1
|
Poskin M, Turk M, Nolfi D, Klotzbaugh R, Dietz C. The beliefs and practices used to promote physical and mental health in youth who identify as lesbian, gay, bisexual, transgender, intersex, or queer plus (LGBTIQ+) experiencing housing insecurity: An integrative review. Public Health Nurs 2024. [PMID: 39105479 DOI: 10.1111/phn.13381] [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: 02/17/2024] [Revised: 06/09/2024] [Accepted: 07/11/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE The purpose of this integrative review was to explore the beliefs and practices used to promote physical and mental health among youth ages 18-25 years, identifying as LGBTIQ+ experiencing housing insecurity. METHOD The approach used strategies described by Whittemore and Knafl. Peer-reviewed, published research articles in English were identified using eight electronic databases. Eighteen research reports using qualitative, quantitative, and mixed methods were identified. Articles were evaluated for quality using the American Association of Critical Care Nurses Evidenced-Level Hierarchy evaluation tool. Data were analyzed and synthesized using Braun and Clarke's method. FINDINGS Four themes related to the purpose were extracted: pervasive experiences of stigma and discrimination, constantly attuned to navigating risks, inconsistent engagement in health information and care, and inner strength developed through personal and community experiences. DISCUSSION There are strong implications for future research, public health nursing practice, and health policy. Public health nurses should incorporate social determinants of health (addressing harmful social processes such as homophobia and racism) as well as a strength-based upstream approach in research, education, and health care practices. More research must also be done to assess engagement in physical and mental health information and care.
Collapse
Affiliation(s)
- Mary Poskin
- School of Nursing, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Melanie Turk
- School of Nursing, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - David Nolfi
- Research Engagement, Gumberg Library, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Ralph Klotzbaugh
- School of Nursing, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Craig Dietz
- KC Care Federally Qualified Health Center, Kansas City, Missouri, USA
| |
Collapse
|
2
|
Jiménez-Barbero JA, Cutillas-Fernández MA, Herrera-Giménez M, Jiménez-Ruiz I. Attitudes of Spanish mental health professionals towards trans people: A cross-sectional study. J Psychiatr Ment Health Nurs 2024; 31:43-51. [PMID: 37489546 DOI: 10.1111/jpm.12957] [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: 12/06/2022] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: The trans community perceives barriers to the mental health services in the form of professionals' transphobia, lack of knowledge, and cultural sensitivity in healthcare. The attitudes of health professionals are mediated by their social context, which can determine their behaviour or attitude towards users. WHAT DOES THE ARTICLE ADD TO EXISTING KNOWLEDGE?: The attitudes of mental health professionals towards trans people are related to variables such as the professional's age, gender, political ideology and religious beliefs. Mental health nursing, psychology and social work are the professions that present more favourable attitudes towards trans people. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The inclusion of a professional perspective that understands sexual and gender diversity among mental health professionals is required. It is necessary to train professionals to promote socio-healthcare based on respect and free from prejudice, discrimination and stigma. ABSTRACT: Introduction The trans community perceives barriers to the mental health services in the form of professionals' transphobia, lack of knowledge and cultural sensitivity in healthcare. Aim Evaluation of the attitudes towards trans people of the professionals who work in the different Spanish mental health services. Method A cross-sectional design was used with a sample of professionals from different professional groups working in mental health units, hospitals and outpatient settings throughout Spain. Results Gender differences were found, with higher values in genderism and sexism among males. Negative attitudes and sexism have also been associated with age and religious beliefs. Mental health nursing, psychology and social work presented more favourable attitudes towards trans people than other mental health professionals. Discussion/Implications for Practice The inclusion of a professional perspective that understands sexual and gender diversity and the acquisition of professional attitudes based on evidence and patient-centred model are basic aspects to promote socio-healthcare based on respect and free from prejudices, discrimination and stigma.
Collapse
Affiliation(s)
- José Antonio Jiménez-Barbero
- Departamento de enfermería, Universidad de Murcia, Murcia, Spain
- Psiquiatra, Servicio Murciano de Salud, Murcia, Spain
| | | | | | - Ismael Jiménez-Ruiz
- Departamento de enfermería, Universidad de Murcia, Murcia, Spain
- ENFERAVANZA, Murcia Institute for BioHealth Research (IMIB-Arrixaca), Murcia, Spain
| |
Collapse
|
3
|
Cutillas-Fernández MA, Jiménez-Barbero JA, Herrera-Giménez M, Forcén-Muñoz LA, Jiménez-Ruiz I. Attitudes and Beliefs of Mental Health Professionals towards Trans People: A Systematic Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6495. [PMID: 37569035 PMCID: PMC10418348 DOI: 10.3390/ijerph20156495] [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: 06/12/2023] [Revised: 07/18/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023]
Abstract
A systematic review was conducted to assess and synthesize recent research on mental health professionals' attitudes towards trans people. The main objectives of our research were (a) to identify, synthesize, and analyze the scientific evidence available so far about the attitudes of mental health professionals towards the trans community, and (b) to determine the factors related to these professionals' attitudes, paying special attention to psychosocial and cultural aspects. A systematic search was carried out in the following electronic databases: Pubmed, Web of Science, PsycINFO, PsycARTICLES, Gender Studies Database, and Lilacs. A total of 32 articles of quantitative (n = 19), qualitative (n = 11), and mixed (n = 2) design, published up to March 2023, were included. Most studies used a cross-sectional or qualitative design, limiting the possibility of generalizing the results. The studies reviewed indicated mostly positive attitudes among the professionals, depending on their psychosocial characteristics. In line with the results of our review, we recommend that the training of professionals is important to improve their positive attitudes towards transgender and gender diverse people.
Collapse
Affiliation(s)
- María Asunción Cutillas-Fernández
- Psychiatrist Servicio Murciano de Salud, 30100 Murcia, Spain
- Department of Nursing, Faculty of Nursing, University of Murcia, 30120 Murcia, Spain
| | - José Antonio Jiménez-Barbero
- Department of Nursing, Faculty of Nursing, University of Murcia, 30120 Murcia, Spain
- ENFERAVANZA, Murcia Institute for BioHealth Research (IMIB-Arrixaca), 30120 Murcia, Spain
| | | | | | - Ismael Jiménez-Ruiz
- Department of Nursing, Faculty of Nursing, University of Murcia, 30120 Murcia, Spain
- ENFERAVANZA, Murcia Institute for BioHealth Research (IMIB-Arrixaca), 30120 Murcia, Spain
| |
Collapse
|
4
|
An Integrative Model of In-Hospital and Out-of-Hospital Nursing Care for Non-Suicidal Self-Injury: A Narrative Review. Brain Sci 2023; 13:brainsci13030466. [PMID: 36979278 PMCID: PMC10046685 DOI: 10.3390/brainsci13030466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/12/2023] Open
Abstract
Background: Non-suicidal self-injury (NSSI) refers to the intentional and repeated physical trauma of an individual without explicit suicidal intent, which has negative effects on the physical and mental well-being of an individual, especially for adolescents. Timely and accessible nursing care may play an important role in the survival and rehabilitation process of NSSI. Methods: In this review, we systematically discuss the nursing care of NSSI behavior and provide recommendations based on an integrated nursing model for NSSI management. Results: As reported in previous studies, a variety of factors can contribute to NSSI behavior, such as personality traits, current psychological status, history of mental illnesses, as well as family and social factors. In-hospital care is the most necessary and effective care during acute episodes of NSSI behavior. To effectively manage inpatients with NSSI behaviors, nurses should first understand the motivation of NSSI, and provide comprehensive and multi-level care through nurse-patient communication, individualized psychological care, and multidisciplinary cooperation with other professionals. While the purpose of out-of-hospital nursing is to reduce the frequency of NSSI behaviors by screening high-risk individuals, providing psychological support, promoting health education, and improving self-awareness. Conclusions: An integrative model of in-hospital and out-of-hospital nursing care can help improve the clinical management and long-term prognosis of patients with NSSI and minimize the risk of suicidal ideation or suicidal behavior.
Collapse
|
5
|
Drescher CF, Kassing F, Mahajan A, Stepleman LM. The Impact of Transgender Minority Stress and Emotion Regulation on Suicidality and Self-Harm. PSYCHOLOGY & SEXUALITY 2023. [DOI: 10.1080/19419899.2023.2164867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Christopher F. Drescher
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University
| | | | - Aaron Mahajan
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University
| | - Lara M. Stepleman
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University
| |
Collapse
|
6
|
Tie B, Tang C, Ren Y, Cui S, He J. Internalized Homophobia, Body Dissatisfaction, Psychological Distress, and Nonsuicidal Self-Injury Among Young Sexual Minority Men in China. LGBT Health 2022; 9:555-563. [PMID: 35708638 DOI: 10.1089/lgbt.2022.0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose: Sexual minority men (SMM) have been shown to be at high risk of nonsuicidal self-injury (NSSI). Internalized homophobia, body dissatisfaction, and psychological distress have been found to be related to NSSI among SMM, but few studies have focused on the mechanisms underlying these associations. Thus, the current study was conducted to examine the association between internalized homophobia and NSSI, and whether body dissatisfaction and psychological distress mediate this relationship among young SMM in China. Methods: In total, 264 young SMM (mean age, 22.00 ± 2.86 years) in Henan Province, China, participated in the study. A set of questionnaires were used to assess participants' internalized homophobia, body fat dissatisfaction, muscularity dissatisfaction, psychological distress, and NSSI. Correlation and mediation analyses were used to examine the data. Results: Internalized homophobia correlated positively with NSSI (r = 0.24, p < 0.001) among young SMM in China. This relationship was partly mediated by body fat dissatisfaction, muscularity dissatisfaction, and psychological distress. Conclusion: The study findings suggest that internalized homophobia is a risk factor for NSSI among young SMM in China, and that body fat and muscle dissatisfaction and psychological distress underlie the association between internalized homophobia and NSSI. In developing interventions targeting NSSI among SMM, the findings of the current study should be considered to improve intervention outcomes.
Collapse
Affiliation(s)
- Bijie Tie
- Department of Psychology, School of Education, Zhengzhou University, Zhengzhou, China
| | - Chanyuan Tang
- Department of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, China
| | - Yaoxiang Ren
- Department of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, China
| | - Shuqi Cui
- Department of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, China
| | - Jinbo He
- Department of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, China
| |
Collapse
|
7
|
Bosse JD, Dion KA, Campbell Galman S, Chiodo LM. Transgender and nonbinary young adults' perception of sibling and parental support for gender identity. Res Nurs Health 2022; 45:569-579. [DOI: 10.1002/nur.22251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 05/10/2022] [Accepted: 06/12/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Jordon D. Bosse
- School of Nursing Northeastern University Boston Massachusetts USA
- External Faculty Nurse Scientist Massachusetts General Hospital Boston Massachusetts USA
| | - Kimberly A. Dion
- Elaine Marieb College of Nursing University of Massachusetts Amherst Massachusetts USA
| | - Sally Campbell Galman
- Child and Family Studies, College of Education University of Massachusetts Amherst Massachusetts USA
| | - Lisa M. Chiodo
- Elaine Marieb College of Nursing University of Massachusetts Amherst Massachusetts USA
| |
Collapse
|
8
|
Wei C, Wang Y, Ma T, Zou Q, Xu Q, Lu H, Li Z, Yu C. Gratitude buffers the effects of stressful life events and deviant peer affiliation on adolescents’ non-suicidal self-injury. Front Psychol 2022; 13:939974. [PMID: 36248536 PMCID: PMC9561820 DOI: 10.3389/fpsyg.2022.939974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Although stressful life events have been shown to be a key risk factor for adolescent NSSI, the potential mediators and moderators of this relationship are unclear. Based on the social development theory and the organism-environment interaction model, we tested whether the link between stressful life events and adolescent NSSI was explained in part by deviant peer affiliation, and whether this process was buffered by gratitude. Chinese adolescents (N = 854; Mage = 16.35; 68.50% female) anonymously completed questionnaires to assess the study variables. The present study demonstrated that stressful life events was linked to NSSI in part because of deviant peer affiliation, and high gratitude was a key protective factor to buffer this indirect effect. Teaching gratitude may be a helpful component of prevention and intervention programs to reduce adolescent NSSI.
Collapse
Affiliation(s)
- Chang Wei
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
- School of Psychology, South China Normal University, Guangzhou, China
| | - Yu Wang
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
- *Correspondence: Yu Wang,
| | - Tao Ma
- Liuxiang Junior High School, Zhuhai, China
| | - Qiang Zou
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
| | - Qian Xu
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
| | - Huixing Lu
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
| | - Zhiyong Li
- College of Education Science, Hubei Normal University, Huangshi, China
| | - Chengfu Yu
- School of Education, Guangzhou University, Guangzhou, China
- Chengfu Yu,
| |
Collapse
|
9
|
Blosnich JR. Interpersonal and self-directed violence among sexual and gender minority populations: Moving research from prevalence to prevention. CURR EPIDEMIOL REP 2022; 9:142-160. [PMID: 36845319 PMCID: PMC9957556 DOI: 10.1007/s40471-022-00299-4] [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: 06/27/2022] [Indexed: 11/03/2022]
Abstract
Purpose of review This scoping review of reviews aimed to detail the breadth of violence research about sexual and gender minorities (SGM) in terms of the three generations of health disparities research (i.e., documenting, understanding, and reducing disparities). Recent findings Seventy-three reviews met inclusion criteria. Nearly 70% of the reviews for interpersonal violence and for self-directed violence were classified as first-generation studies. Critical third-generation studies were considerably scant (7% for interpersonal violence and 6% for self-directed violence). Summary Third-generation research to reduce or prevent violence against SGM populations must account for larger scale social environmental dynamics. Sexual orientation and gender identity (SOGI) data collection has increased in population-based health surveys, but administrative datasets (e.g., health care, social services, coroner and medical examiner offices, law enforcement) must begin including SOGI to meet the needs of scaled public health interventions to curb violence among SGM communities.
Collapse
Affiliation(s)
- John R. Blosnich
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W 34 St., Los Angeles, CA 90089, USA
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania 15240, USA
| |
Collapse
|
10
|
Reynish T, Hoang H, Bridgman H, Nic Giolla Easpaig B. Barriers and enablers to mental health help seeking of sexual, gender, and erotic minorities: A systematic literature review. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2022. [DOI: 10.1080/19359705.2022.2036666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Tamara Reynish
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Ha Hoang
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Heather Bridgman
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Bróna Nic Giolla Easpaig
- Centre for Healthcare Resilience & Implement Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
11
|
Guo J, Ying J, Zhou X, Wang C, Lin N, You J. Double hurt: The impact of interpersonal-level stigma on nonsuicidal self-injury among lesbian, gay, and bisexual individuals. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03166-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
12
|
Ventriglio A, Mirandola M, Galeazzi GM, Amaddeo F, Pinna F, Converti M, Fiorillo A. Mental health for LGBTQI people: a policies' review. Int Rev Psychiatry 2022; 34:200-214. [PMID: 36151824 DOI: 10.1080/09540261.2022.2052266] [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: 10/18/2022]
Abstract
The mental health of lesbian, gay, bisexual, transgender, queer, intersexual (LGBTQI) individuals is significantly influenced by many factors such as difficulties in coming-out, poor acceptance, isolation and discrimination as well as minority-related stress. LGBTQI individuals, in fact, show a significant higher risk of mental health conditions, substance- use disorders and suicide. In addition, mental health services access may be difficult for personal and social barriers as well as a lack of adequate and specific mental health support. This review aims to assess and describe international policies, guidelines, position statements and recommendations regarding the promotion and protection of mental health rights for LGBTQI people. The search has been focussed on peer-reviewed papers, Governmental and Mental Health Association- Guidelines and Position Statements, Health Agencies - Guidelines and Position Statements (with a specific focus on mental health), LGBTQI Alliances and Foundations Publishing (with a specific focus on mental health). In addition, relevant international initiatives, and projects in the field of LGBTQI mental health will be described.
Collapse
Affiliation(s)
- Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Massimo Mirandola
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federica Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | |
Collapse
|
13
|
Kapatais A, Williams AJ, Townsend E. The Mediating Role of Emotion Regulation on Self-harm among Gender Identity and Sexual Orientation Minority (LGBTQ+) Individuals. Arch Suicide Res 2022; 27:165-178. [PMID: 35446245 DOI: 10.1080/13811118.2022.2064254] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The present study was conducted to (1) investigate the role of emotion regulation difficulties among self-harming Lesbian, Gay, Bisexual, Transgender, Queer, or Questioning (LGBTQ+) individuals and (2) to test for a mediating role of emotion regulation difficulties in self-harm among LGBTQ + individuals. METHOD This study investigated the relationship between LGBTQ + status, self-reported levels of emotion regulation difficulties, and self-harm in a community sample (N = 484, aged 16-63), using an online cross-sectional survey. RESULTS LGBTQ + individuals reported more emotion regulation difficulties and were almost seven times more likely to self-harm than non-LGBTQ + participants. Being an LGBTQ + participant was associated with greater self-harm frequency when controlling for age, income, and difficulties in emotion regulation. Emotion regulation difficulties mediated the association between LGBTQ + status and both self-harm status and frequency. CONCLUSIONS The present findings suggest that treating emotion regulation difficulties might reduce both the prevalence and lifetime frequency of self-harm episodes among gender identity and sexual orientation minority individuals. Targeting emotion regulation might be used as an early prevention strategy among LGBTQ + individuals who are at risk for self-harm. Further, enhancing emotion regulation skills among self-harming LGBTQ + individuals might replace maladaptive emotion regulation strategies with healthy alternatives, and can, therefore, foster resilience. HIGHLIGHTSLGBTQ + individuals are at high risk for self-harm.ER-mediated the association between LGBTQ + status and self-harm.Targeting emotion regulation in LGBTQ + people may help reduce self-harm.
Collapse
|
14
|
Christensen K, Chu C, Silverman AL, Peckham AD, Björgvinsson T, Beard C. Prevalence and correlates of past-month suicidal thoughts, suicide attempts, and non-suicidal self-injury among adults in a partial hospital program. J Psychiatr Res 2021; 144:397-404. [PMID: 34741837 DOI: 10.1016/j.jpsychires.2021.10.022] [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: 02/21/2021] [Revised: 09/27/2021] [Accepted: 10/18/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study examined the prevalence and cross-sectional correlates of past-month suicidal thoughts, suicide attempts, interrupted attempts, aborted attempts, and non-suicidal self-injury (NSSI) among patients seeking treatment at a partial hospitalization program (PHP). METHOD 1063 patients (54% female, 87% white, mean age = 33.6 years) receiving treatment at a PHP completed self-report questionnaires and the Columbia-Suicide Severity Rating Scale as part of routine clinical monitoring upon admission to the program. We examined demographic and clinical cross-sectional correlates of self-injurious thoughts and behaviors (SITBs) using descriptive statistics, ordinal regression, and logistic regression analyses. RESULTS In the past month, 44.6% of patients reported active suicidal thoughts, 5.6% reported a suicide attempt, 1.8% reported an interrupted attempt, 5.5% reported an aborted attempt, and 16.6% reported NSSI. Inpatient referral source (ORs = 2.45-5.28), minority sexual orientation (ORs = 1.43-6.94), and more Borderline Personality Disorder (BPD) symptoms (ORs = 1.09-1.23) were each associated with at least three of the five SITBs examined. CONCLUSIONS This study highlights elevated rates of suicidal thoughts, suicide attempts, and NSSI in a partial hospital sample. Given that past attempts predict future attempts and death by suicide, support during the transition from inpatient to outpatient care via programs such as PHPs is needed. Patients referred from inpatient treatment, who identity as a sexual minority, and with more BPD symptoms may require additional support and safety monitoring. Further work is indicated to better understand how PHP patients' SITBs change during and after partial hospitalization.
Collapse
Affiliation(s)
| | - Carol Chu
- McLean Hospital, United States; Department of Psychiatry, Harvard Medical School, United States
| | | | - Andrew D Peckham
- McLean Hospital, United States; Department of Psychiatry, Harvard Medical School, United States
| | - Thröstur Björgvinsson
- McLean Hospital, United States; Department of Psychiatry, Harvard Medical School, United States
| | - Courtney Beard
- McLean Hospital, United States; Department of Psychiatry, Harvard Medical School, United States
| |
Collapse
|
15
|
Fergerson AK, Whitfield MB, Laves E, Muehlenkamp JJ, Brausch AM. Correspondence: Sexual identity & suicide risk among women. Psychiatry Res 2021; 298:113769. [PMID: 33556688 DOI: 10.1016/j.psychres.2021.113769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/26/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Ava K Fergerson
- Department of Psychology, University of Southern Mississippi, 118 College Dr., Hattiesburg, MS 39406, USA.
| | - Meredith B Whitfield
- Department of Psychological Science, Western Kentucky University, 1906 College Heights Blvd., Bowling Green, KY 42101, USA; Department of Psychology, University of Southern Mississippi, 118 College Dr., Hattiesburg, MS 39406, USA; Department of Psychology, University of Wisconsin-Eau Claire, 105 Garfield Ave, Eau Claire, WI 54702, USA
| | - Eliza Laves
- Department of Psychological Science, Western Kentucky University, 1906 College Heights Blvd., Bowling Green, KY 42101, USA; Department of Psychology, University of Southern Mississippi, 118 College Dr., Hattiesburg, MS 39406, USA; Department of Psychology, University of Wisconsin-Eau Claire, 105 Garfield Ave, Eau Claire, WI 54702, USA
| | - Jennifer J Muehlenkamp
- Department of Psychology, University of Wisconsin-Eau Claire, 105 Garfield Ave, Eau Claire, WI 54702, USA
| | - Amy M Brausch
- Department of Psychological Science, Western Kentucky University, 1906 College Heights Blvd., Bowling Green, KY 42101, USA; Department of Psychology, University of Southern Mississippi, 118 College Dr., Hattiesburg, MS 39406, USA; Department of Psychology, University of Wisconsin-Eau Claire, 105 Garfield Ave, Eau Claire, WI 54702, USA
| |
Collapse
|
16
|
Cama SF, Fosbenner S. Nonsuicidal Self-Injury in Youth: A Primer for Pediatricians. Pediatr Ann 2021; 50:e72-e76. [PMID: 33576832 DOI: 10.3928/19382359-20210121-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nonsuicidal self-injury (NSSI) is a relatively common occurrence in youth, and pediatricians must be prepared to address this behavior in their patients in an open and nonjudgmental way. Although NSSI is done without suicidal intent, its occurrence does increase the risk for suicide and is often found with other diagnosable psychiatric conditions. Screening for NSSI should be accompanied by screening for suicidal ideation and comorbid psychiatric disorders to ensure that the patient's current risk is properly assessed and that they have access to the right resources and treatments. This article is a primer for primary care pediatricians for how to talk about and address NSSI in their patients. [Pediatr Ann. 2021;50(2):e72-e76.].
Collapse
|
17
|
Karakaya S, Kutlu FY. LGBT individuals' opinions about their health care experiences: A qualitative research study. J Nurs Manag 2020; 29:24-31. [PMID: 33128281 DOI: 10.1111/jonm.13199] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 11/27/2022]
Abstract
AIM To determine the health problems of LGBT individuals and the conditions of their utilization of health care services from their own perspectives. BACKGROUND Although the health care services have improved over the last decades, LGBT individual still face unique challenges when seeking health care services. METHOD This study was performed using the phenomenological technique as a qualitative research method. The sample consisted of 18 LGBT individuals selected using purposive sampling. Data were collected by semi-structured interviews using focus group and analysed using content analysis. RESULTS Two main themes emerged as a result of the content analysis: awareness and status of benefiting from health care. CONCLUSION To obtain quality care for LGBT individuals, the health care professionals need a persistent awareness-specific knowledge of LGBT health issues. IMPLICATIONS FOR NURSING MANAGEMENT The findings of this study can be a warning for managers and policymakers to plan seriously to reform health care services infrastructures. Content about the health needs of LGBT individuals can be added to the curriculum of medical and nursing schools.
Collapse
Affiliation(s)
- Seda Karakaya
- Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Fatma Yasemin Kutlu
- Florence Nightingale Nursing Faculty, Mental Health and Psychiatric Nursing Department, Istanbul University-Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
18
|
Dunlop BJ, Hartley S, Oladokun O, Taylor PJ. Bisexuality and Non-Suicidal Self-Injury (NSSI): A narrative synthesis of associated variables and a meta-analysis of risk. J Affect Disord 2020; 276:1159-1172. [PMID: 32823255 DOI: 10.1016/j.jad.2020.07.103] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/18/2020] [Accepted: 07/06/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Bisexual people have been found to be at increased risk of non-suicidal self-injury (NSSI) when compared to heterosexual and gay or lesbian people. The purpose of this review was to update the estimated risk of NSSI for bisexual people and to examine variables that have been associated with NSSI in this population. METHODS The protocol for this paper was pre-registered (CRD42019145299). An electronic search of PsycINFO, CINAHL Plus, PubMed, Ovid Online and Web of Science was undertaken from earliest available date to October 2019. Twenty-four eligible papers were identified. Meta-analyses, including moderator analysis, were conducted to ascertain NSSI risk and a narrative synthesis was undertaken of predictors and correlates. All studies were assessed for risk of bias. RESULTS Bisexual people had up to six times the odds of engaging in NSSI compared to other sexualities. Mental health variables of anxiety and depression symptoms were found to be most commonly associated with NSSI for this population. The majority of studies had moderate risk of bias. This review demonstrates that bisexual people have an elevated risk of engaging in NSSI. Increased incidence of anxiety and depression and exposure to negative life events may explain this increased risk. LIMITATIONS Studies were found to be consistently cross-sectional in design and limited to western cultures. A limitation of this review was that only English language papers were included. CONCLUSIONS Results are clinically relevant as they suggest early identification and prevention of NSSI can be achieved. Future research should examine bisexual people independently of others.
Collapse
Affiliation(s)
- Brendan J Dunlop
- Division of Psychology and Mental Health, The University of Manchester, Zochonis Building, Brunswick Street, Manchester, M13 9PL, United Kingdom.
| | - Samantha Hartley
- Division of Psychology and Mental Health, The University of Manchester, Zochonis Building, Brunswick Street, Manchester, M13 9PL, United Kingdom
| | - Olayinka Oladokun
- Division of Psychology and Mental Health, The University of Manchester, Zochonis Building, Brunswick Street, Manchester, M13 9PL, United Kingdom
| | - Peter J Taylor
- Division of Psychology and Mental Health, The University of Manchester, Zochonis Building, Brunswick Street, Manchester, M13 9PL, United Kingdom
| |
Collapse
|
19
|
Mann AJ, Patel TA, Elbogen EB, Calhoun PS, Kimbrel NA, Wilson SM. Sexual orientation, attraction and risk for deliberate self-harm: Findings from a nationally representative sample. Psychiatry Res 2020; 286:112863. [PMID: 32086030 PMCID: PMC7887939 DOI: 10.1016/j.psychres.2020.112863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/08/2020] [Accepted: 02/08/2020] [Indexed: 10/25/2022]
Abstract
To date, there has been limited investigation identifying predictors of deliberate self-harm (DSH) among sexual minority adults. The present study examined the likelihood of DSH by sexual minority status as measured by self-reported sexual identity and sexual attraction in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Among respondents who answered both the sexual identity and attraction items on the NESARC (N = 34,273), the link between sexual minority status and DSH was examined. Univariate analyses yielded greater risk of DSH for all sexual minority identities compared to heterosexual identity. Individuals with same-sex only attraction did not differ from those with different-sex only attraction. At the multivariate level, respondents reporting bisexual and unsure identity and bisexual attraction were at two to three times greater risk of DSH compared to their heterosexual/different-sex counterparts. Same-sex attracted and gay/lesbian individuals did not differ from different-sex attracted or heterosexual individuals in adjusted multivariate models. Findings from this nationally representative sample are consistent with previous research suggesting that sexual minority status is a risk factor for DSH. There is a vital need to incorporate varying measures of sexual minority status within research and in clinics, as well as to inquire about DSH among sexual minorities.
Collapse
Affiliation(s)
- Adam J Mann
- Durham Veterans Affairs Medical Center, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA.
| | - Tapan A Patel
- Durham Veterans Affairs Medical Center, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center; Durham, NC, USA
| | - Eric B Elbogen
- Durham Veterans Affairs Medical Center, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA
| | - Patrick S Calhoun
- Durham Veterans Affairs Medical Center, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center; Durham, NC, USA; Duke University Medical Center, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Nathan A Kimbrel
- Durham Veterans Affairs Medical Center, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center; Durham, NC, USA; Duke University Medical Center, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Sarah M Wilson
- Durham Veterans Affairs Medical Center, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| |
Collapse
|
20
|
Liu RT, Sheehan AE, Walsh RFL, Sanzari CM, Cheek SM, Hernandez EM. Prevalence and correlates of non-suicidal self-injury among lesbian, gay, bisexual, and transgender individuals: A systematic review and meta-analysis. Clin Psychol Rev 2019; 74:101783. [PMID: 31734440 PMCID: PMC6896220 DOI: 10.1016/j.cpr.2019.101783] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/01/2019] [Accepted: 11/06/2019] [Indexed: 01/17/2023]
Abstract
The current review presents a meta-analysis of the existing empirical literature on the prevalence of non-suicidal self-injury (NSSI) among lesbian, gay, bisexual, and transgender (LGBT) individuals, as well as on correlates of NSSI within sexual and gender minority populations. Eligible publications (n = 51) were identified through a systematic search of PsycINFO, MEDLINE, and Embase, supplemented by a search of references of prior reviews on this topic. NSSI prevalence rates were quite elevated among sexual (29.68% lifetime) and gender (46.65% lifetime) minority individuals compared to heterosexual and/or cisgender peers (14.57% lifetime), with transgender (46.65% lifetime) and bisexual (41.47% lifetime) individuals being at greatest risk. Even among these group findings, sexual minority youth emerged as an especially vulnerable population. Moreover, current evidence suggests these rates and differences between LGBT and heterosexual and/or cisgender peers have not declined over time. These findings may in some measure be due to the existence of LGBT-specific risk correlates combined with general risk correlates being more severe among sexual and gender minority populations. Additional research, particularly employing a longitudinal design, is needed in this area to advance efforts to reduce risk for NSSI among sexual and gender minority individuals.
Collapse
Affiliation(s)
- Richard T Liu
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States.
| | - Ana E Sheehan
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States
| | - Rachel F L Walsh
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States
| | - Christina M Sanzari
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States
| | - Shayna M Cheek
- Department of Psychology and Neuroscience, Duke University, United States
| | - Evelyn M Hernandez
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States
| |
Collapse
|
21
|
Bjarnadottir RI, Bockting W, Trifilio M, Dowding DW. Assessing Sexual Orientation and Gender Identity in Home Health Care: Perceptions and Attitudes of Nurses. LGBT Health 2019; 6:409-416. [DOI: 10.1089/lgbt.2019.0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ragnhildur I. Bjarnadottir
- School of Nursing, Columbia University, New York, New York
- College of Nursing, University of Florida, Gainesville, Florida
| | - Walter Bockting
- School of Nursing, Columbia University, New York, New York
- New York State Psychiatric Institute, New York, New York
| | - MaryGrace Trifilio
- Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, New York
| | - Dawn W. Dowding
- School of Nursing, Columbia University, New York, New York
- Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, New York
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| |
Collapse
|
22
|
Oginni OA, Robinson EJ, Jones A, Rahman Q, Rimes KA. Mediators of increased self-harm and suicidal ideation in sexual minority youth: a longitudinal study. Psychol Med 2019; 49:2524-2532. [PMID: 30468143 DOI: 10.1017/s003329171800346x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sexual minority youth have elevated suicidal ideation and self-harm compared with heterosexual young people; however, evidence for mediating mechanisms is predominantly cross-sectional. Using a longitudinal design, we investigated self-esteem and depressive symptoms as mediators of increased rates of suicidal ideation or self-harm (SISH) among sexual minority youth, and the roles of childhood gender nonconformity (CGN) and sex as moderators of these relationships. METHOD In total, 4274 youth from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort reported sexual orientation at age 15 years, and past-year SISH at age 20 years. Self-esteem and depressive symptoms were assessed at ages 17 and 18 years, respectively. CGN was measured at 30-57 months. Covariates included sociodemographic variables and earlier measures of mediator and outcome variables. Mediation pathways were assessed using structural equation modelling. RESULTS Sexual minority youth (almost 12% of the sample) were three times more likely than heterosexual youth to report past-year SISH (95% confidence interval 2.43-3.64) at 20 years. Two mediation pathways were identified: a single mediator pathway involving self-esteem and a multiple-mediated pathway involving self-esteem and depressive symptoms. Although CGN was associated with past-year SISH, it did not moderate any mediation pathways and there was no evidence for moderation by sex. CONCLUSIONS Lower self-esteem and increased depressive symptoms partly explain the increased risk for later suicidal ideation and self-harm in sexual minority youth. Preventive strategies could include self-esteem-enhancing or protecting interventions, especially in female sexual minority youth, and treatment of depression.
Collapse
Affiliation(s)
- O A Oginni
- Social Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - E J Robinson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Jones
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Q Rahman
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - K A Rimes
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
23
|
Cottrell DB. Fostering sexual and gender minority status disclosure in patients. Nurse Pract 2019; 44:43-49. [PMID: 31180978 DOI: 10.1097/01.npr.0000559846.83872.da] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Members of the sexual and gender minority (SGM) community face complex barriers to accessing quality healthcare. NPs have a responsibility to create welcoming care settings where patients can share a trusting provider-patient relationship to disclose their SGM status, an event shown to improve patient outcomes.
Collapse
Affiliation(s)
- Damon B Cottrell
- Damon B. Cottrell is an assistant dean and clinical professor at Texas Woman's University, Denton, Tex., and an NP at Denton Regional Urgent Care, Denton, Tex
| |
Collapse
|
24
|
McCann E, Brown M. Homelessness among youth who identify as LGBTQ+: A systematic review. J Clin Nurs 2019; 28:2061-2072. [PMID: 30786099 DOI: 10.1111/jocn.14818] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/29/2019] [Accepted: 02/09/2019] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore homelessness among lesbian, gay, bisexual, transgender, queer/questioning plus (LGBTQ+) youth and to identify their support and care requirements. BACKGROUND LGBTQ+ youth face many health and societal challenges including issues related to homelessness. DESIGN A systematic review of qualitative, quantitative and mixed methods studies. METHODS A search of relevant electronic databases was carried out and included the dates August 2008-August 2018 and limited to academic journals and peer-reviewed empirical studies written in English. Included studies specifically addressed the homeless experiences of youth aged 13-24 years old who identified as LGBTQ+. The PRISMA checklist was used in the review. A quality assessment instrument was used to review all of the selected papers and narrative methods utilised in the synthesis of the research evidence. RESULTS The search resulted in 319 papers, and after applying distinct inclusion criteria, a total of 14 papers were considered suitable for the systematic review. Following analysis, the four main themes identified were stigma, discrimination and exclusion; mental health issues and substance use; sexual risks and vulnerability; and interventions and supports. CONCLUSION LGBTQ+ homeless youth is a major public health concern that has significant consequences for a young person's physical and psychosocial well-being. RELEVANCE TO CLINICAL PRACTICE Practitioners need to be aware of the specific health and support requirements of LGBTQ+ youth in relation to homelessness. Inclusive and holistic care plans should exist that are fully responsive to the distinct needs of this group guided by definitive policies and sound clinical research. The implications for future nursing practice are presented and discussed.
Collapse
Affiliation(s)
- Edward McCann
- School of Nursing and Midwifery, Trinity College, University of Dublin, Dublin, Ireland
| | - Michael Brown
- School of Nursing and Midwifery, Queen's University Belfast, UK
| |
Collapse
|
25
|
Jackman KB, Bosse JD, Eliason MJ, Hughes TL. Sexual and gender minority health research in nursing. Nurs Outlook 2019; 67:21-38. [DOI: 10.1016/j.outlook.2018.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 10/24/2018] [Accepted: 10/27/2018] [Indexed: 01/15/2023]
|
26
|
Zinchuk MS, Avedisova AS, Guekht AB. Nonsuicidal self-injury behavior in non-psychotic disorders: epidemiology, social and clinical risk factors. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:108-119. [DOI: 10.17116/jnevro2019119031108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
27
|
Jackman KB, Dolezal C, Levin B, Honig JC, Bockting WO. Stigma, gender dysphoria, and nonsuicidal self-injury in a community sample of transgender individuals. Psychiatry Res 2018; 269:602-609. [PMID: 30208349 PMCID: PMC6252073 DOI: 10.1016/j.psychres.2018.08.092] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 07/03/2018] [Accepted: 08/24/2018] [Indexed: 10/28/2022]
Abstract
We investigated rates of nonsuicidal self-injury (NSSI) and correlates of past-year NSSI among transgender people to better understand factors contributing to this health disparity. A community-based sample of 332 transgender people participated in quantitative in-person interviews. The mean age of participants was 34.56 years (SD = 13.78, range = 16-87). The sample was evenly divided between transfeminine spectrum (50.3%) and transmasculine spectrum identities (49.7%) and was diverse in race/ethnicity. We evaluated associations between sociodemographic characteristics, stigma, hypothesized resilience factors, and identity variables with past-year NSSI. 53.3% of participants reported ever having self-injured in their lifetime. Past-year NSSI was reported by 22.3% of the sample and did not significantly differ based on gender identity. In logistic regression models, past-year NSSI was associated with younger age and felt stigma (perceived or anticipated rejection), but not enacted stigma (actual experiences of discrimination), and with gender dysphoria. Efforts to address the high rates of NSSI among transgender people should aim to reduce felt stigma and gender dysphoria, and promote transgender congruence. Future research using a developmental approach to assess variations in NSSI across the life course and in relation to transgender identity development may illuminate additional processes that affect NSSI in this population.
Collapse
Affiliation(s)
- Kasey B Jackman
- School of Nursing, Columbia University, 630 West 168th St., Mail Code 6, New York, NY, USA.
| | - Curtis Dolezal
- New York State Psychiatric Institute/Department of Psychiatry, Columbia University, New York, NY, USA
| | - Bruce Levin
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Judy C Honig
- School of Nursing, Columbia University, 630 West 168th St., Mail Code 6, New York, NY, USA
| | - Walter O Bockting
- School of Nursing, Columbia University, 630 West 168th St., Mail Code 6, New York, NY, USA; New York State Psychiatric Institute/Department of Psychiatry, Columbia University, New York, NY, USA
| |
Collapse
|
28
|
Jackman K, Edgar B, Ling A, Honig J, Bockting W. Experiences of transmasculine spectrum people who report nonsuicidal self-injury: A qualitative investigation. J Couns Psychol 2018; 65:586-597. [PMID: 30070562 DOI: 10.1037/cou0000304] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Transgender populations experience mental and physical health disparities compared to nontransgender populations, including nonsuicidal self-injury (NSSI). Guided by the minority stress theory and Nock's model of NSSI, this study explored perspectives of transmasculine spectrum people (i.e., people with a gender identity that is man, male, transgender man, genderqueer, or nonbinary and who were assigned female at birth) who engage in NSSI. Qualitative interviews were conducted with transmasculine spectrum people (N = 18) who reported a history of NSSI. Their mean age was 24.9 years old (SD = 5.43, range = 17-38). Participants reported that NSSI was influenced by a variety of factors including stress from gender nonconformity in childhood and adolescence. Stigma related to minority status and identity as well as proximal minority stress processes of concealment and expectations of rejection were identified as contributing to NSSI. Transgender identity development tasks such as coming out and identity exploration also appeared to affect NSSI. Finding a community of peers who engage in NSSI was helpful in mitigating social isolation, but at times reinforced NSSI. We discuss clinical implications at the individual and family levels. Interventions to reduce NSSI among transmasculine-spectrum people should include facilitating connections with gender minority peers and providing individual support and family interventions to facilitate transgender identity development. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Collapse
|
29
|
Yıldız E. Suicide in sexual minority populations: A systematic review of evidence-based studies. Arch Psychiatr Nurs 2018; 32:650-659. [PMID: 30029759 DOI: 10.1016/j.apnu.2018.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 12/13/2017] [Accepted: 03/06/2018] [Indexed: 02/05/2023]
Abstract
Sexual minority populations are exposed to more forms of distress than heterosexual individuals, thereby increasing the risk of suicidal behavior. It therefore seems surprising that suicidal behavior in sexual minorities is not sufficiently addressed in the nursing literature.The aim of this review was to integrate evidence-based knowledge and experiences related to suicide in sexual minorities into the nursing literature. This study has been conducted according to PRISMA guidelines, which contains a basic systematic screening process. Fourteen articles met the research criteria. The evaluation encompassed 4 themes: 1) Suicide attempts; 2) Thoughts of suicide; 3) Suicide attempts and completed suicide; 4) Suicidal thoughts and suicide attempts. Most studies focused on the dimensions of attempted suicide. The key finding was that young people in sexual minority groups exhibit more suicidal ideation, more suicide attempts and are more at risk of completed suicide than heterosexual individuals. Family-centered care for young people can therefore be one of the basic principles of nursing practice. Nurses can routinely ask adolescents about their sexual orientation and identity to provide appropriate assessment and care. Additionally, nurses can use educational, counseling, case manager and therapist roles to avoid negative experiences such as homophobia, stigmatization and the discrimination of sexual minorities.
Collapse
Affiliation(s)
- Erman Yıldız
- Department of Psychiatric Nursing, Faculty of Health Sciences, Inonu University, Malatya 44280, Turkey.
| |
Collapse
|
30
|
Staples JM, Neilson EC, Bryan AEB, George WH. The Role of Distal Minority Stress and Internalized Transnegativity in Suicidal Ideation and Nonsuicidal Self-Injury Among Transgender Adults. JOURNAL OF SEX RESEARCH 2018; 55:591-603. [PMID: 29148860 DOI: 10.1080/00224499.2017.1393651] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Transgender people are at elevated risk for nonsuicidal self-injury (NSSI) and suicidal ideation compared to the general population. Transgender (trans) refers to a diverse group of people who experience incongruence between their gender identity and sex assigned at birth. The present study is guided by the minority stress model and the psychological mediation framework, which postulate that sexual minority groups experience elevated stress as a result of anti-minority prejudice, contributing to negative mental health outcomes. This study utilized these theories to investigate the role of internalized transnegativity-internalization of negative societal attitudes about one's trans identity-in the relationships of distal trans stress to suicidal ideation and NSSI. A U.S. national sample of trans adults (N = 237) completed a battery of online measures. Structural equation modeling (SEM) was used to compare models with mediation and moderation effects. Results suggested that internalized transnegativity acts as both a mediator and a moderator in the relationship between distal trans stress and suicidal ideation. Log likelihood comparisons suggested moderation models had the superior fit for these data. Results suggest that clinical interventions should directly target individuals' internalized transnegativity as well as societal-level transnegativity.
Collapse
|
31
|
Jackman KB, Dolezal C, Bockting WO. Generational Differences in Internalized Transnegativity and Psychological Distress Among Feminine Spectrum Transgender People. LGBT Health 2017; 5:54-60. [PMID: 29099335 DOI: 10.1089/lgbt.2017.0034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE This study examined internalized transnegativity and psychological distress in two age groups of transgender individuals who identified their gender identity on the feminine spectrum (rather than congruent with their male sex assigned at birth). Due to greater visibility and acceptance of gender diversity in the United States, we hypothesized that internalized transnegativity would be lower in the younger compared with the older group, and that the younger generation would, therefore, report lower levels of psychological distress than the older generation. METHODS The study sample consisted of trans-feminine individuals (N = 440) who completed a online survey of the U.S. transgender population and comprised a younger group aged 18-24 years (n = 133) and an older group aged 40 years and older (n = 307). Internalized transnegativity was assessed using the Transgender Identity Survey, and psychological distress was assessed with the Brief Symptom Inventory 18. We used regression and mediation analysis to examine differences between the two groups. RESULTS Contrary to our expectations, the older group reported significantly lower levels of both internalized transnegativity and psychological distress compared with the younger group. Internalized transnegativity partially mediated the relationship between age group and psychological distress. CONCLUSION Despite greater visibility of transgender people and increasing acceptance of gender diversity in the United States, the younger trans-feminine individuals reported more psychological distress than the older transfeminine individuals, which was, in part, related to internalized transnegativity. Trans-feminine individuals may benefit from culturally sensitive and clinically competent mental health services to alleviate internalized transnegativity and psychological distress.
Collapse
Affiliation(s)
- Kasey B Jackman
- 1 School of Nursing, Program for the Study of LGBT Health, Columbia University , New York, New York
| | - Curtis Dolezal
- 2 Division of Gender, Sexuality, and Health, New York State Psychiatric Institute/Columbia University Department of Psychiatry , New York, New York
| | - Walter O Bockting
- 1 School of Nursing, Program for the Study of LGBT Health, Columbia University , New York, New York.,2 Division of Gender, Sexuality, and Health, New York State Psychiatric Institute/Columbia University Department of Psychiatry , New York, New York
| |
Collapse
|
32
|
Brennan SL, Irwin J, Drincic A, Amoura NJ, Randall A, Smith-Sallans M. Relationship among gender-related stress, resilience factors, and mental health in a Midwestern U.S. transgender and gender-nonconforming population. Int J Transgend 2017. [DOI: 10.1080/15532739.2017.1365034] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
| | - Jay Irwin
- Department of Sociology and Anthropology, University of Nebraska Omaha, Omaha, Nebraska, USA
| | - Andjela Drincic
- Division of Endocrinology, University of Nebraska Medical Center, Omaha, NE, USA
| | - N. Jean Amoura
- Department of Obstetrics and Gynecology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Amanda Randall
- Grace Abbott School of Social Work, University of Nebraska Omaha, Omaha, NE, USA
| | | |
Collapse
|
33
|
McCann E, Brown M. Discrimination and resilience and the needs of people who identify as Transgender: A narrative review of quantitative research studies. J Clin Nurs 2017; 26:4080-4093. [DOI: 10.1111/jocn.13913] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Edward McCann
- School of Nursing and Midwifery; University of Dublin; Trinity College; Dublin Ireland
| | - Michael Brown
- Health & Social Care Research; Edinburgh Napier University; Edinburgh UK
| |
Collapse
|
34
|
Corcoran N. Promoting health in lesbian and bisexual women: it is not just about behaviour change. J Clin Nurs 2016; 26:3742-3750. [PMID: 27648833 DOI: 10.1111/jocn.13589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2016] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To highlight different ways that healthcare professionals can promote health and reduce health inequalities of lesbian and bisexual women using a health promotion framework that focusses on the wider healthcare context. BACKGROUND Lesbian and bisexual women experience numerous health disparities that place them at high risk of poor health outcomes. The Frieden health impact pyramid (American Journal for Public Health, 100, 2010 and 590) identifies five tiers of public health interventions. This pyramid could be used to promote health in lesbian and bisexual women in healthcare settings. DESIGN A discursive paper. METHODS Literature was searched from 2008-2015 using PubMed, ScienceDirect and published grey literature. Individual key words were used to locate articles that focused on lesbian and bisexual women's health inequalities and to identify the interventions to address these. RESULTS Examples are presented across the tiers of the health impact pyramid in the context of healthcare settings that healthcare practitioners could action to promote health in lesbian and bisexual women. CONCLUSIONS The use of the Frieden triangle offers an alternative way to promote health by conceptualising health promotion interventions that promote lesbian and bisexual women without just focusing on behaviour change. The importance of changing areas of practice in healthcare organisations to be more supportive of lesbian and bisexual women and their healthcare needs is highlighted. RELEVANCE TO CLINICAL PRACTICE This study highlights the ways that healthcare professionals can promote health of lesbian and bisexual women within their healthcare practice to help reduce health disparities.
Collapse
Affiliation(s)
- Nova Corcoran
- Faculty of Life Science and Education, University of South Wales, Lower Glyntaf Campus, Pontypridd, UK
| |
Collapse
|