Gratitude and lower suicidal ideation among sexual minority individuals: theoretical mechanisms of the protective role of attention to the positive

Healthcare discrimination and treatment adherence among sexual and gender minority individuals living with chronic illness: the mediating effects of anticipated discrimination and depressive symptoms

Background: Sexual and gender minority (SGM) individuals are at increased risk for an array of chronic illness due to minority stress. Up to 70% of SGM individuals report healthcare discrimination, which may cause additional challenges for SGM people living with chronic illness including avoiding necessary healthcare. The extant literature highlights how healthcare discrimination is associated with depressive symptoms and treatment nonadherence. However, there is limited evidence on the underlying mechanisms between healthcare discrimination and treatment adherence among SGM people living with chronic illness.Methods: Among a sample of SGM individuals living with chronic illness (n = 149) recruited from social media, the current study examined the mediating roles of anticipated discrimination and depressive symptoms on the relation between healthcare discrimination and treatment adherence in a serial mediation model.Results: We found that healthcare discrimination was associated with greater anticipated discrimination, increased depressive symptoms, and, in turn, poorer treatment adherence. Conclusion: These findings highlight the association between minority stress and both depressive symptoms and treatment adherence among SGM individuals living with chronic illness. Addressing institutional discrimination and the consequences of minority stress may improve treatment adherence among SGM individuals living with chronic illness.

Risk factors for suicide attempts among U.S. military veterans: A 7-year population-based, longitudinal cohort study

BACKGROUND

Population-based data on risk factors for suicide attempts among veterans remains limited.

METHODS

A national probability sample of 2307 veterans was followed over the course of four timepoints spanning seven years to examine how a range of baseline risk factors predict incident suicide attempt. Suicide attempt data were aggregated into a single follow-up timepoint.

RESULTS

Sixty-two veterans (3.1%) reported attempting suicide during the 7-year period. The strongest risk factors for suicide attempts were higher baseline levels of loneliness, lower baseline levels of adaptive psychosocial traits (e.g., dispositional gratitude), baseline thoughts of self-harm, and greater post-baseline trauma exposures (12.3%-41.3% of explained variance). Veterans with multiple co-occurring risk factors were at greatest risk for attempts; of veterans with 0, 1, 2, 3, and all 4 of these factors, the predicted probability of suicide attempt was 2.0%, 5.3%, 13.5%, 30.4%, and 55.0%, respectively.

CONCLUSIONS

Baseline loneliness, dispositional gratitude, thoughts of self-harm, and new-onset traumas emerged as the strongest risk factors for suicide attempts among veterans, underscoring the potential importance of targeting these factors in prevention efforts. Veterans with multiple co-occurring risk factors have substantially greater risk for suicide attempts, suggesting that examination of multiple coinciding vulnerability factors may help improve suicide risk prediction models.

Self-Compassion and Mental Health in Sexual and Gender Minority People: A Systematic Review and Meta-Analysis

Purpose: Literature shows that sexual and gender minority (SGM) individuals are at higher risk of developing minority stress-related mental health problems. Recently, it has been suggested that promoting self-compassion through affirmative mental health care for SGM people can be beneficial. However, no systematic analysis has been published exploring the relationship between self-compassion and mental health indicators in SGM individuals. We aim to fill this gap by synthesizing and meta-analyzing studies that focus on the relationship between self-compassion and mental health in SGM people. Methods: After registering in PROSPERO (CRD42021254774), PubMed, PsycINFO, CENTRAL, and Web of Knowledge were systematically searched to identify studies assessing the association between self-compassion and mental health and/or minority stress indicators in SGM individuals. All screening steps and data extraction were performed independently by the two researchers. The quality of each study was assessed with the National Heart, Lung and Blood Institute tool, and meta-analysis was performed on R software. Results: Twenty-one studies were included in the meta-analysis, corresponding to a total of 6573 nonheterosexual and/or noncisgender participants. All meta-analytic models were significant: higher levels of self-compassion were associated with less depression, anxiety, psychological distress, suicidal ideation, internalized homophobia/transphobia, and stigma, and with more well-being, outness, and social support. Conclusion: This meta-analysis suggests that self-compassion is significantly associated with mental health indicators in SGM people, and this relationship is especially strong with internalized homophobia/transphobia in older SGM adults, and with suicidal ideation in younger SGM individuals. Results suggest that affirmative mental health care may benefit from promoting self-compassion.