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Terrell KR, Stanton BR, Hamadi HY, Merten JW, Quinn N. Exploring life stressors, depression, and coping strategies in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:923-932. [PMID: 35427463 DOI: 10.1080/07448481.2022.2061311] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/22/2022] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
Objective: College students experience a variety of stressors that can increase the risk for mental health concerns, like depression. It is crucial for practitioners working on college campuses to understand the relationship among stressful life events, depression, and coping strategies. The purpose of this study was to explore life stressors' impact on reported depressive symptoms and how adaptive and maladaptive coping strategies moderate that relationship in college students. Participants: Data was used from a comprehensive health behavior survey. Participants included 969 college students. Methods: Multivariable logistic models were used to examine the association between stressful events, depression, and coping strategies. Results: Results from multiple logistic regression analyses indicated that college students who experienced life stressors and participated in more negative than positive coping strategies were 2.49 (95% CI = 1.34, 4.63) times more likely to experience depression. Conclusions: Implications and creative interventions are provided for mental health practitioners working on college campuses.
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Affiliation(s)
- Kassie R Terrell
- Brooks College of Health, Public Health, University of North Florida, Jacksonville, Florida
| | - Bridget R Stanton
- Brooks College of Health, Public Health, University of North Florida, Jacksonville, Florida
| | - Hanadi Y Hamadi
- Brooks College of Health, Health Administration, University of North Florida, Jacksonville, Florida
| | - Julie W Merten
- Brooks College of Health, Public Health, University of North Florida, Jacksonville, Florida
| | - Nathan Quinn
- Brooks College of Health, Public Health, University of North Florida, Jacksonville, Florida
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Lowery St John TY, St George DMM, Lanier CA. Examining Sexual and Dating Violence by Gender Identity Among High School Students. J Adolesc Health 2023; 73:957-960. [PMID: 37610386 DOI: 10.1016/j.jadohealth.2023.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE This study examined the reporting of sexual and dating violence among high school students using a standard gender identity question. METHODS Using data from the 2017 and 2019 Youth Risk Behavior Surveys, multivariable regression models estimated the association between gender identity and four measures of sexual and dating violence, adjusted for confounding by race/ethnicity, grade, and reported sex. RESULTS Of the 198,900 teenagers, 1.8% identified as transgender, 1.6% were not sure, and 1.9% responded that they did not know what question was being asked. Across all measures of violence, transgender, "unsure" and "don't understand" students were significantly more likely than cisgender students to report having been victimized. DISCUSSION Standard analysis practices of eliminating unsure and/or don't understand responses to gender identity questions may underestimate at-risk youth. Researchers seeking to understand disparities in youth violence by gender identity will need to ensure that they employ inclusive measures.
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Affiliation(s)
- Tonya Y Lowery St John
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii.
| | - Diane Marie M St George
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
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3
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Silivri M, Wirf T, Hodges EA, Fredholm YS, Björk M. Conversations About Sexual and Reproductive Health and Rights-From a School Nurse Perspective. J Sch Nurs 2023; 39:406-414. [PMID: 34369177 DOI: 10.1177/10598405211029252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Students have the right to receive education about sexual and reproductive health and rights (SRHR). The United Nations Agenda 2030 for sustainable development includes goals regarding SRHR, including the right to universal access to sexual and reproductive health care services and gender equality. The study used a qualitative design with an inductive approach. Data were collected through semistructured interviews. The results are presented in three categories and nine subcategories. The categories were "having an open attitude," "organizational prerequisites," and "challenging tasks." An open attitude was required to create confidence for both school nurses and students in SRHR conversations. Organizational prerequisites, such as planning SRHR education with others, were successful. Multicultural meetings and conversations regarding gender identity and sexual orientation were challenging tasks. Increased knowledge of SRHR and national standardized guidelines are suggested to achieve Agenda 2030 SRHR goals and to ensure equity in school health care.
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Affiliation(s)
| | - Therese Wirf
- Student Health Care, Prastangsskolan, Eksjö, Sweden
| | - Eric A Hodges
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ylva S Fredholm
- Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Maria Björk
- Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- CHILD Research Group, Jönköping University, Jonkoping, Sweden
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4
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Argenyi MS, Mereish EH, Watson RJ. Mental and Physical Health Disparities Among Sexual and Gender Minority Adolescents Based on Disability Status. LGBT Health 2023; 10:130-137. [PMID: 36301253 PMCID: PMC9986008 DOI: 10.1089/lgbt.2022.0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Sexual and gender minority (SGM) youth and youth with disabilities both experience health disparities. Little data exist on whether SGM youth with disabilities have worse health outcomes compared with SGM youth without disabilities. This study aimed to examine differences in health behaviors and outcomes among a sample of SGM youth by different types of disabilities. Methods: Secondary analyses were conducted with a subset (N = 9418) of the LGBTQ National Teen Survey, a comprehensive survey of risk and protective factors and health outcomes of SGM youth across the United States collected in 2017. Multiple types of disabilities (physical, cognitive, or psychiatric) and mental, behavioral, and physical health outcomes were self-reported. Results: Of the sample, 18.3% reported a disability. Significant findings included higher odds of exercise avoidance, greater depressive symptoms and sleep concerns, and lower self-esteem and overall health ratings among SGM youth who reported any form of disability compared with SGM youth who reported no disability. Youth with cognitive disabilities had lower odds of alcohol use than youth with no disability. Youth with psychiatric disabilities had higher odds of cannabis and cigarette use, and lower physical activity than youth with no disability. Youth with either psychiatric or physical disabilities reported higher body mass index than youth with no disability. Conclusion: SGM youth with disabilities experience greater health disparities than SGM youth with no reported disabilities. Results provide groundwork evidence about the impact of disability status on SGM adolescents. Disability-inclusive or -specific frameworks are needed for future interventions and studies of SGM youth.
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Affiliation(s)
- Michael S Argenyi
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.,Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Ethan H Mereish
- Department of Health Studies, American University, Washington, District of Columbia, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
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5
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State LGBTQ policies and binge drinking among sexual minority youth in the US: a multilevel analysis. Soc Psychiatry Psychiatr Epidemiol 2022; 57:183-194. [PMID: 34143248 DOI: 10.1007/s00127-021-02119-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Though higher rates of binge drinking have been reported among sexual minority (lesbian, gay, and bisexual) youths compared to their heterosexual peers in the United States, questions remain about which specific structural factors drive these inequities. We test whether state LGBTQ (lesbian, gay, bisexual, transgender, queer/questioning) policy climate is associated with youth binge drinking, as well as whether that association is unique to sexual minority youth. METHODS We use LGBTQ policy scores compiled by the Movement Advancement Project in 2017 and analyze 2017 Youth Risk Behavior Survey data (126,432 youths living in 24 states). We fit multi-level logistic regression models to estimate odds ratios for binge drinking with state-level LGBTQ policy scores. RESULT More progressive state-level overall LGBTQ policies were associated with lower odds of binge drinking among sexual minority youths (interaction term OR = 0.990, CI 0.984-0.996, p = 0.0009), but not among heterosexuals (OR = 1.001, CI 0.992, 1.009, p = 0.881). For sexual minorities, living in the most LGBTQ-affirming state was associated with a probability of binge drinking 27% lower than that of those living in the least LGBTQ-affirming state. In sensitivity analyses, policies specific to LGBTQ youth (opposed to general LGBTQ people) were even more strongly related to sexual minorities' binge drinking (interaction term: state-level youth policy score × individual-level sexual identity-of OR = 0.949, CI 0.927-0.971, p = 0.00001). In sex-stratified models, associations with overall LGBTQ policy scores were significant only for girls (OR = 0.986, CI 0.979-0.993, p < 0.001), not boys (OR = 0.997, CI 0.986-1.008, p = 0.551), while associations with youth-focused LGBTQ policies were significant for both sexual minority girls and boys. CONCLUSION Our findings point to state-level LGBTQ policy climate as a potential social determinant of binge drinking problems among sexual minority youths.
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Sava LM, Earnshaw VA, Menino DD, Perrotti J, Reisner SL. LGBTQ Student Health: A Mixed-Methods Study of Unmet Needs in Massachusetts Schools. THE JOURNAL OF SCHOOL HEALTH 2021; 91:894-905. [PMID: 34553384 DOI: 10.1111/josh.13082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, and queer and questioning (LGBTQ) youth experience poor physical and mental health outcomes relative to their non-LGBTQ peers. School health professionals (SHPs), such as school nurses, play a key role in addressing LGBTQ student health needs. However, few studies examine school health needs of LGBTQ students from both the youth and SHP perspective. METHODS From August 2017 to July 2018, 28 LGBTQ youth and 19 SHPs (N = 47) in Massachusetts participated in online focus groups and a brief survey on school health needs and experiences. Qualitative themes were coded using Rapid Qualitative Inquiry principles and NVIVO. RESULTS Both LGBTQ students and SHPs identified an urgent need for inclusive sexual education and mental health services. LGBTQ students raised access to safer bathrooms, information, and guidance on gender transitioning, and access to safe spaces as school-based needs. Missing from SHPs' perspectives, students also discussed sexual violence/harassment of transgender students and racism impacting youth of color. CONCLUSIONS LGBTQ students, especially transgender students and LGBTQ youth of color, have unmet health needs that need to be addressed. Recognizing these needs is the first step towards inclusive health services and support for all students in schools. Next, interventions to increase the capacity of SHPs to address LGBTQ student health are necessary.
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Affiliation(s)
- Lauren M Sava
- The Fenway Institute at Fenway Health, Boston, MA, 02215
| | | | - David D Menino
- Boston Children's Hospital, 21 Autumn Street, Boston, MA, 02215
| | - Jeff Perrotti
- The Massachusetts Commission on LGBTQ Youth, 250 Washington Street 4th Floor, Boston, MA, 02108
| | - Sari L Reisner
- Director of Transgender Research, Brigham and Women's Hospital, Assistant Professor of Medicine, Harvard Medical School, Assistant Professor of Epidemiology, Harvard T.H. Chan School of Public Health, Director of Transgender Health Research and Affiliated Research Scientist, The Fenway Institute at Fenway Health, 221 Longwood Ave, Boston, MA, 02215
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Ancheta AJ, Caceres BA, Jackman KB, Kreuze E, Hughes TL. Sexual Identity Differences in Health Behaviors and Weight Status among Urban High School Students. Behav Med 2021; 47:259-271. [PMID: 34719340 PMCID: PMC8560978 DOI: 10.1080/08964289.2020.1763903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 04/16/2020] [Accepted: 04/24/2020] [Indexed: 10/24/2022]
Abstract
Although racial/ethnic disparities in childhood obesity are well documented in the United States (U.S.), fewer studies have investigated elevated body mass index (BMI) and related health behaviors among sexual minority youth (SMY; gay/lesbian, bisexual, not sure). We examined pooled data from the 2009-2017 Youth Risk Behavior Surveys, which included high school students from 12 urban U.S. school districts. We used sex-stratified logistic regression models to estimate the association of sexual identity with health behaviors and elevated BMI (reference = heterosexual participants). A total of 133,615 participants were included. Sexual minority boys were more likely to report physical inactivity than heterosexual boys. Gay and not sure boys were also less likely to consume the recommended daily intake of fruit. Bisexual girls were more likely than heterosexual girls to report watching television ≥ 3 hours on a school day and to consume sugar-sweetened beverages (AOR 1.30, 95% CI= 1.18-1.43). All SMY reported higher rates of current tobacco use than their heterosexual peers. Sexual minority girls and bisexual boys had significantly higher rates of obesity than their heterosexual counterparts. These findings can inform tailored health promotion initiatives to reduce obesity risk in SMY.
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Affiliation(s)
- April J Ancheta
- Columbia University School of Nursing, New York, New York, USA
| | - Billy A Caceres
- Columbia University School of Nursing, New York, New York, USA
| | - Kasey B Jackman
- Columbia University School of Nursing, New York, New York, USA
| | | | - Tonda L Hughes
- Henrik H. Bendixen Professor of International Nursing (in Psychiatry), Columbia University School of Nursing, New York, New York, USA
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8
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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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9
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Self-Injurious Thoughts and Behaviors Among Sexual and Gender Minority Youth: a Systematic Review of Recent Research. CURRENT SEXUAL HEALTH REPORTS 2020. [DOI: 10.1007/s11930-020-00295-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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10
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Zeglin RJ, Terrell KR, Barr EM, Moore MJ. Depression in High School: Lesbian, Gay, and Bisexual Identity as a Moderator of Sexual Assault. THE JOURNAL OF SCHOOL HEALTH 2020; 90:703-710. [PMID: 32696480 DOI: 10.1111/josh.12934] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 01/08/2020] [Accepted: 05/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Depression continues to be a public health crisis for young adults. For high school students, past research has identified trauma as a significant predictor of depression. Congruent with the theory of cumulative stress, the present study hypothesized that the effect of sexual assault on depression would be stronger among lesbian, gay, and bisexual (LGB) students than among their straight peers. METHODS Using the Youth Risk Behavior Survey completed by students attending Duval County Public Schools in Florida (N = 3053), this study used secondary data analysis to conduct 2 regression analyses, one for boys and one for girls. RESULTS LGB status was associated with 3-fold increase in the odds of reporting depression for both boys and girls. History of sexual assault was associated with a significant increase in reporting depression. There was also a significant interaction effect between sexual orientation and history of sexual assault among male students only (p < .05). Contrary to the hypothesis, the effect was stronger among straight boys than among LGB boys. CONCLUSION Minority students continue to evidence greater risks for depression. Opportunities for systemic changes to address these include training teachers, banning conversion therapy, and implementing comprehensive sex education.
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Affiliation(s)
- Robert J Zeglin
- Assistant Professor and Program Director, University of North Florida, 1 UNF Dr. Jacksonville, FL 32224
| | - Kassie R Terrell
- Assistant Professor, University of North Florida, 1 UNF Dr. Jacksonville, FL 32224
| | - Elissa M Barr
- Professor, University of North Florida, 1 UNF Dr. Jacksonvillen, FL 32224
| | - Michele J Moore
- Department Chair, University of North Florida, 1 UNF Dr. Jacksonville, FL 32224
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Klare DL, McCabe SE, Ford JA, Schepis TS. Prescription drug misuse, other substance use, and sexual identity: The significance of educational status and psychological distress in US young adults. Subst Abus 2020; 42:377-387. [PMID: 32692942 DOI: 10.1080/08897077.2020.1784358] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim was to examine the effects of sexual identity, educational status, and their interaction on the past-year prevalence of controlled prescription use and prescription drug misuse (PDM) in U.S. young adults, 18-25 years. Methods: Data were from the 2015-2017 National Survey on Drug Use and Health (young adult N = 38,298). Past-year prescription opioid, stimulant and benzodiazepine use and PDM were outcomes, with PDM defined as use without a prescription or in ways not intended by the prescriber. Separate regressions by sex evaluated the relationship between prescription medication use or PDM prevalence and sexual identity, educational status/attainment (college student/graduate versus non-college), their interaction and past-year psychological distress. Results: Sexual identity minority young adults had higher rates of prescription use and PDM than heterosexual young adults. After accounting for educational status, though, bisexual men rarely differed from heterosexual men; after including psychological distress, gay men rarely differed from heterosexual men. Versus heterosexual women, lesbian (adjusted odds ratio [AOR] = 2.33, 95% confidence interval [95% CI] = 1.47-2.30) and bisexual (AOR= 1.78, 95% CI = 1.27-2.50) young adult women had higher rates of prescription opioid misuse, after adjusting for educational status, psychological distress and sociodemographics. Versus heterosexual men, benzodiazepine PDM was elevated in gay men (AOR = 1.91, 95% CI= 1.02-3.58). Educational status was generally associated with lower rates of prescription use and PDM, except for stimulant PDM. Conclusions: Screening for psychological distress and PDM is needed in sexual identity minority young adults, especially for prescription opioid misuse among sexual identity minority women. Culturally-sensitive intervention should be considered for those with elevated psychological distress or signs of PDM. Further research on the sex differences found in the link between psychological distress and sexual identity minority opioid and stimulant PDM is warranted.
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Affiliation(s)
- Dalton L Klare
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Jason A Ford
- Department of Sociology, University of Central Florida, Orlando, Florida, USA
| | - Ty S Schepis
- Department of Psychology, Texas State University, San Marcos, Texas, USA
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