On the Concordance of Romantic and Sexual Feelings and Identity Among University Students in Taiwan

The degree to which romantic and sexual feelings correspond to one's sexual identity may signify how a person comes to embrace a specific sexual identity. People who endorse an essentialist perspective may expect to see a high degree of concordance between feelings and identity, and a lack of concordance may be associated with negative consequences. People who endorse a social constructionist perspective may view sexual identity as constructed in situ; a lack of concordance is inevitable and may not be associated with negative consequences. This research tests the levels of concordance of feelings and identity by comparing those with and without romantic and sexual feelings using risk ratios and odds ratios. A representative sample of college students in Taiwan was recruited (N = 3882, with 2440 females and 2988 who identified as heterosexual). The findings suggest that (1) people's romantic and sexual feelings largely correspond to their sexual identity, with all risk ratios and odds ratios higher than 1; (2) the concordance was at its lowest level among those with different-sex feelings; (3) gender differences in concordance were trivial; (4) individuals who were questioning their identity were the least clear about what they expect and want in intimate relationships; and (5) no general negative consequences in intimate relationships were observed among discordant/branched individuals. Implications regarding romantic and sexual feelings, sexual identity, and intimate relationships are further discussed.

Help-Seeking for Severe Intimate Partner Violence Among Sexual and Gender Minority Adolescents and Young Adults Assigned Female at birth: A Latent Class Analysis

Sexual and gender minority adolescents and young adults assigned female at birth (SGM-AFAB) report high rates of intimate partner violence (IPV) victimization. Despite adverse health outcomes of IPV, many survivors, particularly SGM-AFAB, do not seek help. This study (1) examined the proportion of SGM-AFAB who reported severe IPV victimization who sought help; (2) elucidated patterns of help-seeking facilitators and barriers; and (3) identified associations between sociodemographic characteristics, IPV victimization types, and minority stressors and latent classes of help-seeking facilitators and barriers. Participants included 193 SGM-AFAB (Mage = 20.6, SD = 3.4; 65.8% non-monosexual; 73.1% cisgender; 72.5% racial/ethnic minority; 16.6% annual household income $20,000 or less). Most participants who experienced severe IPV did not seek help (62.2%). Having a person or provider who was aware of the participant's abusive relationship was the most common reason for seeking help (50; 68.5%). Minimizing IPV was the most common reason for not seeking help (103; 87.3%). Fewer than 5% of SGM-AFAB who experienced severe IPV and who did not seek help reported SGM-specific help-seeking barriers, including not wanting to contribute to negative perceptions of the LGBTQ community, not disclosing their SGM status, and perceiving a lack of tailored services. Help-seeking facilitators and barriers varied by sociodemographic characteristics. Three classes of help-seeking facilitators and two classes of help-seeking barriers emerged. SGM-AFAB subgroups based on sexual and gender identity, recent coercive control, and identity as IPV victims differed in latent classes. This study's findings confirm SGM-AFAB IPV survivors' low likelihood of seeking help. Our results also underscore the importance of continuing to bolster SGM-AFAB survivors' access to trauma-informed, culturally sensitive, and affirming support. Further, multilevel prevention and intervention efforts are needed to reduce minimization of abuse and anticipatory judgment and blame among SGM-AFAB who hold multiple marginalized identities, experience coercive control, and identify as IPV victims.

Age Differences in the Associations Between Outness and Suicidality Among LGBTQ+ Youth

OBJECTIVE

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth are at increased risk for suicidality compared to their heterosexual and cisgender peers, and outness (the extent to which an individual is open about their LGBTQ+ identity to others) is an important correlate of suicidality. However, previous research has led to mixed findings regarding whether outness functions as a risk or protective factor for suicidality, and the available evidence suggests that age may play an important role. As such, the goal of the current study was to examine whether the associations between outness and suicidality differed between LGBTQ+ adolescents (ages 12-17) and emerging adults (ages 18-24).

METHOD

The analytic sample included 475 LGBTQ+ youth who completed an online survey after contacting a national, LGBTQ+ crisis service provider.

RESULTS

Results indicated that age significantly moderated the association between outness and suicidal ideation, such that greater outness was significantly associated with greater suicidal ideation for adolescents, but not for emerging adults. In contrast, age did not significantly moderate the associations between outness and likelihood of a past suicide attempt or perceived likelihood of a future suicide attempt. However, the main effect of outness was significant in both models, such that greater outness was significantly associated with a greater likelihood of a past suicide attempt and a greater perceived likelihood of a future suicide attempt.

CONCLUSIONS

These findings suggest that the associations between outness and suicidality among LGBTQ+ youth may depend on age as well as the dimension of suicidality (ideation versus attempt). HighlightsBeing more open about one's LGBTQ+ identity may confer risk for suicidality.The influence of outness on suicidal ideation may be strongest during adolescence.There is a need for LGBTQ+ affirming policies and laws to reduce suicidality.

Greater lifetime stressor exposure is associated with poorer mental health among sexual minority people of color

BACKGROUND

Research has shown that sexual minority people of color experience pervasive and sometimes severe life stressors that increase their risk of experiencing mental health problems, and that can contribute to lifelong health disparities. However, no studies in this population have investigated stressor exposure occurring over the entire lifespan. Moreover, it remains unknown whether these stressor-health effects differ based on the timing or types of stressors experienced.

PURPOSE

The purpose of this study is to examine how cumulative lifetime stressor exposure is associated with mental health among Black, Latinx, and biracial Black-Latinx sexual minority persons.

METHOD

Participants were 285 ethnic/racial minority young adults (Mage  = 25.18 years old, SD = 1.94, age range = 19-29 years), who completed the Stress and Adversity Inventory for Adults to assess for retrospective reports of lifetime stressor count and severity. The Brief Symptom Inventory was used to assess participants' symptoms of anxiety, depression, and somatization, which were the main outcomes. Most participants identified as cisgender male (94.7%) and gay (74.2%), with the remaining participants identifying as transgender or genderqueer/nonbinary for gender and bisexual/pansexual, queer, or another sexual orientation.

RESULTS

Multiple regression analyses indicated that experiencing more-and more severe-stressors across the lifespan was related to greater anxiety, depressive, and somatization symptoms. These effects were robust while controlling for race/ethnicity, sexual orientation, education, and employment status, and they differed based on stressor exposure timing, type, primary life domain, and core social-psychological characteristic.

CONCLUSION

Greater cumulative lifetime stressor exposure is related to poorer mental health among sexual minority people of color. Screening for lifetime stressors may thus help identify at-risk persons and provide an opportunity to intervene to help mitigate or prevent mental health disparities in multiply stigmatized adults.

The descriptive analysis of depressive symptoms and White Blood Cell (WBC) count between the sexual minorities and heterosexual identifying individuals in a nationally representative sample: 2005-2014

BACKGROUND

Sexual minorities are at a higher risk of suffering from depressive symptoms compared with heterosexual individuals. Only a few studies have examined the conditions of having depressive symptoms within different sexual minority groups, especially people with sexual orientation uncertainty in a nationally representative sample. Furthermore, few studies have explored whether the mean white blood count (WBC) is different between people with and without depressive symptoms among different sexual minority groups in a nationally representative sample.

METHODS

We analyzed the National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2014 with a sample of 14,090 subjects. We compared the prevalence of depressive symptoms in subpopulations stratified by sex, sexual minority status, and race. We also examined the difference in mean WBC count between depressed and non-depressed people among heterosexual individuals and different sexual minority groups. Additionally, two multivariable logistic regression models were used to explore the association between sexual minority status and depressive symptoms, treating sexual minority status as both a binary and categorical variable.

RESULTS

Female sex (OR: 1.96, 95% CI: 1.72-2.22) and sexual minority status (OR: 1.79, 95% CI: 1.47-2.17) were both independently associated with depressive symptoms. Within the sexual minority population, subjects who were unsure about their sexual identities had the highest odds of having depressive symptoms (OR: 2.56, 95% CI: 1.40-4.68). In the subgroup analysis considering intersectionality, black sexual minority females had the highest rate of depressive symptoms (19.4%, 95% CI: 7.72-40.98). Finally, the mean WBC count differed significantly between people with and without depressive symptoms among male heterosexual individuals, female heterosexual individuals, and female sexual minorities, but not among male sexual minorities.

CONCLUSIONS

Based on sex, race, and sexual minority status, black females of sexual minority status had the highest rate of depressive symptoms. Within sexual minority groups, participants who were unsure about their sexual identities had the highest odds of having depressive symptoms. Finally, the mean WBC count was significantly higher among people with depressive symptoms than those without depressive symptoms only among male heterosexuals, female heterosexuals, and female sexual minorities, but not among male sexual minorities. Future research should investigate the social and biological mechanisms of the differences.

Call to Action: Recommendations for Justice-Based Treatment of Obsessive-Compulsive Disorder With Sexual Orientation and Gender Themes

Gender and sexual minorities are subjected to minority stress in the form of discrimination and violence that leads to vigilance; identity concealment and discomfort; and internalized homophobia, biphobia, and transphobia. These experiences are related to increased susceptibility to mental health concerns in this population. Historically, the behavioral treatment of sexual orientation (SO) and gender-themed obsessive-compulsive disorder (OCD) has inadvertently reinforced anti-lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) stigma and contributed to minority stress in clients, treatment providers, and society at large. We present updated recommendations for treatment of SO- and gender-themed OCD through a more equitable, justice-based lens, primarily through eliminating exposures that contribute to minority stress and replacing them with psychoeducation about LGBTQ+ identities, and exposures to neutral and positive stimuli, uncertainty, and core fears. We also present recommendations for equitable research on SO- and gender-themed OCD.

Brooding Over the Closet: Differentiating Sexual Orientation Rumination and Sexual Orientation Obsessions

Two concepts that describe repetitive thoughts regarding an individual's sexual orientation-sexual orientation rumination and sexual orientation obsessions-have been introduced into the research literature. Despite the fact that these concepts have similarities, important distinctions exist with regard to their theoretical underpinnings, development, and catalyst of stress. As these concepts have never been teased apart in the research literature, understanding how these concepts are similar and different is particularly important. To this end, the present overview synthesizes the current literature regarding these concepts with the purpose of providing a decisional framework for differentiating sexual orientation rumination and sexual orientation obsessions and suggesting areas of future research.

A Transdiagnostic Approach to Sexual Distress and Sexual Pleasure: A Preliminary Mediation Study with Repetitive Negative Thinking

Sexual distress is a core characteristic of sexual dysfunction; however, little is known about its correlates. In the current study, we aimed to contribute to the understanding of both sexual distress and its positive counterpart, sexual pleasure, by taking a transdiagnostic approach to sexual distress using two types of repetitive negative thinking: worry and rumination. Because sexual activity mostly occurs in a dyadic context, we also looked at the potential mediating effect of co-worry and co-rumination, and we used them as mediators. Our preliminary exploratory quantitative study used a cross-sectional design, with a sample of 206 partnered heterosexual people. We used path analysis with parallel mediation, with structural equation modelling being performed using lavaan designed for R environment. Overall, our results show that repetitive negative thinking is associated with both sexual distress and sexual pleasure, and that neither co-rumination nor co-worry mediates these associations. The exception is the indirect effect of rumination on sexual pleasure that is mediated by co-rumination. These results demonstrate that a transdiagnostic approach to sexual distress is a new field worth exploring, and they contribute to establishing the relevance of a cognitive approach to sexual dysfunction.

Universities without Walls: A Blended Delivery Approach to Training the Next Generation of HIV Researchers in Canada

(1) Background: Although HIV has not diminished in importance in Canada, the field of HIV research remains small, and the graduate students who decide to pursue careers within it feel isolated and uncertain about their professional skills and opportunities. Universities Without Walls (UWW) was created in 2009 to help redress these shortcomings. This paper presents a case study of UWW, a non-credit training program for emerging HIV researchers in Canada. In particular, we focus on the possibilities of experiential learning via online and blended delivery. UWW uses both online and in-person teaching modalities to teach engaged scholarship, interdisciplinarity, community-based research (CBR), intervention research, and ethics. (2) Methods: Using a case study, we elucidated the research question: “What are the factors that make Universities Without Walls a viable training environment in the contemporary HIV/AIDS field?” Focus groups were conducted with 13 UWW key stakeholders in 2012 during a program mid-point evaluation; in 2014, telephone or in-person interviews with the three directors were conducted by a UWW fellow (the 4th author of this paper), and in 2019 the authors analyzed the information and anecdotal evidence, which had been incorporated as thick description. In addition, fellows’ self-assessments via portfolio and results from formal learning assessments were included. We also thematically analyzed 65 student self-reports (2009–2015). (3) Results and Discussion: Each UWW cohort lasted 9 months to one year and was comprised of: a) sustained mentorship from the co-directors (e.g., phone conversations, assistance with grant writing, letters of reference, etc.); b) fortnightly online webinars that aim to develop fellows’ knowledge of community-based research (CBR), research ethics, intervention research, and interdisciplinary research; c) community service learning in the form of a “field mentoring placement”; d) face-to-face engagement with fellows and mentors, most notably at the week-long culminating learning institute; e) a stipend for fellows to carry out their training activities. The UWW pedagogical framework features experiential learning, critical pedagogy, and heutagogy made manifest in the field mentoring placements (community service learning), mentorship mediated by technologies, and in-person learning institutes. Our analysis showed that experiential learning was imparted by UWW’s a) transparency about its “implicit curriculum”, the attitudes, values, character, and professional identity imparted in the program as well as the overarching programmatic elements, such as commitment to diversity, the inclusion of those with lived experience, the flexible admissions policies and procedures, interdisciplinary faculty, flexible team, administrative structure, and valuing of technology in conducting research, learning, and teaching; b) curriculum co-designing and co-teaching, and c) sustaining a community of practice. The main results reported in our case study included significant “soft outcomes” for UWW fellows, such as developing a “social presence” as a precursor to lasting professional connections; learning to experience community-based research, intersectionality, and interdisciplinarity by interacting online with persons living with HIV, leaders in the field, and a variety of stakeholders (including nonprofit staff and policymakers). (4) Limitations: While fellows’ self-evaluation data were collected by an independent assessor and anonymized to the extent this was possible, the co-authors inevitably bring their preconceptions and positive biases to UWW’s assessment. As UWW was developed to function outside of traditional academic structures, it is unlikely that the UWW program could be transferred to a post-secondary environment in its entirety. UWW was also built for the socio-political environment of HIV health research. (5) Conclusions: The experiences of those involved with UWW demonstrate that explicit curricular components—such as interdisciplinarity, community-based research, intervention research, and applied ethics—can be learned through a blended delivery when combined with opportunities to apply the knowledge in ways, such as a field mentoring placement and a learning institute. Related to this outcome, our case study describes that implicit curricular components in the formation of a professional—the sense of self in the field as a researcher, student, and community member—can also be delivered through a blended model. However, the tools and activities need to be tailored to each student for their context, while pushing their disciplinarian and professional boundaries.

The Impact of Sociosexualization and Sexual Identity Development on the Sexual Well-Being of Youth Formerly in the Foster Care System

PURPOSE

Youth in the child welfare system experience disproportionate rates of negative sexual health outcomes as well as increased engagement in risky sexual behaviors. This study explored the impact of sociosexualization and sexual identity development on the sexual well-being of youth formerly in the foster care system.

METHODS

Two hundred and nineteen youth formerly in the foster care system completed an Internet-based survey, including measures of the level of sexuality-related topics discussion, relationship quality with the individual with whom the topics were discussed, adverse childhood experiences, severity of sexual abuse history, sexual identity development, and sexual well-being. Hierarchical regressions examined the impact of youths' sociosexualization experiences and four domains of sexual identity development on their sexual well-being.

RESULTS

Sexual Identity Commitment was the strongest positive predictor of youths' sexual well-being (β = .428) followed by Sexual Identity Synthesis/Integration (β = .350) and Sexual Identity Exploration (β = .169). Sexual Orientation Identity Uncertainty negatively impacted sexual well-being (β = -.235), as did adverse childhood experiences (β range = -.150 to -.178) and sexual abuse severity (β range = -.208 to -.322). Sexuality-related discussions with foster parents negatively impacted youths' sexual well-being, whereas discussions with peers were a positive predictor.

CONCLUSION

Enhancing youths' sexual identity development and reducing the impact of traumatic experience are critical to improving sexual well-being. The influence of sexuality-related discussions on sexual well-being requires further analysis as impacts varied widely. Public policies should provide guidance to professionals on what services should be provided to enhance youths' sexual development.

Homophobic Bullying and Sexual Minority Youth Alcohol Use: Do Sex and Race/Ethnicity Matter?

PURPOSE

Sexual minority youth (SMY) are more likely to use alcohol than their heterosexual peers, yet a lack of research on within-group differences and modifiable mechanisms has hindered efforts to address alcohol use disparities. The purpose of the current study was to examine differences in the mediating role of homophobic bullying on the association between sexual orientation identity and drinking frequency and heavy episodic drinking frequency by sex and race/ethnicity.

METHODS

We used data from a subsample of 20,744 youth in seven states from the 2015 Youth Risk Behavior Survey, a population-based data set of 9-12th grade high school students in the United States. We included youth who self-identified as male or female; heterosexual, lesbian/gay, bisexual, or unsure of their sexual orientation identity; and White, Black, or Latino.

RESULTS

Within-group comparisons demonstrated that SMY alcohol use disparities were concentrated among Latino bisexual and unsure youth. All subgroups of SMY at the intersection of race/ethnicity and sex were more likely than their heterosexual counterparts to report homophobic bullying. Homophobic bullying mediated alcohol use disparities for some, but not all, subgroups of SMY.

CONCLUSION

Homophobic bullying is a serious risk factor for SMY alcohol use, although youths' multiple identities may differentiate degrees of risk. Sexual orientation identity-related disparities in alcohol use among Latino, bisexual, and unsure youth were not fully attenuated when adjusted for homophobic bullying, which suggests that there may be additional factors that contribute to rates of alcohol use among these specific subgroups of SMY.

Measurement properties of tools used to assess depression in adults with and without autism spectrum conditions: A systematic review

Depression is the most commonly experienced mental health condition in adults with autism spectrum conditions (ASC). However, it is unclear what tools are currently being used to assess depression in ASC, or whether tools need to be adapted for this group. This systematic review therefore aimed to identify tools used to assess depression in adults with and without ASC, and then evaluate these tools for their appropriateness and measurement properties. Medline, PsychINFO and Web of Knowledge were searched for studies of depression in: (a) adults with ASC, without co‐morbid intellectual disability; and (b) adults from the general population without co‐morbid conditions. Articles examining the measurement properties of these tools were then searched for using a methodological filter in PubMed, and the quality of the evidence was evaluated using the COSMIN checklist. Twelve articles were identified which utilized three tools to assess depression in adults with ASC, but only one article which assessed the measurement properties of one of these tools was identified and thus evaluated. Sixty‐four articles were identified which utilized five tools to assess depression in general population adults, and fourteen articles had assessed the measurement properties of these tools. Overall, two tools were found to be robust in their measurement properties in the general population—the Beck Depression Inventory (BDI‐II), and the patient health questionnaire (PHQ‐9). Crucially only one study was identified from the COSMIN search, which showed weak evidence in support of the measurement properties of the BDI‐II in an ASC sample. Implications for effective measurement of depression in ASC are discussed. Autism Res2018, 11: 738–754. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc.

Lay Summary

Depression is the most common mental health problem experienced by adults with autism. However, the current study found very limited evidence regarding how useful tools developed for the general population are for adults with autism. We therefore suggest how these tools could be adapted to more effectively assess depression in adults with autism, and improve these individuals access to mental health assessment and support.

Psychosocial Risk and Protective Factors for Depression Among Lesbian, Gay, Bisexual, and Queer Youth: A Systematic Review

Many lesbian, gay, bisexual, or queer (LGBQ) youth suffer from depression. Identifying modifiable risk and protective factors for depression can inform the development of psychosocial interventions. The aim of this review is to evaluate the methodological characteristics and summarize the substantive findings of studies examining psychosocial risk and protective factors for depression among LGBQ youth. Eight bibliographic databases were searched, and 35 studies that met all inclusion criteria were included for review. Results show that prominent risk factors for depression include internalized LGBQ-related oppression, stress from hiding and managing a socially stigmatized identity, maladaptive coping, parental rejection, abuse and other traumatic events, negative interpersonal interactions, negative religious experiences, school bullying victimization, and violence victimization in community settings. Prominent protective factors include a positive LGBQ identity, self-esteem, social support from friends, and family support. LGBQ youth may face an array of threats to their mental health originating from multiple socioecological levels.

Pathways to Hazardous Drinking Among Racially and Socioeconomically Diverse Lesbian Women: Sexual Minority Stress, Rumination, Social Isolation, and Drinking to Cope

Lesbian women engage in more hazardous drinking than heterosexual women yet we know relatively little about what explains this disparity. In the present study, race, socioeconomic status, minority stress, general psychological processes and distress were examined as pathways to hazardous drinking among young (18-35 years) Black and non-Hispanic White lesbian women. We used the psychological mediation framework adaptation of minority stress theory and the reserve capacity model as theoretical underpinnings of the conceptual model in the current study. Self-identified lesbian participants (N= 867) completed a one-time online survey that assessed race, socioeconomic status, perceived sexual minority discrimination, proximal minority stress (concealment, internalized homophobia, lack of connection to lesbian community), rumination, social isolation, psychological distress, drinking to cope, and hazardous drinking. Cross-sectional results demonstrated that being Black was associated with hazardous drinking via sequential mediators of rumination, psychological distress, and drinking to cope. Socioeconomic status was associated with hazardous drinking via sequential mediators of sexual minority discrimination, proximal minority stress, rumination, social isolation, psychological distress, and drinking to cope. Understanding these pathways can aid researchers and clinicians studying and working with lesbians who are at risk for hazardous drinking.