Self‐Destructive Symptomatic Frames in Clinical Adolescents: Is the Same Different?

This study examines individual and family predictors of different self‐destructive patterns—only suicidal ideation, only nonsuicidal self‐injury (NSSI), or suicide attempts (that may also include both suicide ideation (SI) and NSSI)—in a sample of outpatient adolescents (N = 42; 86% females) with mean age of 16 years (SD = 1.86). Results indicated that there are differences in youngsters with self‐destructive behaviors in their perception of paternal rejection and maternal control, when compared with youngsters reporting only SI. Adolescents from the groups with self‐destructive behaviors differ only in age. Together, these data highlight the relevance of adopting an ecosystemic perspective, which includes both the patients and their families, regarding treatment and prevention of self‐destructive symptomatic frames.     

Mostly Heterosexual and Lesbian/Gay Young Adults: Differences in Mental Health and Substance Use and the Role of Minority Stress

Individuals mostly attracted to other-sex but also to same-sex partners are a distinct and common sexual orientation group with possibly increased levels of health problems. The current study examined whether mostly heterosexual individuals differed in mental health and substance use from lesbian/gay individuals and whether sexual minority risk and protective factors offer an explanation in a sample of 528 Dutch young adults (16 to 25 years old, M = 21.2 years). Mostly heterosexual participants reported higher levels of psychological distress, suicidality, drug use, and smoking than lesbian/gay participants and equal levels of binge drinking. They also reported higher levels of internalized negativity to same-sex attractions, less openness to family members and others, less community involvement, and lower numbers of lesbian/gay/bisexual friends. However, bootstrapped mediation analysis showed that the differences in minority stress risk and protective factors did not mediate most of the differences in mental health and substance use with one exception: higher levels of psychological distress were mediated by the higher levels of internalized negativity to same-sex attractions. The limited explanatory power of the minority stress factors combined with the elevated level of problems of mostly heterosexual individuals call for future studies examining other risk and protective factors.     

Predictors of suicidal ideation among college students: A prospective cohort study

ABSTRACT

This prospective cohort study investigated longitudinal predictors of suicidal ideation among college students. A non-clinical cohort of college students (N = 171) completed baseline and 3-month follow-up surveys. Depressive symptoms, worst-point suicidal ideation, and suicide attempt history significantly predicted follow-up suicidal ideation severity after adjusting covariates. Similarly, depressive symptoms and worst-point suicidal ideation (but not attempt history) were significant predictors of follow-up suicidal ideation intensity in an adjusted model. The results suggest that current depressive symptoms and lifetime worst-point suicidal ideation are independently valuable constructs that may provide relatively short-term predictive information when screening for suicidal ideation among college students.     

The effects of familial acculturative stress and hopelessness on suicidal ideation by immigration status among college students

Objectives: Based on acculturative family distancing theory, we examined whether familial acculturative stress interacted with hopelessness to predict suicidal ideation differentially among emerging adult immigrant versus nonimmigrant college students. Participants: We recruited 152 generationally and racially/ethnically diverse college students (42 immigrants) from 2012 to 2013. Methods: Participants completed measures of hopelessness, depressive symptoms, ethnic identity, familial acculturative stress, and suicidal ideation. Results: Immigrant status interacted with hopelessness and familial acculturative stress. Hopelessness was associated with less suicidal ideation among immigrants than among nonimmigrants at a familial acculturative stress score below the 11th percentile, but greater suicidal ideation among immigrants than among nonimmigrants at a familial acculturative stress score above the 72nd percentile. Conclusions: Familial acculturative stress may exacerbate the effect of hopelessness on suicidal ideation among immigrant college students, and should be monitored during suicide risk assessment and treatment.     

The unique relationship between childhood sexual abuse,self-injury and suicide ideation: The mediating role of emotion dysregulation

Child sexual abuse (CSA) has serious short-term and long-term effects, including non-suicidal self-injury (NSSI) and suicidal ideation (SI). One possible thread linking CSA to NSSI and suicide risk is emotion dysregulation. The current study assessed whether facets of emotion dysregulation mediated relations of NSSI behaviours and functions, and SI. Participants (N = 121; Mean age = 18.69, age-range 18–22; 78 per cent female), college students with a history of childhood trauma, completed an online survey. Results indicated that facets of emotion dysregulation (i.e. clarity, non-acceptance) mediated the relationship between CSA and SI. CSA was associated with automatic negative reinforcement, social negative and social positive reinforcement NSSI functions, but was not associated with NSSI behaviours. Emotion dysregulation facets did not mediate the relationship between CSA and NSSI functions. Findings highlight the need to help CSA survivors have clarity and acceptance of emotional experiences to reduce SI risk. This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.     

Mental Health Treatment Barriers Among Racial/Ethnic Minority Versus White Young Adults 6 Months After Intake at a College Counseling Center

Abstract

Objective: This study examined mental health treatment barriers following intake at a counseling center among racially/ethnically diverse college students. Methods: College students (N = 122) seen for intake at a college counseling center in 2012–2013 completed self-reports of depressive symptoms, suicidal ideation, and mental health treatment barriers 6 months later. Results: Racial/ethnic minority students less often reported previous mental health treatment and treatment after being seen at the counseling center, compared with white students. They also endorsed more treatment barriers—most commonly, financial concerns and lack of time—and more often endorsed stigma-related concerns. Treatment barriers were associated with not following through with counseling center recommendations and with greater depressive symptom severity but not with suicidal ideation during follow-up. Conclusions: Improving mental health treatment seeking among racial/ethnic minority college students should involve decreasing treatment barriers, improving access to affordable options, providing flexible scheduling or time-limited options, and decreasing stigma.,     

The Indirect Effect of Child Maltreatment Severity on Adult PTSD Symptoms through Anxiety Sensitivity

Although the rate of posttraumatic stress disorder (PTSD) among survivors of child maltreatment is high, individuals differ in symptom severity and many do not experience clinically significant levels of psychopathology. The present study tested the indirect effects of child maltreatment severity on adult PTSD, suicidal ideations, and alcohol dependence via anxiety sensitivity. A sample of 336 participants (mean age of 22.81 years, SD = 8.93; 70.2% female) completed an online survey of child abuse and neglect, anxiety sensitivity, PTSD symptom severity, suicidal ideation severity, and alcohol dependence severity. The results revealed significant indirect effects of child maltreatment on PTSD symptom severity through cognitive and social concerns, but not physical concerns. No direct or indirect effects were demonstrated for suicidal ideations or alcohol dependence severity. These findings elucidate mechanisms in the robust relationship between child maltreatment and adult PTSD symptoms and can potentially inform future research on mechanisms of change in psychotherapy.     

Psychological Distress in Older Portuguese Gay and Bisexual Men: The Mediating Role of LGBT Community Connectedness

Abstract

Objectives: Examining Psychological Distress (PD) among older Portuguese gay and bisexual men (GBM), and the mediator role of LGBT community connectedness (LGBTCC) of minority stress variables on PD. Methods: We performed a mediation analysis with LGBTCC as mediator between minority stress variables and PD with a sample of 110 elderly GBM. Results: We found moderate PD levels; LGBTCC was a significant mediator between concealment of sexual orientation and PD, but not between internalized stigma and expectations of rejection and PD. Conclusions: More attention is needed to Older Portuguese GBM’s mental health. LGBTCC is an important ameliorating factor for older GBM.     

Posttraumatic Stress Disorder and Suicidal Ideation Among Sexually Abused Adolescent Girls: The Mediating Role of Shame

ABSTRACT

Sexual abuse is associated with a host of negative repercussions in adolescence. Yet the possible mechanisms linking sexual abuse and negative outcomes are understudied. The purpose of this study was to investigate the relationships among self-blame, shame, coping strategies, posttraumatic stress disorder, depressive symptoms, and suicidal ideation. The sample included 147 sexually abused adolescent girls between 14 and 18 years of age. A total of 66% of girls reached clinical score for posttraumatic stress disorder, and 53% reached clinical score for depressive symptoms. Close to half (46%) reported suicidal thoughts in the past 3 months. Shame was found to partially mediate the relationship between self-blame and posttraumatic stress disorder. Shame and depressive symptoms were also found to partially mediate the relationship between self-blame and suicidal ideation. Results suggest that shame is a crucial target in interventions designed for sexually abused adolescent girls.     

Differences in Sexual Orientation Diversity and Sexual Fluidity in Attractions Among Gender Minority Adults in Massachusetts

This study characterized sexual orientation identities and sexual fluidity in attractions in a community-based sample of self-identified transgender and gender-nonconforming adults in Massachusetts. Participants were recruited in 2013 using bimodel methods (online and in person) to complete a one-time, Web-based quantitative survey that included questions about sexual orientation identity and sexual fluidity. Multivariable logistic regression models estimated adjusted risk ratios (aRRs) and 95% confidence intervals (95% CIs) to examine the correlates of self-reported changes in attractions ever in lifetime among the whole sample (n = 452) and after transition among those who reported social gender transition (n = 205). The sample endorsed diverse sexual orientation identities: 42.7% queer, 19.0% other nonbinary, 15.7% bisexual, 12.2% straight, and 10.4% gay/lesbian. Overall, 58.2% reported having experienced changes in sexual attractions in their lifetime. In adjusted models, trans masculine individuals were more likely than trans feminine individuals to report sexual fluidity in their lifetime (aRR = 1.69; 95% CI = 1.34, 2.12). Among those who transitioned, 64.6% reported a change in attractions posttransition, and trans masculine individuals were less likely than trans feminine individuals to report sexual fluidity (aRR = 0.44; 95% CI = 0.28, 0.69). Heterogeneity of sexual orientation identities and sexual fluidity in attractions are the norm rather than the exception among gender minority people.     

Gender Minority Social Stress in Adolescence: Disparities in Adolescent Bullying and Substance Use by Gender Identity

Bullying and substance use represent serious public health issues facing adolescents in the United States. Few large-sample national studies have examined differences in these indicators by gender identity. The Teen Health and Technology Study (N = 5,542) sampled adolescents ages 13 to 18 years old online. Weighted multivariable logistic regression models investigated disparities in substance use and tested a gender minority social stress hypothesis, comparing gender minority youth (i.e., who are transgender/gender nonconforming and have a gender different from their sex assigned at birth) and cisgender (i.e., whose gender identity or expression matches theirs assigned at birth). Overall, 11.5% of youth self-identified as gender minority. Gender minority youth had increased odds of past-12-month alcohol use, marijuana use, and nonmarijuana illicit drug use. Gender minority youth disproportionately experienced bullying and harassment in the past 12 months, and this victimization was associated with increased odds of all substance use indicators. Bullying mediated the elevated odds of substance use for gender minority youth compared to cisgender adolescents. Findings support the use of gender minority stress perspectives in designing early interventions aimed at addressing the negative health sequelae of bullying and harassment.     

High Betrayal Adolescent Sexual Abuse and Nonsuicidal Self-Injury: The Role of Depersonalization in Emerging Adults

ABSTRACT

Adolescent sexual abuse can interfere with healthy development. Sexual abuse that is perpetrated by close other(s)—high betrayal—can be additionally harmful, with sexual abuse being linked with dissociation and nonsuicidal self-injury (NSSI). Depersonalization, a dissociative subtype characterized by disconnection between oneself and one’s body and/or thoughts, may further explain the role of dissociation in NSSI. The purpose of the current study was to: 1) isolate the impact of adolescent sexual abuse on NSSI; and 2) examine depersonalization as a pathway between high betrayal adolescent sexual abuse and NSSI. Participants (N = 192) were college students who completed online measures assessing sexual abuse, dissociation, and NSSI. While controlling for child sexual abuse and adult sexual abuse, adolescent sexual abuse predicted NSSI. Moreover, there was an indirect effect of high betrayal adolescent sexual abuse on NSSI through depersonalization, while controlling for child sexual abuse, adult sexual abuse, and medium betrayal (perpetrator: unclose other) adolescent sexual abuse. Findings from the current study have implications for relational cultural therapy as an evidence-informed treatment that highlights the relational harm of interpersonal trauma, while incorporating contextual elements, such as development of maladaptive coping strategies, into therapy.     

Casual Sexual Relationships and Mental Health in Adolescence and Emerging Adulthood

Casual sexual relationships are relatively common in emerging adulthood. Yet the mental health implications of engaging in these relationships are unclear; past research has found negative associations, positive associations, or no association with mental health. In addition, little research has accounted for mental health status prior to entering casual sexual relationships. Using data from the National Longitudinal Study of Adolescent Health (N = 12,401), we measured mental health prior to engaging in casual sexual relationships and subsequent mental health after engaging in these relationships. We found that suicidal ideation and depressive symptoms in adolescence were associated with entrance into casual sexual relationships in emerging adulthood. Furthermore, casual sexual relationships were associated with an increased likelihood of reporting suicidal ideation in emerging adulthood.     

Resilience in Undergraduate Social Work Students: Social Support and Adjustment to Academic Stress1

The purpose of this exploratory study was to analyze the relationship between academic stress and resilience in American, undergraduate social work students (N = 145), and to identify whether social support functioned as a protective factor amid this relationship. Testing social support within models of mediation and moderation served this purpose. Surveys were submitted to three social work programs and solicited empirical data on academic stress; social support and two subsystems, family and friend support; and perceived resilience. The sample reported moderate levels of academic stress, social support, and resilience. Academic stress significantly (p < 0.05), negatively influenced social support and resilience. Social support systems exerted significant, positive influence with each other and with resilience. No social supports mediated the negative stress effect on resilience. Friend support moderated the academic stress–resilience relationship. Implications for social work educators and field agency practitioners regarding enhancement of supportive peer relationships among undergraduate students are discussed.     

Considerations for Culturally Sensitive Research With Transgender Adults: A Qualitative Analysis

Transgender (trans) individuals have historically been left out of research, and previous work has often conflated gender identity with sexual orientation. Furthermore, language used in psychology measures is often heteronormative and uses binary gendered language (e.g., “him”/“her”). The aim of the current study was to provide empirically derived guidance on conducting culturally sensitive research with transgender participants using qualitative data. We recruited trans individuals, ages 18 to 44, to participate in an anonymous, qualitative, national online survey as part of a quantitative study on the relationships among minority stress, sexual behavior, and mental health. The qualitative portion included four open-ended feedback questions. We identified four overarching themes regarding experiences with our survey: (a) emotional reaction; (b) insight gained; (c) being outside the box; and (d) value of the work. Research with trans adults should be more inclusive of diverse gender identities, sexual identities, and sexual behaviors. Steps in this direction may include soliciting feedback from community members regarding survey language and response options, allowing participants to contextualize their responses using open-ended questions, and clarifying language to distinguish between sexual behavior and sexual identity. A list of seven preliminary guidelines was proposed to aid scientists in conducting culturally sensitive research with trans individuals.     

Suicidality among homeless people: Testing the mediating effects of self-efficacy and depression

ABSTRACT

This cross-sectional study examined the mediating effect of PTSD on suicide ideation and suicide attempt through two mediators, self-efficacy and depression, among homeless adults. We recruited a non-random, purposive sample of 156 homeless adults from seven homeless people shelters in Kansas. SEM results suggest that self-efficacy and depression were significant mediators between PTSD and suicide ideation, but not between PTSD and suicide attempt. This study’s findings can be used to identify risk factors associated with suicidal behaviors that can be used to design service programs aimed at preventing suicidal ideation and attempt among people who are homeless.     

Comparison of suicidal ideation,suicide attempt and suicide in children and young people in care and non-care populations: Systematic review and meta-analysis of prevalence

Suicide in children and young people is a major public health concern. However, it is unknown whether individuals who have been in the care of the child welfare system are at an elevated risk. Care is presently defined as statutory provision of in-home care (e.g. child living with birth family but in receipt of legal order involving supervision by social workers) or out-of-home care (e.g. foster care, residential care and kinship care). This paper presents a systematic review and meta-analysis comparing the prevalence of suicidal ideation, suicide attempt and suicide in children and young people placed in care with non-care populations. A systematic search was conducted of 14 electronic bibliographic databases and 32 websites. Of 2811 unique articles identified, five studies published between 2001 and 2011 met the inclusion criteria. Studies reported on 2448 incidents of suicidal ideation, 3456 attempted suicides and 250 suicides. The estimated prevalence of suicidal ideation was 24.7% in children and young people in care compared to 11.4% in non-care populations. The prevalence of suicide attempt was 3.6% compared to 0.8%. Two studies reported on suicide. Suicide risk in children and young people in care was lower in one study (0% vs 0.9%) and higher in the second (0.27% vs 0.06%). The results of the systematic review and meta-analysis confirm that suicide attempts are more than three times as likely in children and young people placed in care compared to non-care populations. Targeted interventions to prevent or reduce suicide attempt in this population may be required. Further comparative studies are needed to establish if children and young people in care are at an elevated risk of suicidal ideation and suicide.     

Identification of Sexually Abused Female Adolescents at Risk for Suicidal Ideations: A Classification and Regression Tree Analysis

This study explored the clinical profiles of 77 female teenager survivors of sexual abuse and examined the association of abuse-related and personal variables with suicidal ideations. Analyses revealed that 64% of participants experienced suicidal ideations. Findings from classification and regression tree analysis indicated that depression, posttraumatic stress symptoms, and hopelessness discriminated profiles of suicidal and nonsuicidal survivors. The elevated prevalence of suicidal ideations among adolescent survivors of sexual abuse underscores the importance of investigating the presence of suicidal ideations in sexual abuse survivors. However, suicidal ideation is not the sole variable that needs to be investigated; depression, hopelessness and posttraumatic stress symptoms are also related to suicidal ideations in survivors and could therefore guide interventions.     

Marital Status and Perceived Discrimination Among Transgender People

Despite calls for increased attention to the experiences of transgender people, scientific understanding of the stigma and discrimination this population experiences is limited. The authors integrate minority stress and marital advantage perspectives to assess marital status differences in transgender‐related perceived discrimination among transgender people in multiple life domains: the workplace, family, health care, and public accommodations. They analyze one of the first and most comprehensive large‐scale samples of transgender people in the United States (N = 4,286), the National Transgender Discrimination Survey. They find that married transgender respondents tend to report lower levels of perceived discrimination than their cohabiting and previously married transgender counterparts. Married transgender respondents do not, however, report lower levels of perceived discrimination than their never married counterparts, once all covariates are accounted for. These marital status differences appear primarily among transwomen but not transmen. Economic resources account for some, but not all, of these differences.     

The Role of Premigration Status in the Acculturation of Chinese–Vietnamese and Vietnamese Americans

Drawing from fifty in‐depth interviews, this research examines the role of existing parental language knowledge on the ethnic identity negotiation of two ethnically distinct children of immigrant groups—Vietnamese and Chinese–Vietnamese—whose families have emigrated from Vietnam to the Southern California region of the United States. While previous research focused primarily on the influence of premigration status on first‐generation immigrants, this article considers how a central aspect of premigration status (intranational ethnicity) applies specifically to the children of first generation immigrants. By taking the premigration approach of comparing the experiences of different ancestral‐origin groups from a single nation (the intranational ethnicity perspective), this analysis suggests that a family's premigration ethnic status shapes the 1.5 and second‐generation's ethnic self‐identification choices through the mediation of parental language knowledge. Specifically, for the children of immigrants with twice‐minority status (Chinese–Vietnamese Americans), parental language knowledge serves as an easy ethnic identity default during these children's early self‐identification process.