Gender dysphoria. - Atkinson, Sean R.; Russell, Darren (Australian Family Physician, 2015)
Background: Gender dysphoria is the distress or discomfort that may occur when a person's biological sex and gender identity do not align. The true prevalence of gender dysphoria is unknown in Australia because of varying definitions, different cultural norms and paucity of data. Individuals who identify as transgender are vulnerable, and have higher rates of discrimination, depression and suicidality, compared with the general population.Objective: The aim of this article is to familiarise general practitioners (GPs) with the principles of transgender care so they may provide a safe and supportive environment for patients presenting with concerns.Discussion: It is important to have a basic understanding of how to conduct an initial consultation of gender dysphoria even if it is an uncommon presentation in general practice. Management should be individualised and may involve a combination of social work, education, counselling, hormone therapy and surgery.
Keywords: Sexuality; Incidence; Australia; Prevalence; Clinical Assessment Tools; Questionnaires; Scales; Social Readjustment Rating Scale

Psychological functioning in a cohort of gay men at risk for AIDS. A three-year descriptive study. - JOSEPH, JILL G.; CAUMARTIN, SUSAN M.; TAL, MARGALIT; KIRSCHT, JOHN P.; KESSLER, RONALD C.; OSTROW, DAVID G.; WORTMAN, CAMILLE B.; Joseph, J G; Caumartin, S M; Tal, M; Kirscht, J P; Kessler, R C; et al. (Journal of Nervous & Mental Disease, 1990)
This study describes the mental health of a large cohort of gay men participating in the Chicago Multicenter AIDS Cohort Study/Coping and Change Study. Six biannual questionnaires were self-administered between 1984 and 1988. General mental health was determined by the Hopkins Symptom Checklist (HSCL). An abbreviated version of the Center for Epidemiologic Study Depression Scale (CESD-5) and an adapted Diagnostic Interview Schedule (DIS) question also measured depression. Suicidal ideation was assessed by one question in the HSCL. AIDS-specific distress was determined by three subscales specifically developed for this study. While mean HSCL and CESD-5 scores were stable during the observational period, AIDS-specific distress increased over time. The HSCL scores for the cohort were somewhat elevated above general population norms but considerably below psychiatric outpatient norms. Fewer than 12% of the men reported elevated HSCL or CESD-5 scores three or more times. A self-reported episode of depression of two weeks or more, measured by the DIS screening question, was experienced by 40.1% of the sample. Suicidal ideation was reported on three or more visits by 18.8% of the men. The younger members of this cohort exhibit greater general and AIDS-specific distress. Income was inversely associated with general distress. HIV-seropositive participants had generally higher AIDS-specific distress scores than those who were seronegative, but their scores were equivalent on the HSCL and CESD-5.
Keywords: Attitude to Health; Acquired Immunodeficiency Syndrome -- Psychosocial Factors; Stress, Psychological -- Diagnosis; Homosexuality; Illinois; Depression -- Diagnosis; Risk Factors; Stress, Psychological -- Epidemiology; Psychological Tests; Anxiety -- Epidemiology; Myers-Briggs Type Indicator; Suicide -- Psychosocial Factors; HIV Seropositivity -- Psychosocial Factors; Anxiety -- Diagnosis; Male; Prospective Studies; Adult; Human; Depression -- Epidemiology; Validation Studies; Comparative Studies; Evaluation Research; Multicenter Studies; Center for Epidemiological Studies Depression Scale; Checklists; Interview Guides

Temporal trends in the incidence of human immunodeficiency virus infection and risk behavior among injection drug users in Baltimore, Maryland, 1988-1998. - Nelson KE; Galai N; Safaeian M; Strathdee SA; Celentano DD; Vlahov D (American Journal of Epidemiology, 2002)
Although the incidence of and mortality from acquired immunodeficiency syndrome have declined recently in the United States, data are needed on the incidence of human immunodeficiency virus (HIV) and risk behaviors among injection drug users (IDUs). The authors studied the temporal trends of HIV incidence and risk behavior, ascertained through semiannual confidential interviews, between 1988 and 1998 in a cohort of 1,532 HIV-seronegative IDUs in Baltimore, Maryland. An additional 338 HIV-negative drug users were recruited in 1994 and were studied by using the same methods. Overall, 277 persons seroconverted to HIV during 8,826.45 person-years of follow-up, an incidence of 3.14 per 100 person-years. The incidence per 100 person-years declined over time from 4.45 in 1988-1990 to 3.35 in 1991-1994 to 1.84 in 1995-1998, a decline of 12% per year. HIV infections were associated with injection of cocaine, more frequent injection, needle sharing, and injection in a shooting galley. Sexual behavior variables associated with HIV incidence included a sexually transmitted infection, male homosexual behavior, and sex with another IDU. These data suggest that high-risk behavior and HIV incidence among IDUs have decreased recently in Baltimore. Nevertheless, additional prevention strategies are needed in these populations.
Keywords: HIV Infections -- Epidemiology; Risk Taking Behavior; Intravenous Drug Users; Funding Source; Maryland; Prospective Studies; Regression; Interviews; Relative Risk; Confidence Intervals; Sex Factors; Univariate Statistics; Multivariate Analysis; Adult; Male; Female; Human

Gynecologic care for transgender youth. - Unger, Cécile A (Current Opinion in Obstetrics & Gynecology, 2014)
PURPOSE OF REVIEW: To provide an overview of the care of the adolescent transgender patient with regard to the guidelines and recommendations that currently exist, and to review the role of the clinician caring for transgender youth. RECENT FINDINGS: The World Professional Association for Transgender Health and the Endocrine Society continue to provide comprehensive guidelines for the care of adolescent transgender patients. The decision to perform surgery on a patient who is a minor remains a complex one, and a case-by-case approach should be taken with important ethical principles in mind. Cross-sex steroid use places transgender adolescents at risk for metabolic disorders, and careful surveillance is necessary. In addition, transgender teens are at high risk for depression, anxiety and suicidality and have been shown to engage in more high-risk behaviors compared with their nontransgender heterosexual counterparts. SUMMARY: Clinicians who care for adolescents can play an important role in the counseling, screening, health maintenance and support of their patients through the transition process.
Keywords: Adolescent Behavior; Adolescent Health Services -- Standards; Depression -- Diagnosis; Health Services -- Standards; Consent -- Psychosocial Factors; Gender Affirmation Surgery -- Ethical Issues; Gender Affirmation Surgery -- Standards; Transgender Persons -- Psychosocial Factors; Adaptation, Psychological; Adolescence; Decision Making, Ethical; Gender Identity; Sex Hormones -- Therapeutic Use; Gonadorelin -- Therapeutic Use; Health Services -- Ethical Issues; Parent-Child Relations; Physician-Patient Relations; Practice Guidelines; Support, Psychosocial; Quality of Health Care; Substance Use Disorders -- Diagnosis; Substance Use Disorders -- Psychosocial Factors; Suicidal Ideation

Gender Dysphoria in Adults. - Zucker, Kenneth J.; Lawrence, Anne A.; Kreukels, Baudewijntje P.C. (Annual Review of Clinical Psychology, 2016)
Gender dysphoria (GD), a term that denotes persistent discomfort with one's biologic sex or assigned gender, replaced the diagnosis of gender identity disorder in the Diagnostic and Statistical Manual of Mental Disorders in 2013. Subtypes of GD in adults, defined by sexual orientation and age of onset, have been described; these display different developmental trajectories and prognoses. Prevalence studies conclude that fewer than 1 in 10,000 adult natal males and 1 in 30,000 adult natal females experience GD, but such estimates vary widely. GD in adults is associated with an elevated prevalence of comorbid psychopathology, especially mood disorders, anxiety disorders, and suicidality. Causal mechanisms in GD are incompletely understood, but genetic, neurodevelopmental, and psychosocial factors probably all contribute. Treatment of GD in adults, although largely standardized, is likely to evolve in response to the increasing diversity of persons seeking treatment, demands for greater client autonomy, and improved understanding of the benefits and limitations of current treatment modalities.
Keywords: Male; Adult; Female

Current issues and forthcoming events. (Journal of Advanced Nursing (Wiley-Blackwell), 2002)
Presents updates on nursing as of October 8, 2002. Information on treatment guidelines for HIV and AIDS in developing countries, issued by the World Health Organization; Details on the Global Polio Eradication Initiative; Discussion on a study on the risk of mental health problems and suicide among bisexuals.

Prognosis of penetrating trauma in elderly patients: a comparison with younger patients...including commentary by Kauder DR, McGonigal MD, Brotman S, Scalea TM with author response - Nagy KK; Smith RF; Roberts RR; Joseph KT; An GC; Bokhari F; Barrett J (Journal of Trauma, 2000)
Background: It has previously been shown that elderly patients have a worse prognosis than their younger counterparts after sustaining blunt trauma. This is due in part to a higher incidence of comorbid conditions as well as less physiologic reserve in an elderly population sustaining largely blunt trauma. We compared the outcome after penetrating trauma in elderly patients to matched 'younger' patients to determine whether they had a similarly poor prognosis. Methods: Elderly patients (> or = 65 years) were identified from our trauma registry. Sex, mechanism of injury, and Abbreviated Injury Score/Injury Severity Score were determined from the registry. Patients presenting with traumatic arrest were excluded. The registry was then searched for patients aged 15 to 40 years with the same sex, mechanism of injury, and Abbreviated Injury Score in each region. A chart review was then performed to determine additional details of their hospital stay. The two groups were then compared using Student's t test and Fisher's exact chi square test, as appropriate. Results: Eighty-five elderly patients (OLD group) were admitted with penetrating trauma between 1983 and 1998. They were compared with 85 matched young patients (YOUNG group). Each group included 66 male and 19 female patients. In each group, gunshot wounds occurred in 45.9%, stab wounds in 52.9%, and shotgun wounds in 1.2% of patients. The average Injury Severity Score in each group was 5.5 +/- 5.6 (range, 1-29) and the regional Abbreviated Injury Scores were likewise equal in both groups. The OLD patients had an average hospital stay of 6.9 +/- 9.1 days compared with 4.3 +/- 5.7 days in the YOUNG patients (p < 0.05). Twenty-seven OLD patients spent 7.3 +/- 9.2 days in the intensive care unit compared with 19 YOUNG patients who stayed 3.4 +/- 3.2 days (p < .05). A total of 91 comorbidities were identified in 58 OLD patients compared with 18 in 15 YOUNG patients (p < .0001). Eighty-six invasive procedures were performed in the OLD group compared with 96 in the YOUNG group (p = not significant). Nineteen OLD patients (22.3%) and 15 YOUNG patients (17.6%) suffered one or more complications, including death (p = not significant). A total of 91% of surviving OLD patients were discharged to home compared with 100% of surviving YOUNG patients (p < .01). Conclusion: Elderly patients who sustain penetrating trauma have more comorbidities than their younger counterparts. This may account for their longer hospital stay and lesser ability to be discharged home. These patients do not have an increased complication rate and should continue to be managed aggressively.
Keywords: Wounds, Penetrating -- Prognosis -- In Old Age; Wounds, Penetrating -- Prognosis -- In Adolescence; Wounds, Penetrating -- Prognosis -- In Adulthood; Comparative Studies; T-Tests; Chi Square Test; Trauma Severity Indices; Purposive Sample; Descriptive Statistics; Adolescence; Adult; Aged; Aged, 80 and Over; Male; Female; Human

Commentary: Social-Ethical Values Issues in the Political Public Square: Principles vs. Packages. - Somerville, Margaret (Journal of Law, Medicine & Ethics, 2004)
Focuses on social-ethical values and the decision-making process confronting social conservatives and social liberals in Canada. Limitations of the Assisted Human Reproduction Act in regard to human embryo stem cell research; Issue of Canadian identity and the politics of abortion, capital punishment, euthanasia and physician-assisted suicide, and same-sex marriage; Problem of justifying the decision to go to war or participating in peace-keeping missions without relying on "party line"; Reasons for legalizing marijuana, which is a "marker" values issue that often identifies peoples' stance in the tough-on-crime debate; Issue of socialized healthcare and its infrastructure in Canada where private care is the exception.

HIV among people with mental illness: contributing factors, prevention needs, barriers, and strategies. - Brown EJ; Jemmott LS (Journal of Psychosocial Nursing & Mental Health Services, 2000)
Findings suggest that PWMI, including those with serious mental illness, are sexually active although some individuals, including mental health professionals, perceive them to be asexual or not sexually active. PWMI may be particularly susceptible to HIV risk-related behaviorss due to poor judgment, limited impulse control, deficits in problem-solving skills, and suicidal intent and self-destructive behavior. Nurses, due to their close interaction with PWMI, are in key positions to document HIV risk-related behaviors and to advocate for integrating HIV risk reduction strategies into the therapeutic milieu.
Keywords: HIV Infections; Acquired Immunodeficiency Syndrome; Mental Disorders; HIV Infections -- Prevention and Control; Acquired Immunodeficiency Syndrome -- Prevention and Control; Risk Taking Behavior -- Prevention and Control; Descriptive Research; Qualitative Studies; Attitude to Mental Illness; Attitude to AIDS; Education, Continuing (Credit); Human

Juvenile Sexual Homicide Offenders: Thirty-Year Follow-Up Investigation. - Khachatryan, Norair; Heide, Kathleen M.; Hummel, Erich V.; Chan, Heng Choon (Oliver) (International Journal of Offender Therapy & Comparative Criminology, 2016)
Sexual homicide by a juvenile offender occurs approximately 9 times per year in the United States. Little is known about the post-incarceration adjustment of these offenders. The current study was designed to follow up 30 years later on a sample of eight adolescent sexual homicide offenders who were convicted of murder and sentenced to adult prison. The results indicated that six out of eight offenders were released from prison, and their mean sentence length was 12 years and 2 months. Four offenders out of the six released were rearrested, but none of the arrests were for homicide, sexual or otherwise. The post-incarceration arrests were for violent, drug-related, and property crimes, as well as possession of a firearm. Three out of the four recidivists have been recommitted to prison. Implications concerning the comparability of results to past research, time served in prison, and types of post-release offenses are discussed.
Keywords: Homicide -- Legislation and Jurisprudence; Homicide; Sexual Abuse -- Legislation and Jurisprudence; Juvenile Delinquency -- Legislation and Jurisprudence; Sexual Abuse; Juvenile Delinquency; Cross Sectional Studies; Time Factors; Young Adult; Female; Recurrence; Homosexuality; Prospective Studies; Male; Correctional Facilities; Adolescence; Adult

Improving adolescent preventive care in community health centers. - Klein JD; Allan MJ; Elster AB; Stevens D; Cox C; Hedberg VA; Goodman RA (Pediatrics, 2001)
OBJECTIVE: To evaluate implementation of the Guidelines for Adolescent Preventive Services (GAPS) in Community and Migrant Health Centers (CMHCs). DESIGN: Before and after comparison of health center policy, clinician and adolescent self-report, and chart reviews in 5 CMHCs. PARTICIPANTS: Eighty-one preintervention and 80 one-year postintervention providers and 318 preintervention and 331 postintervention 14- to 19- year-old adolescent patients being seen for well visits at 5 CMHCs. INTERVENTION: Health center staff were trained to implement GAPS and were provided resource materials, patient questionnaires, and clinician manuals. MAIN OUTCOME MEASURES: Delivery of and receipt of preventive services and perceived access to care. RESULTS: CMHC systems changes were related to stronger leadership commitment to adolescent care. Providers reported high levels of preventive services delivery before and after guideline implementation. After guideline implementation, adolescents reported increases in having discussed prevention content with providers in 19 of 31 content areas, including increased discussion of physical or sexual abuse (10% before to 22% after), sexual orientation (13% to 27%), fighting (6% to 21%), peer relations (37% to 52%), suicide (7% to 22%), eating disorders (11% to 28%), weapons (5% to 22%), depression (16% to 34%), smokeless tobacco (10% to 29%), and immunizations (19% to 48%). Adolescents were also more likely to report knowing where to get reproductive or mental health services and were more likely to have received health education materials. Implementation also increased documentation of recommended screening and counseling in 51 of 79 specific content areas assessed in chart reviews. CONCLUSION: Implementing GAPS increased the receipt of preventive services at these health centers. Adolescents received more comprehensive screening and counseling, more health education materials, and had greater access to care after implementation. GAPS implementation may help improve the quality of care for adolescents.
Keywords: Adolescent Health Services; Preventive Health Care -- In Adolescence; Community Health Services -- In Adolescence; Quality of Health Care -- Evaluation -- In Adolescence; Record Review; McNemar's Test; Chi Square Test; Descriptive Statistics; Purposive Sample; Evaluation Research; Program Evaluation; Anticipatory Guidance; Adolescence; Funding Source; Human

Gender issues in the treatment of suicidal individuals. - Canetto SS (Death Studies, 1994)
Historically, the literature on the treatment of suicidal behavior has not given explicit consideration to gender issues. There are, however, several important reasons for considering the influence of gender in the treatment of suicidal individuals. First, women's patterns of suicidal behavior are different from those of men. Second, reasons for suicidal behavior are often assumed to vary by gender. Third, gender has been recognized as having an impact on the dynamics of psychotherapy. This article focuses on gender dynamics relevant to psychotherapy with suicidal adults. Specifically, it reviews the literature on the relationships between gender and (a) the epidemiology of suicidal ideation and behaviors, (b) the reasons for suicidal behavior, and (c) the initiation and goals of psychological treatment for the suicidal individual.
Keywords: Suicide -- Psychosocial Factors; Suicide -- Prevention and Control; Sex Factors; Suicidal Ideation; Psychotherapy; Socialization; Male; Female

Religious Abuse: Implications for Counseling Lesbian, Gay, Bisexual, and Transgender Individuals. - Super, John T.; Jacobson, Lamerial (Journal of LGBT Issues in Counseling, 2011)
Religion is often the place a lesbian, gay, bisexual, or transgender (LGBT) individual may turn to understand and navigate their sexual orientation identity development. However, religious abuse may occur when a religious group or leader, whether intentionally or unintentionally, uses coercion, threats, rejection, condemnation, or manipulation to force the individual into submission of the religious views about sexuality. The abuse may result in great harm to the victim by causing low self-esteem, guilt, shame, spirituality loss, substance abuse, or thoughts of suicide. Counselors need to be aware of religious abuse to help clients navigate any spiritual divide between religious beliefs and sexuality. Therefore, the purpose of this article is to (a) describe the differences between religion and spirituality,(b) define religious abuse, (c) describe the effects of religious abuse on LGBT individuals and society, and (d) delineate the counseling implications of religious abuse in working with LGBT individuals.
Keywords: Counseling -- Methods; Religion and Religions; LGBTQ+ Persons -- Psychosocial Factors; Attitude to Sexuality; Spirituality; Homophobia -- Psychosocial Factors; Gender Identity; Social Identity; Goal-Setting -- Methods; Conceptual Framework -- Methods; Male; Adult; Gay Men

Vitality and growth in HIV-infected gay men. - Schwartzberg SS (Social Science & Medicine, 1994)
The emphasis in the psychosocial literature on Human Immunodeficiency Virus (HIV) has been placed, correctly, on the traumatic impact of AIDS in terms of mortality, bereavement, suicide, psychopathology, and coping with life amid enormous multiple stressors. However, an important aspect of the HIV epidemic has been paid only minimal attention: many HlV-positive gay men have experienced beneficial, or even life-transforming, aspects of their situation. Seven HlV-positive gay men are described here who have successfully integrated HIV into a framework of world- and self-beliefs that allows for coherence, stability, emotional vitality, and positive self-regard. Eight general characteristics of these men are presented. These men represent a subgroup from a sample of 19 subjects in a qualitative clinical interview study exploring how HlV-positive gay men ascribe meaning to AIDS and their own HIV infection [l].
Keywords: Gay Men; HIV-Positive Persons; Personal Growth; Descriptive Research; Exploratory Research; Interviews; Vignettes; Lazarus Theory of Stress and Coping; Life Change Events; Spirituality; Altruism; Psychological Well-Being; Support Groups; Coping; Attitude to AIDS; Attitude to Death; Peer Group; Phenomenology; Acquired Immunodeficiency Syndrome; Adult; Middle Age; Male; Human

Causes of suicidal behaviors in men who have sex with men in China: a national questionnaire survey. - Chen, Hongquan; Li, Yang; Wang, Lixin; Zhang, Beichuan (BMC Public Health, 2015)
Background: Men who have sex with men (MSM) have become a high-risk group of HIV infection in China. To date, little is known regarding the psychological characteristics in Chinese MSM, especially the prevalence of suicidal ideation and attempts.Methods: A questionnaire survey was conducted on 2,250 MSM recruited from gay bars in 9 large cities in mainland China. Data on the prevalence of suicidal ideation and attempts as well as the underlying causes in the respondents were analyzed.Results: A total of 1530 MSM responded to the question regarding previous suicidal ideation and attempts. Of these respondents, 26.01% had ever considered suicide and 12.55% actually attempted suicide at least once. Romantic gay relationship breakup was the number one cause of suicide behaviors, followed by self-objection to homosexuality, difficulties in finding gay partners or in getting used to heterosexual marriage life, sudden emotional hurts from unexpected events, illegal status of gay marriage in China and disclosure of homosexuality.Conclusions: The survey study has led to a better understanding of the factors contributing to suicide behaviors of MSM in China, which may have significant implications in developing preventive strategies against suicide behaviors in this unique group of individuals.

Cyberbullying and LGBTQ Youth: A Deadly Combination. - Wiederhold, Brenda K. (CyberPsychology, Behavior & Social Networking, 2014)
The author reflects on the effect of cyberbullying among LGBTQ youth. Topics discussed by the author include the suicide of 18-year-old student Tyler Clementi by jumping off the George Washington Bridge after his classmates posted a video of Tyler kissing a man, mental depression experienced by victims of bullying, and available suicide prevention training and community resources.

Correlates and predictors of sexual homicide with HIV in the Florida dental AIDS tragedy. - Horowitz LG (AIDS Patient Care, 1994)
Keywords: Acquired Immunodeficiency Syndrome -- Transmission; Homicide; Dentists; Personality Assessment; Criminal Psychology; Personality; Gay Men; Suicide

Suicide and homosexual youth. (Harvard Mental Health Letter, 1998)
Keywords: Homosexuality; Suicide, Attempted; Adolescence; Female; Heterosexuality; Male; Suicide -- Psychosocial Factors

Suicide related ideation and behavior among Canadian gay and bisexual men: a syndemic analysis. - Ferlatte, Olivier; Dulai, Joshun; Hottes, Travis Salway; Trussler, Terry; Marchand, Rick (BMC Public Health, 2015)
Background: While several studies have demonstrated that gay and bisexual men are at increased risk of suicide less attention has been given to the processes that generate the inherent inequity with the mainstream population. This study tested whether syndemic theory can explain the excess suicide burden in a sample of Canadian gay and bisexual men. Syndemic theory accounts for co-occurring and mutually reinforcing epidemics suffered by vulnerable groups due to the effects of social marginalization.Methods: This study used data from Sex Now 2011, a cross-sectional survey of Canadian gay and bisexual men (n = 8382). The analysis measured the extent to which anti-gay marginalization and several psychosocial health problems are associated with suicide related ideation and attempts. Since psychosocial health problems were hypothesized to have an additive effect on suicide related ideation and attempts, the analysis calculated the effect of accumulated psychosocial health problems on suicide behavior.Results: Suicide ideation and attempts were positively associated with each individual marginalization indicator (verbal violence, physical violence, bullying, sexual violence and work discrimination) and psychosocial health problems (smoking, party drugs, depression, anxiety, STIs, HIV risk and HIV). Furthermore, prevalence of suicide ideation and attempts increased with each added psychosocial health problem. Those who reported 3 or more had 6.90 (5.47-8.70) times the odds of experiencing suicide ideation and 16.29 (9.82-27.02) times the odds of a suicide attempt compared to those with no psychosocial health problems.Conclusions: This investigation suggests that syndemics is a useful theory for studying suicide behavior among gay and bisexual men. Moreover, the findings highlight a need to address gay and bisexual men's health problems holistically and the urgent need to reduce this population's experience with marginalization and violence.

The influence of mental health problems on AIDS-related risk behaviors in young adults. - STIFFMAN, ARLENE RUBIN; DORÉ, PETER; EARLS, FELTON; CUNNINGHAM, RENEE; Stiffman, A R; Doré, P; Earls, F; Cunningham, R (Journal of Nervous & Mental Disease, 1992)
This paper explores how symptoms of mental health problems influence acquired immune deficiency syndrome-related risk behaviors, and how changes in those symptoms relate to risk behaviors engaged in by young adults. Repeated interviews with 602 youths since 1984 provide a history of change in behaviors. Mental health symptoms during adolescence (alcohol/drug [r = .28]; conduct disorder [r = .27]; depression [r = .16]; suicide [r = .14]; anxiety [r = .16]; and posttraumatic stress [r = .09]) are associated with higher numbers of risk behaviors (specifically, prostitution, use of intravenous drugs, and choice of a high-risk sex partner) during young adulthood. Changes in mental health symptoms between adolescence and young adulthood are related to the number of risk behaviors engaged in by young adulthood (total number of symptoms [B = .10], alcohol/drug abuse or dependence [B = .34], depression [B = .20], suicidality [B = .35], anxiety [B = .13], and posttraumatic stress [B = .14]). Changes in symptoms of mental health problems are associated specifically with those risk behaviors that are initiated primarily in young adulthood: intravenous drug use, prostitution, and choice of risky partners. The findings show that prevention and treatment of mental health problems are important components of preventive interventions for human immunodeficiency virus infection in high-risk teens and young adults.
Keywords: Risk Taking Behavior; Mental Disorders -- Psychosocial Factors; Acquired Immunodeficiency Syndrome -- Prevention and Control; Depression -- Psychosocial Factors; Alcoholism -- Psychosocial Factors; Suicide -- Psychosocial Factors; Human; Adolescent Psychology; Attitude to Health; Female; Urban Population; Sexual Partners; Probability Sample; Adolescence; Male; Homosexuality; Anxiety Disorders -- Psychosocial Factors; Age Factors; Stress Disorders, Post-Traumatic -- Psychosocial Factors; Substance Abuse, Intravenous -- Psychosocial Factors; Adult; Validation Studies; Comparative Studies; Evaluation Research; Multicenter Studies

HIV and tuberculosis infection in San Francisco's homeless adults. Prevalence and risk factors in a representative sample. - Zolopa AR; Hahn JA; Gorter R; Miranda J; Wlodarczyk D; Peterson J; Pilote L; Moss AR; Zolopa, A R; Hahn, J A; Gorter, R; Miranda, J; et al. (JAMA: Journal of the American Medical Association, 1994)
Objective: To determine the prevalence and risk factors for human immunodeficiency virus (HIV) and tuberculosis (TB) infection and investigate the relationship between these two infections in homeless adults.Design: Cross-sectional study.Setting: Inner-city shelters and free meal programs.Participants: A representative sample of 1226 adults (> or = 18 years) were enrolled from community sites.Main Outcome Measures: Serum HIV-1 antibody status and tuberculin skin test reactivity.Results: Human immunodeficiency virus seroprevalence was 8.5% (95% confidence interval [CI], 7.0% to 10.1%) and the prevalence of TB infection was 32% (95% CI, 30% to 37%). Nineteen percent of the HIV-seropositive subjects had positive tuberculin skin tests. Independent risk factors for HIV infection included younger age, black race, male homosexual contact, injection drug use, use of injection drugs in shooting galleries, and selling sex. Tuberculosis infection was associated with the duration of homelessness and living in crowded shelters or single-room-occupancy hotels. Injection drug use, a risk factor for HIV, was also a risk factor for TB, with a particularly strong association in women. No evidence of an association between TB and HIV infection was found, even after accounting for anergy.Conclusions: The homeless population in the United States should be considered a group at high risk for HIV infection and TB. Given the constellation of risk factors present, the high prevalence of infection, and lack of access to medical services, we anticipate that these communicable diseases in this population will represent a growing public health problem.
Keywords: Homelessness -- California; HIV Infections -- Epidemiology -- California; Tuberculosis -- Epidemiology -- California; Adult; Middle Age; Male; Female; California; Univariate Statistics; Sex Factors; Logistic Regression; P-Value; Chi Square Test; Fisher's Exact Test; Cross Sectional Studies; Human

Bullying and Childhood Adversity as Predictors of Non-Suicidal Self-Injury Among Sexual Minority Adolescents in the Healthy Allegheny Teen Survey. - McCauley, Heather L.; Montano, Gerald; Miller, Elizabeth (Journal of Adolescent Health, 2016)
Keywords: Bullying; Adolescent Health

Bibliography on AIDS-related bereavement and grief. - Bergeron JP; Handley PR (Death Studies, 1992)
This annotated bibliography on AIDS-related bereavement and grief was compiled to address a steadily increasing population: survivors of persons who have died of AIDS. Bibliographical entries were located by searching printed indexes, including Cumulative Index to Nursing and Allied Health Literature, Hospital Literature Index, Index Medicus, International Nursing Index, Psychological Abstracts, Social Science Index, Social Work Abstracts, and Sociological Abstracts. Databases searched included ERIC (Department of Education), Med-Line (National Library of Medicine), and Psych-Lit (American Psychological Association). References cited at the end of each work were also checked. This bibliography includes publications of studies using the survey method of social research and the case-study approach. It also includes experiences of professionals personally affected by the loss of someone to AIDS, and informational articles and chapters. To be included in this bibliography the work must have dealt exclusively or largely with the topic of AIDS-related bereavement and grief, or it must have addressed some aspect of it not previously covered anywhere in the literature. The topic of AIDS-related bereavement and grief refers to the loss of someone to (or with, as is the case with suicide) Acquired Immune Deficiency Syndrome, and its psychological, emotional, physical, and social effects on the survivor(s). This bibliography does not include publications that deal with related topics such as thanatology, anticipatory grief and mourning, and mortality rates and trends. This work is meant to serve as a resource for professionals in a variety of fields (e.g., nursing, pastoral care, mental health, and social work) involved in social research, bereavement counseling, ministry, and group intervention. It can be useful as a literature search for students in a variety of disciplines and for the AIDS-bereaved themselves. The bibliography is accompanied by an overview of the current state of the literature and a summary of the areas still in need of research and publication.
Keywords: Acquired Immunodeficiency Syndrome -- Psychosocial Factors; Bereavement; Grief; Gay Persons -- Psychosocial Factors; Survivors -- Psychosocial Factors; Family -- Psychosocial Factors; Substance Abuse, Intravenous -- Psychosocial Factors; Health Personnel -- Psychosocial Factors; Male

Charity warns of crisis among young sexual minorities. (Mental Health Practice, 2014)
The article discusses the findings of a survey of 7,000 16-25 years old lesbian, gay bisexual, transgender and questioning (LGBTQ) people which revealed high rates of mental illness including anxiety, depression and suicide in Great Britain.
Keywords: Mental Health; LGBTQ+ Persons -- Psychosocial Factors; Charities

Sexual confusion among certain college males. - Goff J (Adolescence, 1990)
In dealing with college age (18-22) males, clinical observations have shown a fairly common inability to successfully form intimate relationships with same-age females. This problem often appears to be due to an inability to bond and trust that is rooted in the formative years in the nuclear home. When this happens, the young male frequently develops a fear of being sexually abnormal, perhaps even homosexual. This manifests itself in shame, anxiety, depression, denial, reaction formation, performance anxiety, concern about being found out, isolation, substance abuse and, occasionally, acting out. Getting such persons to admit these fears is generally extremely difficult, requiring gentle and empathetic, but persistent, probing on the part of the therapist. Therapy consists of understanding and acceptance by the client that these fears are most often reactive, that they are commonly held, and that when they are seen in proper perspective, they often diminish. The present paper reviews some of the literature on sexual developmental issues of the adolescent male as a backdrop for this problem. The specific difficulties related to reactive homophobia are explored, and some therapeutic approaches suggested.
Keywords: Confusion -- Psychosocial Factors; Gender Identity; Homosexuality; Personality Development; Adolescence; Adult; Denial (Psychology); Depression -- Psychosocial Factors; Locus of Control; Male; Sexuality; Social Conformity; Suicide, Attempted -- Psychosocial Factors

Emerging issues in the relationship between adolescent substance use and suicidal behavior. - Shlosberg, Dan; Zalsman, Gil; Shoval, Gal (Israel Journal of Psychiatry & Related Sciences, 2014)
Adolescent suicidal behavior poses a major global public health concern as it is highly prevalent and associated with mortality and morbidity worldwide. Substanceuse disorders are also an issue of increasing concern among adolescents and have been shown to increase the risk for suicidal behaviors. In this review we address emerging issues in the relationship between adolescent substance use disorders and suicidal behaviors. We focus on common hazardous patterns of substance abuse such as binge drinking and poly-substance abuse and point out developing patterns of substance preferences as evidenced by the contemporary widespread use of synthetic cannabinoids. We address these issues in the context of vulnerable populations such as sexual-minority adolescents and youth with co-occurring mental-disorder diagnoses. Finally, we relate to the present and future challenges presented by these issues to implement effective anti-suicidal treatment and prevention strategies in adolescents with substance use disorders.

Youth suicide and sexual orientation. - Rutter PA; Soucar E (Adolescence, 2002)

Ignoring the evidence dictating the practice: sexual orientation, suicidality and the dichotomy of the mental health nurse. - McAndrew S; Warne T (Journal of Psychiatric & Mental Health Nursing (Wiley-Blackwell), 2004)
International epidemiological studies demonstrate that gay and bisexual males are four times more likely to report a serious suicide attempt than their heterosexual counterparts. Data on completed suicides, usually derived from mortality statistics misrepresent the rate of suicides among homosexual populations. However, an increasing number of studies comparing representative samples of gay, lesbian and bisexual youths with heterosexual controls demonstrate increased rates of mental health problems and subsequent suicide among the homosexual population. Homosexual orientation must therefore be considered a risk factor for mental distress and as such should be a focus for any contemporary public health agenda. One of the difficulties of addressing the problem through a public health agenda is the juxtaposition proffered by our political and social environment. The Diagnostic and Statistical Manual of Mental Disorder ceased to define homosexuality as pathological in 1973 replacing it with a new 'illness' of 'gender identity disorder'. Until recently in England, Section 28 of the Local Government Act (1988), forbidding the promotion of homosexuality, further reinforced negativity towards this group of people. This compounded the negative mental health consequences for those developing a gay sexual orientation in a climate of heterosexism. Current health care policy in England concerns itself with the rising number of suicides among young people but fails to acknowledge the importance of the research findings relating to gay people by integrating them into the development of mental health policy. This paper reviews the literature relating to homosexual people and suicidality, and addresses the seriousness of a policy rhetoric which results from ignoring the evidence while dictating mental health nursing practice.
Keywords: Homosexuality; Mental Disorders -- Risk Factors; Psychiatric Nursing -- Standards; Suicide -- Epidemiology -- United Kingdom; Adolescence; Adult; Bisexuals -- Psychosocial Factors; England; Health Policy; Gay Persons -- Psychosocial Factors; Stigma; Suicidal Ideation -- Prevention and Control; Suicide -- Prevention and Control; United Kingdom

Community a factor in suicide attempts by lesbian, gay, and bisexual teens. - Voelker R; Voelker, Rebecca (JAMA: Journal of the American Medical Association, 2011)
Keywords: Bisexuality; Homosexuality; Social Environment; Suicide, Attempted -- Psychosocial Factors; Adolescence; Bullying; Depression; Female; Male; Oregon; Risk Factors; Stress, Psychological; Substance Use Disorders; Suicide, Attempted

How gay-straight alliance groups mitigate the relationship between gay-bias victimization and adolescent suicide attempts. - Davis, Brennan; Royne Stafford, Marla B; Pullig, Chris (Journal of the American Academy of Child & Adolescent Psychiatry, 2014)
Objective: We examined the relationships between victimization from being bullied, suicide, hopelessness, and the presence of a Gay-Straight Alliance (GSA) on a school campus.Method: We analyzed data from the California Healthy Kids Survey from 2005 to 2007 using hierarchical modeling.Results: We found that gay-bias (versus non-gay-bias) victimization is meaningfully connected with the inwardly destructive behavior of attempted suicide among adolescents. We also found that hopelessness helps explain associations between gay-bias victimization and suicide attempts and that the presence of a GSA club on a school's campus attenuates significant connections between gay-bias victimization and suicide attempts by reducing hopelessness.Conclusion: Gay-bias victims are more likely than other victims to attempt suicide while also feeling more hopeless. The presence of a GSA on campus may help to reduce the attempted suicide and hopelessness associated with gay-bias victimization.

NASN Position Statement: Sexual Orientation and Gender Identity/Expression (Sexual Minority Students): School Nurse Practice. (NASN School Nurse, 2013)
Keywords: School Health Nursing; National Association of School Nurses; LGBTQ+ Persons -- Psychosocial Factors; Nursing Role; Students, Minority; LGBTQ+ Persons -- Statistics and Numerical Data; Suicide -- Risk Factors; Bullying; Risk Assessment -- Nursing; School Policies; Support, Psychosocial; Parental Role

Understanding My Gay Teen. (Brown University Child & Adolescent Behavior Letter, 2011)
The September 2, 2011 issue of the journal is presented which presents facts, opinions and resources about understanding gay teenagers. It mentions the Kinsey Report which reveals that one of every 10 teenagers in the U.S. may be gay. It is advised by Carolyn Wagner of the Parents, Families and Friends of Lesbians and Gays (PFLAG) that parents should offer acceptance. It also talks about the risk of HIV infection and AIDS and threats of depression or suicide and antigay violence.
Keywords: LGBTQ+ Persons -- Psychosocial Factors -- In Adolescence; Communication -- Methods; Parent-Child Relations; Information Resources; World Wide Web; Parental Attitudes; HIV Infections -- Risk Factors; Incidence; Age Factors; Adolescence; Young Adult; Male; Female; Acquired Immunodeficiency Syndrome -- Risk Factors; Suicide -- Risk Factors; Depression -- Risk Factors; Crime Victims

Sexual orientation and suicide: a comment on Renaud et al...Can J Psychiatry. 2010 Jan;55(1):29-34 - Zhao Y; Montoro R; Igartua K; Thombs BD; Zhao, Yue; Montoro, Richard; Igartua, Karine; Thombs, Brett D (Canadian Journal of Psychiatry, 2010)
Keywords: Homosexuality; Lesbians -- Psychosocial Factors; Lesbians -- Statistics and Numerical Data; Sexuality; Suicide; Suicide -- Psychosocial Factors; Adolescence; Anxiety Disorders -- Epidemiology; Anxiety Disorders -- Psychosocial Factors; Cross Sectional Studies; Female; Male; Risk Factors

YEAR IN REVIEW. - Anderson, Norman B. (American Psychologist, 2014)
Keywords: American Psychological Association; Reports; Organizational Objectives; Psychology; Firearms; Community Violence; Civil Rights; Homosexuality; Clinical Governance

YEAR IN REVIEW. - ANDERSON, NORMAN B. (American Psychologist, 2014)
An introduction is presented in which the editor discusses various reports within the issue on topics including the American Psychological Association's (APA) Center for Psychology and Health and The Center for Organizational Excellence and the APA's Good Governance Project.
Keywords: American Psychological Association; Reports; Organizational Objectives; Psychology; Firearms; Community Violence; Civil Rights; Homosexuality; Clinical Governance

Suicidal behaviour in gay, lesbian, and bisexual youth: it's an international problem that is associated with homophobic legislation. - Bagley C; D'Augelli AR (BMJ: British Medical Journal (International Edition), 2000)
Keywords: Suicide; Gay Persons; Homophobia; Mental Disorders; Risk Factors; Adolescence; Sexuality -- In Adolescence

Compassionately Caring for LGBT Persons in Your Faith Community...[corrected][published erratum appears in J Christ Nurs. 2013 Jan;30(1):10] - Sanders, Sarah (Journal of Christian Nursing, 2012)
Keywords: Christianity; LGBTQ+ Persons; Nursing Practice; Parish Nursing; Adolescence; Bisexuality; Churches; Communication; Cultural Competence; Depression -- Risk Factors -- In Adolescence; Discrimination; Education, Continuing (Credit); Ethics, Nursing; Family; Female; Gender Identity; Health Promotion; Health Status; Healthcare Disparities; Homophobia; Homosexuality; Information Resources; Male; Nurse-Patient Relations; Patient Education; Privacy and Confidentiality; Safe Sex -- Education; Sexually Transmitted Diseases -- Prevention and Control; Social Networks; Spiritual Care; Stigma; Suicidal Ideation -- Risk Factors -- In Adolescence; Support, Psychosocial; Transsexualism; Violence

Racial and Sexual Identity-Related Maltreatment Among Minority YMSM: Prevalence, Perceptions, and the Association with Emotional Distress. - Hightow-Weidman, Lisa B.; Phillips, Gregory; Jones, Karen C.; Outlaw, Angulique Y.; Fields, Sheldon D.; Smith, for The YMSM of Color SPNS Initiative Study Group, Justin C. (AIDS Patient Care & STDs, 2011)
Bullying is a form of violence characterized as an aggressive behavior that is unprovoked and intended to cause harm. Prior studies have found that lesbian, gay, bisexual, and transgender (LGBT) youth experience high levels of bullying related to their sexuality and this harassment can lead to engagement in risk behaviors, depression, and suicide. Ethnic/racial minority young men who have sex with men (YMSM) may experience dual levels of stigma and maltreatment due to both their sexuality and their race. The aim of the current study was to assess the prevalence and perceptions of racial and sexual identity-based abuse among a sample of minority YMSM, and whether this maltreatment plays a role in the emotional distress of these youth. We found that overall 36% and 85% of participants experienced racial and sexuality-related bullying, respectively. There was a significant association between experiencing a high level of sexuality-related bullying and depressive symptomatology ( p=0.03), having attempted suicide ( p=0.03), and reporting parental abuse ( p=0.05). We found no association between racial bullying and suicide attempts. In a multivariable logistic regression model, experiencing any racial bullying and high sexuality-related bullying were significant predictors of having a CES-D score ≥16; adjusted odds ratio (OR) 1.83 and 2.29, respectively. These findings contribute to the existing literature regarding the negative experiences and daily stressors facing LGBT youth with regard to both their minority status and LGBT identities. Future interventions for racial/ethnic minority YMSM should provide assistance to achieve a positive view of self that encompasses both their racial and sexual identities.
Keywords: Stigma; Gay Men -- Psychosocial Factors; Bullying; Race Factors; Stress, Psychological; HIV-Positive Persons; Human; Male; Adolescence; Young Adult; Descriptive Statistics; Prospective Studies; Patient Attitudes -- Evaluation; Multiple Logistic Regression; Odds Ratio; Interviews; Center for Epidemiological Studies Depression Scale; Psychological Tests; Support, Psychosocial -- Evaluation; Logistic Regression; Child Abuse; Univariate Statistics; Bivariate Statistics; Confidence Intervals; Chi Square Test; Depression; Suicide, Attempted; Racism; Funding Source

Puzzling out the mysteries of health insurance benefits. - Bruder P (Hospital Topics, 1993)
Keywords: Alternative Therapies -- Economics; Health Care Reform -- Economics; Insurance, Health, Reimbursement; Chiropractic -- Economics; Homosexuality; Mental Health Services -- Economics; Suicide, Assisted -- Economics; United States

Does it Actually 'Get Better' for Bisexual Teens? (Journal of Psychosocial Nursing & Mental Health Services, 2013)
Keywords: Bisexuals -- In Adolescence; Suicide -- Prevention and Control; Adolescence; Depression -- Prevention and Control

Does it Actually 'Get Better' for Bisexual Teens? (Journal of Psychosocial Nursing & Mental Health Services, 2013)
Keywords: Bisexuals -- In Adolescence; Suicide -- Prevention and Control; Adolescence; Depression -- Prevention and Control

Understanding My Gay Teen. (Brown University Child & Adolescent Behavior Letter, 2011)
Keywords: LGBTQ+ Persons -- Psychosocial Factors -- In Adolescence; Communication -- Methods; Parent-Child Relations; Information Resources; World Wide Web; Parental Attitudes; HIV Infections -- Risk Factors; Incidence; Age Factors; Adolescence; Young Adult; Male; Female; Acquired Immunodeficiency Syndrome -- Risk Factors; Suicide -- Risk Factors; Depression -- Risk Factors; Crime Victims

Adolescents who attempt suicide. (JAMA: Journal of the American Medical Association, 1991)
Keywords: Suicide, Attempted -- Psychosocial Factors; Suicide, Attempted -- Prevention and Control; Suicide -- Prevention and Control; Adolescence; Homosexuality; Risk Factors; Adolescent Psychology

TRANSGENDER CHILDREN..."Helping Transgender Children and Teens" (AJN Reports, October 2013) - Doherty, Christine (AJN American Journal of Nursing, 2014)
A letter to the editor in response to the article "Helping Transgender Children and Teens" by Christine Doherty in the October 2013 issue, which discusses suicide cases of transgenic individuals rejected by their families, is presented.
Keywords: Transgender Persons -- Legislation and Jurisprudence -- California; California; Child; Adolescence

On reliability and cultural competence in studies of sexual minority suicidality...Paul PJ, Catania J, Pollack L, et al. Suicide attempts among gay and bisexual men: lifetime prevalence and antecedents. Am J Public Health. 2002;92:1338-1345 - Mathy RM; Paul PJ; Catania J; Pollack L; Moskowitz J; Canchola J; Mills T; Binson D; Stall R (American Journal of Public Health, 2002)
Keywords: Cultural Competence; Homosexuality; Reliability; Sampling Methods; Suicide -- Epidemiology; Adolescence; Adult; Convenience Sample; External Validity; Male; Research, Mental Health; Social Change

Contested conclusions: claims that can (and cannot) be made from the current research on gay, lesbian, and bisexual teen suicide attempts. - Saewyc EM (Journal of LGBT Health Research, 2007)
As the press and communities interpret research reports, their conclusions may go far beyond a study's evidence, especially if groups are trying to support politically-motivated claims about controversial causes and solutions to health problems. Few research designs can "prove" cause and effect, especially in population health research. However, some designs are better than others at identifying influences on health. Several strategies can help non-researchers evaluate studies critically. Using these statistics, this paper explores claims that can (and cannot) be made about causes of suicide attempts among gay, lesbian, and bisexual adolescents, based on current research evidence available.
Keywords: Causal Attribution; LGBTQ+ Persons; Study Design; Suicide, Attempted -- Psychosocial Factors -- In Adolescence; Adolescence; Age Factors; British Columbia; Female; Male; Mental Health; Prevalence; Stress, Psychological; Suicide -- Risk Factors

Treatment of Sexual Minority Youth: Ethical Considerations for Professionals in Psychology. - Dopp, Alex R. (Ethics & Behavior, 2013)
Treatment of sexual minority youth presents psychologists with a number of challenging ethical considerations. The APA Ethics Code is a valuable resource for addressing these issues, but psychologists require additional guidance in order to provide ethical treatment. This article provides relevant background, an overview of the ethical considerations of treating sexual minority youth, and recommendations to improve upon the current state of awareness and available resources. Psychologists must continually strive to improve our understanding of ethical decisions around treatment, training, and research that will serve to address this vulnerable population's unmet mental health needs.
Keywords: Psychotherapy -- Ethical Issues; Psychotherapy -- Standards; LGBTQ+ Persons; Sexuality; Adolescent Health; Professional Competence; Privacy and Confidentiality; Risk Management; Suicide; AIDS Serodiagnosis; Gender Identity; Refusal to Treat -- Legislation and Jurisprudence -- United States; United States

Providing sensitive health care to gay and lesbian youth. - Sanford ND (Nurse Practitioner, 1989)
While the years of adolescence are usually very difficult, for gay and lesbian youth they are tremendously traumatic. Gay and lesbian youth face many problems because of the homophobia in our culture; such a young person often hides his or her gay or lesbian identity, and health care professionals often deny its existence. Increased anxiety and fear cause gay and lesbian youth to be particularly vulnerable to the major problems of adolescence, such as drug and alcohol abuse, sexual acting-out, pregnancy, AIDS, homelessness and suicide. The etiology of homosexuality is still not understood, and a number of theories are discussed in this article. Troiden's model of gay and lesbian identity development is presented, covering sensitization, identity confusion, assumption and commitment. A lack of appropriate role models has been a significant problem, although some change is occurring. Specific ways of helping these troubled adolescents are given, with a particular emphasis on education and providing methods of support.
Keywords: Gay Persons -- Psychosocial Factors -- In Adolescence; Health Promotion -- In Adolescence; Suicide -- In Adolescence; Acquired Immunodeficiency Syndrome -- Prevention and Control -- In Adolescence; Adolescence

Suicide protective and risk factors for sexual minority youth: applying the Cumulative Factor Model. - Rutter PA (Journal of LGBT Issues in Counseling, 2008)
This report explores suicide protective and risk factors for lesbian, gay and bisexual (LGB) youth and offers a Cumulative Factor Model constructed from these factors. Numerous studies to date have concluded that a youth's sexual minority identity is a key risk factor for suicide. Few studies however have explored the internal and external protective factors that may cumulate to increase or reduce suicidal ideation and risk among this LGB population. Counseling implications for both assessment and intervention strategies are discussed in light of this cumulative factor approach to understand and potentially stem LGB youth suicide.
Keywords: LGBTQ+ Persons -- In Adolescence; Minority Groups -- Psychosocial Factors -- In Adolescence; Models, Psychological; Suicide -- Prevention and Control -- In Adolescence; Suicide -- Risk Factors -- In Adolescence; Adolescence; Hardiness -- Evaluation; Mental Disorders -- Epidemiology -- In Adolescence; Suicide -- Etiology -- In Adolescence; United States

Bullying in schools towards sexual minority youth. - Varjas K; Dew B; Marshall M; Graybill E; Singh A; Meyers J; Birckbichler L (Journal of School Violence, 2008)
Gay, lesbian, bisexual, transgender, questioning and intersex (GLBTQI) youth, and those perceived to be GLBTQI, face extensive verbal and physical bullying in schools. Although increasing attention has been made at examining the safety concerns of sexual minority (GLBTQI) youth, there remain important gaps in the literature as well as significant sampling limitations. This article seeks to identify and respond to research gaps by: (a) reviewing existing literature about the causes and risk factors associated with homophobic bullying; (b) reviewing existing literature about the consequences associated with the victims of sexual minority bullying; (c) identifying the limitations to research procedures and methodologies that have been used to investigate this topic; and (d) proposing a research agenda for future investigations of homophobic bullying in schools.
Keywords: Bullying; LGBTQ+ Persons; Schools -- Trends; Acquired Immunodeficiency Syndrome; Adolescence; Depression; HIV Infections; Homeless Persons; Homophobia; Mental Disorders; Minority Groups; Research Priorities; Risk Factors; Substance Abuse; Suicide

Age of MSM Sexual Debut and Risk Factors: Results from a Multisite Study of Racial/Ethnic Minority YMSM Living with HIV. - Outlaw, Angulique Y.; Phillips, Gregory; Hightow-Weidman, Lisa B.; Fields, Sheldon D.; Hidalgo, Julia; Halpern-Felsher, Bonnie; Green-Jones, and The Young MSM of Color SPNS Initiative Study Group, Monique (AIDS Patient Care & STDs, 2011)
The average reported age of sexual debut for youth in the United States is 14.4 years, with approximately 7% reporting their sexual debut prior to age 13. While the research literature on sexual debut for youth addresses gender and ethnic differences (with males and African-American youth experiencing earlier sexual debut), there is limited data regarding factors associated with sexual debut for young men who have sex with men (YMSM). Early sexual debut poses potential health risks, such as contracting HIV with an increased risk of unprotected intercourse. Given current high HIV infection rates for racial/ethnic minority YMSM, learning more about their sexual debuts and associated risk factors of this population is of great importance. This study investigated risk behaviors and emotional distress, and their association with MSM sexual debut for a multisite cohort of racial/ethnic minority YMSM living with HIV. We hypothesized that a MSM sexual debut younger than age 16 would be associated with engagement in more high-risk sexual behaviors (unprotected sex and exchange sex), substance use, and emotional distress than a MSM sexual debut at age 16 or older. Results indicated that participants having a MSM sexual debut before the age of 16 reported more exchange sex; drug use (specifically marijuana); emotional/psychological problems related to substance use; and a history of suicide attempts, compared to participants with later MSM sexual debuts. Comprehensive interventions that are racially/ethnically sensitive, inquire about initial sexual experiences, and focus on sexual health and healthy relationships are needed to improve health outcomes for this population.
Keywords: Gay Men; HIV-Positive Persons; Sexuality -- In Adolescence; Unsafe Sex -- In Adolescence; Risk Taking Behavior -- In Adolescence; Black Persons; Hispanic Americans; HIV Infections -- Risk Factors; Human; Adolescence; Young Adult; Convenience Sample; United States; Interviews; Center for Epidemiological Studies Depression Scale; Questionnaires; Psychological Tests; Descriptive Statistics; Chi Square Test; Prospective Studies; Male; Race Factors; Age Factors; Bisexuals; Child Abuse, Sexual; Minority Groups; Funding Source

Not all adolescents are the same: addressing the unique needs of gay and bisexual male youth. - Garofalo R; Harper GW (Adolescent Medicine: State of the Art Reviews, 2003)
Gay and bisexual male youth confront the everyday struggles of adolescence with the added stress of growing up and shaping their identities within a society that may marginalize or disapprove of them. Despite a resilience and inner-strength that helps them to overcome many of these challenges, gay and bisexual adolescents face unique threats to their health and well-being and are disproportionately affected by many of the leading causes of preventable morbidity and mortality among adolescents. These include human immunodeficiency virus (HIV), other sexually transmitted infections, club drugs, alcohol and other substance use, suicidal thoughts and behavior, exposure to violence and victimization, and disordered eating. This chapter describes the unique challenges of coping with and understanding an emerging sexual minority orientation, reviews the relevant literature on the health threats facing gay and bisexual male youth, and provides a guide for primary care screening and interventions targeting this subpopulation of youth.
Keywords: Adolescent Health; Bisexuality; Gay Men; Men's Health; Adolescence; Adolescent Psychology; Alcohol Drinking; Eating Disorders -- Epidemiology; Health Services Accessibility; HIV Infections -- Epidemiology; Homelessness; Male; Patient History Taking; Privacy and Confidentiality; Professional-Patient Relations; Sexually Transmitted Diseases -- Epidemiology; Smoking; Stigma; Substance Abuse -- Trends; Suicide -- Risk Factors; Violence -- Epidemiology; World Wide Web

Epidemiological studies of female prisoners. IV. Homosexual behavior. - Climent, C E; Ervin, F R; Rollins, A; Plutchik, R; Batinelli, C J (Journal of Nervous & Mental Disease, 1977)
The existence of homosexual behavior in female offenders is investigated not only as an adaptive process but as an established behavior existing prior to detention. Ninety-five prisoners from the Framingham Institution for Women were included: 26 were self-reported homosexuals, 42 were considered homosexuals by prision staff, and 27 were nonhomosexuals. Suicidal thoughts, suicidal attempts, psychiatric problems during menstruation, and a history of violent crimes against persons were characteristic of the homosexual group, whereas a history of crimes against self and property as well as history of alcoholism were common in the nonhomosexual group. Violet behavior together with suicidal attempts in homosexual female prisoners support the hypothesis that aggressive impulses may be expressed either externally or toward the self, the problem being one of impairment in control mechanisms. The findings also suppor the idea that violent behavior, as shown by this group of incarcerated homosexual females, is multidetermined. The factors that influence its appearance and expression could include a history of family violence, impulse control as children, neurological abnormality, sex role identification problems, biochemical abnormalities (manifested as menstrual irregularities), and impulse control problems as adults. A better understanding of human violence must be based on the recognition of the multidimensional nature of the problem using the tools and insights from many disciplines.
Keywords: Prisoners; Homosexuality -- Epidemiology; Suicide, Attempted; Criminal Psychology; Violence; Adaptation, Psychological; Female; Adult; Menstruation Disorders; Human; Validation Studies; Comparative Studies; Evaluation Research; Multicenter Studies; Clinical Assessment Tools; Multidimensional Health Locus of Control Scales; Questionnaires

Doctors must confront homophobia: it causes harm. - Nathanson, Vivienne (BMJ: British Medical Journal, 2013)
The article discusses the duty of doctors to speak against homophobia. It highlights discrimination as a medical issue due to its psychological effects, as well as its physical risks. The link between physical attacks and anxiety to social stigma, which can lead to suicide attempts, is explored. A discussion on the negative effects of conversion therapy, which aims to change sexual orientation using psychological methods, is also provided.
Keywords: Homophobia -- Evaluation; Physicians -- Psychosocial Factors

The Role of Childhood Sexual Abuse, Childhood Gender Nonconformity, Self-Esteem and Parental Attachment in Predicting Suicide Ideation and Attempts in Turkish Young Adults. - Eskin, Mehmet (Suicidology Online, 2012)
Suicidal deaths and behavior in young people are major public health concerns. This study investigated the role of childhood sexual abuse (CSA), self-esteem, childhood gender nonconformity (CGN) and parental attachment in predicting suicidal ideation and attempts in 1203 (696 women) Turkish university students. Participants filled in a self-report questionnaire containing questions about suicidal behavior and measures of CSA, CGN, self-esteem and parental attachment. T-tests were used to compare sexes and pointbiserial correlation coefficients were computed between predictor variables and suicidal behavior. Logistic regression analysis procedure was employed to identify the independent predictors of suicidal ideation and attempts. Of the total sample, 42.5% reported suicidal ideation and 11.5% suicide attempts. CSA made an independent contribution to the prediction of suicidal ideation. Low self-esteem was an independent predictor of suicidal ideation in both sexes and suicide attempts in women. CGN was an independent predictor of suicidal ideation in both sexes. Low attachment to mother for women and low attachment to father for men was significant predictors of suicidal ideation and attempts. Suicidal ideation and attempts are frequent events in university students. It is concluded that self-esteem, CSA, CGN and parental attachment should be taken into consideration in assessing of and designing interventions against suicide risk.
Keywords: Child Abuse, Sexual; Gender Identity -- In Infancy and Childhood; Parent-Child Relations; Suicidal Ideation -- Epidemiology -- Turkey; Suicide, Attempted -- Epidemiology -- Turkey; Young Adult -- Psychosocial Factors -- Turkey; Adolescence; Adult; Attachment Behavior; Child; Confidence Intervals; Cross Sectional Studies; Data Analysis Software; Descriptive Statistics; Human; Odds Ratio; Psychological Tests; Questionnaires; Rosenberg Self Esteem Scale; Scales; Self Concept; Self Report; Students, College; Suicidal Ideation -- Risk Factors; Suicide, Attempted -- Risk Factors; T-Tests; Turkey

Primary care for lesbians and bisexual women. - Mravcak SA (American Family Physician, 2006)
For the most part, lesbians and bisexual women face the same health issues as heterosexual women, but they often have difficulty accessing appropriate care. Physicians can improve care for lesbians and bisexual women by acknowledging the potential barriers to care (e.g., hesitancy of physicians to inquire about sexual orientation and of patients to disclose their sexual behavior) and working to create a therapeutic physician-patient relationship. Taking an inclusive and nonjudgmental history and being aware of the range of health-related behaviors and medicolegal issues pertinent to these patients enables physicians to perform relevant screening tests and make appropriate referrals. Some recommendations, such as those for screening for cervical cancer and intimate partner violence, should not be altered for lesbians and bisexual women. Considerations unique to lesbians and bisexual women concern fertility and medico-legal issues to protect familial relationships during life changes and illness. The risks of suicidal ideation, self-harm, and depression may be higher in lesbians and bisexual women, especially those who are not open about their sexual orientation, are not in satisfying relationships, or lack social support. Because of increased rates of nulliparity, the risks of conditions such as breast and ovarian cancers also may be higher. The comparative rates of alcohol and drug use are controversial. Smoking and obesity rates are higher in lesbians and bisexual women, but there is no evidence of an increased risk of cardiovascular disease.
Keywords: Bisexuals; Lesbians; Primary Health Care; Bisexuals -- Ethical Issues; Bisexuals -- Legislation and Jurisprudence; Breast Neoplasms; Cardiovascular Diseases; Cervix Neoplasms; Depression; Disease Transmission; Education, Continuing (Credit); Female; Health Services Accessibility; Injuries, Self-Inflicted; Lesbians -- Ethical Issues; Lesbians -- Legislation and Jurisprudence; Obesity; Ovarian Neoplasms; Patient Education; Physician-Patient Relations; Pregnancy; Sex Factors; Sexual Health; Sexual Partners; Sexually Transmitted Diseases; Substance Abuse; Suicidal Ideation; Violence

29. The Relationship Between Parental Support and Depression and Suicidality in Transgender Adolescents. - Simons, Lisa; Olson, Johanna; Belzer, Marvin; Clark, Leslie; Schrager, Sheree (Journal of Adolescent Health, 2012)
Keywords: Adolescence; Depression -- Epidemiology; Transgender Persons -- Psychosocial Factors; Parents -- Psychosocial Factors; Support, Psychosocial -- Evaluation; Suicidal Ideation -- Evaluation

Health care issues of gay and lesbian youth. - Garofalo, R; Katz, E (Current Opinion in Pediatrics, 2001)
Gay and lesbian youth are adolescents who, in many ways, are no different from their peers. What distinguishes homosexual youth from other adolescent populations is the emotional, psychological and physical trauma resulting from the homophobia they experience in their daily lives. Although suicide, HIV infection, substance use, and violence appear to disproportionately affect this population, most homosexual youth grow up healthy and happy. Frequently lost in discussions of risk and risk behaviors is an appreciation of the strengths very much present in these young people. Health care providers must remain aware of the unique issues and health risks of homosexual youth but must also remember to address each patient as an individual within the context of general adolescent development. By doing so, pediatricians can play a vital role in preserving and enhancing the health of this "at-risk" population.
Keywords: Lesbians -- Psychosocial Factors; Homosexuality; Prejudice; Adolescent Health Services; Socialization; Male; Adolescent Psychology; Female; Risk Taking Behavior; Adolescence; Questionnaires; Ways of Coping Questionnaire

Making schools safer and healthier for lesbian, gay, bisexual, and questioning students. - Benton J (Journal of School Nursing, 2003)
This article describes some of the special health and safety concerns that many lesbian, gay, bisexual, and questioning youth face in schools. Among these problems are increased drug and alcohol use, sexually transmitted infections and pregnancy risks, depression and suicidality, and increased likelihood of being a victim of harassment or assault. School nurses can play a unique role in the lives of these students. A needs assessment is reviewed that describes school nurses' perceived professional responsibility and their actual practice with regard to lesbian, gay, bisexual, and questioning youth. Five barriers to optimal health care for these students are discussed. Methods that encourage students to view the school nurse as an ally, as well as issues surrounding disclosure or 'coming out,' are discussed. Special considerations of confidentiality, community agency referral, and family disclosure are discussed. Appropriate interventions at school and ways to begin to change the school climate are also presented.
Keywords: Adolescent Health; Bisexuals; Gay Persons; Safety; School Health; School Health Nursing; Students, High School; Adolescence; Counseling; Female; Homophobia -- Prevention and Control; Information Resources; Interpersonal Relations; Male; National Association of School Nurses; Nurse Attitudes; Nurse-Patient Relations; Nursing Assessment; Nursing Role; Patient Advocacy; Privacy and Confidentiality; Referral and Consultation; Self Disclosure; Sex Education; Sexually Transmitted Diseases -- Prevention and Control; Stigma

Gay, Lesbian, and Bisexual Adolescents: A Critical Challenge to Counselors. - Coleman, Eli; Remafedi, Gary (Journal of Counseling & Development, 1989)
Meeting the health care needs of gay, lesbian, and bisexual teenagers has become a public health imperative, and mental health professionals should be prepared for the challenge. The stigma of homosexuality often gives rise to psychosocial problems for adolescents, who are in the process of sexual identity development. The stigma also may complicate delivery of appropriate, ethical, and sound mental health treatment. Suggestions are offered to support healthy development, to assist recovery from stigma, and to avert the disastrous consequences of suicide and AIDS.

Gender nonconformity, bullying and depression. (Brown University Child & Adolescent Behavior Letter, 2013)
The article discusses the associations among gender nonconformity, depression, and bullying. The study uses data from the Growing Up Today Study (GUTS) and the researchers examine differences in depressive symptoms from 12-30 years of age in people who does and do not show signs of gender nonconformity before 11 year old. Results show that gender nonconformity before age 11 years is associated to increase risk for depressive symptoms and physical bullying by nonfamily adults.
Keywords: Gender Identity -- In Infancy and Childhood; Social Conformity -- In Infancy and Childhood; Bullying -- Complications -- In Infancy and Childhood; Depression -- Risk Factors; Research; Child; Suicidal Ideation -- Risk Factors; Bullying -- Prevention and Control; Child Abuse -- Complications

Gender nonconformity, bullying and depression. (Brown University Child & Adolescent Behavior Letter, 2013)
Keywords: Gender Identity -- In Infancy and Childhood; Social Conformity -- In Infancy and Childhood; Bullying -- Complications -- In Infancy and Childhood; Depression -- Risk Factors; Research; Child; Suicidal Ideation -- Risk Factors; Bullying -- Prevention and Control; Child Abuse -- Complications

Higher rates of depression, suicidality among sexual minority youth. (Brown University Child & Adolescent Behavior Letter, 2011)
The article discusses the results from meta-analysis of studies regarding the increased rates of depression and suicide risk among sexual minority youth. Researchers proposes that bad experiences such as discrimination may influence inequality between sexual minority and heterosexual youth. They note that with the increasing suicide rate, the issue has become important for health professionals to identify youth at high risk and to develop interventions.
Keywords: Depression -- Epidemiology; Sexuality; Bisexuality; Suicide -- Risk Factors; Adolescence; Male; Female; Gender Identity

Sexual orientation and youth suicide. - Remafedi, Gary; Remafedi, G (JAMA: Journal of the American Medical Association, 1999)
Discusses studies that have been done on youth suicide. Impact of sexual orientation on suicide rates; The United States government `Report of the Secretary's Task Force on Youth Suicide'; Research on homosexuality that identified a high prevalence of suicide attempts among young men; Higher rates of attempted suicide among homosexual youths than heterosexual ones.
Keywords: Homosexuality; Suicide -- Psychosocial Factors; Bisexuality; Female; Male; Adolescence; United States; Human; Validation Studies; Comparative Studies; Evaluation Research; Multicenter Studies; Impact of Events Scale

Threshold. - Rosen, David (CMAJ: Canadian Medical Association Journal, 2013)
Keywords: Homosexuality; Physicians -- Psychosocial Factors; Internship and Residency; Students, Medical -- Psychosocial Factors; Suicide -- Prevention and Control; Suicide -- Psychosocial Factors

Intimate partner violence. Review and implications of research and policy. - Campbell JC; Glass N; Sharps PW; Laughon K; Bloom T (Trauma, Violence & Abuse, 2007)
Current rates of intimate partner homicide of females are approximately 4 to 5 times the rate for male victims, although the rates for both have decreased during the past 25 years. The major risk factor for intimate partner homicide, no matter if a female or male partner is killed, is prior domestic violence. This review presents and critiques the evidence supporting the other major risk factors for intimate partner homicide in general, and for intimate partner homicide of women (femicide) in particular, namely guns, estrangement, stepchild in the home, forced sex, threats to kill, and nonfatal strangulation (choking). The demographic risk factors are also examined and the related phenomena of pregnancy-related homicide, attempted femicide, and intimate partner homicide-suicide.
Keywords: Homicide; Intimate Partner Violence; Battered Women; Black Persons; Demography; Domestic Violence; Emigration and Immigration; Ethnic Groups; Female; Firearms; Heterosexuals; Homicide -- Legislation and Jurisprudence; Gay Persons; Intimate Partner Violence -- In Pregnancy; Intimate Partner Violence -- Legislation and Jurisprudence; Male; Marriage; Mental Disorders; Pregnancy; Public Policy; Race Factors; Research; Risk Assessment; Risk Factors; Sex Factors; Stalking; Statistics; Substance Abuse; Suicide; Survivors; White Persons

Higher rates of depression, suicidality among sexual minority youth. (Brown University Child & Adolescent Behavior Letter, 2011)
Keywords: Depression -- Epidemiology; Sexuality; Bisexuality; Suicide -- Risk Factors; Adolescence; Male; Female; Gender Identity

Sexual orientation and suicide risk among teenagers. - Bobrow, Robert S (JAMA: Journal of the American Medical Association, 2002)
Keywords: Suicide; Homosexuality; Adolescent Psychology; Adolescence; Bisexuality; Risk Factors

Perinatal and psychosocial circumstances associated with risk of attempted suicide, non-suicidal self-injury and psychiatric service use. A longitudinal study of young people. - Young, Robert; Riordan, Vincent; Stark, Cameron (BMC Public Health, 2011)
Background: Past studies using large population based datasets link certain perinatal circumstances (birth weight, parity, etc) with mental health outcomes such as suicide, self-harm and psychiatric problems. Problematically, population datasets omit a number of social confounds. The aim of this study is to replicate past research linking perinatal circumstances and mental health (suicidality and use of psychiatric services) and to determine if such associations remain after adjusting for social circumstances.Methods: A longitudinal school-based survey of 2157 young people (surveyed at age 11, 13, 15) followed up in early adulthood (age 19). At age 11 parents of participants provided information about perinatal circumstances (birth weight, birth complications, etc.) and psychiatric service use. Participants provided data about their mental health at age 15 (attempted suicide, suicidal thoughts) and at ages 19 (self-harm, psychiatric service use). In addition, data were collected about their social and psychosocial circumstances (gender, deprivation, religion, sexual behaviour, etc.).Results: Predictably, social factors were linked to mental health outcomes. For example, those with same sex partners were more likely (OR 4.84) to self-harm than those without a same sex partner. With a single exception, in both unadjusted and adjusted models, perinatal circumstances were not or only marginally associated with mental health outcomes. The exception was the number of birth complications; young people with two or more complications were approximately 2-3 times more likely than those without complications to use psychiatric services.Conclusions: While we failed to replicate results found using large population based datasets, some of our results are compatible with prior research findings. Further, evidence from this study supports the influence of perinatal circumstances (birth complications) on later psychiatric problems, or at least higher than expected contact with psychiatric service.
Keywords: Mental Health Services -- Utilization; Prenatal Exposure Delayed Effects; Self-Injurious Behavior -- Psychosocial Factors; Suicide, Attempted -- Psychosocial Factors; Adolescence; Child; Female; Great Britain; Human; Prospective Studies; Male; Pregnancy; Questionnaires; Risk Assessment; Young Adult

A Review of the Evidence on the Effects of Intimate Partner Violence on Men. - Randle, Anna A.; Graham, Cynthia A. (Psychology of Men & Masculinities, 2011)
Keywords: Intimate Partner Violence -- Complications; Men; Stress Disorders, Post-Traumatic -- Complications; Depression -- Complications; Suicidal Ideation; Behavioral Symptoms -- Risk Factors; Intimate Partner Violence -- Physiopathology; Intimate Partner Violence -- Epidemiology; Gender Role; Social Values; Homosexuality

Substance abuse. Working toward recovery with the lesbian patient. - Lynch MA (AJN American Journal of Nursing, 1997)
Keywords: Lesbians -- Psychosocial Factors; Substance Abuse -- Nursing; Recovery; Suicide, Attempted; Nursing Assessment; Patient History Taking; Suicidal Ideation; Information Resources; Female

Suicide and sexual orientation: unanswered questions. - Muehrer P (Journal of the California Alliance for the Mentally Ill, 1999)
When one is mentally ill and gay does suicide risk increase?
Keywords: Suicide -- In Adolescence; Sexuality -- In Adolescence; Homosexuality; Heterosexuality; Adolescence

JOURNAL WATCH. SEXUAL ORIENTATION MAY AFFECT WELL-BEING OF STUDENTS. - Joy, Subhashni D. Singh (AJN American Journal of Nursing, 2012)
The article discusses research on the effects of sexual orientation among middle and high school students on their emotional and behaviors, making reference to a study by J.P Robinson and D.L. Espelage published in the 2011 issue of "Educational Researcher."
Keywords: Students, Middle School -- Psychosocial Factors; Students, High School -- Psychosocial Factors; LGBTQ+ Persons -- Psychosocial Factors; Suicidal Ideation; Bullying; Substance Abuse; Adolescence; Wisconsin; Comparative Studies; Academic Performance; Surveys; Mental Status

JOURNAL WATCH. SEXUAL ORIENTATION MAY AFFECT WELL-BEING OF STUDENTS. - Joy, Subhashni D. Singh (AJN American Journal of Nursing, 2012)
Keywords: Students, Middle School -- Psychosocial Factors; Students, High School -- Psychosocial Factors; LGBTQ+ Persons -- Psychosocial Factors; Suicidal Ideation; Bullying; Substance Abuse; Adolescence; Wisconsin; Comparative Studies; Academic Performance; Surveys; Mental Status

Trauma in transgender populations: risk, resilience, and clinical care. - Mizock L; Lewis TK (Journal of Emotional Abuse, 2008)
Keywords: Hardiness; Health Services Accessibility; Transgender Persons; Trauma -- Risk Factors; Attitude to Sexuality; Cultural Competence; Discrimination, Employment; Intimate Partner Violence; Peer Counseling; Race Factors; Risk Taking Behavior; Suicidal Ideation; Support, Psychosocial; Transsexualism; United States; Violence -- Epidemiology -- United States

Editorial. - Burrows GD (Stress & Health: Journal of the International Society for the Investigation of Stress, 2007)
Keywords: Breast Neoplasms; Chronic Pain; Health Status; Homosexuality; Killer Cells, Natural; Models, Theoretical; Serial Publications; Stress, Psychological; Suicide; Terrorism

Letter to the editor...McAndrew S, Warne T (2004) Ignoring the evidence dictating the practice: sexual orientation, suicidality and the dichotomy of the mental health nurse. Journal of Psychiatric and Mental Health Nursing 11, 428-434 - Zucker KJ; McAndrew S; Warne T (Journal of Psychiatric & Mental Health Nursing (Wiley-Blackwell), 2004)
Keywords: DSM; Gender Identity; Homosexuality

Covert cultural sexual abuse of gay male teenagers contributing to etiology of sexual addiction. - Kort J (Sexual Addiction & Compulsivity, 2004)
Gay male teenagers are at high risk for the development of sexual addiction. There exists a regular assault on the sexuality of gay males. This covert cultural sexual abuse suffered by these gay adolescents predisposes them to reenact this trauma through sexual acting out. The trauma model is useful in conceptualizing how to treat this population and address the post traumatic stress disorder suffered from the cultural victimization of homophobia and heterosexism.
Keywords: Homosexuality -- In Adolescence; Sexual Abuse -- In Adolescence; Sexual Addiction -- Etiology -- In Adolescence; Adolescence; Male; Men's Health; Adolescent Psychology; Heterosexuality; Homophobia; Self Disclosure; Trauma; Arousal; Stress Disorders, Post-Traumatic; Suicide

Counseling gay teenagers... Allen LB, Glicken AD. Depression and suicide in gay and lesbian adolescents. PHYSICIAN ASSISTANT. 1996; 20(4):44. - Zimmerman RW; Eddy PD; Allen LB; Glicken AD (Physician Assistant, 1996)
Keywords: Homosexuality -- In Adolescence; Counseling -- In Adolescence; Adolescence

Young people, gender and suicide: a review of research on the social context. - Smalley N; Scourfield J; Greenland K (Journal of Social Work, 2005)
Summary: The paper reviews some recent research on the social context of suicide in young people, with particular reference to evidence about the gendered character of suicidal behaviour. Some implications for social work and social policy are discussed.Findings: Key messages from the research reviewed are presented in relation to some specific social domains. These are employment, social cohesion and social comparison, mental illness, family and relationships, sexual orientation and help-seeking.Applications: This review is especially of use to those in the social work field who are not familiar with the large body of research on the social context of youth suicide in the medical and psychological literature. There is some discussion in the article of the implications of this research for suicide prevention, both in terms of policy and in terms of the practices of individual social workers.
Keywords: Sex Factors; Suicide -- In Adolescence; Adolescence; Employment Status; Family Relations; Female; Help Seeking Behavior; Male; Mental Disorders; Sexuality; Social Values; Social Work, Psychiatric; Substance Abuse

25. Bullying and School-Based Violence in LGBT Teenage Populations. - Gayles, Travis A.; Garofalo, Robert (Journal of Adolescent Health, 2012)
Keywords: Adolescence; Bullying -- Epidemiology; School Violence -- Epidemiology; LGBTQ+ Persons

Keep your eye on... (Brown University Child & Adolescent Behavior Letter, 2010)
Keywords: Antipsychotic Agents -- Adverse Effects -- In Infancy and Childhood; Autistic Disorder -- Etiology; Child; Homosexuality; Measles-Mumps-Rubella Vaccine; Metabolic Diseases -- Risk Factors -- In Infancy and Childhood; Risk Factors; Suicidal Ideation -- Epidemiology; Suicide, Attempted -- Epidemiology

The masculine concepts of control, strength, and responsibility to others were important to men with depression. - Galdas PM (Evidence Based Nursing, 2006)
How does depression influence men's gender identities?DESIGNQualitative secondary analysis.SETTINGInterviews were conducted for use on a UK website that reports personal experiences of health and illness (www.dipex.org).PARTICIPANTS16 men >/=18 years of age (range 30-75 y) who identified themselves as having depression and were well enough to participate in an interview. 5 men were homosexual, 3 were from ethnic minorities, and 5 had bipolar depression.METHODSOpen ended, indepth interviews lasting 90-180 minutes were conducted by an experienced male researcher. Participants were encouraged to focus on issues about depression that were important to them and to discuss specific topics, such as the depression experience, social consequences, and strategies for help seeking and personal coping. The interviews were recorded, transcribed, and analysed in 2 phases. In the first phase, emerging themes were identified and coded using a modified grounded theory approach. In the secondary analysis phase, themes related to masculinity and gender identity were identified from the original transcripts to answer the new research question.MAIN FINDINGS(1) Experiencing depression. Many men felt that their depression stemmed from childhood or teenage years, when they had experienced multiple threats to their sense of masculinity through insults from family and peers and the expectation to be 'macho.'(2) Reconstructing identity around hegemonic (culturally dominant) masculinity. Some men stated that becoming 'one of the boys' was helpful in their recovery from depression, whereas others felt that the pressures of conforming to the standard of hegemonic masculinity made their depression worse and even led to suicide attempts to prove their courage. The men emphasised the importance of the masculine traits of regaining control of the situation and re-establishing independence from drugs and healthcare professionals. On the other hand, some men viewed drugs as a weapon that they controlled in their battle against depression. Some men saw suicide as the ultimate way to gain control. Although the support of partners and feelings of responsibility to family helped some men recover from depression and resist suicidal urges, the pressures of gendered social roles could also hinder recovery.(3) Constructing 'difference' as advantageous. For a few men, the fact that their depression made them different from other men was a good thing--an indication intelligence and sensitivity. Men who were homosexual or from a minority ethnic group were particularly experienced in constructing difference. 1 man stressed the importance of establishing his gender identity in the middle ground between macho and weak, with acknowledgement of vulnerability.CONCLUSIONSThe masculine concepts of greater control, strength, and responsibility to others were important to men with depression. Some men were able to construct identities that resisted the traditional definitions of dominant masculinity, whereas others reinterpreted aspects of the potentially feminising experience of depression as masculine.
Keywords: Depression -- Psychosocial Factors; Men -- Psychosocial Factors; Adult; Aged; Interviews; Male; Middle Age; Qualitative Studies; Secondary Analysis

The abuse of elderly men... a revised version of a paper presented at the National Conference on Understanding and Combating Elder Abuse in Minority Populations, sponsored by the Archstone Foundation, American Public Welfare Association, and the National Center on Elder Abuse, Long Beach, CA, June, 1997. - Kosberg JI (Journal of Elder Abuse & Neglect, 1998)
Elderly men are an under-studied group of abuse victims. Although victimization surveys discriminate against all elderly, abused elderly men are especially invisible. This paper will discuss the high rates of self-abuse by older men and their high risk for abuse when they are lonely, living within inner cities, incarcerated, or gay. Since most men live with a spouse (or significant other), they have also been victims of domestic violence. It is suspected that institutionalized elderly men live in settings that are incongruent with their self-concepts and preferences. Finally, this paper discusses the special vulnerability of men from culturally-diverse backgrounds to elder abuse (resulting from male-dominated socialization and intergenerational conflict).
Keywords: Elder Abuse -- Epidemiology; Aged -- Psychosocial Factors; Risk Factors; Intimate Partner Violence -- In Old Age; Elder Abuse -- Ethnology; Substance Abuse -- In Old Age; Voluntary Reporting; Vulnerability; Men's Health; Suicide -- In Old Age; Sex Factors; Institutionalization -- In Old Age; Elder Abuse -- Etiology; Victims -- Psychosocial Factors; Aged; Male; Female

News in mental health nursing. Sexual orientation linked to suicide attempts in young men. (Journal of Psychosocial Nursing & Mental Health Services, 1997)
Keywords: Gay Men -- Psychosocial Factors; Suicide, Attempted

Latino gay men living in multiple worlds...35th Annual Communicating Nursing Research Conference/16th Annual WIN Assembly, 'Health Disparities: Meeting the Challenge,' held April 18-20, 2002, Palm Springs, California - Guarnero PA (Communicating Nursing Research, 2002)
Keywords: Hispanic Americans -- Psychosocial Factors; Gay Men -- Psychosocial Factors; Family; Culture; Sexuality; California; Male; HIV Seronegativity; HIV Seropositivity; Focus Groups; Content Analysis; Racism; Discrimination; Depression; Suicide; Nursing Role; Human

News from Mental Health America: Latino parents' views on bullying, sexual orientation, and prejudice. - Shern D (Psychiatry (1550-5952), 2007)
Keywords: Bullying; Hispanic Americans -- Psychosocial Factors; Parental Attitudes; Prejudice; Sexuality; Communication; Gender Identity; Mental Disorders; Parent-Child Relations; Risk Factors; Suicide

Group interpersonal therapy reduces depression in adolescent survivors of war. - Mufson L (Evidence Based Mental Health, 2008)
Question: How effective are interventions for depression symptoms in displaced adolescent survivors of war in northern Uganda?Patients: 314 adolescents (14-17 years old) of the Acholi ethnic group living in camps for internally displaced persons, who had depression-like syndromes, defined using the Acholi Psychosocial Assessment Instrument (APAI; a locally defined and validated instrument assessing severity of 35 symptoms). For inclusion, adolescents had to score at least 32 on the APAI (score range 0-105, higher score indicates greater severity of symptoms), although 14 adolescents with scores between 28 and 31 were included to achieve target sample size, and report some difficulties in function on a gender-specific local function measure. Main exclusion criteria: severe suicidal ideation or disability preventing interview.Setting: Two camps for internally displaced persons in northern Uganda; May 2005 to December 2005. Intervention: Group interpersonal psychotherapy, creative play, or waiting list control. The active intervention groups met for weekly sessions lasting 1.5-2 hours for 16 weeks. Group interpersonal psychotherapy was delivered in single sex groups of 6-8 adolescents by a trained facilitator of the same sex, based on a locally adapted manual. Creative play consisted of activities with specific psychosocial goals, followed by discussion relating the activity with real life. Creative play was delivered in mixed sex groups of 25-30 adolescents by trained facilitators. Outcomes: Primary outcome: change in depression symptoms (APAI).Patient follow-up: 83% completed post-intervention assessment; 100% included in last observation carried forward analyses.METHODSDesign: Randomised controlled trial.Allocation: Unclear.Blinding: Single blind (assessors blinded).Follow-up period: 16 weeks (intervention period only).MAIN RESULTSGroup interpersonal therapy significantly reduced depression symptoms compared to control (difference in adjusted mean depression score change from baseline: 9.97, 95% CI 1.66 to 17.93; p = 0.02). However, there was no significant difference between creative play and control in depression symptoms (adjusted mean difference: -2.51, 95% CI -11.42 to +6.39, p = 0.58). If analysed by gender, group interpersonal therapy significantly reduced depression symptoms in girls, but not in boys (adjusted mean difference: girls 12.61, 95% CI 2.09 to 23.14; boys 5.72, 95% CI -1.86 to +13.30).CONCLUSIONSGroup interpersonal therapy, but not creative play, reduces depression symptoms in adolescent survivors of war and displacement in northern Uganda. Group interpersonal therapy may be more effective for girls than boys.
Keywords: Depression -- Therapy -- In Adolescence; Psychotherapy, Group -- In Adolescence; Treatment Outcomes; War -- Psychosocial Factors -- Uganda; Adolescence; Clinical Trials; Uganda

Death and AIDS: a review of the medico-legal literature. - Huber JT (Death Studies, 1993)
As there is still neither a known cure for the acquired immunodeficiency syndrome (AIDS) nor any vaccine to prevent infection with the human immunodeficiency virus (HIV), an AIDS diagnosis continues to denote a death sentence. One might think that approaching dying, death, and bereavement in the AIDS pandemic would be the same as with other terminal illnesses. However, that is not the case. No other single disease in the history of the American legal system has generated more litigation than this disease. This article examines some of the medico-legal issues associated with AIDS-related death such as estate planning, discrimination, insurance, long-term care, the right to die, and suicide as detailed in medical and legal discourse.
Keywords: Acquired Immunodeficiency Syndrome -- Legislation and Jurisprudence; Death -- Legislation and Jurisprudence; Legal Procedure; Attitude to AIDS; Psychosocial Aspects of Illness; United States; Wills; Gay Men; Insurance; Long Term Care; Hospice Care; Right to Die; Discrimination; Terminal Care

New Developments in Intimate Partner Violence and Management of Its Mental Health Sequelae. - Stewart, Donna E; Vigod, Simone; Riazantseva, Ekaterina (Current Psychiatry Reports, 2016)
Intimate partner violence (IPV) is a global public health and human rights problem that causes physical, sexual and psychological harms to men and women. IPV includes physical aggression, sexual coercion, psychological abuse and/or controlling behaviours perpetrated by a current or previous intimate partner in a heterosexual or same-sex relationship. IPV affects both men and women, but women are disproportionately affected with nearly one third reporting IPV during their lifetime. Physical and sexual harms from IPV include injury, increased risk for sexually transmitted diseases, pregnancy complications and sometimes death. Psychological consequences include depression, anxiety, posttraumatic stress disorder, substance abuse, impulsivity and suicidality and non-specific physical complaints thought to be related to the traumatic nature and chronic stress of IPV. Children who witness IPV are also negatively impacted in the short and long term. This paper reviews prevalence, risk factors, adverse effects and current evidence-based mental health treatment advice for IPV victims.
Keywords: Anxiety Disorders -- Psychosocial Factors; Substance Use Disorders -- Etiology; Suicide -- Psychosocial Factors; Depression -- Psychosocial Factors; Depression -- Etiology; Substance Use Disorders -- Psychosocial Factors; Anxiety Disorders -- Etiology; Suicide -- Prevention and Control; Sexual Partners -- Psychosocial Factors; Stress Disorders, Post-Traumatic -- Psychosocial Factors; Stress Disorders, Post-Traumatic -- Etiology; Female; Pregnancy, Unplanned; Male; Mental Health; Risk Factors; Health Status Disparities; Aggression -- Psychosocial Factors; Pregnancy; Prevalence

An attempt to commit suicide by contracting AIDS. - Papathomopoulos, Evangelos; Papathomopoulos, E (American Journal of Psychiatry, 1988)
A letter to the editor is presented in response to the articles about contracting AIDS as a means of committing suicide, and four alcoholic homosexual men who deliberately sought to be infected by AIDS with the purpose of committing suicide that were previously published.
Keywords: Sexuality; Acquired Immunodeficiency Syndrome; Suicide, Attempted -- Psychosocial Factors; Adjustment Disorders -- Psychosocial Factors; Adult; Female

Role of Islam in the management of Psychiatric disorders. - Sabry, Walaa M.; Vohra, Adarsh (Indian Journal of Psychiatry, 2013)
Keywords: Islam; Mental Disorders -- Ethnology; Mental Disorders -- Therapy; Psychotherapy; Spirituality; Cognitive Therapy; Meditation; Music Therapy; Aromatherapy; Depression -- Therapy; Suicide -- Prevention and Control; Obsessive-Compulsive Disorder -- Therapy; Anxiety Disorders -- Therapy; Grief; Homosexuality; Family Role

Contracting AIDS as a means of committing suicide. - Frances, R J; Wikstrom, T; Alcena, V (American Journal of Psychiatry, 1985)
Keywords: Suicide -- Psychosocial Factors; Homosexuality; Acquired Immunodeficiency Syndrome -- Etiology; Alcoholism -- Psychosocial Factors; Suicide, Attempted -- Psychosocial Factors; Depression -- Psychosocial Factors; Male

Conditions predisposing to suicide: a review. - Miles, C P (Journal of Nervous & Mental Disease, 1977)
By reviewing causes of death among cohorts of various major disease entities or conditions, one may infer that a large majority of suicides are associated with a relatively small number of conditions. From the available follow-up studies, we might estimate that the following percentage of affected individuals will die by suicide: primary (endogenous) depression, 15 per cent; reactive (neurotic) depression, 15 per cent; alcoholism, 15 per cent; schizophrenia, 10 per cent; psychopathic personality, 5 per cent; opiate addiction, 10 per cent or more. Rough estimates of the number of suicides per year in the United States attributable to each condition might be as follows (using low incidence figures): depression, 12,900; alcoholism, 6,900; schizophrenia, 3,800; psychopathy, 2,000 (?); drug addiction, 900.
Keywords: Suicide; Depression -- Mortality; Schizophrenia -- Mortality; Age Factors; Anxiety -- Mortality; Substance Use Disorders -- Mortality; Female; Homosexuality; Male; Suicide, Attempted; Antisocial Personality Disorder -- Mortality; Neurotic Disorders -- Mortality; Alcoholism -- Mortality; Prisoners; Sex Factors

Establishing an association between rural youth suicide and same-sex attraction. - Quinn KT (Rural & Remote Health, 2003)
Keywords: Homosexuality -- In Adolescence; Rural Areas; Suicide -- Psychosocial Factors -- In Adolescence; Access to Information; Adolescence; Health Services Accessibility; Homophobia; Gay Men; Lesbians; Loneliness

Prison rape and suicide. - Wiggs, James W.; Wiggs, J W (JAMA: Journal of the American Medical Association, 1989)
Presents a letter to the editor of the December 22, 1989 issue of the 'Journal of the American Medical Association' about the characteristics of inmates who committed suicide that did not address the major issue whether any of them had been subject to homosexual rape.
Keywords: Prisoners; Suicide; Rape; Maryland; Homosexuality; Male