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Bastian MJS, Rohlik LN. Transgender and Gender non-Conforming Mental Health Training and Knowledge for High School Staff: A Scoping Review. J Sch Nurs 2024; 40:74-85. [PMID: 35971302 DOI: 10.1177/10598405221120440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Youth who identify as transgender or gender non-conforming (TGNC) are at greater risk than their peers for mental health concerns. School staff knowledge and training on supporting the mental health of these students may have a significant effect on this population. To better understand where school staff are provided such training, we conducted a scoping review to determine any differences in staff knowledge and training between urban, suburban, and rural high schools. We searched five electronic databases using keywords: transgender or gender variant or gender non-conforming, mental health, school, and student. Twelve articles met the criteria for review. We found no comparative studies that differentiate staff training and knowledge across high school settings. Most articles demonstrated the efficacy of training school staff in supporting TGNC students, and demand from school staff for access to such training. School nurses can lead and advocate for such training to support TGNC students.
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Affiliation(s)
- Maya J S Bastian
- School of Nursing, College of Allied Health and Nursing, Minnesota State University, Mankato, Minnesota, USA
| | - Lindsay N Rohlik
- Department of Nursing, Southwest Minnesota State University, Mankato, Minnesota, USA
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2
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Barbero C, Vagi KJ, Clayton H, Holland K, Hertz M, Krause KH, Brittingham R, Bunge S, Saka SM, Marchessault N, Hynes N, Green D, Spell L, Monteiro K, Murray K, Reilly-Chammat R, Tignor L, Mercado MC. Bullying Victimization and Associations With Substance Use Among US Middle School Students: 2019 Youth Risk Behavior Survey. THE JOURNAL OF SCHOOL HEALTH 2023; 93:1111-1118. [PMID: 37311692 PMCID: PMC11167627 DOI: 10.1111/josh.13354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 03/06/2023] [Accepted: 05/21/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Research shows associations between bullying victimization and substance use for teens. However, more research about this relationship for younger adolescents and across race/ethnicity is needed. METHODS Prevalence and pooled logistic regression analyses of 2019 Middle School Youth Risk Behavior Survey data from 13 states (N = 74,059 students) examined associations between self-reported bulling victimization (at school, electronically, and both) and having ever tried cigarette smoking, alcohol, or marijuana; used an electronic vapor product; or misused prescription pain medicine. Regression analyses were adjusted by age and sex/race/ethnicity. RESULTS All 3 measures of bullying victimization were significantly associated (p < .05) with the 5 substance use behaviors examined (adjusted prevalence ratios ranged from 1.29 to 2.32). These associations held across sexes. Significant associations were found within all 7 race/ethnicity categories, with the most associations reported for the non-Hispanic (NH) white, NH black or African American, Hispanic/Latino, and NH Asian groups. CONCLUSION The association between bullying and substance use by middle school is a highly relevant issue to consider as students return to classrooms.
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Affiliation(s)
- Colleen Barbero
- Behavioral Scientist, Division of Violence Prevention (DVP), Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Kevin J. Vagi
- Behavioral Scientist, Division of Violence Prevention (DVP), Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Heather Clayton
- Senior Advisor for Health Equity, Division of Violence Prevention (DVP), Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Kristin Holland
- Surveillance Branch Chief, Division of Overdose Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Marci Hertz
- Associate Director, Division of Adolescent and School Health (DASH), Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Kathleen H. Krause
- Epidemiologist, Division of Adolescent and School Health (DASH), Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Rochelle Brittingham
- Associate Scientist, Center for Drug and Health Studies, University of Delaware, Newark, DE
| | - Stephanie Bunge
- School Health Consultant, Kentucky Department of Education, Frankfort, KY
| | - Susan M. Saka
- Principal Investigator, University of Hawai’i, College of Education, Honolulu, HI
| | - Nadine Marchessault
- Health Education Specialist and CDCSchool-Based Surveillance ProgramManager, Hawai’i State Department of Education, Honolulu, HI
| | - Nikardi Hynes
- Epidemiologist, Maryland Department of Health, Baltimore, MD
| | - Dan Green
- Survey Epidemiologist, NewMexico Department of Health, Santa Fe, NM
| | - Les Spell
- Data and Policy Consultant, North Carolina Department of Public Instruction, Raleigh, NC
| | - Karine Monteiro
- Health Surveys Unit Manager, Rhode Island Department of Health, Providence, RI
| | - Kristen Murray
- Public Health Analyst and YRBS and School Health Profiles Coordinator, Vermont Department of Health, Burlington, VT
| | - Rosemary Reilly-Chammat
- Associate Director, Rhode Island Department of Elementary and Secondary Education, Providence, RI
| | - Lisha Tignor
- Coordinator of School Psychology, West Virginia Department of Education, Charleston, WV
| | - Melissa C. Mercado
- Lead Behavioral Scientist, Division of Violence Prevention (DVP), Centers for Disease Control and Prevention (CDC), Atlanta, GA
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Lawrence SE, Gower AL, Eadeh HM, Cardona-Correa C, Thomas D, Suresh M, María del Río-González A, Eisenberg ME. Exploring Bias-Based Bullying and Intersecting Social Positions as Correlates of Sexual Risk Behaviors Among Adolescents. LGBT Health 2023; 10:608-616. [PMID: 37358630 PMCID: PMC10712366 DOI: 10.1089/lgbt.2022.0301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
Purpose: The current study extends the limited body of intersectional research on adolescents' sexual health by examining experiences of bias-based bullying and multiple intersecting social positions associated with engagement in sexual risk behaviors. Methods: Participants were 14,968 sexually active 9th and 11th grade students surveyed as part of the 2019 Minnesota Student Survey (15% lesbian/gay/bisexual/queer/pansexual/questioning [LGBQ] and/or transgender/gender diverse [TGD] or gender questioning). Exhaustive Chi-square Automatic Interaction Detection analysis was used to identify experiences (i.e., bias-based bullying victimization) and intersecting social positions (i.e., sexual orientation identity; gender identity/modality; race/ethnicity; physical disabilities/chronic illness; mental health/behavioral/emotional problems) associated with the highest prevalence of three sexual risk behaviors. Results: Overall, 18% of adolescents reported 3+ sex partners in the last year, 14% reported drug/alcohol use before last sex, and 36% reported not discussing protection from sexually transmitted infections with new sexual partners. Adolescents with 2+ marginalized social positions, some of whom also experienced bias-based bullying, were part of 53% of the highest prevalence risk groups. For example, 42% of Multiracial or Latina/x/o gender questioning adolescents who identified as LGBQ reported 3+ sex partners in the last year-twice the sample average. Adolescents who were Black, American Indian/Alaska Native, Latina/x/o, Multiracial, TGD, or gender questioning were in the highest prevalence nodes across all outcomes. Conclusion: Adolescents with multiple marginalized social positions and who experience bias-based bullying engage in high-risk sexual behaviors at higher-than-average rates. Findings underscore the importance of addressing intersecting experiences of stigma to reduce high-risk sex behaviors and promote health equity among adolescents.
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Affiliation(s)
- Samantha E. Lawrence
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Amy L. Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Hana-May Eadeh
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Chris Cardona-Correa
- Department of General Pediatrics, Children's Minnesota, Minneapolis, Minnesota, USA
| | - De'Shay Thomas
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Malavika Suresh
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Ana María del Río-González
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, USA
| | - Marla E. Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
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Heinz A, Költő A, Taylor AB, Chan A. "Are You a Boy or a Girl?"-A Missing Response Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1695. [PMID: 37892357 PMCID: PMC10605027 DOI: 10.3390/children10101695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
Many adolescent health surveys ask if respondents are male or female. Non-response may be due to fear of de-anonymisation or being a gender-nonconforming youth. The present study investigates the frequency of non-response and its potential reasons. To this end, data from 54,833 adolescents aged 11-18 from six countries, participating in the 2018 Health Behaviour in School-aged Children (HBSC) study, were analysed. Respondents were divided into three groups: (1) "Responders" who answered both questions on age and gender, (2) "Age non-responders" who did not answer the question on age, and (3) "Gender non-responders" who answered the question on age but not the one on gender. These groups were compared regarding their non-response to other questions and regarding their health. Overall, 98.0% were responders, 1.6% were age non-responders and 0.4% were gender non-responders. On average, age non-responders skipped more questions (4.2 out or 64) than gender non-responders (3.2) and responders (2.1). Gender non-responders reported more psychosomatic complaints, more frequent substance use and lower family support than responders. This study shows that age and gender non-responders differ in their response styles, suggesting different reasons for skipping the gender question. The health disparities found between the groups suggest that further research should use a more nuanced approach, informed by LGBT+ youth's insights, to measure sex assigned at birth and gender identity.
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Affiliation(s)
- Andreas Heinz
- Department of Health, IU International University of Applied Sciences, Juri-Gagarin Ring 152, 99084 Erfurt, Germany
| | - András Költő
- Health Promotion Research Centre, National University of Ireland, University Rd., H91 TK33 Galway, Ireland;
| | - Ashley B. Taylor
- Stigma and Resilience Among Vulnerable Youth Centre, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Ace Chan
- Stigma and Resilience Among Vulnerable Youth Centre, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Lawrence SE, McMorris BJ, Simon KA, Gower AL, Eisenberg ME. Bullying Involvement at the Intersection of Gender Identity/Modality, Sexual Identity, Race, Ethnicity, and Disability: Prevalence Disparities and the Role of School-Related Developmental Assets. LGBT Health 2023; 10:S10-S19. [PMID: 37754921 PMCID: PMC10623467 DOI: 10.1089/lgbt.2023.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
Purpose: This study examines adolescents' self-reported school-based developmental assets and four intersecting social positions as they relate to prevalence of bullying involvement. Methods: Participants were 80,456 ninth and 11th grade students who participated in the 2019 Minnesota Student Survey (30.2% youth of color; 11% lesbian/gay/bisexual/pansexual/queer/questioning; 2.9% transgender/gender diverse [TGD] or gender questioning). Exhaustive Chi-square Automatic Interaction Detection analysis was used to identify school-based developmental assets (i.e., school safety, school adult support) and intersecting social positions (i.e., sexual identity; gender identity/modality; racial/ethnic identity; physical disabilities/chronic illness; and/or mental health/behavioral/emotional problems) associated with the highest prevalence of involvement as physical and relational bullies, victims, and bully-victims. Results: Adolescents with 2+ marginalized social positions who often lacked school-based developmental assets were part of nearly all the highest prevalence bullying involvement groups. TGD and gender questioning adolescents, Native American youth, and youth living with both physical disabilities/chronic illness and mental health/emotional/behavioral problems-most of whom had additional marginalized social positions and lacked school-based assets-were particularly overrepresented in high prevalence groups. For example, 31.1% of TGD or gender questioning youth of color living with both types of disabilities/health problems who did not feel strongly that school was safe reported involvement as physical bully-victims-nearly six times the sample average rate. Conclusion: Adolescents with multiple marginalized social positions and those lacking certain school-based assets-often overlapping categories-were involved in bullying at higher-than-average rates. Findings underscore the need for schools to address intersecting experiences of stigma and structural oppression that may perpetuate bullying involvement disparities.
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Affiliation(s)
- Samantha E. Lawrence
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Kay A. Simon
- Department of Family Social Science, University of Minnesota, Minneapolis, Minnesota, USA
| | - Amy L. Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Marla E. Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
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Miller-Jacobs C, Operario D, Hughto JM. State-Level Policies and Health Outcomes in U.S. Transgender Adolescents: Findings from the 2019 Youth Risk Behavior Survey. LGBT Health 2023; 10:447-455. [PMID: 36862538 PMCID: PMC10623461 DOI: 10.1089/lgbt.2022.0247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Purpose: Policies have been shown to bear a considerable influence on transgender health. The few studies that have examined policy-related health outcomes in adolescent transgender populations have rarely included policies that directly affect them. Our study explores associations between four state-level policies and six health outcomes in a sample of transgender adolescents. Methods: Our analytic sample consisted of adolescents residing in 14 states that used the 2019 Youth Risk Behavior Survey's optional gender identity question in their surveys (n = 107,558). Chi-square analyses were performed to examine differences between transgender and cisgender adolescents in demographic variables and suicidal ideation, depression status, cigarette use, binge drinking, grades in school, and perceptions of school safety. Multivariable logistic regression models were run for transgender adolescents only to examine associations between policies and health outcomes, adjusting for demographics. Results: Transgender adolescents comprised 1.7% (n = 1790) of our sample. Compared with cisgender adolescents, transgender adolescents were more likely to experience adverse health outcomes in chi-square analyses. Multivariable models indicated that transgender adolescents who lived in a state that had explicit transgender guidance in their antidiscrimination laws were less likely to experience depressive symptoms, and those who lived in a state with positive or neutral athlete guidance were less likely to report past 30-day cigarette use. Conclusion: Our study is one of the first to show protective associations between affirming transgender-specific policies and health outcomes in transgender adolescents. Findings could have important implications for policymakers and school administrators.
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Affiliation(s)
| | - Don Operario
- School of Public Health, Brown University, Providence, Rhode Island, USA
- Department of Social and Behavioral Sciences, School of Public Health, Brown University, Providence, Rhode Island, USA
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Jaclyn M.W. Hughto
- School of Public Health, Brown University, Providence, Rhode Island, USA
- Department of Social and Behavioral Sciences, School of Public Health, Brown University, Providence, Rhode Island, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
- Center for Health Promotion and Health Equity, Brown University, Providence, Rhode Island, USA
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
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7
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Kim I, Sekh MB, Khan T, Gunasekara R, Kogan I. Social Determinants of Health in Urban Transgender Patients: A Case Report. Cureus 2023; 15:e42941. [PMID: 37667722 PMCID: PMC10475246 DOI: 10.7759/cureus.42941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 09/06/2023] Open
Abstract
The social determinants of health (SDOH) are a complex web of factors that influence the health of individuals throughout their lifetime. There are many drivers of health inequities within the SDOH, such as socioeconomic status, education, employment, gender, and race/ethnicity. It is possible that mental illness may develop when these factors negatively affect health. However, current research primarily focuses on SDOH in cisgender individuals leaving a scientific gap in transgender individuals who require unique considerations when providing comprehensive medical care. We present the case of a 20-year-old transgender female who was admitted for suicidal attempts during a methamphetamine overdose, and who had been struggling with mental illness and suicidal gestures since she was a young teenager. The significance of our findings is discussed in the context of the substantial lack of current research on SDOH in transgender individuals to underscore the need for clinical awareness and promote future research.
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Affiliation(s)
- Isaac Kim
- Psychiatry and Behavioral Sciences, Interfaith Medical Center, Brooklyn, USA
| | - Marta B Sekh
- Psychiatry and Behavioral Sciences, Interfaith Medical Center, Brooklyn, USA
| | - Tasmia Khan
- Psychiatry and Behavioral Sciences, Interfaith Medical Center, Brooklyn, USA
| | | | - Irina Kogan
- Psychiatry and Behavioral Sciences, Interfaith Medical Center, Brooklyn, USA
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8
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Holt MK, Parodi KB, Elgar FJ, Vigna A, Moore LB, Koenig B. Identifying protective factors for gender diverse adolescents' mental health. NPJ MENTAL HEALTH RESEARCH 2023; 2:10. [PMID: 38609545 PMCID: PMC10955934 DOI: 10.1038/s44184-023-00029-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/15/2023] [Indexed: 04/14/2024]
Abstract
Few studies have disentangled differences in victimization exposures and mental health symptoms among gender diverse subgroups, nor considered the role of potential protective factors in ameliorating the impact of victimization on gender diverse youths' mental health. Here we report findings from a secondary data analysis, in which we address this gap by analyzing cross-sectional survey data (N = 11,264 in the final analytic sample) from a population-based survey of youth in participating school districts in a large Midwestern U.S. county. Relative to cisgender youth with gender conforming expression, transgender youth and cisgender youth with nonconforming gender expression are more likely to experience victimization and severe mental health concerns. Additionally, school-connectedness moderates the association between bias-based harassment and depression for cisgender youth with gender nonconforming expression, and family support/monitoring buffers the association of peer victimization with suicide attempts among transgender youth. Findings highlight the need to better understand factors which may confer protection among gender diverse adolescents, so that in turn appropriate supports across key contexts can be implemented.
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Affiliation(s)
- Melissa K Holt
- Boston University Wheelock College of Education and Human Development, Two Silber Way, Boston, MA, 02215, USA.
| | - Katharine B Parodi
- Boston University Wheelock College of Education and Human Development, Two Silber Way, Boston, MA, 02215, USA
| | - Frank J Elgar
- McGill University, 1130 Pine Avenue West, Montreal, QC, H3A 1A3, Canada
| | - Abra Vigna
- University of Wisconsin-Madison, Madison, WI, 53726, USA
| | - L B Moore
- Ampersand Healing, West Springfield, MA, 01089, USA
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9
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Lee K, McMorris BJ, Chi CL, Looman WS, Burns MK, Delaney CW. Using data-driven analytics and ecological systems theory to identify risk and protective factors for school absenteeism among secondary students. J Sch Psychol 2023; 98:148-180. [DOI: 10.1016/j.jsp.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 12/13/2022] [Accepted: 03/15/2023] [Indexed: 04/09/2023]
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Rankine J, Fuhrman B, Copperman E, Miller E, Culyba A. School Absenteeism Among Middle School Students With High Exposure to Violence. Acad Pediatr 2022; 22:1300-1308. [PMID: 35342032 PMCID: PMC9509495 DOI: 10.1016/j.acap.2022.03.012] [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: 12/01/2021] [Revised: 03/16/2022] [Accepted: 03/19/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Chronic school absenteeism is linked to failure to graduate high school and poor health in adulthood. Contextual factors associated with absenteeism may be under-recognized in school and clinical settings. We examined the prevalence of self-reported absenteeism and violence exposure and their association among middle school students with identified risk of trauma. METHODS We analyzed baseline data from a dating violence prevention program. Participants completed surveys identifying lifetime exposure to 10 types of violence and past 30-day absence. Violence exposure and absenteeism were summarized and compared across demographic groups. Generalized linear models examined associations between 1) any history of violence exposure, 2) each type of violence exposure, and 3) summed exposures to different types of violence, and frequent absenteeism (≥2 absences in past 30 days). RESULTS Of all participants (overall n = 499), 45.5% reported frequent absenteeism and 71.5% reported violence exposure. Any self-reported violence exposure was associated with absenteeism (aRR = 1.43, 95%CI: 1.06-1.92). However, no specific type of violence exposure predicted absenteeism. Comparing summed exposures to different types of violence to no violence exposure, exposure to 1 type of violence was associated with absenteeism (aRR = 1.59, 95%CI: 1.15-2.20), with no evidence of stronger associations with greater exposure (2-3 types: aRR = 1.37, 95%CI: 1.00-1.88; ≥4 types: aRR = 1.31, 95%CI: 0.98-1.74). CONCLUSIONS Youth in this sample reported both high rates of violence exposure and absenteeism. Prior violence exposure was associated with absenteeism. Resources and contextual support for youth exposed to family or community violence may play a role in school attendance, emphasizing need for trauma-sensitive approaches to absenteeism.
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Affiliation(s)
- Jacquelin Rankine
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa.
| | - Barbara Fuhrman
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa
| | - Ethan Copperman
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa
| | - Elizabeth Miller
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa
| | - Alison Culyba
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, Pa
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11
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Andrzejewski J, Calzo JP, Smith LR, Corliss HL, Felner JK. Binge drinking disparities by gender identity, race, and ethnicity in California secondary schools. JOURNAL OF LGBT YOUTH 2022; 20:896-917. [PMID: 38031567 PMCID: PMC10683934 DOI: 10.1080/19361653.2022.2113198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/20/2022] [Accepted: 08/09/2022] [Indexed: 12/01/2023]
Abstract
Our objective was to estimate disparities in binge drinking among secondary school students in California at the intersection of gender identity, race, and ethnicity, without aggregating racial and ethnic categories. We combined two years of the Statewide middle and high school California Healthy Kids Survey (n=951,995) and regressed past month binge drinking on gender identity (i.e., cisgender, transgender, or not sure of their gender identity), race (i.e., white, American Indian or Alaskan Native, Asian, Black or African American, Native Hawaiian or Pacific Islander, or multiracial), and ethnicity (i.e., Hispanic/Latinx or non-Hispanic/Latinx), and their interaction. Transgender students had greater odds of reporting past month binge drinking than cisgender students, with greater magnitudes among students with minoritized racial or ethnic identities compared to non-Hispanic/Latinx white students. For example, among non-Hispanic/Latinx white students, transgender students had 1.3 times greater odds (AOR=1.30, 95% CI=1.17-1.55), whereas among Hispanic/Latinx Black or African American students, transgender students had 5.3 times greater odds (AOR=5.33, 95% CI=3.84-7.39) of reporting past month binge drinking than cisgender students. Transgender adolescents, particularly those with minoritized racial or ethnic identities, may be at disproportionate risk of binge drinking. Interventions that address systemic racism and cisgenderism from an intersectional perspective are needed.
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Affiliation(s)
- Jack Andrzejewski
- San Diego State University—University of California, San Diego, Joint Doctoral Program in Public Health, San Diego, CA
| | - Jerel P. Calzo
- San Diego State University School of Public Health, San Diego, CA
- Institute for Behavioral and Community Health, San Diego, CA
| | - Laramie R. Smith
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA
| | - Heather L. Corliss
- San Diego State University School of Public Health, San Diego, CA
- Institute for Behavioral and Community Health, San Diego, CA
| | - Jennifer K. Felner
- San Diego State University School of Public Health, San Diego, CA
- Institute for Behavioral and Community Health, San Diego, CA
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12
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Waasdorp TE, Fu R, Clary LK, Bradshaw CP. School Climate and Bullying Bystander Responses in Middle and High School. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2022; 80:101412. [PMID: 35444357 PMCID: PMC9015685 DOI: 10.1016/j.appdev.2022.101412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Bullying bystanders' reactions are important for either stopping or perpetuating bullying behaviors. Given school-based bullying programs' focus on bystanders, understanding the associations between school-level factors and individual bystander responses can improve intervention efficacy. Data from 64,670 adolescents were used to examine bullying bystander responses as a function of 13 school-climate dimensions within 3 main factors (Engagement, Environment, Safety) and individual-level factors (e.g., race/ethnicity, perceptions of student-teacher connectedness). Multi-level models showed schools with better Engagement and Safety had higher odds of defender behaviors, a better Environment was associated with lower odds of passive and assisting behaviors. Differences also varied by individual-level factors. For example, an aggressive climate was associated with passive behaviors more strongly in boys and high schoolers. Further, higher perceived parent-teacher and student-teacher connectedness were associated with positive bystander behaviors, and this was stronger for Black and Latinx youth, highlighting the importance of improving relationships as a crucial starting point.
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Affiliation(s)
- Tracy Evian Waasdorp
- Children's Hospital of Philadelphia. Center for Violence Prevention. 3402 Civic Center Blvd. Philadelphia, PA 19104
- University of Pennsylvania School of Medicine. Department of Psychiatry. Philadelphia, PA 19104
| | - Rui Fu
- Children's Hospital of Philadelphia. Center for Violence Prevention. 3402 Civic Center Blvd. Philadelphia, PA 19104
| | - Laura K Clary
- Johns Hopkins University, School of Public Health. 615 N. Wolfe Street, Baltimore, MD 21205
| | - Catherine P Bradshaw
- University of Virginia, School of Education and Human Development. Bavaro Hall 112D, PO Box 400270, Charlottesville, VA 22904
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13
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Johns MM, Zamantakis A, Andrzejewski J, Boyce L, Rasberry CN, Jayne PE. Minority Stress, Coping, and Transgender Youth in Schools-Results from the Resilience and Transgender Youth Study. THE JOURNAL OF SCHOOL HEALTH 2021; 91:883-893. [PMID: 34533210 DOI: 10.1111/josh.13086] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 06/11/2021] [Accepted: 06/23/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Transgender youth report high rates of negative experiences in schools. Using a lens of minority stress, this study sought to examine in-school experiences of transgender youth to understand youth coping and to identify key opportunities for improving school environments for transgender youth. METHODS Participants included 41 youth across 33 in-depth interviews (Mage = 21.7) and two focus groups (N = 8; Mage = 17.3). Thematic analysis was used to analyze data. Themes related to stress, coping, and facilitators/barriers to stress/coping were derived and coded. RESULTS Distal stressors, such as structural discrimination and prejudice events, were found to contribute to the exclusion of transgender youth from school life, while proximal stressors, such as concealment and expectations of rejection, reinforced transgender youth's feelings of personal isolation. Participants expressed coping with both challenges by advocating for inclusion through direct action with teachers and administrators and seeking/finding connection with trusted staff and peers. CONCLUSIONS Findings suggest that creating safe and supportive environments at school for transgender youth is an attainable goal, as all identified barriers to inclusivity and connection were modifiable. By considering the needs of transgender youth in policies and programming, schools may improve climate for and wellbeing of transgender students.
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Affiliation(s)
- Michelle M Johns
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop US 8-1, Atlanta, GA, 30329, USA
| | - Alithia Zamantakis
- Department of Sociology, Georgia State University, Director of LGBTQ Programs & Services, Shippensburg University, 2022 Deerfield Commons, Shippensburg, PA, 17257, USA
| | - Jack Andrzejewski
- San Diego State University-University of California, San Diego Joint Doctoral Program in Public Health, 9500 Gilman Drive, Mail Code #0507, La Jolla, CA, 92093, USA
| | - Lorin Boyce
- ICF, 2635 Century Parkway NE, Suite 1000, Atlanta, GA, 30345, USA
| | - Catherine N Rasberry
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop US 8-1, Atlanta, GA, 30329, USA
| | - Paula E Jayne
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop US 8-1, Atlanta, GA, 30329, USA
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Martin-Storey A, Santo J, Recchia HE, Chilliak S, Caetano Nardi H, Moreira Da Cunha J. Gender minoritized students and academic engagement in Brazilian adolescents: Risk and protective factors. J Sch Psychol 2021; 86:120-132. [PMID: 34051908 DOI: 10.1016/j.jsp.2021.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/15/2020] [Accepted: 03/14/2021] [Indexed: 11/26/2022]
Abstract
Gender minoritized students experience unique challenges in their school environments that may have consequences for their educational outcomes, including academic engagement. The goal of the current study was to understand the association between gender identity and academic engagement among adolescents attending public high schools in Paraná, Brazil (N = 10,828). In particular, student perceptions of student-teacher relationships, school rule fairness and clarity, school-wide academic engagement, and peer victimization were examined as four facilitator/barrier factors that may account for lower levels of academic engagement for gender minoritized students as compared to their cisgender peers, and these processes were tested for differences across race/ethnicity. Public high school students (ages 12-18 years) completed an in-class survey assessing their gender identities, perceptions of the school environment, and academic engagement. Gender minoritized students reported significantly lower levels of academic engagement as compared to their cisgender peers. They also reported less clear and fair school rules, lower levels of school-wide academic engagement, and higher levels of victimization. These facilitator/barrier variables partially accounted for the lower levels of academic engagement reported by gender minoritized students. No significant differences were observed for gender identity according to race/ethnicity. These findings suggest that facilitators/barriers that account for academic engagement for students in general partially explain gender identity-related disparities, and the implications for school psychologists are discussed.
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Affiliation(s)
- Alexa Martin-Storey
- Département de Psychoéducation, Université de Sherbrooke, 150 Place Charles Le Moyne, Longueuil, QC, Canada.
| | - Jonathan Santo
- Department of Psychology, University of Nebraska at Omaha, United States of America
| | - Holly E Recchia
- Educational and Counselling Psychology, McGill University, Canada
| | | | - Henrique Caetano Nardi
- Departamento de Psicologia Social e Institucional, Universidade Federal do Rio Grande do Sul, Brazil
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15
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Mori Y, Tiiri E, Khanal P, Khakurel J, Mishina K, Sourander A. Feeling Unsafe at School and Associated Mental Health Difficulties among Children and Adolescents: A Systematic Review. CHILDREN-BASEL 2021; 8:children8030232. [PMID: 33802967 PMCID: PMC8002666 DOI: 10.3390/children8030232] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 11/16/2022]
Abstract
This study systematically reviewed the literature on perceived school safety. We investigated the prevalence, factors and associated mental health difficulties, as well as cross-cultural findings. Five databases were searched up to 9 February 2021 for peer-reviewed papers published in English. We included quantitative studies that explored the perception of school safety among children and adolescents. The reference lists of the selected papers were also searched. We conducted a narrative synthesis of the included studies. The review included 43 papers. The mean prevalence of the students who felt unsafe at school was 19.4% and ranged from 6.1% to 69.1%. Their perceived safety was associated with a wide range of personal, school, and social factors. Not feeling safe at school was related to being victimized and mental health difficulties, including depressive symptoms and suicidal behavior. Higher perceived school safety was associated with measures such as the presence of a security officer and fair school rule enforcement. The results showed the lack of cross-cultural studies on perceived school safety. Empirical studies are needed that examine the mechanisms of school safety, using valid measures. A clear definition of school safety should be considered a key aspect of future studies.
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Affiliation(s)
- Yuko Mori
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Correspondence:
| | - Elina Tiiri
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Department of Child Psychiatry, University of Turku and Turku University Hospital, 20521 Turku, Finland
| | - Prakash Khanal
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
| | - Jayden Khakurel
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
| | - Kaisa Mishina
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Department of Nursing Science, University of Turku, 20014 Turun Yliopisto, Finland
| | - Andre Sourander
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Department of Child Psychiatry, University of Turku and Turku University Hospital, 20521 Turku, Finland
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Abstract
While prior research shows how community-based organizations (CBO’s) create new social ties and solidarities, we know less about CBO’s that formalize preexisting relationships of care. Analyzing transgender nonprofits as a strategic case, this article develops the concept of kinship organizations: organizations that incorporate norms, networks, and resources from kinship systems into a formal organization that provides regular social services. Drawing on 7 months of ethnography and 36 formal interviews with staff and clients, I explore how transgender kinship organizations function, develop, and impact broader transgender community. Kinship organizations are highly responsive to crisis, are able to leverage personal and organizational resources, and are therefore capable of providing personalized rapid-response care to very precarious transgender people. On the other hand, subsuming kinship within a nonprofit transforms relationships of mutual care into unidirectional service relationships and relationships of chosen family into work-based hierarchies. This account of kinship organizations contributes to the theory on organizational development and provides new conceptual tools for analyzing boundaries between organizations and communities.
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17
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Pampati S, Andrzejewski J, Steiner RJ, Rasberry CN, Adkins SH, Lesesne CA, Boyce L, Grose RG, Johns MM. "We Deserve Care and we Deserve Competent Care": Qualitative Perspectives on Health Care from Transgender Youth in the Southeast United States. J Pediatr Nurs 2021; 56:54-59. [PMID: 33186863 PMCID: PMC7941262 DOI: 10.1016/j.pedn.2020.09.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Transgender populations experience health inequities that underscore the importance of ensuring access to high quality care. We thematically summarize the health care experiences of transgender youth living in the southeast United States to identify potential barriers and facilitators to health care. DESIGN AND METHODS Transgender youth recruited from community settings in an urban area of the southeast United States participated in individual interviews (n = 33) and focus groups (n = 9) about protective factors. We conducted a thematic analysis of data from 42 participants who described their experiences seeking and receiving health care. RESULTS Participants reported a wide range of gender identities. The individual interview sample was majority Black (54.5%) and the mean age was 21.7 years and focus group participants were all white and the mean age was 16.8 years. Participants described numerous barriers to health care, including limited availability of gender affirming care, logistical challenges, such as gatekeeping and cost, concerns about confidentiality in relation to sexual behavior and gender identity, and inadequate cultural competency among providers regarding gender-affirming care. Facilitators included intake procedures collecting chosen pronouns and names and consistent use of them by providers, and open communication, including active listening. CONCLUSIONS Findings underscore the need for a multi-component approach to ensure both transgender- and youth-friendly care. PRACTICE IMPLICATIONS Providers and office staff may benefit from transgender cultural competency trainings. In addition, clinic protocols relating to confidentiality and chosen name and pronoun use may help facilitate access to and receipt of quality care.
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Affiliation(s)
- Sanjana Pampati
- Oak Ridge Institute for Science and Education (ORISE), TN, United States of America.
| | - Jack Andrzejewski
- Oak Ridge Institute for Science and Education (ORISE), TN, United States of America
| | - Riley J Steiner
- Centers for Disease Control and Prevention, Division of Reproductive Health, GA, United States of America
| | - Catherine N Rasberry
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, GA, United States of America
| | - Susan H Adkins
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, GA, United States of America
| | | | | | - Rose Grace Grose
- Department of Community Health Education, Colorado School of Public Health at the University of Northern Colorado, CO, United States of America
| | - Michelle M Johns
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, GA, United States of America
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18
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Mirabella M, Giovanardi G, Fortunato A, Senofonte G, Lombardo F, Lingiardi V, Speranza AM. The Body I Live in. Perceptions and Meanings of Body Dissatisfaction in Young Transgender Adults: A Qualitative Study. J Clin Med 2020; 9:jcm9113733. [PMID: 33233761 PMCID: PMC7699932 DOI: 10.3390/jcm9113733] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023] Open
Abstract
Body dissatisfaction in individuals with Gender Incongruence (GI) represents a primary source of suffering. Several studies have highlighted how this suffering has psychological, physical, and biological implications. This work aims to explore experiences related to body dissatisfaction and investigate the issues associated with living in a body perceived as incongruent for individuals with GI. Thirty-six individuals, aged between 18 and 30 years old and at stage T0 of hormone treatment, participated in the study. Body dissatisfaction and experiences related to it were investigated using the Clinical Diagnostic Interview. The Consensual Qualitative Research methodology was applied to the transcripts of the interviews. Several themes emerged: experiences with GI development, experiences with puberty and bodily changes, perception of one’s body, psychological problems and complex behavioral patterns related to body dissatisfaction. Results pointed out the complexity implied in the relationship with one’s body for individuals with GI, highlighting specific aspects of body dissatisfaction among these individuals (e.g., eating disorders, sexual difficulties, social withdrawal). This study underlines the need for a deeper understanding of some aspects of GI to better define guidelines for a correct assessment of it. In this way it will be easier to avoid negative outcomes for the psychological and general health of transgender people.
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Affiliation(s)
- Marta Mirabella
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli 1, 00185 Roma, Italy; (G.G.); (A.F.); (V.L.); (A.M.S.)
- Correspondence: ; Tel.: +39-340-986-7587
| | - Guido Giovanardi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli 1, 00185 Roma, Italy; (G.G.); (A.F.); (V.L.); (A.M.S.)
| | - Alexandro Fortunato
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli 1, 00185 Roma, Italy; (G.G.); (A.F.); (V.L.); (A.M.S.)
| | - Giulia Senofonte
- Laboratory of Seminology, Sperm Bank “Loredana Gandini,” Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy; (G.S.); (F.L.)
| | - Francesco Lombardo
- Laboratory of Seminology, Sperm Bank “Loredana Gandini,” Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy; (G.S.); (F.L.)
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli 1, 00185 Roma, Italy; (G.G.); (A.F.); (V.L.); (A.M.S.)
| | - Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli 1, 00185 Roma, Italy; (G.G.); (A.F.); (V.L.); (A.M.S.)
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