the value of stress-management training, and it also suggests that moderate levels of stress may not be as beneficial as previously thought.
Collapse
Affiliation(s)
- Robert Epstein
- American Institute for Behavioral Research and Technology, Vista, CA, 92084, USA.
| | - Jessica Aceret
- American Institute for Behavioral Research and Technology, Vista, CA, 92084, USA
| | - Ciara Giordani
- American Institute for Behavioral Research and Technology, Vista, CA, 92084, USA
| | - Vanessa R Zankich
- American Institute for Behavioral Research and Technology, Vista, CA, 92084, USA
| | - Lynette Zhang
- American Institute for Behavioral Research and Technology, Vista, CA, 92084, USA
| |
Collapse
|
2
|
Hsu J, Mernitz S. The role of romantic relationships for sexual minority young adults' depressive symptoms: Does relationship type matter? SOCIAL SCIENCE RESEARCH 2024; 122:103049. [PMID: 39216913 DOI: 10.1016/j.ssresearch.2024.103049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 09/04/2024]
Abstract
Sexual minority young adults consistently report higher rates of depression than heterosexual young adults. Drawing on the National Longitudinal Study of Adolescent to Adult Health, this study examines if types of romantic relationships provide mental health benefits for lesbian, gay, and bisexual young adults. Further, analyses distinguish between same- and different-sex unions to help determine which relationship types offer the most mental health benefits. The results show that marriage is linked to fewer depressive symptoms for gay and lesbian young adults, compared to being unpartnered or in a dating relationship. Further, same-sex unions are associated with fewer depressive symptoms, but not different-sex unions. Yet, bisexual respondents' depressive symptoms are not associated with romantic relationships, regardless of relationship type. The results suggest that it is important to address the stigma surrounding sexual minority status and same-sex relationships to improve the burden of depressive symptoms on sexual minority young adults.
Collapse
Affiliation(s)
- Jaime Hsu
- Department of Sociology, University of Texas at Austin, USA.
| | - Sara Mernitz
- Population Research Center, University of Texas at Austin, USA
| |
Collapse
|
3
|
Scheadler TR, Rao S, Shuper PA, Beer OWJ, Curtis T, McInroy LB, Eaton AD. Recruiting and Engaging Heterosexual-Identified Men Who have Sex with Men: A Brief Report of Considerations for Sex Researchers. JOURNAL OF SEX RESEARCH 2024:1-9. [PMID: 39037807 DOI: 10.1080/00224499.2024.2380017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Heterosexual-identified men who have sex with men (H-MSM) are a unique population difficult to identify and recruit for research and practice. Yet, engaging H-MSM remains a top research priority to learn more about this population's health needs. A scoping review was conducted to develop a stronger understanding of recruitment patterns involving H-MSM in research. The search and screening procedures yielded 160 total articles included in the present study. Most studies relied on venue-based and internet-based recruitment strategies. Thematic analysis was then used to identify three themes. Locations of H-MSM's sexual encounters related to where sex researchers may recruit participants; sociocultural backgrounds of H-MSM related to important characteristics researchers should acknowledge and consider when working with H-MSM; and engagement with health services related to how H-MSM interact with or avoid HIV/STI testing and treatment and other public health services. Findings suggest H-MSM have sex with other men in a variety of venues (e.g. bathhouses, saunas) but tend to avoid gay-centric venues. H-MSM also are diverse, and these unique identities should be accounted for when engaging them. Finally, H-MSM are less likely to access healthcare services than other MSM, highlighting the need for targeted advertisements and interventions specific for H-MSM.
Collapse
Affiliation(s)
| | - Salem Rao
- Department of Psychology, University of Toronto Mississauga
| | - Paul A Shuper
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health
- Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Toronto
| | - Oliver W J Beer
- Social Work & The Centre for Health Technology, University of Plymouth
| | - Tyrone Curtis
- School of Public Health and Social Policy, Faculty of Human and Social Development, University of Victoria
| | | | - Andrew D Eaton
- Faculty of Social Work - Saskatoon Campus, University of Regina
- Factor-Inwentash Faculty of Social Work, University of Toronto
| |
Collapse
|
4
|
Kim E, Sinco BR, Zhao J, Fang Y, Cunningham C, Frank E, Sen S, Bohnert A, Hughes TM. Duration of New-Onset Depressive Symptoms During Medical Residency. JAMA Netw Open 2024; 7:e2418082. [PMID: 38904957 PMCID: PMC11193122 DOI: 10.1001/jamanetworkopen.2024.18082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/20/2024] [Indexed: 06/22/2024] Open
Abstract
Importance The implications of new-onset depressive symptoms during residency, particularly for first-year physicians (ie, interns), on the long-term mental health of physicians are unknown. Objective To examine the association between and persistence of new-onset and long-term depressive symptoms among interns. Design, Setting, and Participants The ongoing Intern Health Study (IHS) is a prospective annual cohort study that assesses the mental health of incoming US-based resident physicians. The IHS began in 2007, and a total of 105 residency programs have been represented in this national study. Interns enrolled sequentially in annual cohorts and completed follow-up surveys to screen for depression using the 9-item Patient Health Questionnaire-9 (PHQ-9) throughout and after medical training. The data were analyzed from May 2023 to March 2024. Exposure A positive screening result for depression, defined as an elevated PHQ-9 score of 10 or greater (indicating moderate to severe depression) at 1 or more time points during the first postgraduate year of medical training (ie, the intern year). Main Outcomes and Measures The main outcomes assessed were mean PHQ-9 scores (continuous) and proportions of physicians with an elevated PHQ-9 score (≥10; categorical or binary) at the time of the annual follow-up survey. To account for repeated measures over time, a linear mixed model was used to analyze mean PHQ-9 scores and a generalized estimating equation (GEE) was used to analyze the binary indicator for a PHQ-9 score of 10 or greater. Results This study included 858 physicians with a PHQ-9 score of less than 10 before the start of their internship. Their mean (SD) age was 27.4 (9.0) years, and more than half (53.0% [95% CI, 48.5%-57.5%]) were women. Over the follow-up period, mean PHQ-9 scores did not return to the baseline level assessed before the start of the internship in either group (those with a positive depression screen as interns and those without). Among interns who screened positive for depression (PHQ-9 score ≥10) during their internship, mean PHQ-9 scores were significantly higher at both 5 years (4.7 [95% CI, 4.4-5.0] vs 2.8 [95% CI, 2.5-3.0]; P < .001) and 10 years (5.1 [95% CI, 4.5-5.7] vs 3.5 [95% CI, 3.0-4.0]; P < .001) of follow-up. Furthermore, interns with an elevated PHQ-9 score (≥10) demonstrated a higher likelihood of meeting this threshold during each year of follow-up. Conclusions and Relevance In this cohort study of IHS participants, a positive depression screening result during the intern year had long-term implications for physicians, including having persistently higher mean PHQ-9 scores and a higher likelihood of meeting this threshold again. These findings underscore the pressing need to address the mental health of physicians who experience depressive symptoms during their training and to emphasize the importance of interventions to sustain the health of physicians throughout their careers.
Collapse
Affiliation(s)
- Erin Kim
- University of Michigan Medical School, Ann Arbor
| | - Brandy R. Sinco
- Department of Surgery, University of Michigan, Ann Arbor
- Center for Healthcare Outcomes and Policy, Michigan Medicine, Ann Arbor
| | - Joan Zhao
- University of Michigan Medical School, Ann Arbor
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor
| | - Yu Fang
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor
| | - Carrie Cunningham
- Department of Surgery, Massachusetts General Hospital, Boston
- Institute for Technology Assessment, Massachusetts General Hospital, Boston
| | - Elena Frank
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor
| | - Srijan Sen
- University of Michigan Medical School, Ann Arbor
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Amy Bohnert
- University of Michigan Medical School, Ann Arbor
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
- Center for Clinical Management and Research, Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan
- Department of Anesthesiology, University of Michigan, Ann Arbor
| | - Tasha M. Hughes
- University of Michigan Medical School, Ann Arbor
- Department of Surgery, University of Michigan, Ann Arbor
- Center for Healthcare Outcomes and Policy, Michigan Medicine, Ann Arbor
| |
Collapse
|
5
|
Evans JA, Krumrei-Mancuso EJ, Rouse SV. What You Are Hiding Could Be Hurting You: Autistic Masking in Relation to Mental Health, Interpersonal Trauma, Authenticity, and Self-Esteem. AUTISM IN ADULTHOOD 2024; 6:229-240. [PMID: 39139513 PMCID: PMC11317797 DOI: 10.1089/aut.2022.0115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
Background Autistic masking refers to some autistic individuals' tendency to hide, suppress, or camouflage their autistic traits, autistic identity, or autism diagnosis. Autistic masking also may include unconscious or conscious attempts to mimic the behavioral, cognitive, or sensory styles of nonautistic neurotypical people and to suppress natural forms of autistic behavior, cognition, and reactions to sensory experiences. Since autistic people are a stigmatized minority in many neurotypical dominated societies, passing as nonautistic through autistic masking may be an attempt to avoid autism stigma and a reaction to previous interpersonal trauma. Increased autistic masking behaviors are associated with reports of increased depression, anxiety, burnout, and exhaustion in autistic people, and thus, exploring the roots and impact of autistic masking is an important mental health topic. Methods This study investigated the relationships between autistic masking and depression, anxiety, gender identity, sexual orientation, interpersonal trauma, self-esteem, authenticity, and autistic community involvement. Participants were autistic adults (n = 342) recruited through autistic social media groups. Results This study found that higher self-reported autistic masking behaviors were associated with higher reports of past interpersonal trauma, greater anxiety and depression symptoms, lower self-esteem, lower authenticity, and lower participation within the autistic community. Autistic masking was not associated with gender identity or sexual orientation. Conclusions The results of this study highlight the relationship between autistic masking and past interpersonal trauma, finding that autistic masking behavior is associated with mental health, self-esteem, and authenticity risks for autistic adults. We call into question the teaching of autistic masking strategies in therapies and education programs for autistic people based on the negative associations with autistic masking presented in this study and other research in this field.
Collapse
Affiliation(s)
- Joshua A. Evans
- Department of Psychology, Pepperdine University, Malibu, California, USA
| | | | - Steven V. Rouse
- Department of Psychology, Pepperdine University, Malibu, California, USA
| |
Collapse
|
6
|
Stackhouse M. The rural side of the rainbow: Mental health and the intersections of geography, sexuality, and partnership. CANADIAN REVIEW OF SOCIOLOGY = REVUE CANADIENNE DE SOCIOLOGIE 2024; 61:131-152. [PMID: 38593268 DOI: 10.1111/cars.12470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Lesbian, gay, and bisexual (LGB) persons tend to be geographically concentrated in larger metropolitan areas and research persistently observes LGB persons as a disadvantaged population for mental health outcomes when compared to their heterosexual counterparts. Conflicting evidence suggests that mental health risk exposures are greater for LGB people in rural spaces while other research posits that urban residency is more detrimental for LGB mental health. One positively contributing factor to the mental well-being of LGB persons is their partnership status. To date, no study estimates how partnership may ameliorate unfavourable mental health outcomes for LGB populations in urban and rural areas. Using 10 years of pooled data from the nationally representative Canadian Community Health Survey (CCHS), this study examines mental health and the intersection of sexuality, geographic residency, and partnership. Logistic regression models estimate the intersections of sexuality, geography, and partnership status on mental health, stratified by respondents' gender. Findings show partnered gay men in rural areas experiencing better mental health than their partnered heterosexual counterparts in the largest urban cities. Although not significant, the same pattern is observed for partnered lesbian women who do not experience a significant mental health disadvantage at any geographic level. Regardless of partnership and geographic space, bisexual men, and especially bisexual women, exhibit worse mental health outcomes compared to their heterosexual counterparts.
Collapse
|
7
|
Gómez-Chica P, Rueda-Ruzafa L, Aparicio-Mota A, Rodriguez-Arrastia M, Ropero-Padilla C, Rodriguez-Valbuena C, Román P. Examining suicide risk in sexual and gender minority youth: A descriptive observational study on depressive symptoms, social support and self-esteem. J Clin Nurs 2024. [PMID: 38533544 DOI: 10.1111/jocn.17147] [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: 09/28/2023] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
AIM To understand the factors that contribute to the risk of suicide among lesbian, gay, bisexual, transgender, queer, intersex and asexual (sexual minorities) youth. BACKGROUND The increase in the likelihood of suicide has made it an urgent issue in public health, particularly among young people, where it now ranks as the fourth leading cause of death. This issue becomes even more significant when focusing on sexual minorities. METHODS A cross-sectional study was performed in targeted young individuals (15-29 years). Several variables were assessed, including suicide risk, self-esteem, presence and severity of depressive symptoms, perceived social support and self-reported levels of anxiety and depression. RESULTS Statistically significant disparities were observed in suicide risk, presence of depressive symptoms and self-reported levels of anxiety and depression, all of which were more pronounced in sexual minority youth compared to heterosexual cisgender individuals. Likewise, statistically significant differences were noted concerning self-esteem and family support, both of which were lower in sexual minority youth. CONCLUSION This study has identified risk factors, such as anxiety, depression and limited social support, as well as protective factors, like higher self-esteem and self-concept. Understanding and addressing all these factors are essential in reducing the elevated rates of suicide among sexual minority youth. Consequently, evidence-based interventions such as Gender and Sexuality Alliances, which empower and create safe spaces for sexual minority youth, possess substantial potential for effectively addressing this issue. IMPLICATIONS FOR THE PROFESSION Given sexual minorities vulnerability, healthcare pros, especially nurses, must grasp suicide risk factors. They can help by educating, offering care, assessing risk and fighting stigma. This guarantees safety and access to mental health services for at-risk individuals from sexual minorities. REPORTING METHOD The reporting follows the STROBE checklist. PATIENT CONTRIBUTION People who were invited to participate voluntarily completed a range of questionnaires.
Collapse
Affiliation(s)
| | - Lola Rueda-Ruzafa
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
| | - Adrián Aparicio-Mota
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Andalusian Public Foundation for Biomedical Research in Eastern Andalusia (FIBAO), University Hospital Torrecárdenas, Almería, Andalusía, Spain
| | - Miguel Rodriguez-Arrastia
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
| | - Carmen Ropero-Padilla
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
| | - Cristian Rodriguez-Valbuena
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
| | - Pablo Román
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
- Health Research Center CEINSA, University of Almería, Almería, Andalusía, Spain
| |
Collapse
|
8
|
Liang JH, Ge WX, Jin ZG, Wang C, Liu ML, Pu YQ, Huang S, Jiang N, Hu LX, Zhang YS, Gui ZH, Pu XY, Huang SY, Chen YJ. Sexual orientation disparities in the prevalence of suicidal ideation among U.S adults aged 20 to 59 years: Results from NHANES 2005-2016. Psychiatry Res 2024; 331:115639. [PMID: 38039649 DOI: 10.1016/j.psychres.2023.115639] [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: 08/20/2023] [Revised: 11/25/2023] [Accepted: 11/25/2023] [Indexed: 12/03/2023]
Abstract
Existing studies have been limited in providing nationally representative data on the relationship between sexual orientation and suicidal ideation (SI) among adults in the U.S. particularly in terms of gender and racial differences. To fill this research gap, we conducted a study using data from the NHANES conducted between 2005 and 2016. Survey-weighted logistic regression models were used to investigate the relationship between sexual orientation and SI risk. Additionally, we performed further analysis by stratifying the data based on demographic variables and performed sensitivity analysis to ensure the reliability of our findings. This study included a weighted sample of 16,564 adults, representing a noninstitutionalized U.S population of 840.1 million. The overall age-adjusted prevalence of SI was found to be 3.5 %. After adjusting for relevant covariates, the study revealed that individuals who identified as something else, homosexual, and bisexual had a higher prevalence risk of suicidal ideation (SI) compared to heterosexual participants. Additionally, the study found that heterosexual participants were 74.4 % less likely to experience SI compared to bisexual individuals. These findings highlight the urgent requirement for inclusive and supportive prevention strategies to effectively address SI among adult sexual minorities in the U.S.
Collapse
Affiliation(s)
- Jing-Hong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, PR China
| | - Wen-Xin Ge
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, PR China
| | - Zheng-Ge Jin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, PR China
| | - Cong Wang
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, PR China
| | - Mei-Ling Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, PR China
| | - Ying-Qi Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, PR China
| | - Shan Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, PR China
| | - Nan Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, PR China
| | - Li-Xin Hu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, PR China
| | - Yu-Shan Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, PR China
| | - Zhao-Huan Gui
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, 74 Zhongshan 2nd Rd, Yuexiu District, Guangzhou, PR China
| | - Xue-Ya Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, PR China
| | - Shao-Yi Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, PR China
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, PR China.
| |
Collapse
|
9
|
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
|
10
|
Watson RJ, Caba AE, Layland EK, Simon K, Morgan E, Edelman EJ, Chan PA, Eaton L. Co-occurring mental health and drug use experiences among Black and Hispanic/Latino sexual and gender diverse individuals. J Behav Med 2023; 46:986-995. [PMID: 37407904 DOI: 10.1007/s10865-023-00433-7] [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: 08/17/2022] [Accepted: 06/21/2023] [Indexed: 07/07/2023]
Abstract
Black and Hispanic/Latino sexual and gender diverse individuals disproportionately experience overlapping health disparities, such as drug use and elevated depressive symptoms, which are often driven by minority stressors. We sought to better understand the interaction between drug use and mental health, as it may be fruitful in developing effective interventions to address co-occurring health disparities. In a longitudinal, 5-wave sample of 300 Black and Hispanic/Latino sexual and gender diverse (SGD) individuals collected between March 2020 and March 2022, we found a within-person association between greater than average levels of psychological distress (depression and anxiety) and more frequent extra-medical use of cannabis, inhalants, methamphetamines, and opioids over the span of two years. These associations held after adjusting for the direct, within-person association of internalized homonegativity with drug use frequency. These results suggest that psychological distress explains at least some variance in drug use among Black and Hispanic/Latino SGD individuals. This highlights the importance of interventions that focus on mental health among Black and Hispanic/Latino SGD individuals who report drug use.
Collapse
Affiliation(s)
- Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA.
| | - Antonia E Caba
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA
| | - Eric K Layland
- College of Education & Human Development, University of Delaware, Newark, DE, USA
| | - Kay Simon
- College of Education and Human Development, University of Minnesota, Minneapolis, MN, USA
| | - Ethan Morgan
- College of Nursing, The Ohio State University, 1585 Neil Ave, Columbus, OH, 43210, USA
| | - E Jennifer Edelman
- Yale School of Medicine and Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
| | - Philip A Chan
- Department of Medicine, Brown University, Providence Rhode, Island
| | - Lisa Eaton
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA
| |
Collapse
|
11
|
Eaton AD, Scheadler TR, Bradley C, McInroy LB, Beer OWJ, Beckwell E, Busch A, Shuper PA. Identity development, attraction, and behaviour of heterosexually identified men who have sex with men: scoping review protocol. Syst Rev 2023; 12:184. [PMID: 37777815 PMCID: PMC10542689 DOI: 10.1186/s13643-023-02355-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/21/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Heterosexually identified men who have sex with men (H-MSM) are distinct from other heterosexual men and from gay, bisexual, and other sexual minority men. Specifically, H-MSM experience discordance between their sexual identity (i.e., heterosexual) and behaviours (i.e., sexual encounters with other men). This sexual identity-behaviour discordance can create barriers to obtaining healthcare and social support. Understanding and accepting H-MSM as they self-identify may be necessary to implement effective public health and psychosocial interventions. The aim of the present study is to provide an overview of research on H-MSM. METHODS A scoping review will be conducted to identify and describe the identity development, attraction, and behaviour of H-MSM. This scoping review will also identify and describe current trends related to the recruitment of H-MSM and recommend directions for future research. Searches will be conducted in Academic Search Complete, APA PsychInfo, CINAHL Plus with full text, Education Research Complete, Gender Studies Database, GenderWatch, Health Source: Nursing/Academic Edition, LGBTQ + Source, MEDLINE, Psychology and Behavioral Sciences Collection, SocINDEX with full text, Sociological Collection, Social Work Abstracts, ProQuest Dissertations and Theses, and ResearchGate. Primary research studies published in peer-reviewed journals will be included. Dissertations and theses that include primary research on H-MSM will also be included. Reference lists, experts in the field, preprint servers, and relevant conferences will also be consulted for extant and in-progress literature. Two reviewers will independently pilot the data extraction form and conduct the title and abstract screening, with consultation from a research librarian. Seven reviewers will then conduct the full-text article screening. Thematic content analysis will guide the review; through independent review and reviewer meetings, themes and subthemes will be identified and reported from the extracted literature. DISCUSSION This is the first known knowledge synthesis on H-MSM, seeking to better understand sexual identity-behaviour discordance amongst cisgender men. We anticipate that a theoretical framework of H-MSM's sexuality, internal processes, and behaviours will be constructed from this review. Alongside implications for further research with H-MSM, this review may be relevant to sexually transmitted infection public health and to clinicians working in the field of male sexuality. SYSTEMATIC REVIEW REGISTRATION Open Science Framework: https://doi.org/10.17605/OSF.IO/MVY9H.
Collapse
Affiliation(s)
- Andrew D Eaton
- Faculty of Social Work - Saskatoon Campus, University of Regina, Saskatoon, SK, Canada.
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | | | - Cara Bradley
- Dr. John Archer Library, University of Regina, Regina, SK, Canada
| | - Lauren B McInroy
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Oliver W J Beer
- College of Social Work, The Ohio State University, Columbus, OH, USA
- School of Health Professionals, The University of Plymouth, Plymouth, UK
| | - Erin Beckwell
- Faculty of Social Work - Saskatoon Campus, University of Regina, Saskatoon, SK, Canada
| | | | - Paul A Shuper
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
12
|
Liu Y, O’Grady MA. A cross-sectional study of the relationship between depression status, health care coverage, and sexual orientation. DISCOVER MENTAL HEALTH 2023; 3:13. [PMID: 37861944 PMCID: PMC10501004 DOI: 10.1007/s44192-023-00039-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/22/2023] [Indexed: 10/21/2023]
Abstract
Health care coverage is an important factor in receipt of behavioral healthcare. This study uses data from the New York City Community Health Survey to examine how sexual minority status impacts the relationship between depression status and having health care coverage. Approximately 10% of the sample (n = 9571; 47% 45+ years old; 35% White Non-Hispanic; 7% sexual minority) reported probable depression and low health care coverage. Compared to heterosexual participants, a greater proportion of sexual minority participants had low health care coverage (17% vs. 9%) and probable depression (19% vs. 9%). Logistic regression examining the association between probable depression status and health care coverage showed that those with probable depression have odds of low health care coverage that are were 3.08 times those who did not have probable depression; this relationship was not modified by sexual orientation. Continued research to understand the interplay of health care coverage, mental health, and sexual orientation is needed.
Collapse
Affiliation(s)
- Yang Liu
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, USA
| | - Megan A. O’Grady
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, USA
| |
Collapse
|
13
|
Wedel AV, Patterson JG, Lee DN, Stevens EM, Wagener TL, Keller-Hamilton B. E-Cigarette Use among Sexual Minoritized Women and Nonbinary People Assigned Female at Birth: Assessing the Roles of Discrimination, Perceived Stress, and Social Support. Subst Use Misuse 2023; 58:1102-1109. [PMID: 37199173 PMCID: PMC10247437 DOI: 10.1080/10826084.2023.2212056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Background: Young adult sexual minoritized women (SMW) are at disproportionate risk for e-cigarette use, which may in part be due to excess minority stress imposed by discrimination exposure. While discrimination exposure is associated with risk for combustible tobacco/nicotine use among SMW, similar associations have yet to be tested with e-cigarettes. Moreover, it is unknown if discrimination-related risk may be mitigated by protective factors such as social support. This study examined concurrent associations of discrimination, perceived stress, and social support with past 30-day e-cigarette use in a sample of young adult SMW during the COVID-19 pandemic. Methods: N = 501 SMW and nonbinary people assigned female at birth (AFAB) aged 18-30 completed an online survey. A series of logistic regressions examined associations of discrimination, perceived stress, and four forms of social support received during the COVID-19 pandemic with past-30-day e-cigarette use. Results: Among SMW, greater perceived stress (OR = 1.10, p = .03), but not discrimination exposure, was associated with e-cigarette use. Associations of discrimination with e-cigarette use were nonsignificant when most forms of social support (emotional, material/financial, and virtual) were accounted for. Associations of perceived stress with e-cigarette use were strongest among those who needed but did not receive material support. Conclusions: Perceived stress, but not discrimination exposure, was associated with risk for e-cigarette use among young SMW during the COVID-19 pandemic. Effects of nonspecific stress may be compounded by insufficient material/financial support.
Collapse
Affiliation(s)
- Amelia V. Wedel
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Joanne G. Patterson
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Donghee N. Lee
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Elise M. Stevens
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Theodore L. Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Brittney Keller-Hamilton
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| |
Collapse
|
14
|
Bochicchio L, Xu M, Veldhuis CB, McTavish C, Hughes TL. Mental health and substance use among sexual minority women who report childhood sexual abuse: A systematic literature review. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 16:2023-70239-001. [PMID: 37166921 PMCID: PMC10638469 DOI: 10.1037/tra0001476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVE A growing body of literature provides evidence that sexual minority women (SMW; e.g., lesbian, bisexual) are at greater risk of negative mental health and substance use outcomes than are heterosexual women. While minority stress may partially explain these disparities, it does not fully account for them. Therefore, it is necessary to identify how other risk factors (i.e., childhood sexual abuse [CSA]) contribute to SMW's increased risk of negative mental health and substance use outcomes. METHOD We conducted a systematic literature review to identify and synthesize the state of knowledge about CSA and mental health and substance use outcomes among SMW. Two independent reviewers screened 347 articles identified in searches of five databases (Web of Science, PsycInfo, CINAHL, PubMed, and Embase). Eligible articles were peer-reviewed, reported quantitative or mixed methods results focused on mental health or substance use outcomes among adult SMW with a history of CSA. RESULTS Twenty-four papers were included in the review. Findings clearly show that SMW report higher rates of CSA than heterosexual women. Findings also suggest that CSA may mediate the relationship between minority sexual identity and some negative outcomes. CONCLUSIONS Future studies should include minority stress factors, a broader range of mental health outcomes (apart from substance use and suicide), and more nuanced measures of CSA. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Mariah Xu
- School of Nursing, Columbia University
| | - Cindy B Veldhuis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | | | - Tonda L Hughes
- School of Nursing, Columbia University Irving School of Medicine
| |
Collapse
|
15
|
Yan W, Huang C, Li C. Family and Relationship Quality among Young Adults with Different Sexual Orientations in Urban China: The Mediating Effects of Life Satisfaction and Self-Esteem. JOURNAL OF SEX RESEARCH 2023; 60:689-703. [PMID: 36125856 DOI: 10.1080/00224499.2022.2117772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This study explored the ambivalent effects of family on the close relationship quality of Chinese young adults. From a national estimate of the urban population across mainland China, 5,089 participants aged 20-39 were recruited for this study. A three-dimensional conceptualization was applied to identify three groups with different sexual orientations in this study. Group A comprised participants who identified as sexual minority people; Group B comprised participants who identified as heterosexuals but were not exclusively attracted to one sex and/or individuals who had had same-sex sexual experiences; Group C comprised participants who identified as heterosexuals. Groups A and B reported lower close relationship satisfaction and psychological well-being than Group C. Life satisfaction and self-esteem partially mediated the association between family and close relationship satisfaction for all groups. However, this relationship was weaker for Group B, and closeness to family benefitted Group B's life satisfaction to a lesser extent, indicating that the nuanced relationship with family influenced the sexual minority people with heterosexual identities. We recommend future directions and practices in local research and policy-making.
Collapse
Affiliation(s)
- Wenhua Yan
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University
| | - Chengshi Huang
- School of Psychology and Cognitive Science, East China Normal University
| | - Chengyan Li
- Department of Human Resource Management, Shanghai Normal University
| |
Collapse
|
16
|
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
|
17
|
Suen YT, Chan RC, Wong EMY. Association between co-residence and loneliness during COVID-19 among sexual minority people in Hong Kong. Int J Soc Psychiatry 2023; 69:483-492. [PMID: 35876230 PMCID: PMC10076174 DOI: 10.1177/00207640221110435] [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: 11/16/2022]
Abstract
BACKGROUND Research has identified that loneliness during COVID-19 is associated with co-residence status, and individuals living alone were more likely to report loneliness. However, it may not apply to sexual minority people as those living with their family may experience different sexual orientation-related stressors. AIMS This study aims to (1) understand the pattern of living arrangement and loneliness among sexual minority people during COVID-19, (2) examine parental acceptance, family conflict and loneliness among sexual minority people with different living arrangements and (3) investigate the association between parental acceptance and loneliness among sexual minority people with different living arrangements during COVID-19. METHOD An online survey with 1,457 Hong Kong sexual minority people was conducted. RESULTS Sexual minority people living with their partner(s) were less likely to report loneliness. Concurrently, those living with their parent(s) showed a similar level of loneliness as those who lived alone. Living with parent(s) during COVID-19 does not necessarily alleviate feelings of loneliness among them, which we argue may be due to parental unacceptance of their sexual orientation. Nearly half of the respondents stated that their parent(s) were unaccepting of their sexual orientation and 41.8% of them indicated an increase in family conflict during COVID-19. For those living with their parent(s), parental unacceptance is related to more family conflict during COVID-19, which in turn is associated with higher levels of loneliness. CONCLUSIONS Not living with unaccepting parents may reduce family conflict and feelings of loneliness, but this has not been the case for many respondents from a city with high population density and cost of living. Social and mental health service providers need to come up with timely and appropriate interventions to address the unique needs faced by sexual minority people during and after the COVID-19 pandemic.
Collapse
Affiliation(s)
- Yiu Tung Suen
- Gender Studies Programme, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Randolph Ch Chan
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Eliz Miu Yin Wong
- Department of Social Policy, London School of Economics and Political Science, London, UK
| |
Collapse
|
18
|
Chai HW, Mernitz SE, Umberson DJ. Sexual Motives, Stress, and Depressive Symptoms Among Midlife Different-Sex and Same-Sex Couples. THE GERONTOLOGIST 2023; 63:261-273. [PMID: 36063367 PMCID: PMC9960013 DOI: 10.1093/geront/gnac136] [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: 02/15/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Within relationships, sexual motives and stress are independent determinants of psychological health, with notable gendered patterns. However, previous research largely focuses on young adults and different-sex couples. Both sexual motives and levels of stress may be uniquely important to psychological health in midlife, and in potentially different ways for same-sex and different-sex couples. This study examined how the associations between sexual motives, stress, and depressive symptoms differ for midlife men and women in same-sex and different-sex marriages. RESEARCH DESIGN AND METHODS Using dyadic data from same-sex and different-sex midlife married couples (N = 830 individuals; 415 couples), we examined the associations of intrinsic (e.g., sex for enjoyment and pleasure) and extrinsic (e.g., sex to please one's spouse) motives for having sex with depressive symptoms and tested whether these associations differed by levels of stress for same-sex and different-sex spouses. RESULTS Intrinsic sexual motives were associated with fewer depressive symptoms only for same-sex married couples under high stress. Extrinsic sexual motives were related to greater depressive symptoms for women in low-stress conditions and men in high-stress conditions, and this did not differ for same-sex compared to different-sex marriages. DISCUSSION AND IMPLICATIONS Results show that the interplay between sexual motives and stress varies for men and women in same-sex and different-sex marriages. These findings underscore the importance of considering both gender and sexuality in studying sexual motives in midlife and suggest sexual motives as a useful treatment focus for protecting the psychological health of midlife married couples.
Collapse
Affiliation(s)
- Hye Won Chai
- Population Research Center, The University of Texas at Austin, Austin, Texas, USA
| | - Sara E Mernitz
- Population Research Center, The University of Texas at Austin, Austin, Texas, USA
| | - Debra J Umberson
- Population Research Center, The University of Texas at Austin, Austin, Texas, USA
- Department of Sociology, College of Liberal Arts, The University of Texas at Austin, Austin, Texas, USA
| |
Collapse
|
19
|
Davis A, Solomon M, Belcher H. Examination of Race and Autism Intersectionality Among African American/Black Young Adults. AUTISM IN ADULTHOOD 2022; 4:306-314. [PMID: 36777378 PMCID: PMC9908282 DOI: 10.1089/aut.2021.0091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background African American/Black (AA/B) young adults with diagnoses of autism spectrum disorders rarely are studied in a way that acknowledges both their racial identity and their autism diagnosis. Little is known about intersectional oppression in the lives of these young adults. Early adulthood is a time when a young people of color may come to terms with a society that may not treat them fairly and equally due to their race. Autistic AA/B young adults may be even more vulnerable to stress and psychological disempowerment due to the added impact of negative experiences of being Black and having an autism diagnosis. Methods Thirty-two autistic and 30 non-autistic AA/B young adults took part in an online survey examining risk factors of everyday discrimination, perceived stress and potential protective factors of psychological empowerment, and Black identity. Differences in score measures for the autistic and non-autistic samples were examined along with the predictors of perceived stress assessed. Frequencies of intersectional discrimination experiences were also examined. Results Autistic AA/B participants reported significantly less everyday discriminatory experiences than non-autistic AA/B participants, whereas perceived stress was not significantly different between the two groups. The majority of non-autistic AA/B participants endorsed race as their prime source of experiences of discrimination, whereas autistic AA/B participants also cited being autistic as a major contributor to reports of discrimination. Although the autistic group had significantly lower reports of self-determination, they reported higher on the Black identity, private regard scale, pertaining to feelings about group membership, which can be considered a protective factor. There is heterogeneity in reasons for discriminatory experiences for autistic AA/B young adults whereby some of the participants (12%-30%) endorsed race + disability as dual reasons for experiencing regular discrimination. Conclusions Mental health clinicians and other direct service providers working with autistic AA/B young adults should understand that intersecting identities of race and disability may be at play when they are working with these individuals, and that treatment should consider these factors.
Collapse
Affiliation(s)
- Amber Davis
- Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland, USA
| | - Marjorie Solomon
- Department of Psychiatry, University of California Davis, Sacramento, California, USA
| | - Harolyn Belcher
- Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland, USA
| |
Collapse
|
20
|
Li W, Wang Y, Xu M, Liao Y, Zhou H, Ma H, Geng Q. Temporal Trends and Differences in Sexuality among Depressed and Non-Depressed Adults in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14010. [PMID: 36360889 PMCID: PMC9654390 DOI: 10.3390/ijerph192114010] [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: 09/29/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to examine temporal trends and differences in sexuality between depressed and non-depressed adults aged 18-59 in the United States from 2005 to 2016. A total of 21,437 people (5432 with depression) were enrolled in this cross-sectional study. From 2005-2008 to 2013-2016, the average age at first sexual intercourse decreased, while the proportion of normal frequency of sexual activity and heterosexual sexual orientation increased among all the participants. Some differences in sexuality were found between the depressed and non-depressed groups. The average age at first sexual intercourse (p < 0.001), the proportion of normal frequency of sexual activity (p < 0.001), and heterosexual sexual orientation (p < 0.001) were lower in depressed participants, and the differences did not change over time (pfor trend = 0.926 of average age at first sexual intercourse, pfor trend = 0.823 of normal frequency of sexual activity, pfor trend = 0.926 of heterosexual sexual orientation). Moreover, these differences were associated with marital status (pfor interaction < 0.001 by average age at first sexual intercourse), employment status (pfor interaction < 0.001 by average age at first sexual intercourse), education status (pfor interaction = 0.023 by heterosexual sexual orientation) and family income status (pfor interaction = 0.013 by average age at first sexual intercourse and pfor interaction = 0.017 by normal frequency of sexual activity). In conclusion, the study found that the age at first sexual intercourse decreased and the frequency of sexual intercourse increased in all the participants, and differences in sexuality between depressed and non-depressed participants were present; however, these differences had no further increase or decrease during the 12-year period. These differences were associated with marital status, employment status, education status, and family income status. These findings show differences in sexuality between depressed and non-depressed patients but are somewhat different from previous studies; the results may provide directions for future research and social work.
Collapse
Affiliation(s)
- Weiya Li
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510317, China
| | - Yu Wang
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510317, China
| | - Mingyu Xu
- School of Medicine, South China University of Technology, Guangzhou 510641, China
| | - Yingxue Liao
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510317, China
| | - Haofeng Zhou
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510317, China
| | - Huan Ma
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510317, China
| | - Qingshan Geng
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510317, China
| |
Collapse
|
21
|
Sakharkar P, Friday K. Examining Health Disparities and Severity of Depression among Sexual Minorites in a National Population Sample. Diseases 2022; 10:diseases10040086. [PMID: 36278585 PMCID: PMC9624332 DOI: 10.3390/diseases10040086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Health disparities and mental health issues have not been fully explored among sexual minorities. This study aims to examine health disparities and severity of depression among sexual minorities using a nationally representative sample of the US population. Methods: The National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2016 were analyzed. The Patient Health Questionnaire (PHQ-9) was used to examine the severity of depression among sexual minorities compared to heterosexuals. Data were analyzed for descriptive statistics and associations using the Chi-squared test. A multivariate logistic regression analysis was used to quantify the magnitude of association between severity of depression and demographic characteristics. A p-value of <0.05 was considered statistically significant. Results: Among 7826 participants included, 426 (5.4%) were identified as a sexual minority. Moderately severe to severe depression was observed among 9.3% of sexual minorities with women having higher rates (64.2%) than men. Similarly, sexual minorities were two times more likely to have moderately severe to severe depression, two and half times more likely to see a mental health professional, and one and half times more likely to have genital herpes and be a user of illicit drugs than heterosexuals. In addition, they were less likely to be married and more likely to have been born in the United States, be a U.S. citizen, and earn less than USD 25,000 (p < 0.05). Conclusions: Sexual minorities are affected by a range of social, structural, and behavioral issues impacting their health. The screening of individuals with depression who are sexual minorities (especially females), illicit drug users, poor, or aged over 39 years may benefit from early intervention efforts.
Collapse
Affiliation(s)
- Prashant Sakharkar
- College of Science, Health and Pharmacy, Roosevelt University, Schaumburg, IL 60173, USA
- Correspondence: ; Tel.: +1-847-240-4077
| | - Kafi Friday
- College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC 27506, USA
| |
Collapse
|
22
|
Nebot-Garcia JE, Giménez-García C, García-Barba M, Gil-Llario MD, Ballester-Arnal R. What Does Heterosexuality Mean? Same-Sex Attraction, Behaviors, and Discomfort Among Self-identified Heterosexual Young Adults from Spain. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3431-3442. [PMID: 36066679 PMCID: PMC9556375 DOI: 10.1007/s10508-022-02315-6] [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: 09/25/2019] [Revised: 02/09/2022] [Accepted: 02/20/2022] [Indexed: 06/15/2023]
Abstract
Sexuality has been censored by Spanish culture, where legal progress in the form of new policies about sexual diversity rights has not been followed by lower levels of social discrimination. This has affected sexual development across the lifespan for both sexual minorities and heterosexual people who experience their sexuality outside of heteronormativity. However, the literature has regularly excluded the possible consequences of the experience of sexuality within prescriptive categories, particularly in heterosexual people. This study delves deeper into the same-sex experiences of heterosexual women and men and the discomfort they may feel toward such experiences in Spain. A total of 2900 young Spanish people who self-identified as heterosexual completed a questionnaire on sexual diversity and experiences related to sexual orientation. The mean age was 24.22 years (SD = 5.71), 71.1% were women, and 28.9% were men. More heterosexual women than heterosexual men reported having had same-sex attraction, fantasies, desires, and behavioral intentions. However, these men and women reported having similar levels of same-sex sexual intercourse. The discomfort level experienced was higher among heterosexual men and younger people, suggesting the possibility that traditional norms restrict behavioral expression of sexuality among these individuals. At least in the Spanish context, these gender differences should be taken into account to adjust all psychological and educational interventions in the future to improve inclusive sexual attitudes and the treatment of discomfort with sexual orientation. Following these results, research on sexual diversity should focus on young heterosexual people who have different same-sex experiences according to gender differences.
Collapse
Affiliation(s)
- Juan E Nebot-Garcia
- Department of Clinical and Basic Psychology and Psychobiology, Universitat Jaume I, Avda. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - Cristina Giménez-García
- Department of Clinical and Basic Psychology and Psychobiology, Universitat Jaume I, Avda. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain.
| | - Marta García-Barba
- Department of Clinical and Basic Psychology and Psychobiology, Universitat Jaume I, Avda. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - María Dolores Gil-Llario
- Department of Developmental and Educational Psychology, Universitat de València, Valencia, Spain
| | - Rafael Ballester-Arnal
- Department of Clinical and Basic Psychology and Psychobiology, Universitat Jaume I, Avda. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| |
Collapse
|
23
|
Gordián-Arroyo A, Schnall R, Garofalo R, Kuhns LM, Pearson C, Bruce J, Scott Batey D, Radix A, Belkind U, Hirshfield S, Hidalgo MA. Homonegative Victimization and Perceived Stress among Adolescent Sexual Minority Males: The Attenuating Role of Peer and Family Support. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:691-701. [PMID: 36776753 PMCID: PMC9918044 DOI: 10.1080/19317611.2022.2124341] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 07/23/2022] [Accepted: 07/29/2022] [Indexed: 06/18/2023]
Abstract
PURPOSE Research suggests social support may protect sexual minorities from the harmful effects of victimization that undermine mental and sexual health wellness; however, this relationship has been underexplored among a diverse youth population. We examined the association between lifetime homonegative victimization, perceived stress in the last month, and resilience factors among a diverse sample of adolescent sexual minority males. METHODS Data were collected between June 2018 and April 2020 as part of the MyPEEPS Mobile study, a multi-site randomized controlled trial evaluating the effectiveness of a mobile behavioral HIV prevention intervention for adolescents living in the U.S. We analyzed baseline survey data from 542 sexual minority males, aged 13-18 years. We used bivariate analyses to examine relationships among variables and multivariable linear regression models to determine if resilience factors attenuated the association between homonegative victimization and perceived stress. RESULTS Perceived stress was positively associated with younger age, internalized homophobia, experiencing verbal victimization, threats of being outed, and threats of physical violence. Relying on online friends for support and having good family relations both attenuated the relationship between verbal victimization and perceived stress. However, neither of these resilience factors significantly weakened the associations between perceived stress, threats of physical violence, and being outed. CONCLUSION Resilience factors, including peer and family support, may play an attenuating role in the relationship between homonegative victimization and perceived stress among adolescent sexual minority males.
Collapse
Affiliation(s)
- Alvin Gordián-Arroyo
- Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | - Rebecca Schnall
- School of Nursing, Columbia University, New York, New York, USA
- Mailman School of Public Health, Department of Population and Family Health, Columbia University, New York, New York, USA
| | - Robert Garofalo
- Department of Pediatrics, Northwestern University’s Feinberg School of Medicine, Chicago, Illinois, USA
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
| | - Lisa M. Kuhns
- Department of Pediatrics, Northwestern University’s Feinberg School of Medicine, Chicago, Illinois, USA
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
| | - Cynthia Pearson
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Josh Bruce
- Department of Education, Birmingham AIDS Outreach, Birmingham, Alabama, USA
| | - D. Scott Batey
- School of Social Work, University of Alabama, Birmingham, Alabama, USA
| | - Asa Radix
- Department of Medicine, Callen-Lorde Community Health Center, New York, New York, USA
| | - Uri Belkind
- Department of Medicine, Callen-Lorde Community Health Center, New York, New York, USA
| | - Sabina Hirshfield
- Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Marco A. Hidalgo
- Department of Medicine, Medicine-Pediatrics Section, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| |
Collapse
|
24
|
Moschella-Smith EA, Potter SJ, Mumford EA. Academic and Career Outcomes Following Sexual Assault in Early Adulthood: A Comparison of LGBQ+ and Heterosexual Women. Violence Against Women 2022; 29:1168-1182. [PMID: 35989673 DOI: 10.1177/10778012221101919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Young adults (aged 18-24) who identify as lesbian, gay, bisexual, or queer (LGBQ+) report high rates of sexual assault (SA) victimization, yet much of the research on adverse outcomes resulting from SA has overlooked LGBQ+ victims. A probability-based sample of 901 adults was recruited to examine the negative academic and career outcomes attributed to SA during early adulthood among LGBQ+ cisgender women. LGBQ+ women were more likely to report negative impacts on academic and career goals (e.g., changed course of study) and transitions (e.g., switched jobs) following SA victimization than heterosexual women. Implications for research and LGBQ+ services are discussed.
Collapse
Affiliation(s)
| | - Sharyn J Potter
- Prevention Innovations Research Center, University of New Hampshire, Durham, NH, USA
| | | |
Collapse
|
25
|
Krueger EA, Upchurch DM. Sexual orientation, social support, and mental health resilience in a U.S. national sample of adults. Behav Med 2022; 48:207-215. [PMID: 33052771 DOI: 10.1080/08964289.2020.1825922] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Sexual minority mental health disparities can be attributed, in large part, to chronic exposure to stress. There is growing interest in understanding the factors associated with psychological resilience, or the ability to positively cope with life's stressors. Using nationally representative data (2012-2013; N = 14,470), this study compared differences in resilience status (operationalized empirically using SF-12 mental health score among respondents reporting 2+ past-year stressful life events; respondents were categorized as "flourishing," "average," or "languishing") by sexual orientation and assessed whether social support mediated sexual minority disparities in resilience. Comparisons were made across four sexual orientation groups: heterosexuals and three sexual minority subgroups (lesbians/gay men, bisexual, heterosexual-identified sexual minorities [HSM]). Generally, heterosexual respondents were more likely to be flourishing, less likely to be languishing, and reported more social support, compared to sexual minority respondents. In multivariable analysis, bisexual women, HSM women, and gay men had lower odds of resilience than heterosexual women and men, respectively. In mediation models, lower social support was associated with reduced resilience for all sexual minority subgroups except lesbian/gay women. This study demonstrated that sexual orientation is an important determinant of resilience, and further, that social support contributes to sexual minority peoples' abilities to flourish when faced with stress.
Collapse
Affiliation(s)
- Evan A Krueger
- Department of Preventive Medicine, USC Keck School of Medicine
| | - Dawn M Upchurch
- Department of Community Health Sciences, UCLA Fielding School of Public Health
| |
Collapse
|
26
|
Soriano-Moreno DR, Saldaña-Cabanillas D, Vasquez-Yeng L, Valencia-Huamani JA, Alave-Rosas JL, Soriano AN. Discrimination and mental health in the minority sexual population: Cross-sectional analysis of the first peruvian virtual survey. PLoS One 2022; 17:e0268755. [PMID: 35657953 PMCID: PMC9165772 DOI: 10.1371/journal.pone.0268755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 05/06/2022] [Indexed: 11/19/2022] Open
Abstract
Objective
This study sought to evaluate the association between discrimination and having mental health problems in the past 12 months in the sexual minority population in Peru.
Methods
We conducted a cross-sectional analysis of a secondary database corresponding to the first LGBTI survey in Peru in 2017. We included adults who self-identified their sexual orientation as gay, lesbian, bisexual, pansexual, or asexual/others. Both the exposure and dependent variables were self-reported by the participants. Multivariable Poisson regression was used to determine the association by calculating adjusted prevalence ratios (APR) with 95% confidence intervals (95% CI).
Results
Out of 9760 respondents, more than two-thirds of the participants reported having been discriminated against or having experienced violence at some time in their lives (70.3%) and one-fourth reported having mental health problems (23.8%). In the multivariable regression model, the prevalence of mental health problems in the last 12 months was 72% higher for the group of individuals who experienced discrimination when compared with the group that did not experience discrimination (APR = 1.72, 95% CI 1.57–1.88). The association was stronger among who self-identified lesbians (APR = 2.08, 95% CI 1.65–2.64).
Conclusion
The prevalence of mental health problems and discrimination was high in this population. In addition, we found a statistically significant association between discrimination and the occurrence of mental health problems in the last 12 months.
Collapse
Affiliation(s)
- David R. Soriano-Moreno
- Clinical and Epidemiological Research Unit, School of Medicine, Universidad Peruana Unión, Lima, Peru
| | - David Saldaña-Cabanillas
- Clinical and Epidemiological Research Unit, School of Medicine, Universidad Peruana Unión, Lima, Peru
| | - Luigy Vasquez-Yeng
- Clinical and Epidemiological Research Unit, School of Medicine, Universidad Peruana Unión, Lima, Peru
| | | | - Jorge Luis Alave-Rosas
- Clinical and Epidemiological Research Unit, School of Medicine, Universidad Peruana Unión, Lima, Peru
- Department of Internal Medicine, Good Hope Clinic, Lima, Peru
| | - Anderson N. Soriano
- Clinical and Epidemiological Research Unit, School of Medicine, Universidad Peruana Unión, Lima, Peru
- * E-mail: ,
| |
Collapse
|
27
|
Tan S, Cen P, Fang T, Yang X, Zhang Y, Zhu J, Huang H, Wang M, Jiang L, Mo J, Ning C. Chained multimediator model of sexual orientation disclosure, sexual minority stigma, sexual minority identity, social support, and resilience among ymsms. BMC Public Health 2022; 22:797. [PMID: 35449098 PMCID: PMC9026989 DOI: 10.1186/s12889-022-13231-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction This study aimed to investigate sexual orientation disclosure and mental health among young men who have sex with men (YMSMs). To this end, we constructed a chained multimediator model of sexual minority stigma, sexual minority identity, social support, and resilience, with the moderator of sexual orientation disclosure. Methods We conducted a cross-sectional survey of 345 YMSMs in Nanning, China. Bivariate analysis was used to evaluate factors associated with sexual orientation disclosure. Sexual minority stigma was used to predict identity, with social support as the step 1 mediator and resilience as the step 2 mediator. Sexual minority identity was analyzed using a chained moderated mediation model; sexual orientation disclosure was included as a moderator in all models to control its confounding effect. Results The average age of YMSMs was 20.0 ± 1.3 years. Bivariate analysis indicated that YMSMs who disclosed sexual orientation may have experienced less stigma (15.49 ± 3.02 vs 16.21 ± 2.74), obtained more social support (65.98 ± 11.18 vs 63.19 ± 11.13), had strong psychological resilience (37.40 ± 8.57 vs 35.39 ± 7.73), and had a more positive self-identity (104.12 ± 21.10 vs 95.35 ± 16.67); differences between subgroups were statistically significant (p < 0.05). Sexual minority stigma, perceived stigma, and enacted stigma were significantly associated with social support and resilience. The association between sexual minority stigma and sexual minority identity was significantly mediated by social support (indirect effect [95% CI] = − 3.307 [− 4.782, − 1.907]). Resilience significantly mediated the same association for identity (− 2.544 [− 4.052, − 1.114]). The chained relationship from sexual minority stigma to social support, resilience, and identity was also significant, with an indirect effect of − 0.404 [− 0.621, − 0.249]. Conclusion Among YMSMs in China, sexual minority stigma affects sexual minority identity through social support and resilience. Given the psychological effects of stigma, social support and resilience must be considered to better promote positive self-identity and mental health among YMSMs.
Collapse
Affiliation(s)
- Sumin Tan
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Ping Cen
- Nanning Municipal Center for Disease Prevention and Control, Nanning, Guangxi, China.,School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Ting Fang
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Xing Yang
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yun Zhang
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiawen Zhu
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Haimei Huang
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Min Wang
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Li Jiang
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Jieling Mo
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China.
| | - Chuanyi Ning
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China.
| |
Collapse
|
28
|
Comparison of depressive symptoms and inflammation between sexual minorities and heterosexuals using NHANES study of 8538 participants. Sci Rep 2022; 12:3792. [PMID: 35260636 PMCID: PMC8904501 DOI: 10.1038/s41598-022-07702-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/22/2022] [Indexed: 11/08/2022] Open
Abstract
The present study aims to compare the rate of depressive symptoms and inflammation levels between sexual minorities and heterosexuals. Data were obtained from the National Health and Nutrition Examination Survey from 2005 to 2010. Depressive-related symptoms were measured using the Patient Health Questionnaire-9 scoring system. C-reactive protein was analyzed with the Behring Nephelometer. Of 8538 participants, 95.8% self-reported as heterosexual and 4.2% as sexual minority. Depressive symptoms were reported in 7.1% of heterosexuals compared to 15.8% in sexual minorities (P = 0.001). In heterosexuals, C-reactive protein was higher in those with depressive symptoms compared to those without (P < 0.001). In sexual minorities, similar results were found, however, it was statistically insignificant. The intersection group of black sexual minority females reported the highest rate of depressive symptoms at 33.4%. We found that depressive symptoms were higher in sexual minorities compared to heterosexuals. Furthermore, systemic inflammation was highest in the intersection group of black sexual minority females.
Collapse
|
29
|
Nagata JM, Ganson KT, Sajjad OM, Chu J, Tabler J, Blashill AJ. Disparities across Sexual Orientation in Obstructive Airway Disease among U.S. Adults. Ann Am Thorac Soc 2022; 19:500-503. [PMID: 34473611 PMCID: PMC8937228 DOI: 10.1513/annalsats.202104-513rl] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jason M. Nagata
- University of California, San FranciscoSan Francisco, California
| | | | - Omar M. Sajjad
- Geisel School of Medicine at DartmouthHanover, New Hampshire
| | - Jonathan Chu
- University of California, San FranciscoSan Francisco, California
| | | | - Aaron J. Blashill
- San Diego Joint Doctoral Program in Clinical PsychologySan Diego, California
| |
Collapse
|
30
|
Dueñas JM, Morales-Vives F, Galea N. Psychological Issues among Spanish Adolescents and Young People when Coming out of the Closet to Their Families. Psychol Rep 2022; 126:1305-1321. [PMID: 35084250 DOI: 10.1177/00332941211069518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Some social settings may make the process of 'coming out' more difficult for gay males and lesbian females, and the decision to do so may be even more problematic for adolescents and young people. As a result, some may choose to hide their sexual orientation, leading to emotional suffering. This study aims to analyse the differences in perceived stress, life satisfaction, happiness, and psychological distress experienced by both coming out and closeted young people and teens. The sample included a total of 228 Spanish young people aged 16-23 years old (M = 19.69, S.D. = 1.81) who identified themselves as gay or lesbian (73.2% women). The results of this study show that people in the closet show greater psychological distress (anxiety and depressive symptomatology) and perceived stress. Although perceived stress is positively related to psychological distress in both groups, the correlation is higher in the closeted group. This suggests that perceived stress has more serious consequences on the mental health of the closeted group than of the 'coming out' group. To sum up, the results show the importance of family support for gay and lesbian young people.
Collapse
Affiliation(s)
| | | | - Natalie Galea
- Centre for Resilience & Socio-Emotional Health37563University of Malta
| |
Collapse
|
31
|
Lefevor GT, Park SY, Acevedo MJ, Jones PJ. Sexual Orientation Complexity and Psychosocial/Health Outcomes. JOURNAL OF HOMOSEXUALITY 2022; 69:190-204. [PMID: 32903165 DOI: 10.1080/00918369.2020.1815432] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Individuals whose sexual attraction or behavior varies from others' expectations based on their sexual identity were initially described as exhibiting sexual orientation discordance. This conceptualization has been challenged as inaccurate and value-laden, and "branchedness" has been suggested as a value-neutral description. Using a United States national sample of 4,530 participants from the 2013-2014 Center for Collegiate Mental Health database, we challenge the empirical distinctness of the phenomenon of sexual orientation discordance by 1) replicating previous work that indicates that branched individuals evidence unique psychosocial and health outcomes relative to non-branched individuals and 2) using stepwise regression to demonstrate that these differences in outcomes can be accounted for by variation in sexual attraction, behavior, and identity and that "discordance" between indicators failed to explain additional variation in outcomes. We encourage researchers to adopt non-normative language and conceptualizations in their study of sexual orientation complexity and branchedness.
Collapse
Affiliation(s)
- G Tyler Lefevor
- Department of Psychology, Rhodes College, Memphis, Tennessee, USA
| | - So Yeon Park
- Department of Psychology, Brigham Yg University, Provo, Utah, USA
| | - Maximo J Acevedo
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Payton J Jones
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| |
Collapse
|
32
|
Storm S, Deuba K, Shrestha R, Pandey LR, Dahal D, Shrestha MK, Pokhrel TN, Marrone G. Social and structural factors associated with depression and suicidality among men who have sex with men and transgender women in Nepal. BMC Psychiatry 2021; 21:476. [PMID: 34587934 PMCID: PMC8479926 DOI: 10.1186/s12888-021-03477-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 09/13/2021] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The prevalence of depression and suicidality is high among men who have sex with men (MSM) and transgender women (TGW) worldwide. Stigma and discrimination are likely contributing factors. More research is needed in low-income, non-English speaking countries to assess the effects of social and structural factors on depression and suicidality among MSM and TGW. METHODS Nepalese MSM and TGW (n = 340) were recruited using a respondent-driven sampling design and filled out a survey questionnaire. The outcomes were depression and suicidality. Data was analyzed using bivariate and multivariable logistic regression. RESULTS More than half of the participants (59%) suffered from depression. Severe depression was more common among TGW compared to MSM (41 and 20%, respectively). When it comes to suicidality, TGW had higher lifetime prevalence of suicidal thoughts compared to MSM (32 and 5%, respectively). Depression was positively associated with sex work both for MSM (AOR: 7.9; 95% CI 3.4-18.2) and TGW (AOR: 6.5; 95% CI: 2.3-18.2). MSM who were evicted by family had high odds of suicidal thoughts (AOR: 6.2; 95% CI: 1.3-28.8). For TGW, suicidality was associated with being cheated and threatened (AOR: 3.9; 95% CI: 1.2-12.5) and having forced to marry a female (AOR: 2.2; 95% CI 1.1-5.1). CONCLUSIONS Nepalese MSM and TGW suffer from a high degree of mental and psychosocial health issues. Future studies should focus on intervention research and on collecting data from a larger variety of gender and sexual minorities.
Collapse
Affiliation(s)
- Sanna Storm
- grid.4714.60000 0004 1937 0626Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Keshab Deuba
- National Centre for AIDS and STD Control/Global Fund Programs, Kathmandu, Nepal.
| | | | - Lok Raj Pandey
- grid.500537.4National Centre for AIDS and STD Control, Ministry of Health and Population, Kathmandu, Nepal
| | - Deepak Dahal
- grid.500537.4National Centre for AIDS and STD Control, Ministry of Health and Population, Kathmandu, Nepal
| | - Madan Kumar Shrestha
- grid.500537.4National Centre for AIDS and STD Control, Ministry of Health and Population, Kathmandu, Nepal
| | - Tara Nath Pokhrel
- grid.500537.4Family Welfare Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
| | - Gaetano Marrone
- grid.4714.60000 0004 1937 0626Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
33
|
Simon KA, Hawthorne HM, Clark AN, Renley BM, Farr RH, Eaton LA, Watson RJ. Contextualizing the Well-being of Asexual Youth: Evidence of Differences in Family, Health, and School Outcomes. J Youth Adolesc 2021; 51:128-140. [PMID: 34550495 DOI: 10.1007/s10964-021-01500-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022]
Abstract
Despite increasing efforts to better understand sexual and gender minority youth (SGMY), asexual youth remain understudied. This study examines differences in health, family support, and school safety among asexual youth (n = 938) from a national study of SGMY (N = 17,112) ages 13-17. Compared to non-asexual youth, asexual youth were more likely to identify as transgender and report a disability, and less likely to identify as Black or Hispanic/Latino. Transgender (versus cisgender) asexual youth fared worse on most study outcomes. Cisgender asexual (versus cisgender non-asexual) youth fared worse on all study outcomes. Transgender asexual (versus transgender non-asexual) youth reported lower sexuality-related family support. These findings underscore the role of gender identity in understanding the experiences of asexual youth.
Collapse
Affiliation(s)
- Kay A Simon
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA.
| | - Heath M Hawthorne
- Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - Alyssa N Clark
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA
| | - Benton M Renley
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA
| | - Rachel H Farr
- Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - Lisa A Eaton
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA
| |
Collapse
|
34
|
Batchelder AW, Stanton AM, Kirakosian N, King D, Grasso C, Potter J, Mayer KH, O'Cleirigh C. Mental Health and Substance Use Diagnoses and Treatment Disparities by Sexual Orientation and Gender in a Community Health Center Sample. LGBT Health 2021; 8:290-299. [PMID: 34080895 DOI: 10.1089/lgbt.2020.0293] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Purpose: This study assessed disparities in screener- and provider-identified mental health and substance use diagnoses and treatment attendance by sexual orientation and gender in an urban community health center focused on sexual and gender minority individuals. Methods: Using an electronic data query (October 2015 to October 2018), computerized screening results assessing likely depression, anxiety, alcohol use disorder (AUD), and substance use disorder (SUDs); provider diagnoses; and treatment initiation related to mental health and substance use were compared across sexual orientation (heterosexual, gay/lesbian, bisexual, and other) and gender categories (men and women, inclusive of cisgender and transgender individuals; N = 24,325). Results: Bisexual and other-identified individuals were more likely to screen positive for depression and anxiety, followed by gay/lesbian women, compared with heterosexual individuals and gay men (χ2 = 463.22, p < 0.001 and χ2 = 263.36, p < 0.001, respectively). Of those who screened positive for AUDs, women were less likely to be diagnosed by a professional (χ2 = 63.79, p < 0.001) and of those who screened positive for either alcohol or other SUDs, women were less likely to attend one or more substance use-related behavioral health appointments, regardless of sexual orientation (contingency coefficient = 0.14, p < 0.001). Conclusion: This community health center study identified a need for increased mental health services for bisexual and other-identified individuals and increased assessment and initiation of substance use treatment for women, including sexual minority women.
Collapse
Affiliation(s)
- Abigail W Batchelder
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Amelia M Stanton
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Norik Kirakosian
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Dana King
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Chris Grasso
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Jennifer Potter
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Conall O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| |
Collapse
|
35
|
Whitton SW, Dyar C, Godfrey LM, Newcomb ME. Within-person associations between romantic involvement and mental health among sexual and gender minorities assigned female-at-birth. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2021; 35:606-617. [PMID: 33793272 PMCID: PMC8324502 DOI: 10.1037/fam0000835] [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: 06/12/2023]
Abstract
Sexual and gender minorities assigned female at birth (SGM-AFAB) experience significant mental health disparities, making it important to identify protective factors against psychological and substance use problems in this population. We examined whether romantic relationship involvement, a well-established protective factor for mental health in heterosexual adults, is protective for SGM-AFAB young people. Using five waves of data from 488 racially diverse SGM-AFAB (ages 16-31 years at baseline), we assessed within-person associations between relationship involvement and depressive symptoms, anxiety symptoms, and problematic alcohol and cannabis use. We tested for differences in these associations by age; sexual, gender, and racial identity; relationship status; and partner gender, and whether romantic involvement buffers the negative effects of anti-SGM victimization. Multilevel models indicated that participants reported fewer depressive symptoms, alcohol use problems, and cannabis use problems when romantically involved than when single. Romantic involvement was associated with fewer anxiety symptoms for Latinx participants only. Associations did not differ by age and were generally consistent (with some exceptions) across sexual, gender, and racial identity. Effects on substance use were stronger for long-term commitments than dating relationships. Participants reported less depression and anxiety, but more alcohol or cannabis use, when romantically involved with cisgender women than with cisgender men or gender minority partners. Together, findings suggest that relationship involvement is broadly protective of mental health among SGM-AFAB, though it may not buffer the negative effects of SGM victimization. Efforts to reduce SGM-AFAB mental health disparities should consider including strategies to support healthy relationship involvement. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Christina Dyar
- Institute for Sexual and Gender Minority Health and Wellbeing
| | | | | |
Collapse
|
36
|
Maheux AJ, Bryen CP, Carrino EA, Stewart JL, Widman L, Choukas-Bradley S. Depressive symptoms among mostly heterosexual adolescents. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2021. [DOI: 10.1080/19359705.2020.1843583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Anne J. Maheux
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chloe P. Bryen
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Emily A. Carrino
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - J. L. Stewart
- Department of Psychology, North Carolina State University, Raleigh, North Carolina, USA
| | - Laura Widman
- Department of Psychology, North Carolina State University, Raleigh, North Carolina, USA
| | - Sophia Choukas-Bradley
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
37
|
Woznicki N, Arriaga AS, Caporale-Berkowitz NA, Parent MC. Parasocial Relationships and Depression Among LGBQ Emerging Adults Living With Their Parents During COVID-19: The Potential for Online Support. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2021; 8:228-237. [PMID: 38283392 PMCID: PMC10817715 DOI: 10.1037/sgd0000458] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Lesbian, gay, bisexual, and queer (LGBQ) youth continue to be disproportionately at risk for depression. During COVID-19 social distancing, LGBQ youth who live with family may be more consistently exposed to potentially discriminatory family situations, and may receive reduced community and mental health support. However, the Internet offers opportunities to interact with lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities by watching videos of, and developing one-way relationships-or parasocial relationships-with, LGBTQ media personalities on platforms such as YouTube. The current study explored how parasocial relationships with LGBTQ YouTubers may moderate the links between family support, loneliness, and depression symptoms among LGBQ emerging adults living with their parents during the COVID-19 pandemic. A sample of 183 LGBQ emerging adults (age 18-23) was recruited from the United States in mid-July 2020. Results of a moderated mediation regression indicated that parasocial relationship strength moderated the links between family support and loneliness, and loneliness and depression symptoms. The associations between family support and loneliness, and between loneliness and depression symptoms, were weakened by high parasocial relationship strength. These findings contribute to understanding parasocial relationships' connections to well-being among marginalized groups during a crisis and highlight the potential of online solutions to emerging mental health disparities being experienced by LGBQ youth disproportionally affected by the COVID-19 pandemic.
Collapse
Affiliation(s)
- Nathaniel Woznicki
- Department of Educational Psychology, Counseling Psychology and Counselor Education Program. University of Texas at Austin
| | - Andrew S Arriaga
- Department of Educational Psychology, Counseling Psychology and Counselor Education Program. University of Texas at Austin
| | - Norian A Caporale-Berkowitz
- Department of Educational Psychology, Counseling Psychology and Counselor Education Program. University of Texas at Austin
| | - Mike C Parent
- Department of Educational Psychology, Counseling Psychology and Counselor Education Program. University of Texas at Austin
| |
Collapse
|
38
|
Felner JK, Haley SJ, Jun HJ, Wisdom JP, Katuska L, Corliss HL. Sexual orientation and gender identity disparities in co-occurring depressive symptoms and probable substance use disorders in a national cohort of young adults. Addict Behav 2021; 117:106817. [PMID: 33626483 PMCID: PMC8012013 DOI: 10.1016/j.addbeh.2021.106817] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/31/2020] [Accepted: 01/02/2021] [Indexed: 12/21/2022]
Abstract
This study examined sexual orientation and gender identity differences in co-occurring depressive symptoms and substance use disorders (SUDs) among young adults in the Growing Up Today Study national cohort (n = 12,347; ages 20-35; 93% non-Hispanic white). Self-administered questionnaires assessed recent co-occurring depressive symptoms and probable nicotine dependence, alcohol use disorder, and drug use disorder. Multinomial logistic regressions with generalized estimating equations quantified differences in prevalences of depressive symptoms only, SUDs only, and co-occurrence, among sexual minorities (mostly heterosexual; lesbian, gay, and bisexual [LGB]) compared to completely heterosexual participants, and gender minorities compared to cisgender participants. Analyses stratified by sex assigned at birth revealed sexual minorities evidenced greater odds of co-occurrence than their completely heterosexual counterparts (assigned female AORs: 3.11-9.80, ps < 0.0001; assigned male AORs: 2.90-4.87, ps < 0.001). Sexual orientation differences in co-occurrence were pronounced among LGB participants assigned female at birth who evidenced nearly 10 times the odds of co-occurring depressive symptoms with nicotine dependence and drug use disorders than did heterosexual participants assigned female at birth. Relationships between gender identity and co-occurrence were generally weaker, possibly due to low power. Gender minorities assigned male at birth, however, evidenced greater odds of co-occurring depressive symptoms and alcohol use disorders (AOR 2.75, p = 0.013) than their cisgender counterparts. This study adds to the limited research quantifying sexual orientation or gender identity differences in recent co-occurring depressive symptoms and SUDs among young adults and suggests sexual and gender minority young adults should be prioritized in prevention and treatment of co-occurring depression and SUDs.
Collapse
Affiliation(s)
- Jennifer K Felner
- San Diego State University, School of Public Health, Institute for Behavioral and Community Health, Center for Research on Sexuality and Sexual Health, 9245 Sky Park Court, Suite 224, San Diego, CA 92123, United States.
| | - Sean J Haley
- Department of Health Policy and Management, City University of New York's Graduate School of Public Health and Health Policy, 55 West 125(th) St, NY, NY 10027, United States
| | - Hee-Jin Jun
- San Diego State University, School of Public Health, Institute for Behavioral and Community Health, Center for Research on Sexuality and Sexual Health, 9245 Sky Park Court, Suite 224, San Diego, CA 92123, United States
| | | | - Laura Katuska
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States
| | - Heather L Corliss
- San Diego State University, School of Public Health, Institute for Behavioral and Community Health, Center for Research on Sexuality and Sexual Health, 9245 Sky Park Court, Suite 224, San Diego, CA 92123, United States
| |
Collapse
|
39
|
Yap SY, Foo CN, Lim YM, Ng FL, Mohd-Sidik S, Tang PY, Najar Singh JK, Pheh KS. Traditional Chinese Medicine Body Constitutions and Psychological Determinants of Depression among University Students in Malaysia: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5366. [PMID: 34069915 PMCID: PMC8157548 DOI: 10.3390/ijerph18105366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/09/2021] [Accepted: 05/10/2021] [Indexed: 02/08/2023]
Abstract
Depression is commonly observed in university students, who are a high risk group for developing psychiatric disorders during adulthood. This study aimed to determine the prevalence of depression and its traditional Chinese medicine body constitutions and psychological determinants among university students in Malaysia. A cross-sectional pilot study was conducted between 9 and 28 September 2020 among 80 university students in Malaysia. Participants completed online survey questionnaires, including the validated Patient Health Questionnaire (PHQ-9), Constitution in Chinese Medicine Questionnaire (CMCQ), Dysfunctional Attitude Scale (DAS), Depression Anxiety Stress Scale (DASS-21) stress subscale, Perceived Stress Scale (PSS-10), and Rosenberg Self-Esteem Scale (RSES), which assess depression, body constitution, dysfunctional attitude, stress, perceived stress, and self-esteem. Multiple linear regression analyses were performed to determine the associated risk factors for depression. The overall prevalence of depression among university students was 33.8%. The multiple regression analysis showed a significant relationship between depression and qi-stagnation constitution (B = 0.089, p = 0.011), balanced constitution (B = -0.077, p = 0.049), and self-esteem (B = -0.325, p = 0.001). Our findings suggest that some traditional Chinese medicine body constitutions and self-esteem are significant risk factors affecting depression among university students. Identifying risk factors of depression is vital to aid in the early detection of depression among university students.
Collapse
Affiliation(s)
- Sin Yee Yap
- Centre for Cancer Research, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, PT21144, Jalan Sungai Long, Bandar Sungai Long, Kajang 43000, Selangor, Malaysia; (S.Y.Y.); (Y.M.L.); (F.L.N.); (J.K.N.S.)
| | - Chai Nien Foo
- Centre for Cancer Research, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, PT21144, Jalan Sungai Long, Bandar Sungai Long, Kajang 43000, Selangor, Malaysia; (S.Y.Y.); (Y.M.L.); (F.L.N.); (J.K.N.S.)
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, PT21144, Jalan Sungai Long, Bandar Sungai Long, Kajang 43000, Selangor, Malaysia
| | - Yang Mooi Lim
- Centre for Cancer Research, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, PT21144, Jalan Sungai Long, Bandar Sungai Long, Kajang 43000, Selangor, Malaysia; (S.Y.Y.); (Y.M.L.); (F.L.N.); (J.K.N.S.)
- Department of Pre-Clinical Science, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Lot PT21144, Jalan Sungai Long, Bandar Sungai Long, Kajang 43000, Selangor, Malaysia
| | - Foong Leng Ng
- Centre for Cancer Research, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, PT21144, Jalan Sungai Long, Bandar Sungai Long, Kajang 43000, Selangor, Malaysia; (S.Y.Y.); (Y.M.L.); (F.L.N.); (J.K.N.S.)
- Department of Traditional Chinese Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, PT21144, Jalan Sungai Long, Bandar Sungai Long, Kajang 43000, Selangor, Malaysia
| | - Sherina Mohd-Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Seri Kembangan 43400, Selangor, Malaysia;
| | - Pek Yee Tang
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Lot PT21144, Jalan Sungai Long, Bandar Sungai Long, Kajang 43000, Selangor, Malaysia;
| | - Jagjit Kaur Najar Singh
- Centre for Cancer Research, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, PT21144, Jalan Sungai Long, Bandar Sungai Long, Kajang 43000, Selangor, Malaysia; (S.Y.Y.); (Y.M.L.); (F.L.N.); (J.K.N.S.)
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, PT21144, Jalan Sungai Long, Bandar Sungai Long, Kajang 43000, Selangor, Malaysia
| | - Kai-Shuen Pheh
- Department of Psychology and Counselling, Faculty of Arts and Social Science, Universiti Tunku Abdul Rahman, Jalan Universiti, Bandar Barat, Kampar 31900, Perak, Malaysia;
| |
Collapse
|
40
|
Baams L, Ten Have M, de Graaf R, de Jonge P. Childhood trauma and bullying-victimization as an explanation for differences in mental disorders by sexual orientation. J Psychiatr Res 2021; 137:225-231. [PMID: 33691234 PMCID: PMC7612811 DOI: 10.1016/j.jpsychires.2021.02.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 02/03/2021] [Accepted: 02/17/2021] [Indexed: 11/18/2022]
Abstract
Sexual minority individuals are more likely to have mental disorders, including mood, anxiety, and substance use disorders, compared to heterosexual individuals. Whether experiencing trauma or bullying-victimization during childhood explains these differences is currently unclear. We used a psychiatric epidemiological general population-based study to assess whether childhood trauma severity and bullying-victimization before age 16 explains the difference by sexual attraction in mental disorders. Data from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2; N = 6392) were used to examine (1) whether same/both-sex attraction and predominantly other-sex attraction is linked to self-reports of childhood trauma (types and severity) and bullying-victimization, and (2) whether these experiences explain differences between these groups in lifetime and 12-month prevalence of DSM-IV disorders assessed by the Composite International Diagnostic Interview 3.0. Same/both-sex attracted individuals reported a higher childhood trauma severity score compared to exclusively other-sex attracted individuals (B = 0.93, SE = 0.20, p < .001), and were more likely to report bullying-victimization (OR = 2.51 95%CI[1.68, 3.74]). DSM-IV disorders were more prevalent among same/both-sex attracted individuals than among exclusively other-sex attracted individuals (ORs ranged from 1.57 to 4.68). There were no differences in DSM-IV disorders for predominantly other-sex attracted individuals. Childhood trauma severity explained between 9.0% and 57.0% of significant indirect associations between same/both-sex attraction and DSM-IV disorders. Sexual minority individuals experience more types of, and more severe childhood trauma, and are more likely to experience bullying-victimization. These negative experiences partly explained disparities in mental disorders.
Collapse
Affiliation(s)
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), the Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), the Netherlands
| | | |
Collapse
|
41
|
Blosnich JR, Meyer IH, Goldbach JT, Henderson ER, Coulter RWS. Blosnich et al. Respond. Am J Public Health 2021; 111:e20-e21. [PMID: 33689432 DOI: 10.2105/ajph.2021.306165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- John R Blosnich
- John R. Blosnich and Jeremy T. Goldbach are with the Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles. Ilan H. Meyer is with The Williams Institute, School of Law, University of California, Los Angeles. Emmett R. Henderson and Robert W. S. Coulter are with the Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Ilan H Meyer
- John R. Blosnich and Jeremy T. Goldbach are with the Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles. Ilan H. Meyer is with The Williams Institute, School of Law, University of California, Los Angeles. Emmett R. Henderson and Robert W. S. Coulter are with the Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Jeremy T Goldbach
- John R. Blosnich and Jeremy T. Goldbach are with the Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles. Ilan H. Meyer is with The Williams Institute, School of Law, University of California, Los Angeles. Emmett R. Henderson and Robert W. S. Coulter are with the Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Emmett R Henderson
- John R. Blosnich and Jeremy T. Goldbach are with the Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles. Ilan H. Meyer is with The Williams Institute, School of Law, University of California, Los Angeles. Emmett R. Henderson and Robert W. S. Coulter are with the Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Robert W S Coulter
- John R. Blosnich and Jeremy T. Goldbach are with the Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles. Ilan H. Meyer is with The Williams Institute, School of Law, University of California, Los Angeles. Emmett R. Henderson and Robert W. S. Coulter are with the Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| |
Collapse
|
42
|
Turpin RE, Salerno JP, Rosario AD, Boekeloo B. Victimization, Substance Use, Depression, and Sexual Risk in Adolescent Males Who Have Sex with Males: A Syndemic Latent Profile Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:961-971. [PMID: 32274744 PMCID: PMC10712424 DOI: 10.1007/s10508-020-01685-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 03/01/2020] [Accepted: 03/13/2020] [Indexed: 05/10/2023]
Abstract
Adolescent males who have sex with males (AMSM) are at increased risk of HIV/STI acquisition compared to other adolescents, making sexual risk behaviors in this population a priority public health focus. AMSM experience more victimization (including sexual/partner violence), depression, and substance abuse than their heterosexual counterparts; these may form a syndemic associated with risky sexual behavior. We pooled data from the 2015 and 2017 Youth Risk Behavior Survey, restricted to male students who reported a previous male sexual partner (n = 448). Latent profile analysis was used to identify syndemic profiles, with log-binomial and cumulative complementary log-log models used to test associations with substance use at last intercourse, condomless sex at last intercourse, and the number of sexual partners. Nearly all measures of victimization, depression, and substance use had bivariate associations with greater substance use during sex and more sexual partners. We identified three profiles of AMSM: The profile (n = 55) with the greatest risk factors (evident of a syndemic) had substantially higher prevalence of substance use during sex (aPR = 4.74, 95% CI 3.02, 7.43) and more sexual partners (aPR = 2.45, 95% CI 1.39, 4.31) than the profile with the lowest risk factors (n = 326) after adjusting for confounders. This profile was not associated with condomless sex. We identified a syndemic characterized by victimization, depression, and substance use associated with risky sexual behaviors in a nationally representative sample of AMSM. Comprehensive sexual risk reduction interventions incorporating mental health and substance use are critically important in this population.
Collapse
Affiliation(s)
- Rodman E Turpin
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, 4200 Valley Dr., #2242, College Park, MD, 20742, USA.
| | - John P Salerno
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD, USA
| | - Andre D Rosario
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, Washington, DC, USA
| | - Bradley Boekeloo
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD, USA
| |
Collapse
|
43
|
Argyriou A, Goldsmith KA, Rimes KA. Mediators of the Disparities in Depression Between Sexual Minority and Heterosexual Individuals: A Systematic Review. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:925-959. [PMID: 33689086 PMCID: PMC8035121 DOI: 10.1007/s10508-020-01862-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 09/18/2020] [Accepted: 10/07/2020] [Indexed: 05/20/2023]
Abstract
Evidence suggests that sexual minorities (e.g., those identifying as lesbian, gay, or bisexual) experience increased rates of depression compared to heterosexual individuals. Minority stress theory suggests that this disparity is due to stigma experienced by sexual minorities. Stigma processes are proposed to contribute to reduced coping/support resources and increased vulnerability processes for mental health problems. This review provided a systematic examination of research assessing the evidence for mediating factors that help explain such disparities. A literature search was conducted using the databases PubMed, PsycINFO, and Web of Science. The review included 40 identified studies that examined mediators of sexual minority status and depressive outcomes using a between-group design (i.e., heterosexual versus sexual minority participants). Studies of adolescents and adult samples were both included. The most common findings were consistent with the suggestion that stressors such as victimization, harassment, abuse, and increased stress, as well as lower social and family support, may contribute to differing depression rates in sexual minority compared to heterosexual individuals. Differences in psychological processes such as self-esteem and rumination may also play a role but have had insufficient research attention so far. However, caution is needed because many papers had important methodological shortcomings such as the use of cross-sectional designs, inferior statistical analyses for mediation, or measures that had not been properly validated. Although firm conclusions cannot be drawn, the current evidence base highlights many factors potentially suitable for further exploration in high-quality longitudinal research or randomized studies intervening with the potential mediators.
Collapse
Affiliation(s)
- Angeliki Argyriou
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Kimberley A Goldsmith
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Katharine A Rimes
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| |
Collapse
|
44
|
Parra LA, van Bergen DD, Dumon E, Kretschmer T, La Roi C, Portzky G, Frost DM. Family Belongingness Attenuates Entrapment and Buffers Its Association with Suicidal Ideation in a Sample of Dutch Sexual Minority Emerging Adults. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:983-1001. [PMID: 33398694 DOI: 10.1007/s10508-020-01838-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 05/17/2023]
Abstract
Sexual minority emerging adults are more likely to engage in suicidal ideation than their heterosexual counterparts. Experiences of homophobic violence are associated with suicidal ideation. Yet, the specific mechanisms linking homophobic violence to suicidal ideation remain unclear. Entrapment and social belongingness were tested to determine their relevance for understanding the link between homophobic violence and suicidal ideation. A sample of sexual minority Dutch emerging adults (N = 675; ages 18-29, M = 21.93 years, SD = 3.20) were recruited through online platforms and flyers. Homophobic violence was expected to be positively associated with suicidal ideation and entrapment. The association between homophobic violence and suicidal ideation was expected to be indirectly linked through entrapment. We explored whether various sources of social belongingness moderated the path between entrapment and suicidal ideation and whether those sources of social belongingness moderated the indirect effect of homophobic violence on suicidal ideation through entrapment. Results showed that homophobic violence and entrapment were positively associated with suicidal ideation and that family belongingness was negatively associated with suicidal ideation. Homophobic violence and suicidal ideation were not indirectly linked through entrapment. The interaction effect between entrapment and family belongingness was significant, suggesting that, on average, the effect of entrapment on suicidal ideation decreased when family belongingness was high. These results suggest that family belongingness may reduce the association between entrapment and suicidal ideation while adjusting for homophonic violence. Reducing entrapment and improving family belongingness may be useful targets for programs aimed at preventing suicidal ideation among sexual minority emerging adults.
Collapse
Affiliation(s)
- Luis A Parra
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, 90089, USA.
- Department of Human Ecology, University of California, Davis, Davis, CA, USA.
- Center for Mind and Brain, University of California, Davis, Davis, CA, USA.
| | - Diana D van Bergen
- Department of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Eva Dumon
- Department of Head and Skin, Centre of Expertise in Suicide Prevention, Ghent University, Ghent, Belgium
| | - Tina Kretschmer
- Department of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Chaïm La Roi
- Institute for Futures Studies, Stockholm, Sweden
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
| | - Gwendolyn Portzky
- Department of Head and Skin, Centre of Expertise in Suicide Prevention, Ghent University, Ghent, Belgium
| | - David M Frost
- Department of Social Science, University College London, London, UK
| |
Collapse
|
45
|
Jacob L, López-Sánchez GF, Haro JM, Koyanagi A, Kostev K, Grabovac I, Oh H, Pardhan S, McDermott D, Shin JI, Smith L. Association between sexual orientation and subjective cognitive complaints in the general population in England. J Psychiatr Res 2021; 136:1-6. [PMID: 33540178 DOI: 10.1016/j.jpsychires.2021.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/12/2021] [Accepted: 01/22/2021] [Indexed: 10/22/2022]
Abstract
There is a scarcity of literature investigating the association between minority sexual orientations and subjective cognitive complaints (SCC). Therefore, the aim of this study was to investigate the association between identifying as a sexual minority and SCC in a large sample of adults from England. The study further aimed to identify the extent to which the association could be explained by several behavioral, psychological and clinical factors. Cross-sectional data from the 2007 Adult Psychiatric Morbidity Survey (APMS) were analyzed. Sexual orientation was dichotomized into heterosexual and sexual minority orientation. SCC referred to subjective concentration and memory complaints. Control variables included sex, age, ethnicity, marital status, education, employment, and income. Influential factors included smoking status, alcohol dependence, perceived stress, the number of stressful life events, depression, any anxiety disorder, sleep problems, and obesity. This study included 7,400 participants (51.4% women; mean [standard deviation] age 46.3 [18.6] years). After adjusting for control variables, sexual minority orientation was positively and significantly associated with subjective concentration (OR = 1.40, 95% CI = 1.12-1.76) but not memory complaints (OR = 1.19, 95% CI = 0.96-1.47). The number of stressful life events, sleep problems and any anxiety disorder explained 13.4%, 11.0% and 10.9% of the association between sexual orientation and subjective concentration complaints, respectively. In this large sample of English adults, identifying as a sexual minority was significantly associated with subjective concentration complaints, while stressful life events, sleep problems, and anxiety explained a large proportion of the association. Targeted interventions towards sexual minority groups to reduce SCC may be warranted.
Collapse
Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08830, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, 78180, France
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, United Kingdom.
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08830, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08830, Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
| | - Karel Kostev
- Philipps University of Marburg, Marburg, Germany
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - Hans Oh
- University of Southern California, Suzanne Dworak Peck School of Social Work, 1149 South Hill Street suite 1422, Los Angeles, CA, 90015, USA
| | - Shahina Pardhan
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, United Kingdom
| | - Daragh McDermott
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| |
Collapse
|
46
|
Rentería R, Benjet C, Gutierrez-Garcia RA, Ábrego Ramírez A, Albor Y, Borges G, Covarrubias Díaz Couder MA, Durán MDS, González González R, Guzmán Saldaña R, Hermosillo De la Torre AE, Martínez-Jerez AM, Martinez Martinez KI, Medina-Mora ME, Martínez Ruiz S, Paz Pérez MA, Pérez Tarango G, Zavala Berbena MA, Méndez E, Auerbach RP, Mortier P. Suicide thought and behaviors, non-suicidal self-injury, and perceived life stress among sexual minority Mexican college students. J Affect Disord 2021; 281:891-898. [PMID: 33243555 PMCID: PMC7856251 DOI: 10.1016/j.jad.2020.11.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 10/13/2020] [Accepted: 11/07/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sexual minority college students are at a higher risk for suicidal thoughts and self-injurious behaviors compared to heterosexual students. Minority stress theory proposes sexual minority individuals experience higher stress due to stigma. Using a sample of Mexican college students, this study tested perceived life stress as a mediator of suicide and self-injury outcomes across various sexual orientation groups. METHODS The sample of college students (N=7882) was recruited from nine Mexican universities as part of the WHO World Mental Health International College Student (WMH-ICS) initiative. Participants completed an online survey including demographic questions, measure of perceived life stress, suicide outcomes, and non-suicidal self-injury (NSSI) in the past 12 months. RESULTS Logistic regression analyses revealed identifying as a sexual minority significantly predicted a higher likelihood of suicide ideation (ORs 2.05-3.00), suicide attempts (ORs 2.48-8.73), and NSSI (ORs 2.92-4.18) compared to heterosexual students reporting no same-gender attraction. Significant indirect effects from mediation path analyses showed perceived life stress mediated the relationship between a sexual minority identity and suicide ideation (range of proportion mediated 10.48-31.48%), attempts (10.48-31.48%), and NSSI (7.69-20.09%) across each group except among asexual students. LIMITATIONS The cross-sectional nature of the survey design precludes drawing causal inferences. CONCLUSION Findings from this study contribute to minority stress theory by elucidating the role of perceived life stress as a mediator of suicide ideation and attempts and NSSI among sexual minority college students. Clinical interventions may benefit in focusing on experiences of stress across various life areas when supporting sexual minority college students.
Collapse
Affiliation(s)
- Roberto Rentería
- Counseling & Counseling Psychology, Arizona State University, Tempe, Arizona, United States of America
| | - Corina Benjet
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México.
| | - Raúl A Gutierrez-Garcia
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, México
| | - Adrián Ábrego Ramírez
- Dirección de Investigación, Universidad Politécnica de Aguascalientes, Aguascalientes, Aguascalientes, México; Dirección de Educación a Distancia, Universidad Cuauhtémoc, Plantel Aguascalientes, Aguascalientes, Aguascalientes, México
| | - Yesica Albor
- Departamento de Salud Púbica, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Guilherme Borges
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | | | - María Del Socorro Durán
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, México
| | - Rogaciano González González
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, México
| | - Rebeca Guzmán Saldaña
- Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Hidalgo, México
| | | | - Ana María Martínez-Jerez
- Facultad de Derecho y Ciencias Sociales, Universidad Autónoma de Tamaulipas. Tampico, Tamaulipas, México
| | - Kalina I Martinez Martinez
- Departamento de Psicología, Universidad Autónoma de Aguascalientes, Aguascalientes, Aguascalientes, México
| | - María Elena Medina-Mora
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | | | - María Abigail Paz Pérez
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, México
| | - Gustavo Pérez Tarango
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, México
| | - María Alicia Zavala Berbena
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, México
| | - Enrique Méndez
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York City, New York, USA
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| |
Collapse
|
47
|
Meyer IH, Marken S, Russell ST, Frost DM, Wilson BD. An Innovative Approach to the Design of a National Probability Sample of Sexual Minority Adults. LGBT Health 2021; 7:101-108. [PMID: 32130087 PMCID: PMC7138603 DOI: 10.1089/lgbt.2019.0145] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose: Sampling lesbian, gay, and bisexual (LGB) people to recruit a national probability sample is challenging for many reasons, including the low base rate of LGB people in the population. To address this challenge, researchers have relied on diverse approaches to sampling LGB people. We aimed to test an innovative method to assemble a U.S. national probability sample of non-transgender sexual minority adults. Methods: Our approach used two phases. In Phase 1, we identified LGBT respondents in a probability general population sample. These respondents were then queried about their sexual orientation and gender identity using short screening questions to identify non-transgender sexual minority respondents. In Phase 2, the identified sexual minority respondents completed the targeted survey online or on a mailed questionnaire. Results: In Phase 1, using random-digit dialing, a nationally representative sample of 366,644 respondents were screened in a brief telephone interview. Of them, 3.5% (n = 12,837) identified as LGB or transgender. In Phase 2, eligible respondents were asked to participate in a self-administered survey questionnaire. Eligibility was based on gender identity, age, race and ethnicity, and educational restrictions. Of the 3525 who were eligible, 81% (n = 2840) agreed to participate in the study (78% agreed to use the web version and 22% the mailed questionnaire), and 49% of web surveys and 46% of mailed surveys were completed. The final sample included 1331 respondents. Conclusion: The benefits of this approach include the ability to assess sexual minority-specific content in a national probability sample; challenges include high cost and low base rates for Asian and American Indian or Alaska Native individuals in the United States.
Collapse
Affiliation(s)
- Ilan H. Meyer
- The Williams Institute, School of Law, University of California, Los Angeles, Los Angeles, California
| | | | - Stephen T. Russell
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, Texas
| | - David M. Frost
- Department of Social Science, University College London, London, United Kingdom
| | - Bianca D.M. Wilson
- The Williams Institute, School of Law, University of California, Los Angeles, Los Angeles, California
| |
Collapse
|
48
|
Dotan A, Bachner-Melman R, Dahlenburg SC. Sexual orientation and disordered eating in women: a meta-analysis. Eat Weight Disord 2021; 26:13-25. [PMID: 31797331 DOI: 10.1007/s40519-019-00824-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 11/25/2019] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Homosexuality is a clear risk factor for disordered eating in men; however, for women, research has yielded contradictory results. We conducted a meta-analysis to examine the association between sexual orientation and disordered eating in women. METHODS PRISMA guidelines were used. Studies comparing disordered eating between lesbians and heterosexual women were identified using PsycNet database and Google Scholar. Twenty-one studies met inclusion criteria. Overall disordered eating, restricting, binging and purging were examined for heterosexual, lesbian, bisexual and 'mostly heterosexual' women. RESULTS Whereas there was no significant difference in overall disordered eating between lesbians and heterosexual women, lesbians reported restricting less and binging more than heterosexual women. Bisexual women were more likely than lesbian women to restrict food intake and purge, and more likely than heterosexual women to have overall disordered eating and restrict food intake. "Mostly heterosexual" women were more likely than heterosexual women to restrict food intake, binge and purge. CONCLUSIONS Women of different sexual orientations show distinct patterns of disordered eating. Bisexual and "mostly heterosexual" women appear to be particularly at risk. Stress resulting from binegativity and rigid views of sexuality in a dichotomous society, rather than sexual orientation itself, may be associated with disordered eating in women. Findings should be viewed with caution because there were few studies with bisexual and "mostly heterosexual" women. This study elucidates the nature of the association between disordered eating and sexual orientation. Findings provide a possible explanation for previous inconsistencies, since opposing trends for different behaviors cancel each other out. LEVEL OF EVIDENCE Level I, systematic review and meta-analysis.
Collapse
Affiliation(s)
- Aviv Dotan
- Clinical Psychology Program, Ruppin Academic Center, Emek Hefer, Israel
| | - Rachel Bachner-Melman
- Clinical Psychology Program, Ruppin Academic Center, Emek Hefer, Israel. .,Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Mt Scopus, Jerusalem, Israel.
| | - Sophie C Dahlenburg
- School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, SA, Australia
| |
Collapse
|
49
|
"Constant Stress Has Become the New Normal": Stress and Anxiety Inequalities Among U.S. College Students in the Time of COVID-19. J Adolesc Health 2021; 68:270-276. [PMID: 33288459 DOI: 10.1016/j.jadohealth.2020.10.030] [Citation(s) in RCA: 129] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/23/2020] [Accepted: 10/30/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The purpose of this study is to document young adults' perceived stress and anxiety in a diverse sample of college students across the U.S. during the COVID-19 pandemic. METHODS We recruited, via Instagram, a sample of full-time college students aged 18-22 from across the U.S. We surveyed them in April (baseline; N = 707; mean age = 20.0, SD = 1.3) and July (follow-up) 2020. This study presents overall levels of perceived stress and general anxiety symptoms and inequalities across each of these outcomes by gender, sexual orientation, race/ethnicity, and household income. We also explore potential explanations for these health issues by analyzing baseline qualitative data. RESULTS All students, on average, were suffering from perceived stress and anxiety, with especially high levels in April. We also identified inequalities in college student mental well-being, particularly by gender identity and sexual orientation. Women reported worse well-being compared with men; transgender and gender diverse and sexual minority youths reported worse outcomes than their cisgender, heterosexual peers at both time points. Qualitative data illustrate how the COVID-19 pandemic has generated educational, economic, and environmental stressors that are affecting college students' well-being. CONCLUSIONS As colleges and universities think about how to manage and mitigate the infectious disease dimensions of COVID-19 among their student populations, they must also consider who is most at risk for increased stress and anxiety during the pandemic.
Collapse
|
50
|
Rentería R, Benjet C, Gutiérrez-García RA, Abrego-Ramírez A, Albor Y, Borges G, Covarrubias Díaz-Couder MA, Durán MDS, González-González R, Guzmán Saldaña R, E Hermosillo De la Torre A, Martínez-Jerez AM, Martinez Martinez KI, Medina-Mora ME, Martínez Ruiz S, Paz Pérez MA, Pérez Tarango G, Zavala Berbena MA, Méndez E, Auerbach RP, Mortier P. Prevalence of 12-month mental and substance use disorders in sexual minority college students in Mexico. Soc Psychiatry Psychiatr Epidemiol 2021; 56:247-257. [PMID: 32886133 DOI: 10.1007/s00127-020-01943-4] [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: 08/19/2019] [Accepted: 08/07/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Mental health disparities have been documented among sexual minority college students, but there is a dearth of evidence from developing countries. The aim is to estimate the prevalence of 12-month mental and substance use disorders across a range of sexual identities among first-year college students in Mexican universities, and test whether there is an association between sexual identity and disorders and whether the association is moderated by gender. METHOD The University Project for Healthy Students, a web-based survey conducted as part of the World Health Organization's World Mental Health International College Student initiative, recruited 7874 students from nine Mexican universities in 2016 and 2017. Logistic regressions estimated the association of sexual identity with 12-month major depressive episode, generalized anxiety disorder, panic disorder, alcohol abuse/dependence, and drug abuse/dependence, with interaction terms for gender. RESULTS Compared to heterosexual students reporting no same-sex attraction (SSA), heterosexual students with SSA (AORs range 1.77-3.67) and lesbian/gay and bisexual students (AORs range 2.22-5.32) were at a higher risk for several disorders. Asexual students were at higher risk for drug abuse/dependence (AOR = 3.64). Students unsure of their sexual identity were at a higher risk for major depressive episode, panic disorder, and drug abuse/dependence (AORs range 2.25-3.82). Gender differences varied across sexual identity and disorder. CONCLUSION These findings are the first empirical report of sexual minority psychiatric disparities among a college student population from a developing nation and underscore the importance of clinical interventions that address mental health needs among sexual minority college students.
Collapse
Affiliation(s)
- Roberto Rentería
- Counseling & Counseling Psychology, Arizona State University, Tempe, Arizona, USA
| | - Corina Benjet
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico.
| | - Raúl A Gutiérrez-García
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, Mexico
| | - Adrián Abrego-Ramírez
- Dirección de Investigación, Universidad Politécnica de Aguascalientes, Aguascalientes, Aguascalientes, Mexico.,Dirección de Educación a Distancia, Universidad Cuauhtémoc, Plantel Aguascalientes, Aguascalientes, Mexico
| | - Yesica Albor
- Departamento de Salud Púbica, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad De México, Mexico
| | - Guilherme Borges
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico
| | | | - María Del Socorro Durán
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, Mexico
| | - Rogaciano González-González
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, Mexico
| | - Rebeca Guzmán Saldaña
- Instituto de Ciencias de la Salud y Coordinación de Investigación, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico
| | | | - Ana María Martínez-Jerez
- Unidad Académica de Ciencias Jurídicas y Sociales, Universidad Autónoma de Tamaulipas, Ciudad Victoria, Tamaulipas, Mexico
| | - Kalina I Martinez Martinez
- Departamento de Psicología, Universidad Autónoma de Aguascalientes, Aguascalientes, Aguascalientes, Mexico
| | - María Elena Medina-Mora
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico
| | | | - María Abigail Paz Pérez
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, Mexico
| | - Gustavo Pérez Tarango
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, Mexico
| | | | - Enrique Méndez
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York City, NY, USA
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| |
Collapse
|