Do student service members/veterans experience worse mental health stigma than their peers? A comparative study in a national sample

ABSTRACT

Objectives: Examine differences in mental health treatment-related stigma in student service members and veterans (SSM/Vs) and peers from 57 post-secondary institutions across the United States. Methods: In total, 909 SSM/Vs and 1818 demographically- and institutionally-matched non-SSM/Vs completed assessments of stigma-related barriers to mental health service utilization as part of the Healthy Minds Study between 2011 and 2015. Results: When compared to non-SSM/V peers, SSM/Vs reported more mental health treatment-related stigma toward help-seekers and less confidence in the helpfulness of therapy/counseling and psychotropic medications. However, effect sizes were small in magnitude (ds = .10 to .16), and depressed students in both groups reported greater stigma. Conclusions: SSM/Vs experience greater treatment-related stigma than non-SSM/V peers, which may deter service use in many cases. However, differences in stigma were small and other under-studied barriers to help-seeking may apply to the substantive subset of SSM/Vs and non-SSM/Vs who may benefit from utilizing available services.     

Mental Health and Clinical Correlates in Lesbian,Gay, Bisexual,and Queer Young Adults

Abstract

Objective: This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students. Participants: College students at a large public university. Methods: An anonymous, voluntary survey was distributed via random e-mail generation to university students during April and May of 2011. LGBQ students were compared with their heterosexual counterparts on psychological and physical status as well as academic performance. Results: LGBQ students reported worse depressive symptoms, higher levels of perceived stress, considered themselves less attractive, and were more likely to be overweight. LGBQ students were significantly more likely to report histories of affective, substance use, and certain anxiety disorders as well as compulsive sexual behavior and compulsive buying. Conclusions: The higher rates of many psychiatric conditions among LGBQ students underscore the need for universities to provide LGBQ students a nonjudgmental environment to discuss sexual orientation and health issues.     

Health behaviors of culturally diverse inner-city community college students

ABSTRACT

Objective: To determine the prevalence of risk behaviors related to cigarette use, alcohol use, nutrition, physical fitness, and sexual behavior. Participants: Participants were 1,075 students attending an urban community college during the Spring 2012 semester. Methods: Data were collected in randomly selected classes using the American College Health Association National College Health Assessment II (ACHA-NCHA II) paper survey and analyzed using Statistical Package for the Social Sciences (SPSS) version 22 for frequencies and chi-square test of independence. Results: The sample population reported poor diet, low rates of physical activity, high rates of overweight/obesity, low rates of condom use for vaginal sex, multiple sexual partners, and unintentional pregnancy. Protective health behaviors included low rates of cigarette smoking and alcohol use, high rates of condoms use for anal sex, and high rates of human immunodeficiency virus (HIV) testing. Conclusion: Students are at high risk for health problems related to poor diet, lack of exercise, and risky sexual behaviors. Additional research is recommended to determine the most effective intervention strategies.     

Life after loss: Comparing student service member/veteran and civilian mental health characteristics among individuals exposed to death by suicide

Objective: This study evaluated the mental health characteristics and beliefs of student service members/veterans (SSM/Vs) who have been exposed to another’s death by suicide.

Participants: A total of 39 SSM/Vs exposed to suicide and 32 SSM/Vs not exposed to suicide were sampled from a larger, epidemiological survey. An age- and gender-matched group of 39 civilian (C) students was drawn from a larger sample of individuals exposed to suicide.

Methods: Data were collected as part of an Internet-based, campus needs survey that occurred in Fall 2014. Participants were asked to complete measures about suicide-related behaviors, suicide prevention, help-seeking, and demographics.

Results: SSM/Vs exposed to suicide had more positive mental health/suicide prevention beliefs than SSM/Vs not exposed to suicide. Cs exposed to suicide were not significantly different from either group. Unique help-seeking patterns were also identified.

Conclusions: The current study identifies unique characteristics of SSM/Vs exposed to suicide that may inform prevention programming.     

Nonsuicidal Self-injury in a College Population: General Trends and Sex Differences

Abstract

Objective: To describe basic nonsuicidal self-injury (NSSI) characteristics and to explore sex differences. Methods: A random sample from 8 universities were invited to participate in a Web-based survey in 2006–2007; 38.9% (n = 14,372) participated. Analysis assessed sex differences in NSSI prevalence, practices, severity, perceived dependency, and help-seeking; adjusted odds ratios for NSSI characteristics were calculated by sex status. Results: Lifetime NSSI prevalence rates averaged 15.3%. Females were more likely than males to self-injure because they were upset (adjusted odds ratio [AOR] = 1.6; 95% confidence interval [CI] = 1.3–2.1) or in hopes that someone would notice them (AOR = 1.6, 95% CI = 1.1–2.7). Males were 1.6 times (95% CI = 1.2–2.2) more likely to report anger and 4.0 times (95% CI = 2.3–6.8) more likely to report intoxication as an initiating factor. Sexual orientation predicted NSSI, particularly for women (Wald F = 8.81, p ≤ .000). Only 8.9% of the NSSI sample reported disclosing NSSI to a mental health professional. Conclusions: NSSI is common in college populations but varies significantly by sex and sexual orientation. NSSI disclosure is low among both sexes.     

Predicting disclosure of MSM status to providers in a primarily socially conservative state

ABSTRACT

Purpose: This study aimed to determine what predicts a man who identifies as MSM living in a conservative state to inform his provider of his sexual behaviors and/or his sexual orientation. Methods: We administered an anonymous online survey to 148 men who reported seeing a general medical provider in the last 12 months. All participants resided in Oklahoma. Results: When controlling for HIV status, previous STI diagnosis, and age, logistic regression modeling yielded significant results (x²(9) = 31.22, p <.001) predicting 70.3% of cases. Age and overall disclosure of sexual orientation and/or sexual behaviors were significant predictors. Conclusion: Individuals who did not disclose their sexual orientation or same-sex behaviors to friends and family members were less likely to inform their providers of their sexual orientation. Disclosure of MSM status provides additional opportunities to enhance primary and secondary prevention strategies in rural and conservative areas that are necessary to optimize health, including but not limited to HIV screening and discussion of pre-exposure prophylaxis that their counterparts in urban settings more readily receive.     

Predictors of well-being in the lives of student service members and veterans

Objective: The current study examined predictors of well-being, including quality of life and academic engagement, in a sample of student service members and veteran college students. Methods: Eighty-seven student service members/veterans (SSM/V) completed an online survey containing questions about post-deployment social support, emotion regulation skills, psychological distress, academic engagement, quality of life, and demographics. Participants were recruited from September 2012 through May 2014. Results: Results provided partial support for the proposed bi-directional mediational relations between post-deployment social support and emotion regulation predicting to quality of life and academic engagement. Path models indicated that both post-deployment social support and emotion regulation skills partially mediated the relation with quality of life while accounting for the effect of psychological distress, and that emotion regulation skills fully mediated the relation between social support and academic engagement. Conclusions: These findings suggest that both social support and emotion regulation skills may be useful targets for health promotion and intervention efforts for this population. Limitations and clinical implications for the development of on-campus SSM/V focused health promotion services are discussed.     

Mental health and substance use of sexual minority college athletes

ABSTRACT

Objective: Assess the mental health and substance use of sexual minority collegiate student-athletes in the United States, as compared with heterosexual college students and heterosexual student-athletes. Participants: Undergraduate students (N = 196,872) who completed the American College Health Association's National College Health Assessment (Fall 2008–Fall 2012 administrations). Methods: Written cross-sectional survey. Results: Sexual minority student-athletes had a higher risk of experiencing mental health difficulties than their heterosexual athlete peers. There were no significant differences in mental health between sexual minority male athletes and nonathletes. Sexual minority female athletes appeared to fare better than nonathlete peers. Substance use was greater among sexual minority students (athlete and nonathlete) and was mediated by mental health. Conclusions: Participation in athletics does not appear to be associated with an elevated risk of negative mental health outcomes for sexual minority participants; however, there are disparities in mental health outcomes by sexual orientation regardless of athletics participation.     

The alcohol contexts of consent,wanted sex,sexual pleasure,and sexual assault: Results from a probability survey of undergraduate students

Objective: To examine, in a probability sample of undergraduate students, characteristics of students’ most recent sexual experiences (including alcohol use) as well as their experiences with nonconsensual sex. Participants: In January and February 2015, 22,046 students were invited to participate in an anonymous, cross-sectional, Internet-based survey; 7,032 surveys were completed (31.9%). Methods: Measures included background characteristics (age, gender, sexual orientation), most recent sexual event items (sexual pleasure, wantedness, alcohol use), and experiences with nonconsensual sex (since college and lifetime). Results: Respondents reporting sober consensual sex were more likely to report higher levels of sexual pleasure and wantedness. Nonconsensual oral, vaginal, or anal penetration occurring during college were reported by 15.8% of women and 7.7% of men. Students more often told friends, partners, or family members and rarely disclosed to university faculty or police. Conclusions: Implications for campus policy and health education are addressed.     

Condom Use Completeness,Perceptions, and Sexual Quality at Most Recent Sexual Event: Results from a U.S. Nationally Representative Probability Sample

Abstract

Objectives: To explore perceptions of condoms associated with complete use and evaluate relationships between condom perceptions, condom use, and sexual quality.

Methods: Using data from a U. S. nationally representative probability sample, we assessed individuals’ condom use perceptions and related characteristics of their most recent sexual event through bivariate and regression analyses (n?=?234).

Results: Most participants reported complete condom use and neutral or positive perceptions of condoms. Though incomplete use was associated with orgasm among women, arousal and pleasure did not differ by gender or duration of condom use.

Conclusions: We found no evidence that delayed application or early condom removal increased sexual arousal or pleasure, which may help sexual health promotion interventions address negative cultural ideas about condoms.     

Modeling the impact of social discrimination on the physical and mental health of Portuguese gay,lesbian and bisexual people

Background: Despite growing acceptance of same-sex sexuality in Portugal, identity development of lesbian, gay and bisexual (LGB) individuals is still restricted by negative societal attitudes, which maintain the experience of stigmatization and discrimination. The purpose of this study is to document the frequency of discriminatory events experienced by sexual minorities and their association with indicators of physical and mental health in Portugal. Methods: A total of 610 LGB participants completed an online survey (mean age?=?34.48, SD?=?11.54). Most participants were single and self-identified as gay (73.8%). The survey included five categories of survey items: demographic information, social support, physical health, mental health, and discrimination experiences. Results: Physical and mental health results revealed that bisexual people were more likely to report higher levels of psychological distress than gay men. Overall, between one-fifth and one-fourth of the participants in this sample frequently felt the need to hide their sexual orientation to prevent discrimination experiences across the different settings. Regarding actual discrimination experiences, close to 20% reported having suffered from verbal abuse, followed by close to 10% who suffered from written threats, harassment, and physical threats. A hierarchical multiple regression analysis was performed to assess the effects of anticipated and actual discrimination on mental health. Possible confounding variables were added in the first block – age, sexual orientation, being in a relationship, body mass index, and HIV status. Anticipated and actual discrimination experiences were added in the second block. The first block of the analysis explained 6% of the overall variance, while the second block – discrimination experiences – explained an additional 17%. Conclusion: Portuguese culture and stigma/discrimination create discriminatory experiences which impact LGB people's health. Unless policies are changed to allow for the acceptance of LGB people, they will continue to experience violence and discrimination as a result of homophobia.     

The understudied half of undergraduates: Risky sexual behaviors among community college students

Abstract

Objective: This study examines the prevalence and risk factors associated with risky sexual behaviors in community college students. Participants: A diverse sample of 18–19-year-old community college students (N?=?264). Methods: Baseline data from an online prevention program administered in 2015. Results: Community college students in this sample disproportionately experienced sexual assault and were unlikely to test for STIs. Higher intentions to engage in risky sexual behaviors were associated with gender and sexual experience, but also with having lower intentions to communicate with a sexual partner about pregnancy and STIs, and having higher gender norm endorsement. Conclusions: Older adolescents attending community colleges may be at high risk for poor sexual health outcomes, and appropriate theory-based education should be tailored to meet the needs of these underserved students.     

What College Students Do Not Know: Where Are the Gaps in Sexual Health Knowledge?

Abstract

Objective: This study aimed to understand the gaps in college students’ knowledge regarding sexual health information. Participants: A sample of 242 participants enrolled in an introductory college course participated in this study in the Fall 2009 semester. Methods: Students participated in 1 of 2 brief interventions and wrote a response paper about their experience. The papers were analyzed using conventional content analysis for information that was new to participants by looking for key words that suggested learning took place. Results: The findings indicated that the majority of participants learned new information. Most learning occurred regarding sexually transmitted infections (ie, types, symptoms, prevalence, treatment, testing) and correct condom use. There were also demographic differences regarding reported new information. Conclusions: Findings can be used to develop future sex education programs for college students by providing college educators with an understanding of where students lack knowledge of sexual health.     

Oral health among student veterans: Effects on mental and physical health

Abstract

Objective: The purpose of this study was to explore differences in oral health among students by military service status in postsecondary settings. Participants: Secondary data were obtained from the American College Health Association’s 2011–2014 National College Health Assessment II. Method: Demographic characteristics of the study sample were explored by calculating frequencies and percentages by military service status. Research questions were explored with maximum likelihood multiple logistic regression. Results: Service member and veteran students are at greater risk for neglecting health behaviors associated with positive oral health, including that they were less likely to get dental exams and that those who deployed in the past were the least likely to be practicing good oral health. Conclusions: The results suggest that improving oral health will contribute to improving health and mental health outcomes in this population, and provide important information for health specialists working with service members and veterans on college campuses.     

Posttraumatic stress and growth in student service members and veterans: The role of personal growth initiative

ABSTRACT

Objective: This study explored the extent to which personal growth initiative (PGI) may predict posttraumatic stress and growth in student service members/veterans (SSM/V). Participants: Participants were 136 SSM/V (79% men) representing multiple branches of the armed forces. Forty-four percent of participants reported having combat experience. Methods: Data collection occurred from October 2013 to February 2014. Data were collected via a Web-based survey that included demographics and measures of personal growth initiative, posttraumatic stress, posttraumatic growth, and perceived social support. Results: Results indicated that PGI is not a unique predictor of posttraumatic stress but is a unique predictor of higher levels of posttraumatic growth. PGI appears to be at least as important as perceived social support in facilitating growth in SSM/V. Conclusions: This study provides further evidence for PGI's potential to facilitate growth after a traumatic event.     

Sexual and Reproductive Health Behaviors of California Community College Students

Abstract

Objective: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was administered in class to randomly selected classrooms at 12 institutions and electronically to randomly selected e-mails of students at 1 institution from March through April 2007. Results: This sample of community college students reported higher rates of risky sexual behaviors, unintended pregnancy, emergency contraception, and sexually transmitted diseases, and lower rates of human immunodeficiency virus (HIV) testing, than the overall ACHA-NCHA reference group. Those who had been tested for HIV reported more sexual partners, and lower rates of condom use. Conclusions: The data provide justification for broader educational programs and access to family planning services, condoms, and HIV testing on community college campuses.     

Do military veteran and civilian students function differently in college?

Objective: The authors sought to assess military veterans' functioning in college by comparing their experience with that of civilian students. Participants: The study, conducted from April 2012 to February 2013, included 445 civilian and 61 student service member/veteran (SSM/V) undergraduates, drawn from a community college and two 4-year Catholic colleges, in Pennsylvania, New Jersey, and New York. Methods: Participants completed anonymous online surveys. Six areas of functioning in transition to college were examined: Health, Fitting In, Emotional Adjustment, Productivity, Perceived Career Support, and Social Engagement. Results: Students, both SSM/V and civilian, with past exposure to a potentially traumatic event fit in worse than students without such exposure. Past exposure to trauma was associated with poorer emotional adjustment in civilian students, but not in SSM/V. Conclusions: Implications of results were discussed.     

Deficits in young men's knowledge about accessing sexual and reproductive health services

Objective: The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. Methods and Participants: Self-report online surveys were administered to 18- and 19-year-old college students from a northern California public university (N = 183; 39.9% men; 32.2% Latino). Results: Women reported higher overall K-SRHC service access point scores than men. Findings indicated that gender and family planning self-efficacy were the strongest correlates of K-SRHC service access points. Men with a regular source of health care had higher K-SRHC service access points than men without. Conclusions: Results suggest that college men need additional education about how to access sexual and reproductive health services to support their own and their partner's health.     

College students' use of technology to communicate with romantic partners about sexual health issues

Objective: To examine college students' technology-assisted sexual communication perceptions and practices alongside their beliefs about the effectiveness of face-to-face (F-t-F) sexual communication. Participants: 144 college students at a private university in the Northeast, U.S., completed a survey in October 2016. Method: A cross-sectional online survey examined how college students use text messaging and private social media messaging to communicate with romantic partners about sexual health issues. Results: Students who have communicated with romantic partners via technology reported being likely to do so again in the future, to perceive the effectiveness of technology-assisted sexual communication to be comparable to F-t-F sexual communication, and to be confident in their ability to initiate sexual communication with romantic partners via F-t-F communication. Conclusions: College students may see text messaging and social media messaging as useful for sexual communication, which has important implications for college health professionals who wish to promote frequent, effective sexual communication.     

Baseline Characteristics of Dependent Youth Who Have Been Commercially Sexually Exploited: Findings From a Specialized Treatment Program

ABSTRACT

Commercial sexual exploitation of children has emerged as a critical issue within child welfare, but little is currently known about this population or effective treatment approaches to address their unique needs. Children in foster care and runaways are reported to be vulnerable to exploitation because they frequently have unmet needs for family relationships, and they have had inadequate supervision and histories of trauma of which traffickers take advantage. The current article presents data on the demographic characteristics, trauma history, mental and behavioral health needs, physical health needs, and strengths collected on a sample of 87 commercially sexually exploited youth. These youth were served in a specialized treatment program in Miami-Dade County, Florida, for exploited youth involved with the child welfare system. Findings revealed that the youth in this study have high rates of previous sexual abuse (86% of the youth) and other traumatic experiences prior to their exploitation. Youth also exhibited considerable mental and behavioral health needs. Given that few programs emphasize the unique needs of children who have been sexually exploited, recommendations are offered for providing a continuum of specialized housing and treatment services to meet the needs of sexually exploited youth, based on the authors’ experiences working with this population.