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.     

Strengths and coping strategies in the life narratives of sexual minority women

This study explored self-described strengths and strategies for coping with stress among sexual minority women (SMW), drawing on qualitative narratives of sexual minority and heterosexual women who were recruited from a population-based sample. In-depth follow-up qualitative telephone interviews were conducted with 48 women who had participated in the National Alcohol Survey, a U.S. population-based survey. Participants included 25 SMW and 16 matched exclusively heterosexual women. Narrative data were analyzed using inductive thematic analysis and constant comparison to explore the study aim, with an emphasis on themes that diverged or that were particularly salient for SMW relative to heterosexual women. Strengths and coping strategies that were especially meaningful in the narratives of sexual minority women emerged in two areas. First, participants described development of intrapersonal strengths through nurturing an authentic sense of self and embracing multifaceted identity. Second, participants described multiple strategies for cultivation of interpersonal resources: navigating distance and closeness with family of origin, cultivating supportive friends and chosen family, connecting to community, finding solace and joy with animals, and engaging in collective action. Findings underscore the importance of considering protective factors that are salient to SMW in developing or refining prevention and intervention efforts.     

An examination of sexual risk behaviors in adolescent substance users

ABSTRACT. Objectives: This study examined the risk for engaging in high-risk sexual behavior associated with substance use in a sample of U.S. adolescents. Methods: The sample (N = 15,425) was obtained via the Youth Risk Behavior Surveillance System, a survey of public high school students. Results: Substance use was associated with sexual risk behaviors, with odds ratios being greatest for adolescents who used cigarettes and illicit substances, as well as those who engaged in injection drug use. Conclusions: Results highlight the need for prevention and intervention programs targeting sexual risk behaviors in substance-using adolescents as a means to decrease the spread of sexually transmitted infections.     

Adolescents in residential treatment: The prevalence of ACEs,substance use and justice involvement

Abstract

Although associations between developmental trauma, juvenile justice involvement and youth substance use have been previously reported in the published literature, the interconnection among these three factors has not been adequately studied. This article describes the interconnection among these three factors and calls for greater attention to the role of adverse childhood experiences (ACEs) in the diagnosis and treatment of youth who present with histories of substance use and/or offending behavior. Pilot data are presented that show high rates of self-reported trauma exposure, substance use history, justice involvement, and mental health problems in a sample of adolescents in residential treatment. The data point to the need for residential treatment centers to consider trauma histories in developing treatment plans for youth with current and prior substance use and offending behavior.     

Coping with victimization in heterosexual and sexual minority university students

This study examined perceived social support available to victims of traditional and cyber forms of bullying in a heterosexual and sexual minority emerging adult university student population. Questionnaires were completed by 521 students ages 18 to 25 years old. The questions related to their sexuality, experience of bullying, and perception of social support. Perceived social support was lower for sexual minority individuals than for heterosexual individuals only when no bullying behavior was present. No significant differences in perceived social support between sexual minority and heterosexual individuals were found when they were traditionally bullied, cyberbullied, or experienced both forms of bullying victimization. Implications for practice and future research are discussed.     

A content analysis of sexual health and substance use information presented on study abroad websites: Findings and recommendations

Abstract

Objective: Despite study abroad students frequently engaging in risky behaviors, there is a dearth of research exploring prevention efforts taken by study abroad programs. The goal of this project was to examine information presented on study abroad program websites regarding sexual assault, alcohol use, drug use, and risky sexual behavior. Participants: A total of 753 universities in the US were selected from the Carnegie Classification of Institutes database. Method: Coders evaluated the website of each institution’s study abroad program for the presence of information about the four factors of interest. Results: Sixty-seven percent of the websites provided no information on any of these risk behaviors. Chi-square analyses revealed institutional demographic differences in the presentation of prevention information. We also identified three emerging themes about avenues for modifying website content. Conclusion: Study abroad programs can provide more detail and action oriented information on their websites for students.     

Problematic alcohol use and sexting as risk factors for sexual assault among college women

ABSTRACT

Sexual assault is a major public health concern and college women are four times more likely to experience sexual assault than any other group. We investigated whether sexting is a mechanism by which alcohol use increases risk for college women to be targeted for sexual assault. We hypothesized that sexting would mediate the relationship between problem drinking and sexual assault, such that drinking (T1 = beginning fall semester) would contribute to increased sexting (T2 = end fall semester), and in turn increase the risk of being targeted for sexual assault (T3 = end spring semester). Results: Among 332 undergraduate women (M(SD)age = 19.15(1.69), 76.9% Caucasian), sexting (T2) predicted sexual assault (T3; b = 3.98, p = .05), controlling for baseline sexual assault (b = 0.82, p < .01). Further, sexting (T2) mediated the relationship between problem drinking (T1) and sexual assault (T3) (b = 0.04, CI[.004,.12]). Conclusion: Findings suggest that sexting is one mechanism through which drinking increases the risk of college women being targeted for sexual assault.     

Real and assumed sexual minority status: Longitudinal associations with depressive symptoms

Sexual minority status persists in being linked to poorer adolescent mental health. Using a longitudinal sample (N = 845), we examined how youth's own same-gender attraction and their perceptions of peers' beliefs about their same-gender attraction (i.e., assumed attraction) were associated with trajectories of depressive symptoms from grade eight (when students are typically 13–14 years old) to grade 10. Reporting either same-gender attraction, assumed same-gender attraction or both were associated with higher initial levels of depressive symptoms that persisted over time compared to youth with real and assumed other-gender attraction only. These links were partially mediated by experiences of discrimination. Findings suggest the importance of understanding adolescent perceptions of peer beliefs in the association between same-gender attraction and depressive symptoms.     

Barriers to Treatment for Women With Substance Use Disorders

Substance-dependent women are facing tremendous barriers that impede them from entering into treatment programs. Such barriers include the lack of childcare, fear of stigma, lack of family or financial support, denial, and the co-occurring disorders. Strategies are paramount to the removal of these barriers, whereas treatment and relapse prevention aid in the rehabilitation process.     

Use of evidence-based substance use treatment practices in Mississippi

Over the past decade, substance abuse treatment professionals have begun to implement evidence-based practices (EBPs) into the treatment of substance use disorders. There is a growing body of research on the diffusion of EBP in addiction treatment; however, less is known about individual state initiatives to implement EBPs among community providers. The current study aimed to evaluate the progress of an initiative of the Mississippi Department of Mental Health (MDMH) to increase the implementation of evidence-based substance abuse treatment practices by certified providers. In addition, the study examines potential barriers to implementing these practices. To accomplish this goal, we reported the findings of two surveys of Mississippi addiction professionals conducted in 2010 and in 2013.     

Choose who’s in your circle: how women’s relationship actions during and following residential treatment help create recovery-oriented networks

ABSTRACT

Women in recovery from substance use disorders often have difficulty establishing recovery-supportive networks. This exploratory study uses qualitative thematic analysis to examine how 88 women in recovery describe the actions they take to manage their personal social networks 12 months after intake into residential substance use treatment. Participants describe disconnecting or limiting contact with recovery-endangering people and adding recovery-supportive people to their networks as primary relationship actions for maintaining recovery. Their actions to build recovery-supportive networks can provide a focus for clinical work to help them become integrated into their communities.     

Dimensions of ethnic identity as protective factors for substance use and sexual risk behaviors in African American college students

Objective: To examine ethnic identity and ethnic socialization as potential protective factors for risk behaviors among US college students. Participants: Participants were 398 African American and Afro-Caribbean students recruited from 30 colleges and universities during September 2008–October 2009. Methods: Data on hazardous alcohol use, substance use, sexual behaviors, ethnic identity, and ethnic/racial socialization were collected. Hierarchical linear and negative binomial regression analyses were conducted to determine the degree to which ethnic identity and ethnic/racial socialization predicted the risk behaviors. Results: Ethnic Identity affirmation, belonging, and commitment (EI-ABC) significantly predicted lower substance use and hazardous alcohol use. Ethnic/racial socialization was not a significant predictor of substance use or sexual risk behaviors. Conclusions: Components of ethnic identity are potentially protective against alcohol and substance use behaviors. Additional research is recommended to determine effective intervention strategies.     

A cross-national study on adolescent substance use: Intentions,peer substance use,and parent-adolescent communication

This longitudinal two-wave cross-national study investigated whether intentions, friends' substance use, and parent-adolescent substance-use specific communication predict adolescent alcohol and cannabis use 1 year later, while estimating reversed links. The temporal order between these two substances was also examined. We used multi-group cross-lagged panel modeling on data from 2 ethnically and socioeconomically diverse samples: Sint Maarten (N = 350; M_age = 14.19) and the Netherlands (N = 602; M_age = 13.50). Results showed that in the Netherlands, cannabis use predicts more subsequent problems (alcohol use, intention to use cannabis, and affiliation with cannabis-using friends). But for Sint Maarten, alcohol use predicts more subsequent problems (cannabis use, intention to use alcohol, and affiliation with alcohol-using friends). These opposing results demonstrate that caution is warranted when generalizing results across countries.     

Comparing the effectiveness of behavioral interventions in adults with co-occurring tobacco and substance use disorders: a systematic review of literature

ABSTRACT

This systematic literature review compares the e?ectiveness of various behavioral interventions delivered to persons with co-occurring tobacco and substance use disorders. It examines ?ndings of six randomized trials and three secondary analyses from randomized trials. Based on the ?ndings of this literature review, support is given to the following: (1) The consequences of tobacco use and smoking are deadly, costly, and can have an inhibitory e?ect on the progress of people in substance abuse treatment, (2) tobacco cessation options are a preventive intervention that can be easily incorporated into a treatment facility’s standard of practice and should be made available within the context of all substance abuse treatment facilities, and (3) concurrently treating tobacco use disorder and substance use disorder(s) is an e?ort that will help meet the social work profession’s Grand Challenge to ‘Close the Health Gap.’     

Association between sexually explicit messages and sleep health among French sexual minority men

It has been demonstrated that sexual minority men (SMM) participate in sexting. While research has shown that engagement in the exchange of sexually explicit media is associated with poor health outcomes, no previous research has investigated its association with sleep health outcomes. This study sought to examine the association between sexually explicit media and sleep health among SMM, a population that suffers from poor sleep health. A popular geosocial networking application was used to recruit SMM individuals (N?=?580) in the Paris, France, metropolitan area. Multivariate analyses, adjusting for sociodemographics, were used to test the association between the frequency of sexually explicit messaging and three dimensions of sleep health: (1) sleep quality, (2) sleep duration, and (3) two aspects of sleep problems. In multivariate analyses, those who reported engaging in sexually explicit messaging more were more likely to report getting less than seven?hours of sleep (aRR = 1.24; 95% CI = 1.08, 1.43) compared with those who reported engaging in sexually explicit messaging less. No significant associations were found between sexting and sleep quality or reporting sleep problems. Sexually explicit messaging was associated with shorter sleep duration. Intervention targeted at individuals who sext could potentially improve sleep health outcomes.     

DSM-5 substance use disorders among college-age young adults in the United States: Prevalence,remission and treatment

Abstract

Objective: To determine the prevalence, remission, and treatment associated with DSM-5 substance use disorders (SUDs) among young adults based on college attendance. Participants: The population-based sample included 2,057 young adults aged 19–23 in college/school and 1,213 not currently attending college/school who participated from April 2012 through June 2013. Methods: Face-to-face interviews were conducted as part of a cross-sectional national survey. Results: The prevalence of any past-year DSM-5 SUD was 39.6% among young adults in college and 44.5% among those not attending college. Past-year tobacco use disorder and multiple DSM-5 SUDs were more prevalent among those not attending college. Among those with prior-to-past-year SUDs, abstinent remission was low among college (1.0%) and noncollege (1.9%) young adults. Conclusions: Approximately two in five U.S. college students had at least one past-year DSM-5 SUD. Sustained abstinent remission from SUDs is extremely rare (1–2%) and the majority of those with SUDs do not receive treatment.     

‘Moved around like bags of rubbish nobody wants’: how multiple placement moves can make young women vulnerable to sexual exploitation

This paper discusses findings from an exploratory study that sought to identify how local authority care places young women at risk of sexual exploitation through prostitution by unpicking the ‘culture of care’, and focuses on frequent placement moves and the role of discontinuity. The author's experience of working with sexually exploited young women in local authority care, and women in street prostitution, provides a backdrop for the study. Findings are drawn from life story interviews with 14 young women with backgrounds of local authority care and prostitution and the ethical dimensions are also discussed. Young women reported that multiple placement moves within care were profoundly destabilising. Their capacities to develop trusting relationships with others and feel settled were limited by frequent placement breakdowns, leading to a kaleidoscope of ways in which they became vulnerable to sexual exploitation through prostitution. Copyright © 2009 John Wiley & Sons, Ltd.     

Disclosure of sexual assault experiences among undergraduate women at historically black colleges and universities (HBCUs)

ABSTRACT

Objective: To document the sexual assault disclosure experiences of historically black college or university (HBCU) students. Participants: A total of 3,951 female, undergraduate students at 4 HBCUs. Methods: All women at the participating schools were recruited in November 2008 to participate in a Web-based survey including both closed- and open-ended questions. Survey data were weighted for nonresponse bias. Results: The majority of sexual assault survivors disclosed their experience to someone close to them, but disclosure to formal supports, particularly law enforcement agencies, was extremely rare. Nonreporters had concerns about the seriousness of the incident and their privacy. On the basis of qualitative data, strategies identified by students to increase reporting included more education and awareness about sexual assault, more survivor services and alternative mechanisms for reporting, and better strategies for protecting the confidentiality of survivors. Conclusions: Official sexual assault victimization data are of limited utility in conveying the extent of sexual assault among HBCU students, and efforts to increase reporting, such as peer education and enhanced confidentiality procedures, are needed.     

The use of vignettes to empower effective responses to attempted sexual assault

Objective: Women assertively resisting sexual aggression have the best chances of avoiding completed rape. Especially with acquaintances, there are significant social and psychological barriers to resistance. Novel vignettes depicting acquaintance rape were designed to enhance self-efficacy, reduce unrealistic optimism, and empower assertive resistance. Participants: The data were collected using a Web-based survey of 449 female college students from multiple universities in August–October 2014. Methods: Between-subjects mixed-methods design. Participants were randomly assigned to read one of four vignettes and complete self-report measures of personal vulnerability, self-efficacy, and beliefs and intention about resistance. Results: Although vignettes did not impact self-efficacy, one vignette enhanced perceived controllability and decreased unrealistic optimism. Women who read about completed acquaintance rape described intention to use physically assertive responses at double the rate of women reading about successful resistance. Conclusions: As low-cost, easily disseminated materials, vignettes about sexual assault may enhance campus prevention efforts.     

Appalachian Women’s Use of Substance Abuse Treatment: Examining the Behavioral Model for Vulnerable Populations

The Gelberg–Andersen Behavioral Model for Vulnerable Populations was applied to understand vulnerable Appalachian women’s (N = 400) utilization of addiction treatment. A secondary data analysis included multiple multivariate analyses. The strongest correlates of treatment utilization included ever injecting drugs (OR = 2.77), limited availability of substance abuse treatment facilities (OR = 2.03), and invalidated violence abuse claims (OR = 2.12). This study contributes theory-driven research to the greater social work addiction literature by confirming that vulnerable domains related to substance abuse treatment utilization warrant unique considerations compared to nonvulnerable domains. Findings also highlight the importance of understanding the unique role that cultural factors play in treatment utilization among Appalachian women. Inferences relevant to clinicians and policymakers are discussed.