1
|
Wang PW, Chang YP, Tsai CS, Yen CF. Predictors of depressive and anxiety symptoms among lesbian, gay and bisexual young adult individuals experiencing the COVID-19 pandemic: A four-year follow-up study. J Formos Med Assoc 2024; 123:1267-1272. [PMID: 38423925 DOI: 10.1016/j.jfma.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/17/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND/PURPOSE Depressive and anxiety symptoms were common among lesbian, gay, and bisexual (LGB) individuals during the COVID-19 pandemic. This 4-year follow-up study was conducted to investigate the predictors of depressive and anxiety symptoms in Taiwan's young adult LGB population. METHODS Baseline data, including depressive and anxiety symptoms, demographic characteristics, sexual stigma, self-identity confusion, and family support were collected from 1000 LGB individuals. The participants' depressive and anxiety symptoms were reassessed 4 years after the baseline measurements. The predictive effects of the baseline factors on depressive and anxiety symptoms at follow-up were examined through linear regression analysis. RESULTS Greater lack of identity, unconsolidated identity, sexual orientation microaggression, and lower perceived family function at baseline were significantly associated with more severe depressive and anxiety symptoms at follow-up. After adjustment for baseline depressive symptoms, being men, greater lack of identity, lower perceived family function, and more severe anxiety symptoms at baseline were significantly associated with more severe depressive symptoms at follow-up. After adjustment for baseline anxiety symptoms, greater unconsolidated identity and more severe depressive symptoms at baseline were significantly associated with more severe anxiety symptoms at follow-up. CONCLUSIONS Intervention aimed at reducing depressive and anxiety symptoms in LGB individuals should be developed considering the predictors identified in this study.
Collapse
Affiliation(s)
- Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine and School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY, USA
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine and School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
| |
Collapse
|
2
|
Yen CF, Tsai CS, Chang YP, Wang PW. Predictors of new-onset suicide risk and persistent suicide risk among young adult lesbian, gay and bisexual individuals experiencing the COVID-19 pandemic: a follow-up study. Epidemiol Psychiatr Sci 2024; 33:e57. [PMID: 39494581 PMCID: PMC11561679 DOI: 10.1017/s2045796024000635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 08/28/2024] [Accepted: 09/12/2024] [Indexed: 11/05/2024] Open
Abstract
AIMS The aim of this 4-year follow-up study was to examine the predictive effects of demographics, three types of sexual stigma, three types of self-identity confusion, anxiety, depression, family support and problematic Internet use before the coronavirus disease 2019 (COVID-19) pandemic on new-onset suicide risk and persistent suicide risk in young adult lesbian, gay and bisexual individuals who experienced the COVID-19 pandemic in Taiwan. METHODS Baseline data were collected from 1,000 lesbian, gay and bisexual individuals in 2018 and 2019. Outcome data on suicide risk were collected again in 2023. The suicide module of the Mini International Neuropsychiatric Interview was used to assess suicide risk in terms of thoughts of death, desire to self-harm, thoughts of suicide, plans for suicide and suicide attempts in the preceding month at the initial and follow-up assessments. Baseline three types of sexual stigma, self-identity disturbance, depression, anxiety and problematic Internet use were used to examine their prediction of new-onset suicide risk and persistent suicide risk at follow-up. RESULTS In total, 673 individuals participated in the follow-up survey. Notably, 16.5% of the participants who had no suicide risk at baseline had new-onset suicide risk at follow-up; 46.4% of the participants who had suicide risk at baseline also had suicide risk at follow-up. Participants who were transgender (p = .003), who perceived greater levels of microaggression (p < .001), and who had greater levels of problematic Internet use at baseline (p = .024) were more likely to have new-onset suicide risk at follow-up. Participants who had greater levels of self-identity confusion were more likely to have persistent suicide risk at follow-up (p = .023). CONCLUSION Intervention strategies for reducing suicide risk in lesbian, gay and bisexual individuals should be developed with consideration of the predictors identified in this study.
Collapse
Affiliation(s)
- Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY, USA
| | - Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
3
|
Huang MF, Chang YP, Chou WJ, Yen CF. Predictors of problematic smartphone use among young adult lesbian, gay and bisexual individuals during the COVID-19 pandemic: a four-year follow-up study. BMC Psychiatry 2023; 23:905. [PMID: 38053156 PMCID: PMC10696814 DOI: 10.1186/s12888-023-05326-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/30/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND This 4-year follow-up study was conducted to evaluate the predictive effects of prepandemic individual and environmental factors on problematic smartphone use (PSU) among young adult lesbian, gay, and bisexual (LGB) individuals during the COVID-19 pandemic. METHODS Data on prepandemic PSU, demographics, sexual stigma (e.g., perceived sexual stigma from family members, internalized sexual stigma, and sexual microaggression), self-identity confusion (e.g., disturbed identity, unconsolidated identity, and lack of identity), anxiety, depression, and family support were collected from 1,000 LGB individuals between August 2018 and June 2019. The participants' PSU was surveyed again after 4 years (between August 2022 and June 2023). The associations of prepandemic individual and environmental factors with PSU at follow-up were analyzed through linear regression. RESULTS In total, 673 (67.3%) participants completed the follow-up assessment. The severity of PSU significantly decreased after 4 years (p = .001). Before the incorporation of PSU at baseline into the analysis model, the results of the model revealed that high levels depressive symptoms (p < .001), disturbed identity (p < .001), and perceived sexual stigma from family members (p = .025) at baseline were significantly associated with PSU at follow-up. After the incorporation of PSU at baseline into the analysis model, the results of the model revealed that high levels PSU (p < .001) and depressive symptoms (p = .002) at baseline were significantly associated with PSU at follow-up. CONCLUSION Interventions aimed at reducing the severity of PSU among LGB individuals should be designed considering the predictors identified in our study.
Collapse
Affiliation(s)
- Mei-Feng Huang
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY, USA
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 32 Dapi Rd. Niaosong Dist, Kaohsiung, 83341, Taiwan.
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, and School of Medicine College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 80708, Taiwan.
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
| |
Collapse
|
4
|
Wang PW, Chang YP, Tsai CS, Yen CF. Sexual stigmas among lesbian, gay, and bisexual individuals with problematic internet use and depression. Front Psychiatry 2023; 14:1163032. [PMID: 37255683 PMCID: PMC10225597 DOI: 10.3389/fpsyt.2023.1163032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/02/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Sexual stigma causes psychological distress among lesbian, gay, and bisexual (LGB) individuals. LGB individuals are more likely to exhibit both problematic Internet use (PIU) and significant depression than are heterosexual individuals. Whether the severities of sexual stigma varied among LGB individuals with various statuses of comorbid PIU and depression warrants study. The present study aimed to investigate the differences in the experiences of familial sexual stigma (FSS), internalized sexual stigma (ISS), and sexual orientation microaggressions (SOMs) among LGB individuals with various statuses of comorbid PIU and depression. Methods In total, 1,000 self-identified LGB young adult individuals participated in the study. The level of PIU was assessed using the Chen Internet Addiction Scale, depression was assessed using the Center for Epidemiological Studies-Depression Scale, the experience of FSS was assessed using the Homosexuality-Related Stigma Scale, the experience of ISS was assessed using the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, and the experience of sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory. The differences in the levels of FSS, ISS, and SOMs among the four groups [i.e., the groups with both PIU and depression (comorbid group), only depression, only PIU, and neither PIU nor depression (neither group)] were investigated using multivariate analysis of covariance. Results The results indicated that LGB individuals with comorbid PIU and depression reported higher levels of ISS and SOMs than did those with depression only and PIU only, respectively. Moreover, LGB individuals with PIU or significant depression had higher levels of FSS and SOMs than did those with neither PIU nor depression. Discussion The results of this study supported that the experiences of FSS, ISS, and SOMs were significantly associated with various levels of PIU and depression in LGB individuals.
Collapse
Affiliation(s)
- Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY, United States
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan
| |
Collapse
|
5
|
Chen YL, Chang YP, Yen CF. Effects of gender nonconformity and biological sex on the relationship between sexual orientation microaggressions and anxiety and depressive symptoms among lesbian, gay, and bisexual Taiwanese young adults: A moderated-moderation study. J Affect Disord 2023; 334:129-136. [PMID: 37150223 DOI: 10.1016/j.jad.2023.04.131] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 03/11/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Sexual orientation microaggressions (SOMs) may negatively affect lesbian, gay, and bisexual (LGB) individuals' mental health. However, the moderating effects of gender nonconformity and biological sex on the relationship between SOMs and anxiety and depressive symptoms has never been examined. We evaluated the moderating effect of gender nonconformity on the association of SOMs with anxiety and depressive symptoms among LGB young male and female adults. We hypothesized that the associations of SOMs with anxiety and depressive symptoms weakened with increasing gender nonconformity among gay and bisexual men but strengthened with increasing gender nonconformity among lesbian and bisexual women. METHODS In total, 1000 self-identified LGB young adult individuals participated in the study. The experience of sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory, anxiety was assessed using the State subscale on the State-Trait Anxiety Inventory, and depression was assessed using the Center for Epidemiological Studies-Depression Scale. The two-way moderation models stratified by sex examined the moderating effects of gender nonconformity on the association between SOMs and anxiety symptoms in the male and female participants. The three-way moderated moderation models were used to determine whether gender nonconformity and sex jointly moderated the associations between SOMs and anxiety and depressive symptoms. RESULTS In the two-way moderation models stratified by sex, gender nonconformity exerted opposite moderating effects on the association between SOMs and anxiety and depressive symptoms in the male and female participants. For the male participants, the association between SOMs and anxiety (β = -0.08) and depressive symptoms (β = -0.09) weakened with increasing gender nonconformity. For the female participants, the association between SOMs and anxiety (β = 0.08) and depressive symptoms (β = 0.13) strengthened with increasing gender nonconformity. The three-way moderated moderation models further confirmed that sex moderated the moderating effects of gender nonconformity on the associations between SOM and anxiety (β = -0.16, p = .047) and depressive symptoms (β = -0.22, p < .001). LIMITATION The cross-sectional study design limited the inferences that could be made concerning the temporal relationship between SOMs and mental health problems. CONCLUSIONS The association between SOMs and anxiety and depressive symptoms weakened with increasing gender nonconformity in gay and bisexual men, whereas the association between SOMs and anxiety and depressive symptoms strengthened with increasing gender nonconformity in lesbian and bisexual women.
Collapse
Affiliation(s)
- Yi-Lung Chen
- Department of Psychology, Asia University, Taichung, Taiwan; Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, NY, USA
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
| |
Collapse
|
6
|
Lin CY, Griffiths MD, Pakpour AH, Tsai CS, Yen CF. Relationships of familial sexual stigma and family support with internalized homonegativity among lesbian, gay and bisexual individuals: The mediating effect of self-identity disturbance and moderating effect of gender. BMC Public Health 2022; 22:1465. [PMID: 35915488 PMCID: PMC9344633 DOI: 10.1186/s12889-022-13815-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background The mediators of the association between familial attitudes toward sexual orientation and internalized homonegativity among lesbian, gay, and bisexual (LGB) individuals have not been well examined. Methods A cross-sectional survey study was carried out to examine the (i) associations of familial sexual stigma and family support with internalized homonegativity among young adult LGB individuals in Taiwan, and (ii) mediating effect of self-identity disturbance and the moderating effect of gender. Self-identified LGB individuals (N = 1000; 50% males and 50% females; mean age = 24.6 years) participated in the study. Familial sexual stigma, family support, self-identity disturbance, and internalized homonegativity were assessed. Structural equation modeling was used to examine relationships between the variables. Results The results indicated that familial sexual stigma was directly associated with increased internalized homonegativity, and indirectly associated with increased internalized homonegativity via the mediation of self-identity disturbance among LGB individuals. Family support was indirectly associated with decreased internalized homonegativity via the mediation of low self-identity disturbance. The direct association between family support and internalized homonegativity was only found among lesbian and bisexual women but not among gay and bisexual men. Conclusions Program interventions for familial sexual stigma, family support, and self-identity disturbance are warranted to help reduce internalized homonegativity among LGB individuals.
Collapse
Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung and School of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 32 Dapi Rd. Niaosong Dist., Kaohsiung, 83341, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, and School of Medicine College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 80708, Taiwan. .,College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
| |
Collapse
|
7
|
Lin CY, Tsai CS, Fan CW, Griffiths MD, Chang CC, Yen CF, Pakpour AH. Psychometric Evaluation of Three Versions of the UCLA Loneliness Scale (Full, Eight-Item, and Three-Item Versions) among Sexual Minority Men in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8095. [PMID: 35805754 PMCID: PMC9265606 DOI: 10.3390/ijerph19138095] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
The UCLA Loneliness Scale, with different short versions, is widely used to assess levels of loneliness. However, whether the scale is valid in assessing loneliness among sexual-minority men is unknown. Additionally, it is unclear whether the 8-item and 3-item short versions are comparable to the full 20-item version. The present study compared the validity of the three versions of the UCLA Loneliness Scale (i.e., 20-item, 8-item, and 3-item versions) among gay and bisexual men in Taiwan. The participants comprised 400 gay and bisexual men in Taiwan who completed a cross-sectional online survey, which included the UCLA Loneliness Scale, Center for Epidemiological Studies Depression Scale (CES-D) and State-Trait Anxiety Inventory (STAI). Confirmatory factor analysis was used to evaluate factorial validity. Convergent validity was examined between the three versions of the UCLA Loneliness Scale and the CES-D and STAI. Known-group validity was investigated with participants' sexual orientation and educational levels. The unidimensional construct was supported in all three versions of the UCLA Loneliness Scale tested in the present study. Convergent validity was supported as the level of loneliness was correlated with the level of depression and anxiety for all three versions. There were no significant differences between gay and bisexual men, although significant differences were found across different educational levels. The study confirmed that all three versions of the UCLA Loneliness Scale were comparable with satisfactory reliability and validity in Taiwanese sexual-minority men.
Collapse
Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Orlando, FL 32803, USA;
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK;
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 70246, Taiwan
- Department of Health Psychology, Chang Jung Christian University, Tainan 71101, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
| | - Amir H. Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, SE-551 11 Jönköping, Sweden;
| |
Collapse
|
8
|
Lee JI, Chang YP, Tsai CS, Yen CF. Internalized Sexual Stigma among Lesbian, Gay, and Bisexual Individuals in Taiwan: Its Related Factors and Association with Mental Health Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042427. [PMID: 35206614 PMCID: PMC8872568 DOI: 10.3390/ijerph19042427] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 02/04/2023]
Abstract
Internalized sexual stigma (ISS) is one of the major issues that can compromise the health of sexual minority populations. This quantitative study aimed to examine: (1) the relationships of individual factors (gender, age, education level, sexual orientation, and age of identification of sexual orientation) and perceived family support with ISS; and (2) the associations of ISS with mood problems and the moderating effects of gender on the associations among Taiwanese young adult lesbian, gay, and bisexual (LGB) individuals. In total, 500 male and 500 female young adult LGB individuals aged between 20 and 30 years participated in this study. The experience of ISS, individual (e.g., gender, age, education level, sexual orientation, and age of identification of sexual orientation) and environmental factors (perceived family), mood problems (e.g., anxiety and depression) were collected. The individual and environmental factors related to ISS and the associations of ISS with mood problems were examined using multivariate linear regression analysis. The results indicated that gender, sexual orientation, age of identification of sexual orientation, and perceived family support were significantly associated with all or some dimensions of ISS in LGB individuals. Various dimensions of ISS had different relationships with anxiety and depression. Gender had moderating effects on the association between the identity dimension of ISS and sexual orientation as well as between the social discomfort dimension of ISS and anxiety. Various dimensions of ISS among LGB individuals should be routinely assessed by mental health service units. Intervention programs should be provided for LGB individuals, especially those with factors related to ISS.
Collapse
Affiliation(s)
- Jia-In Lee
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
- Department of Psychiatry, School of Medicine, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY 14260, USA;
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Correspondence: (C.-S.T.); (C.-F.Y.); Tel.: +886-7-7317-123 (ext. 8751) (C.-S.T.); +886-7-3124-941 (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
- Department of Psychiatry, School of Medicine, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (C.-S.T.); (C.-F.Y.); Tel.: +886-7-7317-123 (ext. 8751) (C.-S.T.); +886-7-3124-941 (C.-F.Y.)
| |
Collapse
|
9
|
Ademiluyi A, Li C, Park A. Implications and Preventions of Cyberbullying and Social Exclusion in Social Media: Systematic Review. JMIR Form Res 2022; 6:e30286. [PMID: 34982712 PMCID: PMC8767467 DOI: 10.2196/30286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/25/2021] [Accepted: 08/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background The growth of social networking has created a paradigm in which many forms of personal communication are being replaced by internet communication technologies, such as social media. This has led to social issues, such as cyberbullying. In response, researchers are investigating cyberbullying to determine its implications in various life sectors. Objective This manuscript reviews the methods, results, and limitations of the current cyberbullying research and discusses the physical and mental repercussions of cyberbullying and social exclusion as well as methods of predicting and counteracting these events. On the basis of the findings, we discuss future research directions. Methods Using ScienceDirect, ACM Digital Library, and PubMed, 34 research articles were used in this review. A review was conducted using the selected articles with the goal of understanding the current landscape of cyberbullying research. Results Studies have analyzed correlations between depressive and suicidal ideations in subjects as well as relationships in the social, educational, and financial status of the perpetrators. Studies have explored detection methods for monitoring cyberbullying. Automated detection has yet to become effective and accurate; however, several factors, such as personal background and physical appearance, have been identified to correlate with the likelihood that a person becomes a survivor or perpetrator of web-based cybervictimization. Social support is currently common in recovery efforts but may require diversification for specific applications in web-based incidents. Conclusions Relations between social status, age, gender, and behaviors have been discovered that offer new insights into the origins and likeliness of cyberbullying events. Rehabilitation from such events is possible; however, automatic detection is not yet a viable solution for prevention of cyberbullying incidents. Effects such as social exclusion and suicidal ideations are closely tied to incidents of cyberbullying and require further study across various social and demographical populations. New studies should be conducted to explore the experiences of survivors and perpetrators and identify causal links. The breadth of research includes demographics from China, Canada, Taiwan, Iran, the United States, and Namibia. Wider ranges of national populations should be considered in future studies for accurate assessments, given global internet communication technology activity. The studies emphasize the need for formal classification terminology. With formal classification, researchers will have a more definite scope, allowing specific research on a single definable topic rather than on general bullying events and symptoms. Of all the studies, 2 used a longitudinal design for their research methodology. The low number of longitudinal studies leaves gaps between causation and correlation, and further research is required to understand the effects of cyberbullying. Research addressing ongoing victimization is required for the various forms of cyberbullying; social support offers the most effective current standard for prevention.
Collapse
Affiliation(s)
- Adesoji Ademiluyi
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte Charlotte, Charlotte, NC, United States
| | - Chuqin Li
- Department of Software and Information Systems, University of North Carolina at Charlotte Charlotte, Charlotte, NC, United States
| | - Albert Park
- Department of Software and Information Systems, University of North Carolina at Charlotte Charlotte, Charlotte, NC, United States
| |
Collapse
|
10
|
Relationships of Sexual Orientation Microaggression with Anxiety and Depression among Lesbian, Gay, and Bisexual Taiwanese Youth: Self-Identity Disturbance Mediates but Gender Does Not Moderate the Relationships. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412981. [PMID: 34948591 PMCID: PMC8701819 DOI: 10.3390/ijerph182412981] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 12/03/2022]
Abstract
The aims of this cross-sectional survey study were to examine the association between sexual orientation microaggression and anxiety and depression among young adult lesbian, gay, and bisexual (LGB) individuals in Taiwan, as well as to examine the mediating effect of self-identity disturbance and the moderating effect of gender. In total, 1000 self-identified LGB individuals participated in the study. The experience of sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory, self-identity disturbance was assessed using the Self-Concept and Identity Measure, anxiety was assessed using the State subscale on the Chinese version of the State-Trait Anxiety Inventory, and depression was assessed using the Center for Epidemiological Studies-Depression Scale. Structural equation modeling (SEM) was used to examine relationships between the variables. The SEM results demonstrated that sexual orientation microaggression was directly associated with increased anxiety and depression, as well as being indirectly associated with increased anxiety and depression via the mediation of self-identity disturbance among young adult LGB individuals. Gender did not moderate the relationships between any of the variables. Both sexual orientation microaggression and self-identity disturbance warrant program interventions for enhancing mental health among LGB individuals.
Collapse
|
11
|
Ko NY, Lu WH, Chen YL, Li DJ, Chang YP, Wang PW, Yen CF. Cognitive, Affective, and Behavioral Constructs of COVID-19 Health Beliefs: A Comparison Between Sexual Minority and Heterosexual Individuals in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124282. [PMID: 32549345 PMCID: PMC7345535 DOI: 10.3390/ijerph17124282] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/13/2020] [Accepted: 06/13/2020] [Indexed: 12/23/2022]
Abstract
This online survey study aimed to compare the cognitive, affective, and behavioral constructs of health beliefs related to coronavirus disease 2019 (COVID-19) between sexual minority and heterosexual individuals in Taiwan. In total, 533 sexual minority and 1421 heterosexual participants were recruited through a Facebook advertisement. The constructs pertaining to cognition (perceived relative susceptibility to COVID-19, perceived COVID-19 severity, having sufficient knowledge and information on COVID-19, and confidence in coping with COVID-19), affect (worry toward COVID-19), and behavior (adoption of health-protective behaviors) in relation to health beliefs about COVID-19 were compared between sexual minority and heterosexual participants. The results indicated that sexual minority participants had lower perceived susceptibility to COVID-19, greater self-confidence in coping with COVID-19, and lower worry about COVID-19 and were less likely to maintain good indoor ventilation and disinfect their household than heterosexual individuals. Sexual orientation is the modifying factor for the Health Belief Model in the COVID-19 pandemic and should be taken into consideration when medical professionals establish prevention programs for COVID-19.
Collapse
Affiliation(s)
- Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
| | - Wei-Hsin Lu
- Department of Psychiatry, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City 60002, Taiwan;
- Department of Senior Citizen Service Management, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan
| | - Yi-Lung Chen
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan;
- Department of Psychology, Asia University, Taichung 41354, Taiwan
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80276, Taiwan;
- Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY 14214-3079, USA;
| | - Peng-Wei Wang
- Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Correspondence: (P.-W.W.); (C.-F.Y.); Tel.: +886-7-312-1101 (ext. 6822) (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Correspondence: (P.-W.W.); (C.-F.Y.); Tel.: +886-7-312-1101 (ext. 6822) (C.-F.Y.)
| |
Collapse
|
12
|
The Impact of Emotional Symptoms and Family Support on the Association Between Homophobic Bullying and Sedative/Hypnotic Use among Gay and Bisexual Men in Taiwan: A Moderated Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113870. [PMID: 32485987 PMCID: PMC7311954 DOI: 10.3390/ijerph17113870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/22/2020] [Accepted: 05/28/2020] [Indexed: 11/16/2022]
Abstract
Sedative/hypnotic use and homophobic bullying have become a big mental health concern for gay and bisexual men. However, few studies have investigated the mediators and moderators of the association between them. The current study aimed to build a conceptual model to estimate the mediating effect of emotional symptoms and the moderating effect of family support on this association among gay and bisexual men in Taiwan. A total of 500 gay or bisexual men were recruited for the study. Their history of homophobic bullying, their experience of sedative/hypnotic use, their perceived family support, and their current emotional symptoms were evaluated using self-reporting questionnaires. A moderated mediation model was developed to test the mediating effect of emotional symptoms and the moderating effect of family support. A higher level of homophobic bullying was significantly associated with sedative/hypnotic use among gay and bisexual men and this was mediated by a higher severity of emotional symptoms. A moderating effect of family support was identified, wherein the mediating effect of emotional symptoms was weaker when there was a higher level of perceived family support, thus revealing the protective effect of family support. The significant impact of emotional symptoms and family support on the association between homophobic bullying and sedative/hypnotic use was identified. Timely interventions for emotional symptoms and the enhancement of family support are crucial for gay and bisexual men.
Collapse
|