Coping strategies used by LGB older adults in facing and anticipating health challenges: A narrative analysis

ABSTRACT

Given that lesbian, gay, and bisexual (LGB) older adults face notable health disparities compared to their heterosexual counterparts, there is a need for understanding how LGB adults cope with health challenges in late life. The current study analyzes narratives from nine LGB adults age 65 and older living in an urban area in the Southeast United States. Participants spoke of coping strategies related to health promotion behaviors, shifting perspectives of health and body, trusting in spirituality for comfort, and accepting the end of life. We discuss implications for social services professionals who work with older LGB adults and for future research.     

How Condom Discontinuation Occurs: Interviews With Emerging Adult Women

We have almost no data on how and when couples stop using condoms. This qualitative study investigated the process of condom discontinuation. From November 2013 to April 2014, a total of 25 women living in a college town in the Midwest, ages 18 to 25, participated in semistructured interviews centered around three domains: partner interactions, contraceptive use, and sexually transmitted infection (STI) prevention. Analysis followed a critical qualitative research orientation. Participants described actively seeking the best options to prevent pregnancy, perceiving condom discontinuation in favor of hormonal methods as a smart decision, and reported wanting to discontinue using condoms due to physical discomfort. Oftentimes, nonverbal communication around contextual instances of condom unavailability paved the way for discontinuation. Participants indicated the decision to stop using condoms was neither deliberate nor planned. Condom discontinuation rarely occurred at one point in time; instead, it was preceded by a period of occasional use. Even after participants described themselves as not using condoms, sporadic condom use was normal (typically related to fertility cycles). This study provides a more detailed understanding of how and why emerging adults negotiate condom discontinuation, thereby enhancing our ability to design effective condom continuation messages. Attention should be paid to helping emerging adults think more concretely about condom discontinuation.     

Challenges and Coping Strategies of Children with Parents Affected by Schizophrenia: Results from an In-Depth Interview Study

This article presents results from an in-depth interview study investigating challenges and coping strategies of children with parents affected by schizophrenia. Thirty-four qualitative interviews of children were conducted and evaluated by content analysis. The interviewees spoke of a wide range of challenges that they must deal with daily. A variety of available coping strategies, social and personal resources were identified in the study. The results show that there is a need for professional support, especially on a low-threshold basis, that helps affected children to develop appropriate and diverse forms of coping.     

An Exploration of Risk Factors Associated With Dating Violence: Examining the Predictability of Adolescent Female Dating Violence Perpetration

Teen dating violence is a growing issue impacting the adolescent experience, with adolescent females at risk to perpetrate violence. This study used the National Longitudinal Study of Adolescent Health to examine the prevalence of related dating violence risk factors and their ability to predict perpetration by adolescent females. The predictor variables identified for teen dating violence perpetration were race, exposure to violence, adolescent alcohol use, propensity to engage in risk behaviors, mental health, and delinquency. Logistic regression analyses were conducted to determine the likelihood to predict perpetration. Unlike prior regional studies, this research did not support inclusion of these risk factors for adolescent female dating violence perpetration. Practice implications are also discussed with attention to curriculum support, community needs, and research opportunities.     

Condom Failure: Examining the Objective and Cultural Meanings Expressed in Interviews With African American Adolescents

The purpose of this study was to explore the meaning and context of self-reported “condom failure” among sexually active African American adolescents. Semistructured interviews regarding methods of protection from pregnancy and sexually transmitted disease (STD) with 124 youth (ages 14–19 years) were content analyzed. The findings suggested three meanings of condom failure. First, condom failure represents a legitimate and important risk related to sexual activity. Second, it can serve as an excuse repertoire for adolescents who engaged in unprotected sex and later experienced either pregnancy or a STD. Third, it may serve as an explanation for males who deceive their partners into having unprotected sex. The findings are discussed with regard to their implications for HIV or STD prevention and research.     

The Family Safety Model: A Comprehensive Strategy For Working With Domestic Violence

There has been continuous debate about the viability, efficacy and appropriateness of providing services to perpetrators and couples where domestic violence is the presenting problem in therapy. This paper argues that within a comprehensive and integrated model of service provision that encompasses all family members, it can be appropriate and effective to incorporate these service options if screening, monitoring and service models are carefully selected and provided in a context of agency safety and support.     

Social Isolation and Spousal Violence: Comparing Female Marriage Migrants With Local Women

This research examined the impact of network participation, social support, and social control on the violence victimization of female marriage migrants by a spouse. Data were from a household survey of 492 cross‐border and 379 local married couples in Hong Kong in 2007. The findings indicated that female marriage migrants were more vulnerable to spousal violence and more socially isolated, compared with local women. Husbands of marriage migrants were also more socially isolated compared with men who married locally. The network participation of both husband and wife was associated positively with spousal violence against women, whereas their perceived social control was associated negatively with violence. Female marriage migrants' greater vulnerability to spousal physical assault was a result of their younger age compared with local women, but their greater vulnerability to spousal psychological aggression and sexual coercion was related, in part, to their own and their husbands' network participation as well as their level of social control.     

Typologies of Childhood Exposure to Violence: Associations With College Student Mental Health

Abstract

Objective: This study examined typologies of childhood violence exposure (CVE) and the associations of profiles with current demographic characteristics and mental health in emerging adulthood. Participants: The study evaluated a sample of college students from 2 US geographic regions (Midwest, n = 195; Southeast, n = 200). Methods: An online questionnaire (collected 2013–2014) assessed CVE and current mental health. Latent class analysis was used to identify typologies of CVE. Follow-up analyses were conducted to distinguish differences between typologies in demographic characteristics and mental health. Results: Four distinct profiles emerged: High-Exposed, Domestic-Exposed, Community-Exposed, and Low-Exposed. High- and Domestic-Exposed groups were more likely to be first-generation college students and to experience symptoms of psychopathology. Conclusions: This study offers a unique presentation of CVE profiles and a nuanced interpretation of their differential relationship to current demographic characteristics and mental health. It may befit university mental health initiatives to engage first-generation students and utilize comprehensive assessments of previous victimization.     

Peer Stress in Preadolescence: Linking Physiological and Coping Responses With Social Competence

This study examined associations between real‐time physiological and coping responses in the context of salient peer stress experiences in preadolescence, as well as independent and interactive associations linking physiological and coping responses with social competence. Physiological responses included respiratory sinus arrhythmia reactivity (RSAR) and skin conductance level reactivity (SCLR) during laboratory‐based peer‐evaluative stress experiences. Engaged and disengaged coping strategies were assessed with real‐time responses to peer‐evaluative stress (assessed immediately following peer‐evaluative stress experiences in the laboratory) and with questionnaire‐based responses to peer victimization. Analyses consistently revealed associations between lower RSAR (lower vagal withdrawal) and lower teacher‐reported social competence among preadolescents with disengaged (and low engaged) coping responses to peer‐evaluative stress in the laboratory, as well as disengaged coping responses to peer victimization.     

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.     

Sexual Violence on the College Campus: A Template for Compliance With Federal Policy

Objective: The author introduces a template, the Model Policy for the Prevention and Response to Sexual Assault, to assist institutions of higher education to benchmark campus policy compliance with federal laws directed at sexual assault. The author presents a detailed review of policy criteria recommended by the National Institute of Justice. The author proposes 2 unique criteria not found in the National Institute of Justice report for consideration for a comprehensive campus sexual assault policy. Conclusion: The template provides an inclusive system to benchmark campus sexual assault policies. Conforming to the template provides compliance with federal laws and demonstrates that the campus fosters a climate that does not tolerate sexual violence.     

Safer Sex in Later Life: Qualitative Interviews With Older Australians on Their Understandings and Practices of Safer Sex

Rates of sexually transmitted infections (STIs) are increasing in older cohorts in Western countries such as Australia, the United Kingdom, and the United States, suggesting a need to examine the safer sex knowledge and practices of older people. This article presents findings from 53 qualitative interviews from the study Sex, Age, and Me: A National Study of Sex and Relationships Among Australians Aged 60+. Participants were recruited through an online national survey. We consider how participants understood “safer sex,” the importance of safer sex to them, the safer sex practices they used (and the contexts in which they used them), and the barriers to using safer sex. Older adults had diverse understandings, knowledge, and use of safer sex practices, although participants tended to focus most strongly on condom use. Having safer sex was strongly mediated by relationship context, trust, perceived risk of contracting an STI, concern for personal health, and stigma. Common barriers to safer sex included erectile difficulties, embarrassment, stigma, reduced pleasure, and the lack of a safer sex culture among older people. The data presented have important implications for sexual health policy, practice, and education and health promotion campaigns aimed at improving the sexual health and well-being of older cohorts.     

Coping With Overload and Stress: Men and Women in Dual‐Earner Families

This study tested gender differences in a model positing relationships between work and family demands, overload, 4 coping mechanisms, and stress. The coping mechanisms were hypothesized to moderate the relationship between overload and stress. The sample consisted of 1,404 men and 1,623 women in dual‐earner families. Respondents relied on 2 coping strategies: scaling back and restructuring family roles. Men were more likely than women to respond to overload by scaling back and less likely to respond by work‐role restructuring. Coping by family‐role restructuring moderated the relationship between role overload and stress for both groups; however, the gender difference was not significant. Coping by work‐role restructuring moderated the relationship between overload and stress only for men.     

Competing Values in Serving Older and Vulnerable Adults: Adult Protective Services,Mandated Reporting,and Domestic Violence Programs

State mandatory reporting statutes may directly or indirectly list domestic violence programs as among those that are mandated reporters of cases of suspected abuse, neglect, or exploitation of older individuals and those with disabilities. Domestic violence programs, however, may not consider themselves to be mandated reporters, because the responsibility of reporting abuse may be contrary to their programmatic philosophy. In the Commonwealth of Virginia, the potential conflict between domestic violence programs and Adult Protective Services about the issue of mandated reporting has created tension between these organizations as each entity continues interpreting the issues and policies of mandated reporting through its own lens. The authors draw out some of the reasons for the conflict as well as make recommendations for improving relationships between the two organizations, which will ultimately benefit vulnerable adults who are experiencing abuse.     

You Catch More Flies With Honey: Sex Work,Violence, and Masculinity on the Streets

Violence among inner‐city men is a pressing social concern, and the central focus of much academic research. Many frame it as a phenomenon that certain men perpetuate—those who inhabit disadvantaged, impoverished communities—and argue it is linked to performances of “street” masculinity. In this article, I examine male street‐based sex workers’ willingness to become embroiled in violent exchanges. In a departure from theoretical predictions, my findings reveal these men expend considerable effort to remain nonviolent with others immersed in the sex trade, a decision based upon their desire for the acquisition of capital as well as their calculation of risks. In doing so, they construct and perform a nuanced version of masculinity, which I call pacifist masculinity. Few studies analyze peaceful and conciliatory interactions among men in these contexts, an absence that only serves to reify assumptions about rampant hostility and aggression. I draw on interviews with 19 men involved in street prostitution in Chicago in 2012. This article contributes to a clearer understanding of male–male violence in high‐risk environments, examines the prominent factors that inform decisions to assault others, and explores how such actions challenge hegemonic masculinity.     

“If I Can Offer You Some Advice”: Rapport and Data Collection in Interviews Between Adults of Different Ages

Reflexively analyzing interactions between myself (young adult woman) and 150 adult research participants, I explore how interviewees responded to the interviewer's perceived age in combination with other social identity categories. Addressing a gap in scholarship on adult‐adult interview interactions, this article examines how age gradations, in combination with other axes of similarity or difference, affect researcher‐interviewee rapport and data acquisition. Racial similarity, regardless of age, unlocked access to the topic of race/ethnicity. Age intersected with gender such that women within a decade of the woman interviewer's age assumed similarity and were communicative. In interviews with similarly‐aged heterosexual men, awareness of sexuality inhibited answers around intimacy. With older interviewees, gender similarity bridged the age chasm with women. In contrast, age and gender difference inspired older men to act paternalistically and give unsolicited advice. Even among adults, interviewees' classification of the interviewer's age contours the interactional dynamic, impacts data acquisition, and reproduces social distinctions.     

Physical Abuse of Older Adults in Nursing Homes: A Random Sample Survey of Adults With an Elderly Family Member in a Nursing Home

Few empirical studies have focused on elder abuse in nursing home settings. The present study investigated the prevalence and risk factors of staff physical abuse among elderly individuals receiving nursing home care in Michigan. A random sample of 452 adults with elderly relatives, older than 65 years, and in nursing home care completed a telephone survey regarding elder abuse and neglect experienced by this elder family member in the care setting. Some 24.3% of respondents reported at least one incident of physical abuse by nursing home staff. A logistic regression model was used to estimate the importance of various risk factors in nursing home abuse. Limitations in activities of daily living (ADLs), older adult behavioral difficulties, and previous victimization by nonstaff perpetrators were associated with a greater likelihood of physical abuse. Interventions that address these risk factors may be effective in reducing older adult physical abuse in nursing homes. Attention to the contextual or ecological character of nursing home abuse is essential, particularly in light of the findings of this study.     

Reasons Why Adolescents and Young Adults Have Sex: Associations With Psychological Characteristics and Sexual Behavior

We critically review the concepts of sexual addiction, sexual compulsivity, and sexual impulsivity and discuss their theoretical bases. A sample of 31 self‐defined sex addicts was assessed by means of interview and questionnaires and compared with a large age‐matched control group. A tendency to experience increased sexual interest in states of depression or anxiety was strongly characteristic of the sex addict group. Dissociative experiences were described by 45% of sex addicts and may have some explanatory relevance. Obsessive‐compulsive mechanisms may be relevant in some cases, and the addiction concept may prove to be relevant with further research. Overall, results suggested that out of control sexual behavior results from a variety of mechanisms. We propose an alternative theoretical approach to investigating these mechanisms based on the dual control model and recent research on the relation between mood and sexuality.     

The Unique Coping Strategies of African American Families With a Loved One With Schizophrenia: The Use of the Family Crisis Oriented Personal Evaluation Scale

This study assesses how a sample of African American families with a loved one with schizophrenia cope using a commonly used family coping scale (F-COPES). The scale's overall performance and psychometric properties were tested to highlight how such families cope. The results demonstrated that families used proactive verses passive ways of coping. An exploratory factor analysis also demonstrated several unique ways in which this sample coped that were not included in the original subscales of the scale. The utility of using a family coping scale such as the F-COPES for practice and research with similar populations is reviewed.