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Mereish EH, Abramson JR, Lee H, Watson RJ. Intersectional Oppression-Based Stress, Drinking to Cope Motives, and Alcohol Use and Hazardous Drinking Among Sexual and Gender Minority Adolescents Who Are Black, Indigenous, and People of Color. LGBT Health 2024. [PMID: 38973422 DOI: 10.1089/lgbt.2024.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
Purpose: This study examined the associations between intersectional oppression-based stress and recent alcohol use and hazardous drinking among sexual and gender minority (SGM; e.g., queer or transgender) adolescents who were Black, Indigenous, and People of Color (BIPOC), also known as queer and transgender BIPOC (QTBIPOC) adolescents, and the mediating role of coping motives (i.e., drinking to cope) on these associations. Methods: Data were from a subsample of QTBIPOC adolescents who used alcohol in the past year (n = 1365) from a national U.S. sample of SGM adolescents aged 13-18 years. Results: Intersectional oppression-based stressors were associated with greater odds of recent alcohol use and hazardous drinking, as well as greater coping motives. Coping motives mediated the associations between intersectional-based stressors and both recent alcohol use and hazardous drinking among the aggregate sample of QTBIPOC adolescents, as well as among some subgroups of BIPOC adolescents. Conclusions: The results of this study highlight that intersectional oppression-based stressors are prevalent among QTBIPOC adolescents and serve as a risk factor for alcohol use and hazardous drinking. Multilevel interventions are needed to target and dismantle intersectional oppressions to address alcohol inequities impacting QTBIPOC adolescents. Drinking to cope motives mediated the associations between intersectional oppression-based stress and drinking outcomes, underscoring another important mechanism to target within a context of oppression in drinking interventions.
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Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Psychology, University of Maryland, College Park, Maryland, USA
| | - Jessica R Abramson
- Lavender Lab, Department of Psychology, University of Maryland, College Park, Maryland, USA
| | - Hyemin Lee
- Lavender Lab, Department of Psychology, University of Maryland, College Park, Maryland, USA
| | - Ryan J Watson
- Department of Human Development And Family Sciences, University of Connecticut, Storrs, Connecticut, USA
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2
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Caba AE, Mallory AB, Simon KA, Renley BM, Rathus T, Watson RJ. Sexual Identity Disclosure and Alcohol Experiences Among LGBTQ+ Adolescents. Behav Med 2024; 50:170-180. [PMID: 37036276 PMCID: PMC10562512 DOI: 10.1080/08964289.2023.2190078] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 02/23/2023] [Accepted: 03/04/2023] [Indexed: 04/11/2023]
Abstract
Sexual and gender minority youth (SGMY) report greater alcohol use in comparison to their heterosexual counterparts. Prior research has found that elevated alcohol use among SGMY can be explained by minority stress experiences. Sexual identity outness may be another factor that drives alcohol use among SGMY, given that outness is associated with alcohol use among older sexual and gender minority samples. We examined how patterns of sexual identity outness were associated with lifetime alcohol use, past-30-day alcohol use, and past-30-day heavy episodic drinking. Data were drawn from the LGBTQ National Teen Survey (N = 8884). Participants were SGMY aged 13 to 17 (mean age = 15.59) years living in the US. Latent class analysis was used to identify sexual identity outness patterns. Multinomial regressions were used to examine the probability of class membership by alcohol use. Six outness classes were identified: out to all but teachers (n = 1033), out to siblings and peers (n = 1808), out to siblings and LGBTQ+ peers (n = 1707), out to LGBTQ+ peers (n = 1376), mostly not out (n = 1653), and very much not out (n = 1307). SGMY in classes characterized by greater outness to peers, friends, and family had greater odds of lifetime alcohol use compared with SGMY in classes characterized by lower outness. These findings suggest that SGMY with greater sexual identity outness may be a target for alcohol use prevention programming. Differences in sexual identity outness may be explained by minority stress factors.
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Affiliation(s)
- Antonia E. Caba
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
| | - Allen B. Mallory
- Department of Human Sciences, The Ohio State University, Campbell Hall 151H, 1787 Neil Ave, Columbus, OH 43210
| | - Kay A. Simon
- Department of Family Social Science, University of Minnesota, 1985 Buford Ave, St Paul, MN 55108
| | - Benton M. Renley
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
| | - Taylor Rathus
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
| | - Ryan J. Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
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3
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Carson I, Wu W, Knopf A, Crawford CA, Zapolski TCB. On the Relationship Between Online Heterosexist Discrimination and Mental Health and Substance Use Among LGBTQ+ Young Adults. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1277-1291. [PMID: 38253740 DOI: 10.1007/s10508-023-02800-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024]
Abstract
LGBTQ+ individuals experience disproportionately higher rates of mental health and substance use difficulties. Discrimination is a significant factor in explaining these disparities. Meyer's (2003) minority stress theory (MST) indicates that proximal group-specific processes mediate the relationship between discrimination and health outcomes, with the effects moderated by other social factors. However, online discrimination has been understudied among LGBTQ+ people. Focusing on LGBTQ+ young adults experiencing online heterosexist discrimination (OHD), the current study aimed to investigate the effect of OHD on mental health outcomes and explore whether the effect was mediated by proximal factors of internalized heterosexism, online concealment, and acceptance concerns and moderated by social support. Path analysis was used to examine the effects. A total of 383 LGBTQ+ young adults (18-35) from an introductory psychology subject pool, two online crowdsourcing platforms, and the community completed a questionnaire assessing these constructs. OHD was associated with increased psychological distress and cannabis use. Two proximal stressors (acceptance concerns and sexual orientation concealment) mediated the relationship between OHD and psychological distress. Sexual orientation concealment also mediated the relationship between OHD and cannabis use. There was no evidence that online social support from LGBTQ+ peers moderated any of the relationships. MST is a viable guiding framework for exploring OHD. Acceptance concerns and online concealment are important constructs to consider and may be potential treatment targets for individuals experiencing psychological distress or engaging in cannabis use due to OHD.
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Affiliation(s)
- Ian Carson
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, USA.
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, USA
| | - Amy Knopf
- Section of Community Health, Indiana University School of Nursing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Christopher Andrew Crawford
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, USA
| | - Tamika C B Zapolski
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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4
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Espino E, Jiménez-Díaz O, Del Rey R, Elipe P. Outlining Individual and Contextual Factors Related to LGBTQ+ Bullying: A Systematic Review of Two Decades of Research. TRAUMA, VIOLENCE & ABUSE 2024; 25:898-917. [PMID: 37078578 DOI: 10.1177/15248380231165724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Scientific interest in lesbian, gay, bisexual, transgender, queer and any other sexual orientation, gender identity and/or expression (LGBTQ+) bullying in educational settings has grown exponentially in recent years. However, the varied ways of measuring its occurrence and associated factors have made it difficult to achieve a holistic understanding of this problem. Therefore, this systematic review aimed to provide an updated overview of individual and contextual factors related to LGBTQ+ bullying over the past two decades, based on the measurement approach to this phenomenon. Studies published from 2000 to 2020 were analyzed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses strategy. Inclusion and exclusion criteria were applied in a staggered process, and 111 articles met all the criteria. Studies focusing on LGBTQ+ bullying victimization or aggression were eligible for inclusion. Our analysis revealed LGBTQ+ bullying is usually examined by measures of general aggressions (47.8%) from the victims' perspective (87.3%). The best-represented factors across studies were individual characteristics (63.1%; n = 70), especially participants' sexual orientation and gender identity and expression (68.5%). Boys/males, from a binary gender perspective, and sexual and gender minority youth in general, were more at risk of being targeted for LGBTQ+ bullying. Although contextual factors were far less well-represented, the results revealed that gay-straight alliances, anti-homophobia policies, and social support act as protective factors. This review highlights the need to analyze LGBTQ+ bullying considering the full spectrum of sexual and gender diversity, to examine in more detail its contextual risk/protective factors, and to design public policies and psychoeducational programs in order to address the low effectiveness of generic interventions. Implications for future research and practice are discussed.
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Ray CM, Norris AL, Liu GS, Bogen KW, Pearlman DN, Reidy DE, Estefan LF, Orchowski LM. Interpersonal Violence Victimization Experiences of Middle School Youth: An Exploration by Gender and Sexual/Romantic Attraction. JOURNAL OF HOMOSEXUALITY 2023; 70:2901-2924. [PMID: 35700379 PMCID: PMC9869166 DOI: 10.1080/00918369.2022.2082907] [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: 06/15/2023]
Abstract
Sexual minority youth (SMY) are at increased risk for interpersonal violence victimization compared to heterosexual youth. The current study examined how self-reported victimization (i.e., bullying, sexual harassment and dating violence) among middle school youth varied as a function of sexual/romantic attraction as well as gender identity. Cross-sectional data were gathered from students at seven middle schools in New England (n = 2245). Mean comparisons with post-hoc Tukey tests determined differences in rates of past 6-month and lifetime interpersonal violence victimization by sexual/romantic attraction and the intersection of gender and attraction. As hypothesized, interpersonal violence victimization among middle school youth differed as a function of sexual/romantic attraction as well as gender. To date, most research has focused on older samples, particularly high-school youth and young adults. These data are consistent with these prior studies documenting increased risk for interpersonal violence victimization among youth who indicate same-gender attraction but add to the literature in demonstrating the expansive forms of peer victimization that same-gender-attracted youth already experience by early adolescence. Given that victimization is associated acutely and longitudinally with many deleterious outcomes, including poorer mental health and increased risk for subsequent victimization, greater structural supports are needed for early adolescent SMY.
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Affiliation(s)
- Colleen M Ray
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alyssa L Norris
- Center for Behavioral & Preventive Medicine, The Miriam Hospital and Brown University, Providence, Rhode Island, USA
| | - Grace S Liu
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katherine W Bogen
- Department of Psychology, University of Nebraska, Lincoln, Nebraska, USA
| | - Deborah N Pearlman
- Center for Epidemiologic Research, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Dennis E Reidy
- School of Public Health, Center for Research on Interpersonal Violence, Georgia State University, Atlanta, Georgia
| | - Lianne F Estefan
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lindsay M Orchowski
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Rosales R, Zelaya DG, Moreno O, Figuereo V, Chavez SJ, Ordoñez S, Costas I, Ponce M, Miranda R. Latinx Sexual Minority Adolescent Substance Use: State of the Science and Call for Intersectional Minority Stressors and Protective Factors. CURRENT ADDICTION REPORTS 2023; 10:396-411. [PMID: 38774111 PMCID: PMC11104555 DOI: 10.1007/s40429-023-00503-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 05/24/2024]
Abstract
Purpose of review Latinx sexual minority adolescents (LSMA) are at an intersection of ethnic and sexual minority (SM) status and may experience heighten risk of substance use and related problems. These youth may also hold unique protective factors that help mitigate the effects of minority stress and curb substance use. Little is known, however, about the intersectional minority stressors (i.e., due to ethnicity and SM status) and protective factors related to substance use among this population. Recent Findings According to the minority stress model, there are unique minority stressors and resiliency factors that can help explain differences in behavioral health rates between white SM and SM of color. Research supports the notion that minority stressors (e.g., stigma/risk, homophobic bullying, and family rejection of SM status) confer risk for substance use among LSMA. In terms of resilience, less is known, but there may be some protective factors that have not been measured that could explain lower rates in some substances (i.e., club drugs and methamphetamine). Summary Little is known about how the intersections of ethnicity and SM status are associated with substance use in adolescence. Future research should assess the temporal relationship of multilevel (i.e., intrapersonal, relational, and system), intersectional (i.e., ethnicity and SM status) minority stressors and protective factors unique to LSMA on substance use. We propose that the findings from these future studies will help to create socioculturally appropriate behavioral health treatments that consider the intersectional risks and strengths within the LSMA population.
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Affiliation(s)
- Robert Rosales
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - David G Zelaya
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Oswaldo Moreno
- Virginia Commonwealth University, College of Humanities & Sciences, Department of Psychology, Richmond, VA, USA
| | - Victor Figuereo
- University of Pittsburgh, School of Social Work, Pittsburgh, PA, USA
| | - Sarah J Chavez
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Sophia Ordoñez
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Isabel Costas
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Melissa Ponce
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Robert Miranda
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA; Emma Pendleton Bradley Hospital, Riverside, RI, USA
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Baams L, Kaufman TML. Sexual Orientation and Gender Identity/Expression in Adolescent Research: Two Decades in Review. JOURNAL OF SEX RESEARCH 2023; 60:1004-1019. [PMID: 37307300 DOI: 10.1080/00224499.2023.2219245] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
There is a long history of research among adolescents who are minoritized and marginalized for their sexual orientation and gender identity/expression (SOGIE). However, it remains unclear how we can best conceptualize and assess SOGIE in adolescence, resulting in different subpopulations and findings across studies. Addressing this issue, we present a narrative literature review of the conceptualization and assessment of SOGIE, and provide recommendations for conceptualizing and operationalizing these concepts. Our review indicated that most research with adolescent populations still almost exclusively assesses isolated dimensions of sexuality and gender (e.g., attraction but not identity). We argue that to make research inclusive and equitable, scholars are required to make clear substantiated decisions and be transparent about the SOGIE dimensions and, thus, subpopulations they represent.
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Affiliation(s)
- Laura Baams
- Department of Pedagogy and Educational Sciences, University of Groningen
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8
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Russell ST, McCurdy AL. Examination of the "model minority" stereotype through ethnicity and sexual orientation heterogeneity among Asian American youth. J Adolesc 2023; 95:1258-1273. [PMID: 37280705 PMCID: PMC10524967 DOI: 10.1002/jad.12200] [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: 10/23/2022] [Revised: 05/04/2023] [Accepted: 05/20/2023] [Indexed: 06/08/2023]
Abstract
INTRODUCTION The "model minority" stereotype disguises heterogeneity among Asian American youth, many of whom are harmed by policies and attitudes that assume this population to be uniformly high achieving and "problem free." The current study uses an intersectional lens to disaggregate this population by ethnicity and sexual orientation subgroups to demonstrate differences in academic performance and substance use behavior among Asian American youth. This study also investigates the extent to which racial/ethnicity and sexual orientation-based bullying may explain such links. METHODS Participants included 65,091 Asian American youth (46.41% Southeast Asian; 37.01% East Asian; 16.58% South Asian) in grades 6-12, who were part of the California Healthy Kids Survey (2015-2017). Participants were 49.4% female and about a third each were in grades 6-8, grades 9-10, and grades 11-12. School-based surveys were administered. Youth reported on substance use, grades, and bias-based bullying experiences in the past 12 months. RESULTS Generalized linear mixed-effects model results showed that outcomes varied widely across youth ethnicity and sexual orientation subgroups. Inclusion of racial/ethnic and sexual orientation bullying in these models attenuated the direct effects between ethnic and sexual identities and academic performance and substance use outcomes. CONCLUSIONS Implications of this work suggest that research and policy should not treat Asian American students as uniformly high-performing and low-risk, because the experiences of those who deviate from these assumptions will be left undetected. Interventions targeting bias-based bullying may be able to reduce disparities in academic and substance use outcomes among Asian American youth.
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Affiliation(s)
- Stephen T Russell
- Department of Human Development and Family Sciences, Population Research Center, The University of Texas at Austin, Austin, Texas, USA
| | - Amy L McCurdy
- Department of Human Development and Family Sciences, Population Research Center, The University of Texas at Austin, Austin, Texas, USA
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9
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Turpin RE, Dangerfield DT, Oke T, Hickson DA. Parental Sexuality Disclosure, Discrimination, and Depression Among Black Sexual Minority Men and Black Transgender Women. FAMILY & COMMUNITY HEALTH 2023; 46:95-102. [PMID: 36799942 PMCID: PMC9942094 DOI: 10.1097/fch.0000000000000360] [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: 06/18/2023]
Abstract
Racial and sexuality-based discrimination can induce depressive symptoms among Black sexual minority men and transgender women (BSMM/BTW). BSMM and BTW who disclose their sexuality to parents may be better prepared to cope with discrimination. We explored the relationship between discrimination and depression among BSMM and BTW and whether parental disclosure modified this relationship. Secondary analysis of The MARI Study was used to test the relationship between discrimination and depression modified by level of disclosure of sexuality to parents among 580 BSMM and BTW in Jackson, Mississippi, and Atlanta, Georgia. Bivariate tests and linear regression models were stratified by sexuality disclosure to parents. Discrimination was associated with greater depression, with significant dose-response modification across levels of disclosure. After adjustment, maximum discrimination scores were associated with depression scores 10.7 units higher among participants with very open disclosure (95% CI, 10.4-11.8), 15.3 units higher among participants with somewhat open disclosure (95% CI, 3.7-26.9), and 19.5 units higher among participants with no disclosure (95% CI, 10.2-26.8). Disclosure of sexuality to supportive parents can substantially benefit the mental health of BSMM and BTW. Future studies should explore intervention approaches to providing social support for BSMM and BTW in unsupportive families.
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Affiliation(s)
- Rodman E Turpin
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia (Dr Turpin); George Washington University, Milken Institute School of Public Health, Washington, District of Columbia (Dr Dangerfield); School of Social Work, University at Buffalo, Buffalo, New York (Mr Oke); and Us Helping Us, People Into Living Inc, Washington, District of Columbia (Drs Hickson and Dangerfield, and Mr Oke)
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10
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Rosales R, Sellers CM, Lee CS, Santos B, O'Brien K, Colby SM. Examining Racial/Ethnic Differences in the Association of Victimization and Suicidal Thoughts and Behaviors with Alcohol Use Among Sexual Minority Youth. LGBT Health 2023; 10:109-120. [PMID: 36044041 PMCID: PMC9986026 DOI: 10.1089/lgbt.2021.0267] [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: 02/03/2023] Open
Abstract
Purpose: Integrating Minority Stress Theory and Bagge and Sher's Theoretical Framework of the Alcohol-Suicide Attempt Relation, this study aimed to test whether experiencing both minority stress and suicidal thoughts and behaviors (STBs) had a greater strength of association with Latinx and Black sexual minority youth (SMY)'s alcohol use compared with that of White SMY. Methods: Using data on 2341 non-Latinx Black, Latinx, and non-Latinx White SMY from the 2015 and 2017 Youth Risk Behavior Surveys, we tested the prevalence of STBs, victimization, and alcohol use for Black and Latinx participants compared with White participants. Multivariate logistic regression analyses tested the main effects of STBs, victimization, and race/ethnicity on alcohol use. Finally, interaction terms assessed the interaction among STBs, victimization, and race/ethnicity on alcohol use. Results: The results supported our hypothesis, based on Minority Stress Theory, that experiencing victimization would be associated with greater alcohol use. Results also supported Bagge and Sher's theoretical framework showing that suicide plan and attempts were associated with greater alcohol use. When taking all of these stressors into account, results showed that Latinx SMY who experienced victimization had greater current prevalence of alcohol use than their White counterparts. However, Latinx SMY who were victimized and experienced suicidal ideation reported lower alcohol use than White SMY. Conclusion: These findings support the double jeopardy and resiliency hypotheses, which suggest that minority stressors have differing associations for each racial/ethnic SMY group's alcohol use. More research is needed that helps to disentangle the protective and risk factors for alcohol use among Black and Latinx SMY.
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Affiliation(s)
- Robert Rosales
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, Rhode Island, USA.,Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Christina M Sellers
- College of Social, Sciences, Policy, and Practice, School of Social Work, Simmons University, Boston, Massachusetts, USA.,Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Christina S Lee
- School of Social Work, Boston University, Boston, Massachusetts, USA
| | - Bryan Santos
- Independent Researcher, Worcester, Massachusetts, USA
| | - Kimberly O'Brien
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, Rhode Island, USA.,Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island, USA
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Mereish EH, Cox DJ, Goldbach JT. Heterosexist Bullying Victimization and Perpetration and Substance Use Among Heterosexual Adolescents. Int J Behav Med 2022; 30:431-437. [PMID: 35698020 DOI: 10.1007/s12529-022-10109-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although heterosexist bullying mainly affects sexual minority adolescents, heterosexual adolescents may also be targets. Research is needed to understand the impact of heterosexist bullying victimization on heterosexual adolescents' behavioral health. Moreover, there is a dearth of research examining the negative consequences of perpetrating heterosexist bullying among heterosexual adolescents. The purpose of this study was to examine the associations between heterosexist bullying victimization and perpetration and substance use in a racially diverse sample of heterosexual adolescents. METHODS A probability sample of middle and high school heterosexual students (N = 2,337; aged 11-19; 52.7% female; 35.9% Black or African American and 31.9% White) using random cluster methods was obtained from a southeastern US school district. Multiple logistic regression models were used to test the relationships between experiencing and perpetrating heterosexist bullying and substance use while accounting for sociodemographics. RESULTS Of the participants, 7.1% reported heterosexist bullying victimization and 7.8% reported perpetration of heterosexist bullying. Of those engaging in heterosexist bullying, 29.5% also experienced it as a victim. Perpetrating heterosexist bullying was associated with greater odds of recent and lifetime alcohol, cigarette, e-cigarette, cannabis, and prescription drug use. Heterosexist bullying victimization was only associated with recent and lifetime cigarette use and lifetime e-cigarette use. CONCLUSIONS The results demonstrate the negative correlates of heterosexist bullying victimization and perpetration on heterosexual adolescents' substance use. The findings underscore the need to address sexual stigma, such as heterosexist bullying, among not only adolescents experiencing it but also its perpetrators to help reduce substance use among all adolescents.
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Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Health Studies, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA.
| | - Diana J Cox
- Department of Psychology, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA
| | - Jeremy T Goldbach
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
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12
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Schrager SM, Mamey MR, Rhoades H, Goldbach JT. Adolescent stress experiences over time study (ASETS) protocol: design and methods of a prospective longitudinal study of sexual minority adolescents in the USA. BMJ Open 2022; 12:e054792. [PMID: 35264352 PMCID: PMC8915334 DOI: 10.1136/bmjopen-2021-054792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Sexual minority adolescents (SMA) report higher rates of anxiety, self-harm, depression and suicide than heterosexual peers. These disparities appear to persist into adulthood and may worsen for certain subgroups, yet the mechanisms that drive these concerns remain poorly understood. Minority stress theory, the predominant model for understanding these disparities, posits that poorer outcomes are due to the stress of living in a violently homophobic and discriminatory culture. Although numerous studies report associations between minority stress and behavioural health in adolescence, no study has comprehensively examined how minority stress may change throughout the course of adolescence, nor how stress trajectories may predict health outcomes during this critical developmental period. METHODS AND ANALYSIS Between 15 May 2018 and 1 April 2019, we recruited a US national sample of diverse SMA (n=2558) age 14-17 through social media and respondent-driven sampling strategies. A subset of participants (n=1076) enrolled in the longitudinal component and will be followed each 6 months until 1 July 2022. Primary outcomes include symptoms of depression, anxiety and post-traumatic stress disorder; suicidality and self-harm and substance use. The key predictor is minority stress, operationalised as the Sexual Minority Adolescent Stress Inventory. We will use parallel cohort-sequential latent growth curve models to test study hypotheses within a developmental framework. ETHICS AND DISSEMINATION All participants provided assent to participate, and longitudinal participants provided informed consent at the first follow-up survey after reaching age 18. All study procedures were reviewed and approved by the University of Southern California Social-Behavioral Institutional Review Board, including a waiver of parental permission given the potential for harm due to unintentional 'outing' to a parent during the consent process. The final anonymous data set will be available on request, and research findings will be disseminated through academic channels and products tailored for the lay community.
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Affiliation(s)
- Sheree M Schrager
- California State University, Dominguez Hills, Carson, California, USA
| | - Mary Rose Mamey
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Harmony Rhoades
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Jeremy T Goldbach
- The Brown School, Washington University in St Louis, St. Louis, Missouri, USA
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Goldbach JT, Rhoades H, Mamey MR, Senese J, Karys P, Marsiglia FF. Reducing behavioral health symptoms by addressing minority stressors in LGBTQ adolescents: a randomized controlled trial of Proud & Empowered. BMC Public Health 2021; 21:2315. [PMID: 34949171 PMCID: PMC8696968 DOI: 10.1186/s12889-021-12357-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 11/30/2021] [Indexed: 11/11/2022] Open
Abstract
Background Minority stress may lead to poorer mental health for sexual and gender minority adolescents, yet no interventions have been tested through an RCT to address these concerns. Methods We report on an RCT of an intervention—Proud & Empowered—with four high schools. Measures assess the intervention’s impact on mental health symptoms. Results Compared to the control, participants in the treatment condition reported significant differences in minority stress, anxiety, and depressive symptoms. Moderation analyses showed that the intervention significantly moderated the relationship between minority stress and PTSD (b = -1.28, p = .032), depression (b = -0.79, p = .023), and suicidality (b = 0.14, p = .012) symptoms; those in the intervention condition had mitigated relationships between measures of stress and health outcomes compared to those in the control condition. Conclusions Results suggest that Proud & Empowered help reduce mental health symptoms and exposure to minority stressors and build coping strategies. Trial Registration The intervention was registered on clinicaltrials.gov on August 1, 2019 under Trial #NCT04041414.
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Affiliation(s)
- Jeremy T Goldbach
- The Brown School, Washington University in St. Louis, 1 Brookings Dr, MO, 63130, St. Louis, USA.
| | - Harmony Rhoades
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th St., MRF Bldg, CA, 90089-0411, Los Angeles, USA
| | - Mary Rose Mamey
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th St., MRF Bldg, CA, 90089-0411, Los Angeles, USA
| | - John Senese
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th St., MRF Bldg, CA, 90089-0411, Los Angeles, USA
| | - Peter Karys
- The LGBT Community Center, 208 W. 13th St, 10011, New York, NY, USA
| | - Flavio F Marsiglia
- School of Social Work, Arizona State University, 411 N. Central Ave., Suite 720, 85004, Phoenix, AZ, USA
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Cordoba E, Garofalo R, Kuhns LM, Pearson C, Bruce J, Batey DS, Radix A, Belkind U, Hidalgo MA, Hirshfield S, Garibay Rodriguez R, Schnall R. Risk-taking behaviors in adolescent men who have sex with men (MSM): An association between homophobic victimization and alcohol consumption. PLoS One 2021; 16:e0260083. [PMID: 34855787 PMCID: PMC8638971 DOI: 10.1371/journal.pone.0260083] [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: 12/16/2020] [Accepted: 09/21/2021] [Indexed: 11/18/2022] Open
Abstract
Objective The aim of this study was to determine whether homophobic victimization was associated with alcohol consumption and riding with an intoxicated driver or driving a car while under the influence of alcohol or drugs among adolescent men who have sex with men (MSM). Methods Cross-sectional analysis used baseline data from a national HIV prevention trial (NCT03167606) for adolescent MSM aged 13–18 years (N = 747). Multivariable logistic regression models assessed associations between homophobic victimization (independent variable) and alcohol-related outcomes (dependent variables), controlling for age, parents’ education level, sexual orientation, health literacy, race, and ethnicity. Results Most participants (87%) reported at least one form of homophobic victimization in their lifetime, with verbal insults being the most frequently reported (82%). In the bivariate analysis, alcohol consumption and riding with an intoxicated driver or driving a car while under the influence were associated with many forms of victimization. Exposure to at least one form of victimization was associated with increased odds of alcohol consumption (OR: 2.31; 95% CI: 1.38–3.87) and riding with an intoxicated driver or driving a car while under the influence (OR: 2.25; 95% CI: 1.26–4.00), after controlling for covariates. Conclusion Increased risk of alcohol consumption and risky alcohol-related behaviors were found among adolescent MSM who experienced homophobic victimization. Interventions should address homophobic victimization and its impact on adolescent MSM, as well as disentangling motivations for underage drinking, riding with an intoxicated driver or driving a car while under the influence.
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Affiliation(s)
- Evette Cordoba
- School of Nursing, Columbia University, New York, New York, United States of America
- * E-mail:
| | - Robert Garofalo
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States of America
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Evanston, Illinois, United States of America
| | - Lisa M. Kuhns
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States of America
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Evanston, Illinois, United States of America
| | - Cynthia Pearson
- Indigenous Wellness Research Institute, School of Social Work, University of Washington, Seattle, Washington, United States of America
| | - Josh Bruce
- Birmingham AIDS Outreach, Birmingham, Alabama, United States of America
| | - D. Scott Batey
- Department of Social Work, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Asa Radix
- Callen-Lorde Community Health Center, New York, New York, United States of America
| | - Uri Belkind
- Callen-Lorde Community Health Center, New York, New York, United States of America
| | - Marco A. Hidalgo
- Children’s Hospital Los Angeles, The Saban Research Institute, Los Angeles, CA, United States of America
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Sabina Hirshfield
- Department of Medicine, STAR Program, SUNY Downstate Health Sciences University, Brooklyn, New York, United States of America
| | | | - Rebecca Schnall
- School of Nursing, Columbia University, New York, New York, United States of America
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15
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Hsueh L, Layland EK, Kipke MD, Bray BC. Linking racism and homonegativity to healthcare system distrust among young men of color who have sex with men: Evidence from the Healthy Young Men's (HYM) study. Soc Sci Med 2021; 284:114219. [PMID: 34271403 PMCID: PMC8958666 DOI: 10.1016/j.socscimed.2021.114219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 07/01/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Experiences with racism predict healthcare system distrust among people of color, but Black and Latino young men who have sex with men (YMSM) also experience overlapping forms of stigma associated with their sexual identities and behaviors (i.e., homonegativity and internalized homonegativity). These forms of minority stress may drive healthcare system distrust among Black and Latino YMSM but have received far less attention. OBJECTIVES To examine the associations of racism, homonegativity, and internalized homonegativity with healthcare system distrust among a community sample of Black and Latino YMSM. METHODS Data came from waves 2-4 (years 2017-2018) of the Healthy Young Men's study, a longitudinal cohort study of Black and Latino YMSM living in Los Angeles County. Data across waves (n = 424, nobs = 1272) were combined and analyzed using a fixed effects approach and adjusting for repeated measures across participants. A series of regression models that added sets of covariates (demographics, syndemic indicators, and health-related factors) were tested to examine associations of racism, homonegativity, and internalized homonegativity with healthcare system distrust. RESULTS Adjusting for demographics and syndemic indicators, racism, but not homonegativity or internalized homonegativity, was associated with healthcare system distrust. Adjustment for health-related factors had little impact on results. CONCLUSIONS Among Black and Latino YMSM, greater exposure to racism is associated with greater healthcare system distrust. Efforts to strengthen healthcare system trust should explicitly target the institutional policies that disproportionately harm people of color.
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Affiliation(s)
- Loretta Hsueh
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
| | - Eric K Layland
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, 135 College Street, Suite 200, New Haven, CT, 06510, USA
| | - Michele D Kipke
- Children's Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA, 90027, USA; Departments of Pediatrics and Preventive Medicine, University of Southern California Keck School of Medicine, 1975 Zonal Ave., Los Angeles, CA, 90027, USA
| | - Bethany C Bray
- Center for Dissemination and Implementation Science, University of Illinois at Chicago, 818 South Wolcott Ave., Chicago, IL, 60612, USA
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16
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Watson RJ, Fish JN, Poteat VP, Wheldon CW, Cunningham CA, Puhl RM, Eaton LA. Teacher Support, Victimization, and Alcohol Use Among Sexual and Gender Minority Youth: Considering Ethnoracial Identity. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:590-601. [PMID: 33609259 PMCID: PMC8195836 DOI: 10.1007/s11121-021-01216-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 12/28/2022]
Abstract
Although scholarship continues to document higher rates of alcohol use for sexual and gender minority (SGM) youth compared with heterosexual and cisgender youth, research identifying factors that mitigate SGM youths' risk is nascent. Youth spend substantial time in schools; therefore, teachers could play significant roles in attenuating these health concerns. We used data from a nationwide survey of 11,189 SGM youth (Mage = 15.52; 67.7% White) to explore whether perceived teacher social-emotional support attenuated the association between victimization and alcohol use, further conditioned by youths' specific ethnoracial identity. As expected, victimization was associated with more frequent alcohol use; however, greater perceived teacher support attenuated this association. The attenuating effect of perceived teacher support was significantly stronger for Hispanic/Latinx youth than White youth. Our findings have implications for alcohol use prevention among SGM youth, who face significant marginalization in schools and society. If we are to prevent alcohol use disparities among SGM youth, scholars and stakeholders (e.g., school administrators, teachers) should invest in building teacher efficacy to intervene in SGM-specific victimization.
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Affiliation(s)
- Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA.
| | - Jessica N Fish
- Department of Family Science, University of Maryland, 1142 Valley Drive, College Park, MD, 20742, USA
| | - V Paul Poteat
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Campion Hall 307, 140 Commonwealth Ave., Chestnut Hill, MA, 02467, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B. Moore Ave, Philadelphia, PA, 19122, USA
| | - Casey A Cunningham
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
| | - Rebecca M Puhl
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
| | - Lisa A Eaton
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
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17
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Pollitt AM, Mallory AB. Mental and Sexual Health Disparities Among Bisexual and Unsure Latino/a and Black Sexual Minority Youth. LGBT Health 2021; 8:254-262. [PMID: 33861625 PMCID: PMC8213006 DOI: 10.1089/lgbt.2020.0374] [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] [Indexed: 12/13/2022] Open
Abstract
Purpose: Sexual minority youth (SMY), particularly bisexual youth and youth unsure of their sexual identity, are at greater risk of poor mental and sexual health outcomes than heterosexual youth. The purpose of this study was to examine disparities in intimate partner violence (IPV) and mental and sexual health for Black and Latino/a bisexual and unsure youth compared with their White bisexual and unsure and Black and Latino/a heterosexual peers. Methods: We used aggregated state and school district 2015 Youth Risk Behavior Survey data to demonstrate differences in mental health (e.g., depressive symptoms and suicidality), sexual health (e.g., number of sexual partners and contraceptive use), and physical and sexual IPV between Black and Latino/a bisexual and unsure youth, and their White bisexual and unsure and Black and Latino/a heterosexual peers. Results: Bisexual and unsure youth had higher odds of depressive symptoms, suicidal ideation and plans, and physical IPV than their same-race heterosexual peers. Black and Latina bisexual and unsure females were more likely to report sexual health risk behaviors than Black and Latina heterosexual females. There were few differences between bisexual and unsure youth of color and White youth. Conclusion: We add to a growing body of literature showing disparities in IPV and mental and sexual health among bisexual and unsure youth of color. Pronounced risk for poor health outcomes among bisexual and unsure females of color needs to be especially addressed by prevention and intervention efforts. We encourage further research on the health of SMY with multiple marginalized identities.
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Affiliation(s)
- Amanda M. Pollitt
- Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Allen B. Mallory
- Population Research Center, University of Texas at Austin, Austin, Texas, USA
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
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18
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Fish JN. Future Directions in Understanding and Addressing Mental Health among LGBTQ Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2020; 49:943-956. [PMID: 33074740 PMCID: PMC7736182 DOI: 10.1080/15374416.2020.1815207] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Today's LGBTQ youth come of age at a time of dynamic social and political change with regard to LGBTQ rights and visibility, yet remain vulnerable to compromised mental health. Despite advances in individual-level treatment strategies, school-based programs, and state-level policies that address LGBTQ mental health, there remains a critical gap in large-scale evidence-based prevention and intervention programs designed to support the positive development and mental health of LGBTQ youth. To spur advances in research and translation, I pose six considerations for future scholarship and practice. I begin by framing LGBTQ (mental) health disparities in a life course perspective and discuss how research focused on the timing of events could offer insight into the optimum targets and timing of prevention and intervention strategies. Next, I argue the importance of expanding notions of "mental health" to include perspectives of wellbeing, positive youth development, and resilience. I then consider how research might attend to the complexity of LGBTQ youths' lived experience within and across the various contexts they traverse in their day-to-day lives. Similarly, I discuss the importance of exploring heterogeneity in LGBTQ youth experiences and mental health. I also offer suggestions for how community partnerships may be a key resource for developing and evaluating evidence-informed programs and tools designed to foster the positive development and mental health of LGBTQ youth. Finally, I acknowledge the potentials of team science for advancing research and practice for LGBTQ youth health and wellbeing. Throughout, these future directions center the urgent needs of LGBTQ youth.
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Affiliation(s)
- Jessica N. Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, 4200 Valley Drive, Suite 1142, College Park, MD, 20742
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19
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Alcohol Use and Suicidality by Sexual Orientation Among U.S. Youth, 2009-2017. Am J Prev Med 2020; 59:394-403. [PMID: 32446749 PMCID: PMC7483808 DOI: 10.1016/j.amepre.2020.03.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/07/2020] [Accepted: 03/06/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Alcohol use and suicidality remain serious risks for U.S. youth. Research has established that disparities exist in these outcomes between heterosexual and sexual minority youth. However, research into the associations between alcohol use and suicidality has yet to consider the differential role of sexual orientation. METHODS Using a pooled, diverse sample from the 2009-2017 Youth Risk Behavior Survey, associations of alcohol use and suicidality by sex and sexual orientation, and changes in these outcomes over time, were investigated. Analyses were conducted in 2019. RESULTS Suicidality was highest among nonheterosexuals, who ranged from twofold to sevenfold higher odds to report suicidality across all time points, with the most striking disparities among male sexual minority youth. Rates among all students remained stable or increased over time; notable exceptions included a decrease in suicide attempts among bisexual students. Among all students, current alcohol use was associated with elevated levels of suicidality. For female students, the association between drinking and suicidality did not significantly differ by sexual identity; for male students, it was significant regardless of sexual identity and most pronounced among not sure youth. CONCLUSIONS These results emphasize the need for additional research into the relationship between contemporaneous alcohol use and suicidality, with attention to differences based on sex, sexual orientation, and other factors that may impact these relationships. There is a particular need for research to examine the temporal nature of the association such that evidence-informed, high-impact interventions can be developed to improve suicidality outcomes among sexual minority youth.
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20
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Wen G, Zheng L. The Influence of Internalized Homophobia on Health-Related Quality of Life and Life Satisfaction Among Gay and Bisexual Men in China. Am J Mens Health 2020; 13:1557988319864775. [PMID: 31311400 PMCID: PMC6637842 DOI: 10.1177/1557988319864775] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The aim of this study was to examine the influences of internalized homophobia on Chinese gay and bisexual men's quality of life and life satisfaction. Four hundred and eighty-three participants completed the Internalized Homophobia Scale, Chinese SF-12 Health Survey Version 2, and Satisfaction With Life Scale via the Internet. Scores for quality of life in several domains and life satisfaction were significantly lower than the heterosexuals' norm scores. The present study revealed that internalized homophobia significantly negatively correlated with the mental component summary score and life satisfaction. The mental component summary score mediated the relationship between internalized homophobia and life satisfaction. Sexual orientation moderated the relationship between internalized homophobia and mental component score. Gay and bisexual men in China experience poorer quality of life and less satisfaction with life compared to heterosexuals, and internalized homophobia contributes to both.
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Affiliation(s)
- Guangju Wen
- 1 Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China.,2 Faculty of Psychology, Southwest University, Chongqing, China
| | - Lijun Zheng
- 1 Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China.,2 Faculty of Psychology, Southwest University, Chongqing, China
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21
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Paceley MS, Fish JN, Thomas MMC, Goffnett J. The Impact of Community Size, Community Climate, and Victimization on the Physical and Mental Health of SGM Youth. JOURNAL OF YOUTH STUDIES 2020; 52:427-448. [PMID: 34413699 PMCID: PMC8372682 DOI: 10.1177/0044118x19856141] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Sexual and gender minority (SGM) youth experience high rates of victimization leading to health disparities. Community size and community climate are associated with health outcomes among SGM youth; however, we lack studies that include them as covariates alongside victimization to understand their collective impact on health. This study utilized minority stress theory to understand how community context shapes experiences of victimization and health among SGM youth. SGM youth in one Midwestern U.S. state completed an online survey (n = 201) with measures of physical health, mental health, community context, and victimization. Data were analyzed via multiple regression using a path analysis framework. Results indicate that perceived climate was associated with mental, but not physical, health; Community size was unrelated to health outcomes. Victimization mediated the association between community climate and mental health.
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22
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Költő A, Cosma A, Moreau N, Young H, Thorsteinsson EB, Gobina I, Godeau E, Saewyc EM, Nic Gabhainn S. Self-Reported Health and Patterns of Romantic Love in Adolescents from Eight European Countries and Regions. LGBT Health 2020; 7:90-100. [PMID: 32053046 PMCID: PMC7138602 DOI: 10.1089/lgbt.2019.0107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose: Sexual minority youth (SMY) are at increased risk of poor health, but it remains unclear whether this phenomenon is universal. In this study, nationally representative samples of 15-year olds from eight European countries and regions were investigated to test if adolescents who have been in love with same- or both-gender partners report poorer health than those exclusively in love with opposite-gender partners or who have never been in love. Methods: A subsample of 13,674 adolescents participating in the 2014 Health Behaviour in School-aged Children (HBSC) study was used. We conducted binary logistic regression, adjusted for gender, region, and relative family affluence, to analyze associations between self-reported romantic love, multiple psychosomatic symptoms, and poor self-rated health. Results: Adolescents reporting same-gender love (adjusted odds ratio [aOR] = 1.50, 95% confidence interval [CI]: 1.11-2.02) and both-gender love (aOR = 3.57, 95% CI: 2.65-4.83) had significantly higher odds for multiple psychosomatic symptoms than those who reported opposite-gender love. Similarly, both SMY groups had higher odds of poor self-rated health (aOR = 2.95, 95% CI: 1.64-5.31 and aOR = 3.08, 95% CI: 1.79-5.31, respectively). Those who reported that they have never been in love had significantly lower odds for multiple symptoms. Adjustment for sociodemographic variables and stratifying by gender did not substantially change the odds ratios. Conclusion: Adolescents in love with same- and both-gender partners reported poorer subjective health outcomes than those in love with opposite-gender partners or who reported never being in love, suggesting that SMY health inequalities are found across various European countries and regions.
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Affiliation(s)
- András Költő
- Health Promotion Research Centre, School of Health Sciences, National University of Ireland Galway, Galway, Ireland
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Alina Cosma
- Department of Interdisciplinary Social Science: Cultural Diversity and Youth, School of Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Nathalie Moreau
- Service d'Information Promotion Education Santé (SIPES), Centre de Recherche “Epidémiologie, Biostatistiques et recherche clinique,” Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - Honor Young
- The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, United Kingdom
| | - Einar B. Thorsteinsson
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, Australia
| | - Inese Gobina
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | | | - Elizabeth M. Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, Vancouver, Canada
| | - Saoirse Nic Gabhainn
- Health Promotion Research Centre, School of Health Sciences, National University of Ireland Galway, Galway, Ireland
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23
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Li DJ, Chen SL, Chang YP, Yen CF. Factors Affecting Painkillers, Sedatives/Hypnotics, Nicotine, and Unhealthy Alcohol Use Among Gay and Bisexual Men in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E851. [PMID: 32013262 PMCID: PMC7038077 DOI: 10.3390/ijerph17030851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 01/29/2023]
Abstract
Substance use has become a major health problem globally for sexual minorities. However, few studies have explored multi-dimensional factors associated with smoking, drinking, and prescription drug use. We aimed to investigate the factors affecting painkiller, sedative/hypnotic, nicotine and unhealthy alcohol use among gay and bisexual men in Taiwan. We recruited 500 gay or bisexual men and assessed their experiences of using painkillers, sedatives/hypnotics, nicotine, alcohol and multi-dimensional factors with self-reported questionnaires. Multivariate logistic regression with a forward stepwise model was used to verify the factors associated with substance use. Overall, 9.4%, 5.4%, and 13.8% of the participants reported using painkillers, sedatives/hypnotics, and nicotine, respectively, and 5.6% reported unhealthy alcohol use. Victims of traditional homophobic bullying in childhood and adolescence were more likely to report nicotine use, sedative/hypnotic use, and unhealthy alcohol use in early adulthood than non-victims. Missing classes or truancy at senior high school was associated with painkiller and sedative/hypnotic use in early adulthood. Traditional homophobic bullying and missing classes or truancy in childhood and adolescence predicted substance use in early adulthood among the gay and bisexual men in this study. Timely preventions and interventions for substance use are crucial for gay and bisexual men, especially for those who experience homophobic bullying and missing classes or truancy.
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Affiliation(s)
- Dian-Jeng Li
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80276, Taiwan
| | - Shiou-Lan Chen
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY14214–3079, USA;
| | - Cheng-Fang Yen
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
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24
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Krueger EA, Fish JN, Upchurch DM. Sexual Orientation Disparities in Substance Use: Investigating Social Stress Mechanisms in a National Sample. Am J Prev Med 2020; 58:59-68. [PMID: 31761516 PMCID: PMC6925636 DOI: 10.1016/j.amepre.2019.08.034] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Sexual minorities are disproportionately more likely than heterosexuals to suffer from substance use disorders, but relatively little is known about differences in substance use disorders across diverse sexual minority subgroups. There is also limited understanding of how different social stressors account for sexual orientation disparities in substance use disorders. METHODS Using nationally representative data collected in 2012-2013 (n=34,597), differences in past-year DSM-5 alcohol, cannabis, and tobacco use disorders were assessed across 4 sexual orientation groups (heterosexuals and 3 sexual minority subgroups, lesbian/gay-, bisexual-, and heterosexual-identified sexual minorities). This study assessed whether stressful life events mediated substance use disorder disparities between heterosexuals and each sexual minority subgroup, and whether stressful life events and lesbian, gay, and bisexual discrimination events mediated these substance use disorder differences. Analyses were conducted in 2019. RESULTS For both men and women, substance use disorders and stress experiences varied by sexual identity. For example, compared with heterosexual men, larger proportions of gay and bisexual men had a past-year alcohol use disorder. Among women, all sexual minority subgroups had higher rates of each substance use disorder than heterosexuals. For each substance use disorder, stressful life events mediated disparities between heterosexuals and sexual minority subgroups, except for heterosexual-identified sexual minority men. Both stressful life events and lesbian, gay, and bisexual discrimination mediated substance use disorder differences between sexual minority subgroups, with stronger indirect effects through lesbian, gay, and bisexual discrimination for lesbians/gay men and stronger indirect effects through stressful life events for bisexual adults, generally. CONCLUSIONS Sexual minority subgroups have a greater prevalence of substance use disorders, mediated through both stressful life events and lesbian, gay, and bisexual discrimination. More research is needed to comprehensively assess the processes underlying sexual orientation substance use disparities.
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Affiliation(s)
- Evan A Krueger
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California.
| | - Jessica N Fish
- Department of Family Science, University of Maryland School of Public Health, College Park, Maryland
| | - Dawn M Upchurch
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California
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25
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Watson RJ, Fish JN, Poteat VP, Rathus T. Sexual and Gender Minority Youth Alcohol Use: Within-Group Differences in Associations with Internalized Stigma and Victimization. J Youth Adolesc 2019; 48:2403-2417. [PMID: 31605292 DOI: 10.1007/s10964-019-01130-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/21/2019] [Indexed: 01/24/2023]
Abstract
Sexual and gender minority (SGM) youth are more likely to use alcohol than their heterosexual cisgender peers. At the same time, SGM youth experience sexuality- and gender identity-specific stressors known to exacerbate negative health outcomes. Though scholars have established a link between minority stressors (e.g., internalized stigma and victimization) and increased alcohol use for SGM youth as a whole, there is little indication of whether internalized stigma and victimization are more strongly associated with alcohol use for specific groups of SGM youth. A United States sample of 11,811 racially and geographically diverse 13-17 year old SGM youth was used to employ a series of gender-stratified multivariable regression models to examine the association among internalized stigma, victimization, and alcohol-related behaviors, and whether they differed for specific groups of sexual minority youth. Sexual orientation moderated several associations between sexual minority stressors (i.e., victimization and stigma) and youth's alcohol use (i.e., recent use and heavy episodic drinking) across models stratified by gender (i.e., male, female, and non-binary). For example, bisexual boys had stronger associations between SGM-specific victimization and alcohol use frequency and heavy episodic drinking relative to gay boys; conversely, victimization and alcohol use frequency were more weakly associated among bisexual girls relative to lesbian/gay girls. Pansexual girls showed weaker associations between internalized stigma and alcohol use frequency compared to lesbian/gay girls. This paper demonstrates who among SGM youth are more likely to engage in alcohol-related behaviors as a function of differential forms of SGM-related victimization and stigma. These findings can inform substance use interventions that are tailored to youth of diverse sexual orientations and gender identities.
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Affiliation(s)
- Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA.
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, 1142 Valley Drive, College Park, MD, 20742, USA
| | - V Paul Poteat
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Campion Hall 307, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
| | - Taylor Rathus
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
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26
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Feinstein BA, Turner BC, Beach LB, Korpak AK, Phillips G. Racial/Ethnic Differences in Mental Health, Substance Use, and Bullying Victimization Among Self-Identified Bisexual High School-Aged Youth. LGBT Health 2019; 6:174-183. [PMID: 31033384 PMCID: PMC6551981 DOI: 10.1089/lgbt.2018.0229] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose: Sexual minority youth are at increased risk for mental health problems and substance use, and accumulating evidence indicates that bisexual youth are at greatest risk. However, bisexual youth are not a homogenous group and scholars have called for greater attention to the intersections of multiple marginalized identities. As such, we examined racial/ethnic differences in mental health (sadness/hopelessness and suicidal ideation), substance use (cigarette use, binge drinking, marijuana use, and other illicit drug use), and bullying (in-person and electronic) among self-identified bisexual high school-aged youth (overall and by sex). Method: Data from the local versions of the Youth Risk Behavior Survey were pooled across jurisdictions and years (2011-2015), resulting in an analytic sample of 18,515 bisexual youth who were racially/ethnically diverse. Results: Black and Hispanic bisexual youth were less likely to report in-person and electronic bullying than White bisexual youth. In addition, Black bisexual youth were less likely to report sadness/hopelessness and suicidal ideation than White, Hispanic, and Other race/ethnicity bisexual youth. Black bisexual female youth were also less likely to report cigarette use, binge drinking, and other illicit drug use than White bisexual female youth. In contrast to most of our findings, Black bisexual youth were more likely to report marijuana use than White bisexual youth. Most of the significant racial/ethnic differences in mental health and substance use remained significant after controlling for bullying. Conclusion: These findings highlight the heterogeneity of bisexual youth and the need to consider multiple marginalized identities to understand the health disparities affecting this diverse population.
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Affiliation(s)
- Brian A. Feinstein
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Blair C. Turner
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Lauren B. Beach
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Aaron K. Korpak
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Gregory Phillips
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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27
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Baams L. Sexual Orientation Disparities: Starting in Childhood and Observable in Adolescence? J Adolesc Health 2019; 64:145-146. [PMID: 30660245 DOI: 10.1016/j.jadohealth.2018.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 11/21/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Laura Baams
- Department of Pedagogics and Educational Sciences, University of Groningen, Groningen, the Netherlands
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