Patterns of childhood maltreatment and intimate partner violence, emotion dysregulation, and mental health symptoms among lesbian, gay, and bisexual emerging adults: A three-step latent class approach

Suicidal ideation risk among LGB Spanish university students: The role of childhood and adolescence adversities and mental disorders

BACKGROUND

Childhood/adolescence adversities and mental disorders are higher among LGB youths.

AIMS

To evaluate the role of childhood maltreatment, bullying, and mental disorders on the association between sexual orientation and suicidal ideation (SI); and the role of mental disorders on the association between sexual orientation discrimination and SI.

METHODS

Baseline and 12-month follow-up online surveys of Spanish first-year university students (18-24-year-olds). Multivariable logistic regression models assessed the effects of childhood/adolescence adversities and mental disorders in the relationship between sexual orientation, discrimination and SI.

RESULTS

A total of 1224 students were included (16.4 % LGBs). Risk factors of lifetime SI were sexual orientation (OR 2.4), any bullying (OR 2.4), any childhood maltreatment (OR 4.0), and any mental disorders (OR 3.8). Final model Area Under the Curve (AUC) 0.78. Among homosexual and bisexual students, discrimination showed increased risk of 12-month SI (OR 2.2), but this effect was no longer statistically significant when any 12-month mental disorder was added (OR 7.8). Final model AUC 0.72.

LIMITATIONS

Sample of interest was relatively small. But it was similar to comparable studies and statistical adjustments have been performed. Assessment of mental disorders and SI was not based on clinical assessment. However, validated scales showing good diagnostic agreement with clinical judgement were used.

CONCLUSIONS

Childhood/adolescence adversities and mental disorders interact in the association between sexual orientation and SI. Mental disorders may mediate the association between sexual orientation discrimination and SI. Further research using larger samples and causal modelling approach assessing the mediators of SI risk among LGBs is needed.

Intimate Partner Violence Among Sexual Minority Women: A Scoping Review

Intimate partner violence (IPV) is prevalent among sexual minority women (SMW). However, compared to IPV research with heterosexual women and other LGBTQ+ population groups, SMW are understudied. We conducted a scoping review to examine the current state of knowledge about IPV among SMW, and to identify gaps and directions for future research. A search of Medline, Embase, CINAHL, and PsycINFO databases returned 1,807 papers published between January 2000 and December 2021. After independent reviewers screened these papers for relevance, 99 were included in the final review. Papers were included if they used quantitative methods and reported IPV data on adult SMW separately from other groups. Findings confirmed high rates of IPV among SMW and highlighted groups with particular vulnerabilities, including non-monosexual women and SMW of color. Risk factors for IPV in this population include prior trauma and victimization, psychological and emotional concerns, substance use, and minority stressors. Outcomes include poor mental and physical health. Findings related to the effects of minority stressors on IPV and comparisons across sexual minority groups were inconsistent. Future research should focus on IPV perpetration; mechanisms underlying risk for IPV, including structural-level risk factors; and understanding differences among SMW subgroups.

Associations between Sexual Minority Identities, Heterosexism, Identity Concealment, and Depression in Lesbian, Gay, and Bisexual Emerging Adults: Adjusting for the Effects of General Stressors

OBJECTIVES

Lesbian, gay, and bisexual (LGB) individuals experience stressors distinctively tied to their sexual identities, such as externalized and internalized heterosexism and identity concealment, which are correlated with increased psychological distress, including depression. The present study examined the variance in depression scores resulting from heterosexism, LGB identity concealment, and minority sexual identities, after adjusting for race/ethnicity and interpersonal violence victimization experiences.

METHODS

Participants were 277 LGB emerging adults 18 to 29 years old (mean 25.39, standard deviation 2.77; 46 lesbian women, 71 gay men) recruited from an online platform.

RESULTS

Nearly 41% reported moderate to severe depression symptoms. A two-step hierarchical regression model examining the effect of sexual minority stressors, heterosexism, LGB identity concealment, and minority sexual identity on depression after controlling for childhood maltreatment and face-to-face intimate partner violence types was significant. Bisexual women (vs gay men), those with greater exposure to heterosexism, and those with a greater degree of identity concealment experienced significantly higher scores on depression. In addition, being a person of color (including identifying as Hispanic), exposure to childhood maltreatment, and experiencing psychological intimate partner violence significantly predicted increases in depression scores.

CONCLUSIONS

Findings emphasize the importance of assessing minority stressors and taking them into account when providing clinical interventions to LGB individuals.

"Many bad things had been happening to me": Children's perceptions and experiences of polyvictimization in the context of child physical abuse

BACKGROUND

The association between child maltreatment and polyvictimization has received growing attention since being identified by Finkelhor and colleagues in 2005.

OBJECTIVE

The current study was designed to explore the experiences and perceptions of children who reported polyvictimization during forensic interviews.

METHODS

This mixed-methods study sample comprised 117 children aged 5-14, referred for the first time to forensic interviews following suspected physical abuse by a parent. More than one-third of the children reported polyvictimization. A thematic analysis was carried out to spotlight these children's experiences.

RESULTS

The analysis identified three main themes: the way children comprehend the polyvictimization, the consequences of the polyvictimization regarding the children's negative self-attribution, and the way the polyvictimization was constructed through the dynamic with the forensic interviewers.

CONCLUSIONS

The findings pointed to the importance of the forensic interview platform in assessing children's maltreatment burden. The current study also provided a glance into the possible involvement of the mechanics of self-blame among maltreated children. These findings have the potential to enhance our understanding of the excessive psychological toll taken on polyvictimized children.

LGBTQ+ identity-related abuse during childhood and associations with depression and suicide behavior: Role of adulthood cisheterosexism and expressive suppression

BACKGROUND

Exposure to minority stressors specific to LGBTQ+ individuals, such as heterosexism and cissexism (or cisheterosexism) is not covered under the traditional adverse childhood experiences framework. This is important because childhood identity-related abuse by a parent/caregiver can lead to mental health challenges in later life through the adoption of maladaptive coping mechanisms.

OBJECTIVE

The present study aimed to examine the role of cisheterosexism and expressive suppression as serial mediators in the associations between identity-related abuse and depressive symptoms and suicide behavior.

PARTICIPANTS AND SETTING

Participants included 563 LGBTQ+ identifying adults between 18 and 64 years (M = 30.02, SD = 9.05) from different regions of Spain and were recruited through social media (e.g., Twitter, Facebook, and Instagram).

METHOD

A serial mediation model was conducted with cisheterosexism and expressive suppression as the mediators in the associations between LGBTQ+ identity-related childhood abuse and depressive symptoms and suicide behavior.

RESULTS

Findings indicated a positive indirect effect of identity-related abuse on depressive symptoms through cumulative cisheterosexism (B = 0.628, p < .01), and via cumulative cisheterosexism and suppression (B = 0.146, p < .05). No significant indirect effect was found for identity-related abuse on depressive symptoms via suppression (B = 0.086). An indirect effect was found for identity-related abuse on suicide behavior via cumulative cisheterosexism (B = 0.250, p < .01).

CONCLUSIONS

Findings reveal that LGBTQ+ identity-related cisheterosexist experiences perpetrated by parents or caregivers are associated with harmful, long-term impacts on symptoms of depression and suicide behavior via experiences of cisheterosexism and expressive suppression.

Maltreatment experiences and mental health indicators among elite athletes

This study explored the relationships between athletes' experiences of maltreatment and mental health indicators. Canadian National Team athletes completed an online, anonymous survey that assessed reported experiences of maltreatment (psychological, physical, sexual harm and neglect), and mental health indicators of well-being, eating disorders and self-harming behaviours. All forms of maltreatment had a significant, positive correlation with eating disorder and self-harming behaviours, and a negative correlation with well-being. The relationships between maltreatment and mental health indicators differed based on identity characteristics of the athletes. Further work is needed on the prevention and intervention of maltreatment in sport to reduce the behaviours associated with negative health outcomes.

Experiences of Technology-Facilitated Abuse Among Sexual and Gender Minorities

Technology-facilitated abuse (TFA) against sexual and gender minority (SGM) adults is a serious though understudied issue. Few studies have examined the types, extent, and perpetrators of TFA against SGMs, and those that have analyzed any of these phenomena have mostly done so with samples of youths. This article offers results of a nationally representative survey on experiences of TFA among a sample of 2,752 U.S. adults aged 18 to 35 years, including 504 SGMs. The prevalence and types of TFA against SGMs were examined using a 27-item inventory capturing six general types of TFA, including surveillance, cyber-interference/communications, reputational harm, monitoring/tracking, fraud, and controlling/limiting access. Respondents could also indicate their relationship to the perpetrator. Results revealed significant differences in the prevalence, types, and perpetrators of TFA against SMGs (compared to non-SGMs), such that SGMs experienced greater levels of TFA victimization, were more likely to be victimized by perpetrators who were not intimate or ex-intimate partners, and were more likely to experience all forms of TFA, except for monitoring/tracking. No significant differences were found for general experiences of TFA victimization between cisgender and non-cisgender individuals or between sexual minority males and sexual minority females. Results thus show that although SGMs and non-SGMs experience similar types of TFA, SGMs experience TFA at higher rates. These findings provide a vital foundation for future work on TFA victimization among SGMs and offer insights for policy and practice, particularly for practitioners and clinicians working with SGMs. Findings indicate a potential need for greater access to health care, victim services, technological support, and legal aid for SGMs due to their increased risk of TFA victimization.

Preliminary Pilot-Testing of Intimate Partner Violence Screening for Transgender and Gender Diverse (TGD) Individuals in Med-Peds and Family Medicine

INTRODUCTION

Transgender and gender diverse (TGD) individuals, comprised of those whose gender identity does not correspond with the sex they were assigned at birth, represent approximately 1.4 million people in the U.S., with a higher prevalence among those 18-24 years old. TGD individuals experience high levels of intimate partner violence (IPV), which leads to disproportionately negative mental and physical health outcomes for this population. As a result, there is a resounding need to connect TGD populations to health-promoting services, supports and resources. Med-Peds and Family Medicine clinics may be particularly well-positioned to support these efforts due to physicians' focus on transitional-aged youth and young adults under 30.

METHODS

The current manuscript reports on processes and outcomes related to a quality improvement (QI) initiative that aimed to test the feasibility and acceptability of implementing IPV screening within both a Med-Peds and a Family Medicine specialty clinic serving TGD populations in Los Angeles, CA. This QI initiative included screeners that capture IPV in cisgender/non-TGD populations (Humiliation, Afraid, Rape, Kick [HARK]) as well as in TGD populations specifically (IPV-T). We utilized a mixed-methods approach to both quantify and qualify responses to existing IPV screening as well as informal feedback from clinic "champions" in each clinic.

RESULTS

Quantitative and qualitative findings from this QI initiative, featuring both general and TGD-specific IPV screening measures with 140 TGD individuals, elucidated several important processes that can support effective IPV screening and referral to supports and services. These include the importance of interdisciplinary teams, the utility of an iterative approach to screener roll-out, and the essential role of solidifying a referral process in these efforts. This project additionally shed light on the potential utility and challenges of implementing both general and TGD-specific IPV screening measures. Our pilot test did not support the necessity of a TGD-specific IPV screener for identifying and responding to IPV in this population, yet additional data is critical to generate more conclusive recommendations.

CONCLUSION

We recommend larger-scale data collection efforts to evaluate the utility of integrating general and TGD-specific screeners into clinic workflows to ensure optimal health promotion for the TGD population in Med-Peds and Family Medicine clinics.

Meta-Analysis of Cyber Intimate Partner Violence Perpetration and Victimization: Different Types and their Associations with Face-to-Face IPV among Men and Women

Cyber intimate partner violence (C-IPV) is a technology-mediated form of violence. It has been examined only in the last 10 years as a form of violence that can cause psychological damage to its victims. How this phenomenon connects to and differs from face-to-face IPV (F2F-IPV) has been, as yet, little studied. Research has not made clear whether sex differences may impact its use, particularly in light of the fact that no physical coercion is used in C-IPV. Thus, the current research aimed to investigate through a meta-analysis: differences between the average levels of different types of C-IPV victimization and perpetration; the association between C-IPV and F2F-IPV victimization and perpetration; and whether the answers to these questions were dependent on sex. The current meta-analysis drew on 46 studies, within 44 papers, with a total sample of 27,491 participants. Findings from 22 of these studies showed no significant sex differences between the average levels of different types of C-IPV victimization and between different types of C-IPV perpetration. These 22 studies showed positive large effect sizes for the correlation between C-IPV and F2F-IPV perpetration and victimization. Moreover, in both perpetration and victimization, sex did not impact the level of association. The findings suggested that C-IPV and F2F-IPV are highly correlated, and though not the same, they may share similar characteristics. Additionally, the results suggested that sex differences do not impact non-physical aggression, such as C-IPV. The implications for preventive strategies include that IPV interventions should also focus on alleviating instances of C-IPV.

Anabolic Steroid Use and Intimate Partner Violence Among Sexual Minority Men

This study examined the relationship between intimate partner violence (IPV) and use of anabolic-androgenic steroids (AAS), in a relationship context, among men who have sex with men (MSM). The sample was collected online via Prolific.co and consisted of 491 MSM. Data were analyzed using structural equation modeling. While accounting for the influence of factors known to be linked to IPV (adverse childhood experiences and alcohol use), the use of AAS in a relationship context was uniquely linked to greater perpetration of IPV. AAS use was not uniquely linked to IPV victimization. Findings from this study contribute to literature on IPV among MSM by including a group-specific risk factor (AAS use) in modeling risk for IPV. Limitations, implications, and future directions for research are discussed.

Violent victimization at the intersections of sexual orientation, gender identity, and race: National Crime Victimization Survey, 2017-2019

INTRODUCTION

Prior research has found that experiences with violence in the U.S. differ across individual demographic characteristics, including race, gender, and sexual orientation. However, peer reviewed studies have yet to examine the relationship between the intersections of race, gender, and sexual orientation, victimization risk, and characteristics of victimization.

METHODS

We use data from three years (2017-2019) of the National Crime Victimization Survey, the primary source of information on criminal victimization in the United States, to examine victimization at the intersection of sexual orientation, gender, and race/ethnicity. We test whether non-Hispanic Black, Hispanic, and non-Hispanic White sexual and gender minority (SGM) persons aged 16 or over are victimized at greater rates than their non-SGM counterparts and assess whether there are differences between sexual minority females and males of each racial group. We further document characteristics of victimization such as reporting to the police by SGM status and race or ethnicity.

RESULTS

We find that SGMs are disproportionately more likely to be victims of violent crime than non-SGM people, and these disparities are present across the assessed racial and ethnic groups (non-Hispanic Black odds ratio [OR] = 3.3, 90% CI [CI] = 1.36, 5.16; Hispanic OR = 4.5, CI = 2.25, 6.71; non-Hispanic White OR = 4.8, CI = 2.25, 6.71). However, sexual orientation disparities are statistically distinguishable for lesbian or bisexual (LB) non-Hispanic White and Hispanic females but not for non-Hispanic Black LB females. Among LB females, the overall differences in victimization were primarily driven by bisexual respondents. We further find racial and ethnic differences among SGM victims in the likelihood of having the victimization reported to the police, in the utilization of community (non-police) resources, and in other aspects of victimization experiences, such as whether arrests occurred or in the suspicion that the violent incident was a hate crime.

CONCLUSIONS

Our findings raise indicate a complex picture of how sexual orientation, gender identity, sex, and race and ethnicity interact in victimizations and their characteristics that should be further explored.

Daily Heterosexist Experiences in LGBTQ+ Adults from Spain: Measurement, Prevalence, and Clinical Implications

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals face unique stressors related to their sexual and gender identities that have a detrimental impact on their mental health. Nonetheless, studies have not yet investigated these minority stressors among LGBTQ+ individuals from Spain. The limited availability of standardized tools/instruments to measure minority stressors in Spanish makes it challenging to explore these experiences among Spanish speaking individuals. The present study aimed to examine the factor structure of the Daily Heterosexist Experiences Questionnaire (DHEQ) among LGBTQ+ adults from Spain, compare rates of minority stressors across diverse gender and sexual orientations, and examine the impact of daily heterosexist experiences (henceforth referred to as heterosexist experiences) on symptoms of depression and suicidal behavior. The sample was composed of 509 LGBTQ+ identifying adults in the age range of 18 to 60 years old. Confirmatory factor analysis indicated a good fit for the six dimensions of the DHEQ scale. Individuals identified as transgender or reporting a minority sexual orientation (i.e., asexual, pansexual) indicated higher levels of exposure to heterosexist experiences. Moreover, those with higher levels of heterosexist experiences had higher symptoms of depression and suicide behavior. The present study provides a tool for examining minority stressors in Spanish speaking LGBTQ+ adults. Assessing for minority stressors may aid in the identification of risk and protective factors when working with LGBTQ+ treatment seeking adults.

Psychosocial and Culturally-Specific Factors Related to Intimate Partner Violence Victimization among a Sample of Latino Sexual Minority Cis Men in the U.S

A growing body of research illustrates that sexual minority men (SMM) experience elevated rates of intimate partner violence (IPV) compared to heterosexual individuals. Researchers have examined the relationship between minority stress and IPV victimization among sexual minority men. A majority of the IPV research identifying risk factors associated with IPV victimization among SMM have sampled predominately non-Hispanic White SMM, while Latino SMM are consistently under-represented in IPV research. This study examines the associations between (1) co-occurring psychosocial factors (e.g., depression, anxiety, childhood sexual abuse, drug use, and problematic drinking) and (2) Latino-specific minority stress factors (e.g., U.S.-born, language, race/ethnic identities, and discrimination) on IPV victimization in a nationwide sample of Latino SMM. Data were collected from Latino SMM aged 18 or older, identified as cis-male, and in a romantic relationship with a cis-male partner (N = 530). The participants were recruited through social media and geo-location-based dating mobile applications. A majority (72%) of the sample reported IPV victimization in their lifetime. Specific to forms of IPV, more than half (51.9%) of the sample reported monitoring behaviors, while 49.6% reported emotional IPV, 45.1% reported physical IPV, 31.5% reported controlling behaviors, and 22.3% reported HIV-related IPV. In multivariable models, psychosocial and Latino-specific factors were associated with the increased likelihood of IPV victimization. Regarding Latino-specific factors, being born in the U.S. and race-based discrimination predicted IPV victimization. These findings highlight the extent to which minority stress elevates the risk of IPV for Latino SMM and point to the need to address social factors in IPV prevention services. Further, work on SMM IPV victimization tends to focus on the potential role of sexual orientation-related discrimination, whereas the current study points to the importance of race-based discrimination.

Latent Classes of Bidirectional Face-to-Face and Cyber Intimate Partner Violence Among Lesbian, Gay, and Bisexual Emerging Adults: The Role of Minority Stressors

The rates of intimate partner violence have been found to be higher among lesbian, gay, and bisexual (LGB) individuals when compared with heterosexual populations. However, lesser is known about the impact of specific minority stressors experienced by LGB populations on their face-to-face intimate partner violence (IPV) and cyber IPV experiences. Using a three-step latent class approach, the present study investigated (i) the latent classes of self-reported types of face-to-face IPV and cyber IPV perpetration and victimization and (ii) their associations with LGB distal and proximal minority stressors (i.e., vicarious trauma, discrimination, family rejection, and LGB-identity disclosure). Participants were 288 LGB emerging adults in the age range of 18-29 years (bisexual: n = 168, gay: n = 72, and lesbian: n = 48). Findings showed the presence of four latent classes, namely, face-to-face IPV (n = 32; 37.5% gay, 18.8% lesbian, and 43.8% bisexual individuals), cyber IPV (n = 66; 33.3% gay, 12.1% lesbian, and 54.5% bisexual individuals), psychological and stalking cyber IPV (n = 89; 15.7% gay, 15.7% lesbian, and 68.5% bisexual individuals), and low IPV (n = 101; 23.8% gay, 19.8% lesbian, and 56.4% bisexual individuals). Furthermore, multinomial logistic regressions indicated that greater exposure to the minority stressors such as exposure to heterosexism, namely, discrimination and harassment, rejection from one's family of origin, and exposure to vicarious trauma, as well as a lower degree of LGB-identity disclosure, largely predicted latent classes with greater probabilities of IPV exposure, namely, cyber IPV, face-to-face IPV classes, and psychological and stalking cyber IPV. Findings suggest the importance of addressing the role of minority stressors in IPV interventions and the creation of competent LGB-related services and training modules for clinicians.

Childhood emotional abuse, rejection sensitivity, and depression symptoms in young Chinese gay and bisexual men: Testing a moderated mediation model

BACKGROUND

There is a high and increasing prevalence of depression symptoms among gay and bisexual individuals. Studies have found that childhood emotional abuse (CEA) can impact mental-health problems in adulthood; however, limited research on this association among marginalized populations, especially in China. This study aimed to explore the relationship between CEA and depression symptoms in adulthood among gay and bisexual youths in China and to test the mediating role of rejection sensitivity and the moderating role of sexual identity in this relationship.

METHODS

Participants comprised 496 gay and bisexual Chinese men aged 18-29 years. They responded to a questionnaire that assessed history of CEA, rejection sensitivity, and depression symptoms.

RESULTS

CEA showed a positive association with depression symptoms among participants. Participants' rejection sensitivity played a partial mediating role in the relationship between CEA and depression symptoms. Sexual identity had a moderating effect on the CEA's influence on depression symptoms, with a stronger impact for gay men than bisexual men.

LIMITATIONS

Cross-sectional approach limited casual inferences among variables. Recall bias regarding CEA may have impacted the accuracy of the effect sizes observed.

CONCLUSION

This study contributes to improving understanding of CEA's role as a substantial risk factor for strong depression symptoms in adulthood among gay and bisexual youths and it demonstrates that focusing on educating families and establishing equal policies is important to decrease and eliminate depression symptoms. Theories of sexual minority stress and biphobia are applicable for explaining mental health outcomes among young members of sexual minorities in China.

Childhood maltreatment class and sexually violent behavior among university men in Vietnam

Background

Sexual violence against women remains a global public health problem, with Southeast Asia having among the highest rates of violence victimization globally. Exposure to violence in adolescence--a highly prevalent experience in Vietnam--is associated with later perpetration of violence against others. However, childhood maltreatment as a latent construct is understudied, with most analyses focusing on theoretical categories, potentially missing key patterns of victimization, particularly poly-victimization. Poor understanding of these experience limits researchers’ ability to predict and intervene upon cyclical perpetration of violence. This study aims to identify latent classes of childhood maltreatment, and to test associations between class membership and sexually violent behavior during the first 12 months of university in a sample of Vietnamese men.

Methods and findings

Heterosexual and bisexual men aged 18–24 matriculating into two universities in Hanoi were recruited for the randomized controlled trial of GlobalConsent, a six-module online sexual-violence prevention program. Participants (N = 793) completed a baseline survey, were randomized 1:1 to GlobalConsent or attention control, and were invited to complete post-test surveys at six-months post-baseline and 12-months post-baseline. Validated scales were employed to assess childhood maltreatment and past-six-month sexually violent behavior at each post-test. Latent class analysis identified four classes of childhood maltreatment: Limited-to-no, physical, physical and emotional, and poly-victimization. Associations between childhood maltreatment class and sexually violent behavior demonstrate a threshold effect, wherein poly-victimized men were significantly more likely than men in other classes to have engaged in sexually violent behavior during the 12-month follow-up period.

Conclusions

There is a vital need for screening and intervention with men who have experienced childhood maltreatment in Vietnam to prevent future violence perpetration. Education is needed to break the cycle of violence intergenerationally and in romantic relationships by changing harmful norms around men's sexual privilege and the normalization of childhood maltreatment.

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Exposure to childhood maltreatment is associated with later perpetration of violence.

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Sexual violence against women remains a global health concern.

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Latent classes identify patterns of maltreatment associated with later sexual violence.

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Polyvictimization is associated with sexual violence perpetration beyond other latent classes.

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Understanding these associations allows for intervention upon cyclical perpetration of violence.

Witnessing Parental Violence and Cyber IPV Perpetration in Hispanic Emerging Adults: The Mediating Role of Attitudes Toward IPV

Recent studies indicate that the perpetration of intimate partner violence via cyberspaces (cyber IPV), namely, psychological aggression, sexual aggression, and cyberstalking is high among emerging adults. However, little is known of the risk factors that lead to cyber IPV and far lesser within Hispanic adults. Based on the intergenerational transmission of violence hypothesis, the present study examined the indirect effect of witnessing parental violence during childhood on the three types of cyber IPV through attitudes condoning IPV in Hispanic men and women, separately. Participants were 1,136 Hispanic emerging adults in the age range of 18-29 years (M = 20.53 years, SD = 2.42; 72.5% women, 88% Mexican descent). Over half of the participants (54.2%) witnessed at least one instance of parental violence during childhood. In contrast to women, men were more likely to hold attitudes accepting of IPV and perpetrate cyber sexual IPV, whereas women were more likely to report cyberstalking perpetration. Men and women with exposure to mother-to-father violence held attitudes justifying IPV that was associated with perpetrating the three cyber IPV types in adulthood (women: B_range = .016-.036; men: B_range = .016-.024). No significant gender differences were found in the associations of mother-to-father WPV and father-to-mother WPV on the three types of cyber IPV perpetration. These findings are discussed in the context of Hispanic culture, which has specific implications for cyber IPV intervention strategies.

Emotion Regulation as a Pathway Connecting Early Life Adversity and Inflammation in Adulthood: a Conceptual Framework

Chronic inflammation is implicated in a variety of diseases (e.g., cardiovascular disease and cancer). Much evidence suggests that early life adversity (ELA), such as maltreatment or neglect, can increase risk for inflammation in adulthood. ELA may program proinflammatory activity via its effects on brain areas involved in emotion regulation. Of multiple emotion regulation strategies, some are considered maladaptive (e.g., expressive suppression), while others are generally adaptive (e.g., cognitive reappraisal). We propose a conceptual framework for how emotion regulation tendencies may affect vulnerability or resilience to inflammation in adults who experienced adversity in childhood and/or adolescence. In support of this framework, we summarize evidence for the relationships between emotion dysregulation and higher inflammation (i.e., vulnerability), as well as between cognitive reappraisal and lower inflammation (i.e., resilience), in healthy adults with a history of ELA. Plausible neurobiological, physiological, psychosocial, and ELA-specific factors, as well as interventions, contributing to these associations are discussed. Strengths and limitations of the extant research, in addition to ideas for future directions, are presented.

"I Went into This as One Person, and Then Came Out a Totally Different Person": Native LGBTQ2S+ Young Adults' Conceptions of Trauma

Intersecting sources of stigma influence harmful mental health outcomes for lesbian, gay, bisexual, transgender, queer, and Two-Spirit (LGBTQ2S+) young adults (YA) of color as they must manage multiple oppressions. Experiencing both mental health challenges and victimization, LGBTQ2S+ YA of color struggle with distinctive psychological traumas. There is a critical need to determine how certain groups of LGBTQ2S+ YA of color's marginalized social statuses shape trauma understandings. Native LGBTQ2S+ people in general endure diverse forms of oppression and trauma, such as histories of colonialism, contemporary racism, sexism, homophobia, and classism. Understanding the subjective interpretations of violence and trauma among Native LGBTQ2S+ YA is needed to best meet their mental health needs. Through in-depth interviews with 13 Native LGBTQ2S+ YA between 18 and 24 years old, this study delineates processes of how an underrepresented, underserved group of rurally embedded YA conceptualize violent and traumatic life experiences within the context of their mental health. First, participants described their traumatic experiences as shaping persistent harmful mental health outcomes throughout their lives. Second, YA conceptualized trauma as pivotal moments that were profound and influential in their significance as a turning point in their lives. Finally, YA underscored multiple traumas as cumulative and complex in how they interacted to create distinctively harmful mental health challenges. Expansive conceptualizations of trauma can better inform understandings of trauma etiology and promote inclusive health services.

Cumulative interpersonal childhood adversity and post-traumatic stress symptoms across heterosexual, cisgender and gender and sexually diverse adolescents: The mediating role of emotion regulation

BACKGROUND

Emotion regulation has been identified as an explanatory factor in the association between interpersonal childhood adversity and post-traumatic stress symptoms (PTSS). However, most studies focused on adults or older adolescents, neglecting youth from the community, especially gender and sexually diverse (GSD) adolescents, who have a higher risk for exposure to adverse events and psychological difficulties, compared to their heterosexual, cisgender (HC) peers.

OBJECTIVE

The present cross-sectional study aimed to examine the mediating role of emotion regulation difficulties in the association between cumulative interpersonal childhood adversity and PTSS across HC and GSD adolescents.

METHODS

A sample of 2904 ninth grade students (M_age = 14.53, SD = 0.61) completed a self-report survey. Multigroup path analyses were conducted to examine the proposed mediation model in all groups, and comparisons were made using chi-square difference tests.

RESULTS

Greater difficulties in emotion regulation mediated the association between greater cumulative interpersonal childhood adversity (β = 0.36, p < .001) and greater PTSS (β = 0.35, p < .001) - regardless of HC or GSD status - although the direct association between cumulative interpersonal childhood adversity and PTSS was significantly stronger among GSD boys (β = 0.36, p < .001) and GSD girls (β = 0.35, p < .001) than among HC boys (β = 0.21, p < .001) and HC girls (β = 0.25, p < .001).

CONCLUSIONS

Findings offer a modifiable target for prevention and/or intervention among middle adolescents, as emotion regulation difficulties may partially explain the presence of PTSS following cumulative interpersonal childhood adversity.

Sexual Violence Associated With Sexual Identity and Gender Among California Adults Reporting Their Experiences as Adolescents and Young Adults

IMPORTANCE

Disproportionate levels of violence exist in lesbian, gay, bisexual, queer, asexual, and other sexual identity (LGBQA+) communities, often starting in adolescence and young adulthood, but little research exists on the range of sexual violence (SV) experiences.

OBJECTIVE

To assess risk of experiences of sexual violence among California LGBQA+ adults during adolescence and young adulthood.

DESIGN, SETTING, AND PARTICIPANTS

This survey study analyzed data from Cal-VEX 2020, a state-representative survey of California residents aged 18 years and older, to assess associations between LGBQA+ identification and types of SV experienced in adolescence (ages 13-17 years) and young adulthood (ages 18-24 years) using gender-stratified adjusted logistic regression. Forms of SV included verbal, cyber, and coercion or physically aggressive sexual harassment; homophobic or transphobic slurs; and forced sex.

EXPOSURE

Sexual identity.

MAIN OUTCOMES AND MEASURES

The outcome of interest was experiences with any 5 forms of sexual violence (verbal sexual harassment, homophobic or transphobic slurs, cyber sexual harassment, sexual coercion or physically aggressive sexual harassment, and forced sex) during adolescence or young adulthood.

RESULTS

A total of 2102 contacted individuals (response rate, 26.2%) completed the Cal-VEX survey and were included in these analyses. Among these, the mean (SD) age was 46.6 (17.7) years, 1149 identified as female, 953 identified as male, and 214 respondents (9.6%) identified as LGBQA+. Compared with heterosexual individuals, LGBQA+ individuals had significantly higher odds of having experienced homophobic or transphobic slurs (women: AOR, 14.65; 95% CI, 5.14-41.77; men: AOR, 14.17; 95% CI, 6.96-28.86) and forced sex (women: AOR, 5.35; 95% CI, 2.74-10.43; men: AOR, 2.68; 95% CI, 1.01-7.10) in adolescence. LGBQA+ women also had higher odds of having experienced verbal and coercion or physically aggressive sexual harassment in adolescence (AOR, 2.33; 95% CI, 1.30-4.19). In young adulthood, LGBQA+ individuals also had higher odds of having experienced homophobic or transphobic slurs (women: AOR, 18.58; 95% CI, 7.12-48.49; men: AOR, 16.73; 95% CI, 8.26-33.92) in young adulthood. LGBQA+ men also had higher odds of having experienced homophobic or transphobic slurs (AOR, 16.73; 95% CI, 8.26-33.92); verbal (AOR, 3.29; 95% CI, 1.44-7.53), cyber (AOR, 6.32; 95% CI, 1.50-26.52), and coercion or physically aggressive (AOR, 5.54; 95% CI, 2.08-14) sexual harassment; and forced sex (AOR, 21.26; 95% CI, 5.63-80.35) in young adulthood.

CONCLUSIONS AND RELEVANCE

This survey study found that adult LGBQA+ individuals were at increased risk for having experienced SV across the continuum during adolescence and young adulthood, consistent with prior research. Multifold solutions are needed to support LGBQA+ youth, including altering social norms accepting SV and homophobia, creating safer schools and other institutional environments, and supporting healthy sexual and romantic partnerships.

Unique, Additive, and Interactive Effects of Types of Intimate Partner Cybervictimization on Depression in Hispanic Emerging Adults

The advent of modern technology has inadvertently created newer avenues for intimate partner victimization (IPV) to transpire. This study investigated (a) whether psychological, sexual, and stalking intimate partner cybervictimization (cyber IPV) types were uniquely associated with depression and whether there were (b) additive and (c) interactive effects of cyber IPV types on depression, after controlling for face-to-face IPV among Hispanic emerging adults. Participants were 903 Hispanic emerging adults in the age range of 18 to 29 years (M = 20.68, SD = 2.42; 74% female) attending a public university in South Texas. Participants completed an online questionnaire assessing cyber IPV types (psychological, sexual, and stalking), face-to-face IPV types (physical, psychological, and sexual), and depression. Results indicated that nearly three-fourths (73%) of the sample endorsed at least one type of cyber IPV. Hierarchical regression analysis showed that psychological and sexual cyber IPV was uniquely associated with depression. An accumulating effect (additive effect model) of the three types of cyber IPV on depression was also found. Interaction effect model analysis yielded no significant effects. Findings reveal the detrimental effect of cyber IPV on mental health and calls for institutions and clinicians to develop preventive and treatment programs to aid victim-survivors.

Physical and Sexual Intimate Partner Aggression Among College Students: Examining the Roles of Cyber Intimate Partner Aggression and Alcohol Use

Intimate partner aggression (IPA) is a serious and prevalent problem among college students. Two factors that may increase risk for in-person IPA are cyber IPA and alcohol use. This study examines the interaction between three types of cyber IPA (cyber psychological, stalking, and sexual IPA) and alcohol use in predicting in-person physical and sexual IPA perpetration. Participants were 268 undergraduate students, who participated in a mass screening at a large midwestern university. More than half of the sample reported perpetrating cyber IPA. A multivariate logistic regression model was used to examine study hypotheses. The R² for physical IPA perpetration was .69 and the R² for sexual IPA perpetration was .46. Cyber stalking IPA and alcohol interacted to predict physical IPA perpetration, such that the relationship between cyber stalking IPA and physical IPA perpetration was stronger among individuals who used more alcohol. Contrary to expectations, cyber IPA and alcohol did not interact to predict sexual IPA. However, consistent with hypotheses, cyber stalking IPA was positively associated with sexual IPA perpetration. The high prevalence of cyber IPA and its association with in-person IPA perpetration suggests that prevention programs targeting cyber IPA on college campuses may be warranted.

Exploring the role of trauma in underpinning sexualised drug use ('chemsex') among gay, bisexual and other men who have sex with men in Singapore

BACKGROUND

Sexualised drug use (SDU) has been identified as a major risk factor for HIV, as well as other mental health comorbidities among gay, bisexual and other men who have sex with men (GBMSM). While multiple studies have been conducted on the topic, few have explored the role of trauma in underpinning experiences of SDU among substance use treatment-experienced GBMSM. This qualitative study investigates life histories of trauma, and proposes a framework to better situate the factors driving SDU among treatment-experienced GBMSM.

METHODS

We conducted semi-structured in-depth interviews with 33 purposively-sampled GBMSM with a history of SDU, and seeking treatment for it in Singapore. Interview topics included participants' experiences and life histories of SDU, substance use, incarceration, trauma, as well as stories of resilience and ongoing recovery from SDU. Interviews were audio-recorded, transcribed, coded, and analysed using inductive thematic analysis, from which a trauma-informed framework was developed.

RESULTS

Participants firstly articulated the positive and desired aspects of SDU, such as its utility in allowing them to achieve positive emotional states, sexual enhancement, and feelings of connectedness and intimacy. Participants also described how SDU, in contrast, was used as a coping mechanism to deal with emotional and situational 'precipitants', including dealing with loneliness and a low self-esteem, sexual shame and social anxiety, as well as general stressful situations. Participants also articulated how such precipitants were underpinned by experiences of trauma, including those relating to HIV-related stigma, racism, sexual violence, death and loss, neglect, as well as internalised homophobia. Next, participants illustrated how such trauma were in turn reinforced by several 'preconditions', including the accessibility of substances, emphasis on sexual capital, and lack of access to mainstream support structures in the gay male community, alongside general sociolegal barriers to accessing care.

CONCLUSIONS

This study proposes the role of trauma and the preconditions underpinning them in motivating SDU among a sample of largely substance use treatment-experienced GBMSM in Singapore. Interventions that provide support for GBMSM seeking treatment for SDU should provide trauma-informed care to address the complex barriers to treatment effectiveness.

Classes of lifetime adversity in emerging adult women and men and their associations with weight status

The aim of this paper was to better understand how child and adult adversities cluster together into classes, and how these classes relate to body weight and obesity. Analyses included 2015 and 2018 data from emerging adults (18-25 years old) who participated in a state surveillance system of 2- and 4-year college students in Minnesota (N = 7475 in 2015 and N = 6683 in 2018). Latent Class Analyses (LCA) of 12 child and adult adversities were run stratified by gender and replicated between 2015 and 2018. The distal outcome procedure and three-step Bolck-Croon-Hagenaars approach were used to estimate predicted BMI means and predicted probabilities of obesity for each class, adjusted for covariates. The LCA identified seven classes in women and 5 in men. In women, BMI ranged from 23.9 kg/m2 in the lowest-BMI class ("Adult Adversities and Childhood Household Dysfunction"; 95% CI: 22.6-25.1) to 27.3 kg/m2 in the highest-BMI class ("High Lifetime Adversities"; 95% CI: 25.9-28.7), a statistically significant difference of 3.4 kg/m2. In men, the adjusted BMIs ranged from 24.6 kg/m2 ("Low Adversities"; 95% CI: 24.3-25.0) to 26.0 kg/m2 ("Childhood Household Mental Illness"; 95% CI: 25.1-26.9), a statistically significant difference of 1.4 kg/m2. The pattern was similar for obesity. These results indicate that specific classes of child and adult adversities are strongly associated with BMI and obesity, particularly in women. A key contribution of LCA appeared to be identification of small classes at high risk for excess weight.

Association of sexual minority status, gender nonconformity with childhood victimization and adulthood depressive symptoms: A path analysis

BACKGROUND

Sexual minority status and childhood gender nonconformity have been associated with elevated risks of childhood adversities and poorer mental health.

OBJECTIVE

To explore how abuse and bullying explain the disparities in the associations of sexual minority status and childhood gender nonconformity with adulthood depressive symptoms in men.

PARTICIPANTS AND SETTING

We conducted a cross-sectional study using a self-report questionnaire among Chinese adult men (18-35 years) who were identified as heterosexual (n = 873) and sexual minority (n = 858) in Guangzhou from 2017 to 2019.

METHODS

Structural equation modeling (SEM) were conducted for path analysis.

RESULTS

The levels of exposure to childhood maltreatment were higher in sexual minorities than in straight men, and sexual minority status predicted an increased risk of depressive symptoms via childhood maltreatment (indirect effect: β = 0.026, p = 0.004). Meanwhile, childhood gender nonconformity predicted higher depressive symptoms via both family (indirect effect: β = 0.042, p < 0.001) and school (indirect effect: β = 0.028, p < 0.001) victimization, and there was a direct effect (β = 0.154, p < 0.001) of gender nonconformity on depressive symptoms.

CONCLUSION

Sexual minority status and gender nonconformity are indicators of men's increased risk of childhood victimization and adulthood depressive symptoms. As a result, intervention based on both family and school dimensions needs to be developed.

Differences in Health-Related Quality of Life and Health Behaviors Among Lesbian, Bisexual, and Heterosexual Women Surviving Cancer from the 2013 to 2018 National Health Interview Survey

Purpose: Health-related quality of life (HRQoL) and health behaviors contribute to cancer morbidity and mortality, which are elevated in lesbian and bisexual women (LBW). The purpose of this study was to assess differences in HRQoL and health behaviors between heterosexual and lesbian women and heterosexual and bisexual women cancer survivors. Methods: We pooled 2013-2018 National Health Interview Survey data. HRQoL comprised physical, mental, financial, and social health domains. Health behaviors included tobacco and alcohol use, physical activity, and preventive health care. Weighted, multivariable logistic regression models estimated odds ratios (ORs) with 95% confidence intervals (CIs). Results: The sample included 10,830 heterosexual, 141 lesbian, and 95 bisexual cancer survivors. Lesbian women reported higher odds of fair/poor self-rated health (OR: 1.68, 95% CI 1.02-2.78), chronic obstructive pulmonary disease (OR: 1.98, 95% CI 1.09-3.56), and heart conditions (OR: 1.90, 95% CI 1.16-3.12) than heterosexual women. Bisexual women reported higher odds of severe psychological distress (OR: 3.03, 95% CI 1.36-6.76), heart conditions (OR: 1.98, 95% CI 1.12-3.53), and food insecurity (OR: 2.89, 95% CI 1.29-6.50) than heterosexual women. For health behaviors, lesbian women reported greater odds of current (OR: 2.34, 95% CI 1.26-4.34) and former tobacco use (OR: 1.89, 95% CI 1.21-2.96), and bisexual women had lower odds of a recent mammogram (OR: 0.42, 95% CI 0.23-0.78) than heterosexual women. Conclusions: LBW cancer survivors reported disparities in HRQoL and health behaviors. In cancer care settings, identification of LBW patients requiring physical and mental health promotion, financial services, and supported tobacco cessation may improve health and survival.

Unique and Cumulative Effects of Intimate Partner Cybervictimization Types on Alcohol Use in Lesbian, Gay, and Bisexual Emerging Adults

The use of modern technology has inadvertently created newer platforms for intimate partner victimization to take place. The present study investigated (1) whether psychological, sexual, and stalking cyber intimate partner victimization (cyber IPV) types were uniquely associated with alcohol use, and (2) whether there was additive effect of cyber IPV types on alcohol use, after controlling for histories of childhood maltreatment types and face-to-face intimate partner victimization among lesbian, gay, and bisexual (LGB) emerging adults. Participants were 277 self-identifying LGB individuals in the age range of 18-29 years (M = 25.39, SD = 2.77; 16.6% lesbian, 25.6% gay, 43% bisexual women). Participants completed an online questionnaire assessing cyber IPV types, namely, psychological, sexual, and stalking, five forms of childhood maltreatment, face-to-face IPV types (i.e., physical, psychological, and sexual), and alcohol use. Findings indicated that 29.2% (n = 81) endorsed all three types of cyber IPV. Hierarchical regression analysis showed that only sexual cyber IPV was uniquely associated with alcohol use. In support of the cumulative risk hypothesis, those with exposure to three types of cyber IPV were more likely to have greater alcohol use compared to those with exposure to any one type of cyber IPV. Findings indicate that cyber IPV can lead to behavioral health challenges, such as an increase in alcohol use among LGB emerging adults. Findings call for interventions focusing on generating awareness regarding the ill effects of cyber IPV and for mental health professionals to develop treatment programs to aid in the well-being of the victim.

Childhood maltreatment, cognitive emotion regulation strategies, and alcohol craving and dependence in alcohol-dependent males: Direct and indirect pathways

OBJECTIVES

Childhood maltreatment (CM) and cognitive emotion regulation strategies (CERSs) may be important in alcohol craving and dependence in alcohol-dependent individuals. The aim of this study was to evaluate direct effects of CM on the subscales of alcohol craving and alcohol dependence and its indirect effects via CERSs in individuals with a diagnosis of alcohol dependence.

METHODS

In a cross-sectional design, 329 alcohol-dependent males completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Cognitive Emotion Regulation Questionnaire-Short version (CERQ-Short), the Alcohol Dependence Scale (ADS), the Obsessive Compulsive Drinking Scale (OCDS), and the Beck Depression Inventory-II (BDI-II).

RESULTS

Participants with alcohol dependence had early age of onset of alcohol use (mean = 20.78 years), relatively long duration of alcohol use (mean = 11.14 years), and low education (mean = 9.55 years). Indirect effects were observed from CM to the subscales of alcohol craving and dependence only through maladaptive CERSs after adjusting for demographic and clinical factors. No direct effect was observed through CM on the subscales of alcohol craving and dependence.

CONCLUSIONS

Although drawing causal conclusions from the current research is impossible, the findings suggest that maladaptive CERSs may be a possible mechanism relating CM to alcohol craving and dependence in treatment-seeking alcohol-dependent individuals, while adaptive CERSs may be less important regarding this relation. However, the findings of the current study need longitudinal research.

Stressors and Drinking in Sexual Minority Women: The Mediating Role of Emotion Dysregulation

Sexual minority women are at elevated risk for exposure to stressors (both traumatic and discriminatory) and have higher rates of alcohol consumption and problems. The psychological mediation framework (Hatzenbuehler, 2009) suggests that both general (e.g., traumatic events to which minorities and nonminorities may be exposed) and minority-group-specific (e.g., discrimination) stressors contribute to psychopathology through mediators such as emotion dysregulation. Guided by this framework, the present study longitudinally examined the relationship between stressors and problematic drinking outcomes (i.e., binge drinking and alcohol-related problems), as mediated by emotion dysregulation, in sexual minority women (SMW). It addressed two research questions: (1) whether stressors longitudinally predict problematic drinking outcomes in SMW, as mediated by emotion dysregulation, and (2) for which specific forms of stressor (i.e., traumatic events and/or discrimination) this mediational relationship is present. Young adult women (N = 1057) who identified as lesbian or bisexual completed annual measures of daily heterosexism, traumas, and drinking outcomes for four years, and completed a measure of emotion dysregulation during the third year of data collection. We found an indirect relationship between discrimination and problematic drinking outcomes via emotion dysregulation. These findings are consistent with the psychological mediation framework (Hatzenbuehler, 2009) and suggest that SMW group-specific processes such as discrimination may be especially important in conferring risk for problem drinking via emotion dysregulation. Clinicians are advised to assess unique stressors faced by SMW and their potential contribution to problematic drinking outcomes, and to target emotion dysregulation in alcohol treatments.