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Brooks BD, Kaniuka A, Job SA, Hodgkinson N, Kelliher Rabon J, Williams SL, Hirsch JK. Anticipated Sexual Minority Stress and Mental Health after the 2016 Presidential Election: Examining a Psychological Mediation Framework. J Homosex 2023; 70:3125-3148. [PMID: 35759638 DOI: 10.1080/00918369.2022.2087481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sexual minorities are at an increased risk for psychopathology, compared to heterosexual counterparts, in part due to stressors unique to their sexual minority identity. The greater socio-political climate may exacerbate sexual minority stress, and the context of the 2016 United States presidential election infringed upon the rights and well-being of LGBQ individuals. In our sample of sexual minorities (n = 253), we examined the association between anticipated stigma in response to the 2016 presidential election and symptoms of anxiety and depression, and the potential mediating role of self-compassion, hopelessness and social support. Greater anticipated stigma was associated with less self-compassion, less perceived social support, and greater hopelessness, and, in turn, greater symptoms of anxiety and depression. Anticipated stigma may erode feelings of environmental support and may be internalized as negative views of the self and future. From a public health perspective, policy-makers should be aware that the discussion and/or enactment of policies which discriminate against LGBQ persons may negatively impact mental health. Clinically, bolstering self-compassion and interpersonal functioning, and targeting hopelessness, through strategies such as Acceptance and Commitment Therapy and Compassion-Focused Therapy, may buffer the impact of minority stress among sexual minorities.
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Affiliation(s)
- Byron D Brooks
- Department of Psychology, Loyola University Chicago, Chicago, Illinios, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA
| | - Andrea Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Sarah A Job
- Department of Population Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Nicole Hodgkinson
- Department of Psychology, Loyola University Chicago, Chicago, Illinios, USA
| | - Jessica Kelliher Rabon
- Division of Pediatric Psychology, Prisma Health - Upstate, Greenville, South Carolina, USA
| | - Stacey L Williams
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Jameson K Hirsch
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
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Brooks BD, Job SA, Kaniuka AR, Kolb R, Unda Charvel P, Araújo F. Healthcare discrimination and treatment adherence among sexual and gender minority individuals living with chronic illness: the mediating effects of anticipated discrimination and depressive symptoms. Psychol Health 2023:1-17. [PMID: 37339152 DOI: 10.1080/08870446.2023.2220008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 05/15/2023] [Accepted: 05/24/2023] [Indexed: 06/22/2023]
Abstract
Background: Sexual and gender minority (SGM) individuals are at increased risk for an array of chronic illness due to minority stress. Up to 70% of SGM individuals report healthcare discrimination, which may cause additional challenges for SGM people living with chronic illness including avoiding necessary healthcare. The extant literature highlights how healthcare discrimination is associated with depressive symptoms and treatment nonadherence. However, there is limited evidence on the underlying mechanisms between healthcare discrimination and treatment adherence among SGM people living with chronic illness.Methods: Among a sample of SGM individuals living with chronic illness (n = 149) recruited from social media, the current study examined the mediating roles of anticipated discrimination and depressive symptoms on the relation between healthcare discrimination and treatment adherence in a serial mediation model.Results: We found that healthcare discrimination was associated with greater anticipated discrimination, increased depressive symptoms, and, in turn, poorer treatment adherence. Conclusion: These findings highlight the association between minority stress and both depressive symptoms and treatment adherence among SGM individuals living with chronic illness. Addressing institutional discrimination and the consequences of minority stress may improve treatment adherence among SGM individuals living with chronic illness.
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Affiliation(s)
- Byron D Brooks
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Sarah A Job
- Department of Population Health Sciences, University of Central Florida, Orlando, FL, USA
| | - Andréa R Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Rachel Kolb
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | | | - Fabiana Araújo
- Department of Psychiatry and Behavioral Neurosciences, University of Chicago, Chicago, IL, USA
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Job SA, Kaniuka AR, Reeves KM, Brooks BD. Interactions of Sexual Orientation and Gender Identity with Race/Ethnicity in Prevalence of Lifetime and Current Asthma Diagnosis. LGBT Health 2023. [PMID: 36946646 DOI: 10.1089/lgbt.2022.0186] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Purpose: The current study explored how sexual orientation and gender identity interact with race/ethnicity to predict self-reported lifetime and current diagnosis of asthma. Methods: Using the 2020 Behavioral Risk Factor Surveillance System survey, we conducted logistic regression analyses, weighted for complex samples, stratified by sexual orientation and gender identity, and controlling for race/ethnicity, age, smoking, population density, and body mass index. Results: Analyses showed that there were significantly higher adjusted odds of lifetime asthma among gay men and bisexual men in comparison to heterosexual men, gay/lesbian women and bisexual women in comparison to heterosexual women, and transgender men in comparison to cisgender individuals. In addition, analyses showed that there were significantly higher odds of current asthma among women with other minority sexual orientations in comparison to heterosexual women. Finally, there was a significant interaction between race/ethnicity and sexual orientation among men. Conclusions: Sexual minority men of color might be particularly vulnerable to chronic asthma. Future research should examine asthma prevalence in sexual and gender minority (SGM) individuals of specific marginalized racial/ethnic groups. Future responses to SGM asthma inequities should include low-cost screening and treatment targeting SGM individuals, and policies improving air quality in urban areas.
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Affiliation(s)
- Sarah A Job
- Department of Population Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Andréa R Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Karli M Reeves
- Department of Population Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Byron D Brooks
- Department of Psychology, Loyola University Chicago, Chicago, Illinois, USA
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Brooks BD, Kaniuka AR, Motley DN, Job SA, Williams SL. "We are just magic": A qualitative examination of self-love among Black same-gender loving men. Cultur Divers Ethnic Minor Psychol 2022; 28:280-289. [PMID: 35201796 DOI: 10.1037/cdp0000529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Black same-gender loving men (BSGLM) represent a population with understudied lived experiences as both racial and sexual minority individuals. Most existing research among BSGLM focuses on sexual health outcomes in the context of minority stress, without consideration of the full experiences of BSGLM or strengths-based approaches. The present study aimed to address this gap in the literature by examining self-love among BSGLM using a phenomenological qualitative approach. METHOD Adult BSGLM in the U.S. (n = 19; Mage = 31.79 years [SD = 8.88]) were recruited online and completed interviews via phone and video conferencing. Data were coded independently by two trained coders via an iterative approach that included in vivo coding and line-by-line comparative coding. Codes were grouped thematically, guided by sexual minority identity and positive psychology literature. RESULTS Three major themes related to self-love among BSGLM emerged: (a) Freedom of identity, meaning participants' ability to construct an identity outside of societal expectations; (b) Community connection and pride, or participants' connection to and pride derived from the BSGLM community; and (c) Adversarial growth and resilience, or ways that adversity related to BSGLM identity generated personal growth. CONCLUSIONS Current findings may have clinical implications. Using narrative therapy approach, facilitating connectedness to the BSGLM community, and implementing gratitude interventions in therapeutic settings may enhance self-love and positive self-regard among BSGLM. Future research should continue to give voice to the full lived experience of BSGLM. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Kaniuka AR, Job SA, Brooks BD, Guo Y, Bowling J. Human Papillomavirus Vaccination Initiation and Completion Among Heterosexual and Sexual Minority U.S. Adults. LGBT Health 2022; 9:177-185. [PMID: 35180364 DOI: 10.1089/lgbt.2021.0369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The current study examined the relationship between sexual orientation and human papillomavirus (HPV) vaccination status (no vaccination vs. vaccination initiation [one to two doses] or completion [three or more doses]) among a nationally representative sample of U.S. adults. Methods: Pooled Integrated Public Use Microdata Series-National Health Interview Survey data from 2013 to 2017 were used. The analysis sample (N = 35,266) reported on HPV vaccination status, sexual orientation, and demographic covariates. Multinomial logistic regression, stratified by sex, was conducted to assess the relationship between sexual orientation and HPV vaccination status. Results: Most of the sample (80.37%) had not received any HPV vaccination dose, and only ∼10% reported vaccine completion (three or more doses). After adjusting for demographic covariates, gay and bisexual males were more likely than heterosexual males to initiate (gay: adjusted odds ratio [AOR] = 2.46, 95% confidence interval [CI] = 1.67-3.62; bisexual: AOR = 2.30, 95% CI = 1.28-4.12) and complete (gay: AOR = 2.59, 95% CI = 1.45-4.65; bisexual: AOR = 3.20, 95% CI = 1.56-6.55) HPV vaccination. Bisexual females were more likely than heterosexual females to initiate (AOR = 1.99, 95% CI = 1.55-2.54) and complete (AOR = 1.45, 95% CI = 1.23-1.86) HPV vaccination. Females of another sexual orientation were less likely than heterosexual females to complete HPV vaccination (AOR = 0.49, 95% CI = 0.26-0.92). Conclusions: HPV vaccination remains low across sexual orientation groups. Sexual minority status may be a promotive factor in HPV vaccination for specific subgroups.
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Affiliation(s)
- Andrea R Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Sarah A Job
- Department of Population Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Byron D Brooks
- Department of Psychology, Loyola University Chicago, Chicago, Illinois, USA
| | - Yuqi Guo
- School of Social Work, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina, USA.,School of Data Science, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Jessamyn Bowling
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
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Kaniuka AR, Job SA, Brooks BD, Williams SL. Gratitude and lower suicidal ideation among sexual minority individuals: theoretical mechanisms of the protective role of attention to the positive. The Journal of Positive Psychology 2020. [DOI: 10.1080/17439760.2020.1818814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Andrea R. Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Sarah A. Job
- Department of Psychology, East Tennessee State University, Johnson City, TN, USA
| | - Byron D. Brooks
- Department of Psychology, East Tennessee State University, Johnson City, TN, USA
| | - Stacey L. Williams
- Department of Psychology, East Tennessee State University, Johnson City, TN, USA
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Brooks BD, Job SA, Clark EA, Todd EA, Williams SL. Concealment as a moderator of anticipated stigma and psychiatric symptoms. Journal of Gay & Lesbian Mental Health 2020. [DOI: 10.1080/19359705.2020.1721037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Byron D. Brooks
- Social Issues and Relations Lab, Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Sarah A. Job
- Social Issues and Relations Lab, Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Emily A. Clark
- Social Issues and Relations Lab, Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Emerson A. Todd
- Social Issues and Relations Lab, Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Stacey L. Williams
- Social Issues and Relations Lab, Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
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Bush HA, Job SA. Stressors of providing care to the elderly. AORN J 1993; 57:938, 941-5. [PMID: 8466207 DOI: 10.1016/s0001-2092(07)69097-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- H A Bush
- Texas Woman's University, Denton
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