Internalized Homophobia and Suicide Ideation Among Sexual Minority Adults: The Serial Mediation of Core Self-Evaluations and Depression

A Theoretical Model for Predicting the Derivation of Sexual Satisfaction in Gay Men

This study tests a theoretical model of sexual satisfaction in gay men that incorporates self and self-with-other schemata, identity processes, and sexual communication behaviors. Structural equation modeling based on cross-sectional correlational survey data from 199 gay men in the United Kingdom and Germany examined associations between the self-schema of internalized homonegativity, the self-with-other schema of anxious attachment style, identity resilience, sexual communication behaviors, and sexual satisfaction. The results showed a direct effect of internalized homonegativity, but not of anxious attachment style, on sexual satisfaction. Both internalized homonegativity and anxious attachment style had indirect effects through identity resilience and sexual communication behaviors. Therapeutic interventions to enhance sexual satisfaction in gay men should focus on the identification and management of internalized homonegativity (a self-schema) and anxious attachment style (a self-with-other schema) while also supporting the development of identity resilience and sexual communication skills.

Family as a Pathway to Suicidal Behaviors Through Depression Symptoms and Internalized Homophobia

Research consistently highlights how systemic and social factors can adversely impact mental health, and the potential buffering effects of family support, yet raced sexual minorities are vastly underrepresented among these studies. As rates of suicide increase among Black people and remain high among men and those in gender and sexually diverse communities, this study sought to examine to relationships between family dynamics and suicidality among young Black men who have sex with men (MSM) in young adulthood. We used an online survey to conduct a logistic regression to examine family factors (family support, open family communication, other adult support, and other adult value), depression symptoms, and internalized homophobia on suicide attempts. The conceptualization of the study's design and interpretation of the results were informed by minority stress theory and the phenomenological variant of ecological systems theory. The results indicate that higher levels of family support and open family communication were associated with lower levels of suicidality. Implications for future research and applications for healthcare providers and human services professionals who support young Black MSM in emerging adulthood are discussed.

Association between negative life events and suicidal behavior in adolescents: roles of core self-evaluation, depression and gender

PURPOSE

Negative life events are essential proximal factors that may induce suicidal behavior in adolescents, but the mechanisms connecting this link remain to further explored. The present study aimed to investigate the relationship between negative life events (NLEs) and adolescents' suicidal behavior, and the roles of core self-evaluation, depression and gender playing between them.

METHODS

Using the whole-group sampling approach, 5296 Chinese adolescents (51.5% males, Meanage = 12.93) took part in this cross-sectional study in September 2021 and completed a battery of surveys including NLEs, suicidal behavior, CSE (core self-evaluation) and depression. Logistic regression and latent structural equation models were used to test the direct and indirect effects between NLEs and suicide behavior with multi-group path analysis, gender differences in this serial mediating effect were also tested.

RESULTS

After controlling for age and gender, NLEs were directly associated with adolescents' suicidal behavior. CSE and depression played significant serial mediating effects in this relationship. Moreover, significant gender differences were obtained in these serial mediating pathways, with stronger effects in girls.

CONCLUSION

Integrating the environmental, individual cognitive and emotional factors, our findings would be helpful in understanding the mechanism of these antecedents on adolescents' suicide behavior, which has specific practical significance for preventing and reducing suicidal behavior.

The Relationship Between Past Condom Use and Condom Use Intention Among Male Construction Worker Clients of Sex Workers in the Western Cape, South Africa: A Parallel Multiple Mediator Model

Male clients of sex workers in South Africa are at high risk for HIV, yet limited research has examined the psychological factors influencing their condom use intentions. This study addressed this gap by assessing the mediating roles of positive attitudes towards condom use, condom use self-efficacy, and perceived norms in the relationship between past condom use and intentions to use condoms. A cross-sectional survey was used to obtain data from male construction workers who reported sexual intercourse with a sex worker in the past three months. Using a parallel multiple mediator model, the analysis revealed that condom use self-efficacy (β = 0.060, 95% CI [0.021, 0.107]) and positive attitudes towards condom use (β = 0.027, 95% CI [0.004, 0.058]) significantly mediated the relationship between past condom use and condom use intention, while perceived norms did not (β = - 0.001, 95% CI [- 0.007, 0.007]). These findings underscore the importance of targeting instrumental and affective attitudes and enhancing self-efficacy to promote consistent condom use in this population. Although perceived norms were not determined to be statistically significant in this study, their potential role as a mediator merits further exploration, particularly in light of the study limitations. This research highlights the need for tailored interventions to reduce HIV risk among male clients of sex workers in South Africa.

Association analysis of suicide risk assessed with Mini International Neuropsychiatric Interviews' Suicidality Module in adolescents with non suicidal self injury disorder

Objective

Many adolescents with non suicidal self injury disorder have suicidal ideation. However, the specific characteristics of adolescents with NSSI-D that contribute to high suicide risk remain unclear. This study observes the association between depressive and anxiety symptoms and suicide risk among adolescents with non suicidal self injury disorder, and explores the mechanism underlying the high risk of suicide in this population.

Method

Adolescents with non suicidal self injury disorder and their parents from a psychiatric outpatient clinic were selected to conduct paper questionnaires to measure their sociodemographic conditions. The Mini International Neuropsychiatric Interviews' Suicidality Module(MINISM) was used to assess suicide risk of participants. The Self-Rating Depression Scale(SDS), Self-Rating Anxiety Scale(SAS), and Piers-Harris Children's Self-Concept Scale(PHCSS) were used to measure depressive and anxiety symptoms, and self-concept of adolescents with non suicidal self injury disorder. According to the high suicide risk cutoff value of MINISM, the sample was divided into high suicide risk group and non-high suicide risk group. We performed descriptive and correlation statistical and network analysis to study the types of depressive and anxiety symptoms associated with suicide risk and the mechanism underlying suicide risk among non suicidal self injury disorder adolescents.

Results

A total of 112 non suicidal self injury disorder adolescent participants were included in this study. Severe depressive symptoms(OR=8.205, 95%CI=3.454-19.490) and severe anxiety symptoms(OR=3.926, 95%CI=1.613-9.554) are associated with a high risk of suicide. The father's college/university education(p<0.01) is associated with severe anxiety symptoms, and low self-concept(p<0.01) is associated with severe depressive symptoms. Network analysis suggests the centrality of anxiety symptoms and father's education level.

Conclusion

The results of statistical analysis suggest that severe depressive symptoms are related to the high risk of suicide (based on MINISM) in adolescents with NSSI-D statistical significantly, and anxiety symptoms and low self-concept are associated with depressive symptoms in NSSI-D adolescents. Interventions targeting anxiety symptoms in adolescents with NSSI-D may help reduce their suicide risk.

The socioecology of sexual minority stigma: Advancing theory on stigma-based mechanisms underlying sexual orientation-based disparities in health

Research in public health and psychology has identified sexual minority stigma-related risk factors that contribute to sexual orientation-based health disparities across settings and societies worldwide. Existing scholarship, however, has predominantly focused on these factors as independent, stand-alone risk factors, neglecting their interconnected nature across different levels. This article theoretically explores how sexual minority stigma may function as a multilevel socioecological system, by building on prevailing theories and emphasizing the interplay between structural, interpersonal, and intrapersonal stigma-related factors. Drawing on the minority stress and socioecological theories, three central tenets are proposed, namely 1) chronosystem with immediate, accumulating, or lasting effects across spatiotemporal contexts, 2) nested multilevel system with cross-level effects, and 3) mechanistic pathways linking stigma exposure to health. By providing a nuanced and comprehensive understanding of how sexual minority stigma may operate as a multilevel socioecological system, this article reflects on the novel implications of this interpretation for future research and aims to guide future conceptualizations and studies, acknowledging the complexity of sexual minority stigma exposure across historical contexts, societies, and the individual life course in shaping physical and mental health of sexual minorities. Limitations of current research and recommendations for future research are being discussed.

Minority Stressors, Social Provisions, and Past-Year Suicidal Ideation and Suicide Attempts in a Sample of Sexual Orientation and Gender Identity/Expression Minority People in Canada

Purpose: Mental health disparities in sexual orientation and/or gender identity and/or expression (SOGIE) minority groups are well-documented, with research consistently showing higher levels of suicidality, even in Canada, considered one of the world's most accepting countries of SOGIE minority groups. Adverse outcomes in these groups are often framed using minority stress theory, with social support frequently studied as an integral buffer to these outcomes. This analysis explores facets of minority stress and social support associated with past-year suicidal ideation and suicide attempts. Methods: A cross-sectional internet survey of SOGIE diverse people in Canada (n = 1542) was conducted. Binary logistic regression calculated bivariate and multivariate factors associated with past-year suicidal ideation and suicide attempts. Backward elimination (retaining sociodemographic factors and self-rated mental health) identified salient minority stress and social support (provisions) factors. Results: Over half (56.72%) of participants had ever thought of dying by suicide, with 24.84% having attempted suicide. During the past year, 26.80% had thought of dying by suicide, with 5.32% having attempted suicide. Victimization events, and guidance (e.g., someone to talk to about important decisions) and attachment (e.g., close relationships providing emotional security) social provision subscales remained salient after backward elimination procedures. Conclusion: Our findings emphasize that a fulsome, multilevel approach considering structural, community, and individual strategies to address overt discrimination, integrating social connections and guidance, is necessary to prevent dying by suicide.

Initial Development and Validation of the Brief Internalized Heterosexist Racism Scale for Gay and Bisexual Black Men: A Measure of Internalized Heterosexist Racism

We introduce internalized heterosexist racism (IHR), or the internalization of damaging stereotypes, harmful beliefs, and negative attitudes about being a sexual minority person of color. We also present the initial development and validation of the Brief Internalized Heterosexist Racism Scale for gay and bisexual Black men (IHR-GBBM), a unidimensional, 10-item measure of IHR. Exploratory factor analyses on an internet-obtained sample of gay and bisexual Black men (N = 312; Mean age = 30.36 years) show that the IHR-GBBM had evidence of good internal consistency, and good convergent, discriminant, concurrent, and incremental validity. The IHR-GBBM was positively correlated with internalized racism, internalized heterosexism, and discrimination (racist, heterosexist). IHR was also negatively correlated with race stigma consciousness, weakly positively correlated with sexual identity stigma consciousness, but not correlated with either race identity, sexual identity, or social desirability. Hierarchical regressions showed that the IHR-GBBM explained an additional variance of 2.8% and 3.1% in anxiety symptoms and substance use coping, respectively, after accounting for (1) sociodemographics, (2) internalized racism and internalized heterosexism, and (3) an interaction of internalized racism and internalized heterosexism. Older participants and those who were "out" about their sexual identity reported lower IHR. Those who did not know/want to report their HIV status reported greater IHR. Results revealed no sexual identity, sexual position, relationship status, income, education, or employment status differences in IHR. We hope the development of the IHR-GBBM spurs future research on predictors and consequences of IHR. We discuss limitations and implications for the future study of internalized heterosexist racism.

Internalized homophobia and sexual risk behavior in men who have sex with men: The mediational role of sexual self-concept

Men who have sex with men (MSM) are one of the populations most likely to be infected with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) worldwide. Sexual risk behaviors (SRB) are the main route of HIV transmission. Among the factors associated with SRB, internalized homophobia (rejection of one's sexuality) is a risk factor unique for MSM. However, how this factor influences SRB is not clear. Therefore, the present study attempts to clarify the mechanism of action of the relationship between internalized homophobia on SRB based on the mediating effects of sexual self-concept. A study was conducted with 124 MSM living in Chile over 18 years of age (M = 24.4 and SD = 4.19). Through path analysis, it was observed that internalized homophobia has slight inverse effects on SRBs (multiple sexual partners and sexual activity under the influence of alcohol or drugs) when the sexual self-efficacy dimension acts as a mediating variable. These findings suggest that developing sexually transmitted infections (STIs) and HIV/AIDS prevention campaigns focused on MSM must highlight the development of a healthy sexual self-concept and address self-stigma.