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Emotional intimacy is key to intimate partner relationship quality and satisfaction. For sexual minority men, queer and feminist theorists consistently link emotional intimacy to diverse sexual practices and partnership dynamics formulated within the relationship. This Photovoice study adds to those insights by drawing on individual photovoice interviews with 16 sexual minority men to describe participant's experiences of, and strategies for emotional intimacy in their intimate relationships. Analysis revealed three distinct yet entwined themes: (i) embracing vulnerabilities to drive self-acceptance; (ii) building relationality with partners; and (iii) securing connections with family, friends and community. By embracing vulnerabilities to drive self-acceptance, participants spoke to embodied courage and autonomy as key components for addressing wide-ranging emotional intimacy challenges in their relationships. In theme two, building relationality with partners, participants described how empathy, trust and reciprocity underpinned collaborative work to foster emotional intimacy. Lastly, in securing connections with family, friends and community, acceptance and inclusion were key to participants' sense of belonging and legitimacy which aided their emotional intimacy with partners. The findings provide guidance for tailored programmatic efforts to assist sexual minority men build intimate relationships.
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Peer support has a long history of helping people navigate mental health challenges and is increasingly utilized within men's mental health promotion initiatives. Despite considerable research conceptualizing and evaluating peer support in various contexts, little is known about the gendered dimensions of men's peer support and mutual help for mental health. This article provides an empirically informed commentary on men's peer support and informal help-seeking preferences to make recommendations for future directions for research and practice. Research examining men's peer support is emergent and the available evidence suggests that there is potential to conceptually align with many men's values and preferences for mental health help-seeking. Peer support offers a non-clinical, strength-based adjunct to professional support that may aid men in navigating a range of mental health challenges. Consideration must be given to the influence of gender socialization and men's diverse experiences with developing and maintaining peer relationships. It should not be assumed that authentic and supportive relationships will naturally form when men congregate together. As a growing number of interventions and programs emerge targeted at boys and men, there are important opportunities to leverage these health promotion efforts to encourage and coach men to engage in mutual help. Opportunities for research and practice are discussed to better understand and harness the health-promoting potential of peer support for men's mental health.
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Promoção da Saúde , Saúde Mental , Grupo Associado , Apoio Social , Humanos , Masculino , Promoção da Saúde/métodos , Saúde do HomemRESUMO
BACKGROUND: Men account for three-quarters of all suicide deaths in many Western nations including Australia. Whilst extensive research has examined risk factors for suicidal ideation and behaviour in men, protective factors remain underexplored, particularly social support, resilience and coping behaviours. Such factors are important to examine particularly in the context of COVID-19, where enforced isolation (among other negative lifestyle effects) has created widespread risk for the development of suicidal ideation. This mixed-methods study aimed to examine associations of various protective factors with suicidal ideation in men, using data from an online survey conducted during the COVID-19 pandemic. In addition, we aimed to qualitatively investigate men's self-reported protective strategies when experiencing suicidal thoughts and behaviour. METHODS: A convenience sample of 700 men (age M = 50.3 years; SD = 15.2 years) responded to an online survey including quantitative measures of suicidal ideation, planning and attempt, alongside employment and relationship status, coping, social support, resilience, and a qualitative free-text item gauging men's self-reported protective strategies. Multinomial logistic regression was applied to compare odds of sub-categories of suicide risk (ideation; planning) according to protective factors. Qualitative responses were analysed via thematic analysis. RESULTS: Men in a relationship, and those lower in emotion-focused and avoidant coping reported lower odds of suicidal ideation. Maintaining employment throughout the pandemic was protective against suicidal ideation and planning; as was greater perceived social support from friends. Greater self-reported resilience was protective against suicidal ideation and planning. Qualitative analyses led to the development of two themes: coping and connecting, reflecting men's intra- and interpersonal management strategies; and sustaining selflessness, where men's imaginings of the collateral damage of their suicidal behaviour was protective against action on suicidal thoughts or plans. CONCLUSIONS: Findings of this study speak to the nuanced roles of interpersonal connections, resilience and coping behaviours in protecting against suicidal ideation and planning in men. In addition, qualitative insights further cement men's identification with familial protector and/or provider roles as protective against suicidal action.
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COVID-19 , Ideação Suicida , Masculino , Humanos , Pessoa de Meia-Idade , Fatores de Proteção , Pandemias , Homens , Fatores de RiscoRESUMO
ABSTRACT: The Psychic Pain Scale (PPS) measures a form of mental pain involving overwhelming negative affect and loss of self-control. Understanding psychic pain among men is needed to advance efforts for preventing male suicide. The present study examined the factor structure and psychosocial correlates of the PPS among 621 online help-seeking men. Confirmatory factor analysis indicated a higher-order factor comprising affect deluge and loss of control factors. Psychic pain evinced significant associations with general psychological distress, r = 0.64; perceived social support, r = -0.43; social connectedness, r = -0.55; and suicidal ideation, r = 0.65 (all p 's < 0.001)-the latter three remained significant after controlling for general distress. Psychic pain also mediated the association between social disconnection and suicidal ideation (standardized indirect effect = -0.14 [-0.21, -0.09]), after controlling for social support and distress. Findings support the PPS as a promising measure for investigating psychic pain among men and indicate psychic pain as a link between social disconnection and suicidal ideation.
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Ideação Suicida , Suicídio , Humanos , Masculino , Apoio Social , Dor , Fatores de RiscoRESUMO
Anxiety is the most prevalent mental disorder experienced by young men, and when untreated, is predictive of co-morbid mental health challenges and suicide. Despite the rising prevalence, there is a conspicuous absence of qualitative research to distil and theorise young men's anxiety. Twenty-five young Australian men (15-25 years), who had been diagnosed with an anxiety disorder or self-reported anxiety symptoms, took part in individual semi-structured interviews. Interviews were transcribed verbatim and analysed using a constructivist grounded theory approach. A three-process grounded theory (Resisting-Reckoning-Responding; Triple R Anxiety Model) depicted young men's experiences of anxiety, gilded and guided by their masculine socialisation. Initially, young men noticed somatic symptoms (i.e., headaches, nausea and myalgia) but did not connect these symptoms to anxiety. Avoiding anxiety (e.g., denying, distracting) proved unhelpful in the longer term and as symptoms diffused, a subsequent process of reckoning anxiety (i.e., meaning making) ensued. As young men gained insight to the life limiting bounds of their anxiety, some were prompted towards actions of acceptance, seeking help proactively and employing strength-based adaptive coping strategies. This theoretical conceptualisation of young men's anxiety has the capacity to enhance identification and treatment efforts, improving young men's mental health outcomes across the lifespan.
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Masculinidade , Homens , Masculino , Humanos , Austrália , Homens/psicologia , Saúde do Homem , Ansiedade , Transtornos de AnsiedadeRESUMO
Men's emotions in intimate partner relationships have received little research attention. The current interpretive descriptive study included 30 Canadian-based men to address the research question: What are the connections between masculinities and men's emotions in and after intimate partner relationships? Three inductively derived themes included emergent distressing emotions wherein participants' predominance for holding in abeyance their concerns about the relationship manifested varying levels of emotional stoicism. Within this context most men denied or downplayed and did not express their emotions. When the relationship broke, men were overwhelmed by mixed and weighty break-up emotions comprising diverse and often-times discordant emotions, including sadness, shame, anger, regret and guilt, calling into question men's rationality for deciphering and expressing what was concurrently but inexplicably felt. Shame and anger were prominent emotions demanding the participant's attention to all that happened in and at the end of the relationship. In the third theme, understanding and transitioning after-burn emotions, participant's grief levered their efforts, including soliciting professional help for deconstructing, reframing and expressing their emotions in the aftermath of the partnership ending. The findings contextualise and in some instances counter claims about the utility of men's emotional stoicism by mapping participants' feelings in and after intimate partner relationships.
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Emoções , Masculinidade , Masculino , Humanos , Canadá , Comportamento Sexual , Parceiros Sexuais , Saúde do HomemRESUMO
Arts engagement is gaining recognition as a non-clinical approach to promote mental health and well-being. However, the perceived utility of the arts to promote mental health among men with low socioeconomic status (SES) and how to best engage them is underexplored. This study explores the lived experiences of men with low SES who engage with the arts in Northern Ireland (n = 41). Data collected via focus groups (n = 5) and interviews (n = 11) were analysed using reflexive thematic analysis to inductively derive four themes. Theme 1 highlights how the arts facilitated friendship, a collective identity, peer support and a reason to socialize. Themes 2 and 3 explore how the arts enhanced self-esteem and emotional regulation by developing a routine, purpose, sense of mastery, a sense of catharsis through immersion in a soothing endeavour and an alternative outlet for self-expression. Theme 4 covers strategies that facilitate male engagement in the arts such as using a familiar space, delivering to an existing male group, framing the programme around male interests not health or creativity, building on existing strengths and capacities, enabling ownership, using tangible action-orientated activities, and being non-authoritative and flexible with delivery. This is one of the first studies to highlight the gendered dimensions in which men with low SES engage with and experience mental health benefits through arts engagement. This study points towards relevant theories to further understand the pathways between the arts and improved mental health among men which can inform development of tailored arts programmes for men.
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Regulação Emocional , Saúde Mental , Humanos , Masculino , Saúde do Homem , Grupos Focais , Baixo Nível SocioeconômicoRESUMO
BACKGROUND: Alcohol consumption is common among young men and occurs in many contexts. The sexualized substance use literature has generated some insight into the role of alcohol alongside other substances in the context of sex, though there remain opportunities for targeted and context-sensitive studies to examine the sexual practices and outcomes associated with alcohol, specifically. METHODS: This interpretive description study explores how experiences and contexts of alcohol use feature in the sexual lives of young men who use substances with sex. Data collection involved in-depth interviews conducted between 2018 and 2021 in Vancouver, Canada, with N = 76 young men (ages 18-30; mean = 23.9 years) who use substances with sex, including men with diverse sexual identities. Data were analyzed in an iterative manner through a social constructivist lens and an interpretive description framework, leveraging constant comparison techniques. FINDINGS: This analysis yielded three interconnected themes: (1) using alcohol for sexual(ity) freedoms; (2) backgrounding alcohol within a sexualized polysubstance milieu; and (3) navigating the risks and consequences of using alcohol with sex. Alcohol use was found to reduce inhibitions and support experimentation, including by facilitating the transgression of conservative or restrictive social and sexual norms. Alcohol was seldom explicitly classified as a sexualized substance, though it was evidently a widespread and normative social practice. This practice was associated with important risk and consequences, including with respect to consent, pregnancy and sexually transmitted and bloodborne infection risk, and sexual dysfunction. CONCLUSIONS: Findings from this study position alcohol as a backgrounded yet significantly influential substance that young men use with sex. The sexualized use of substances must be understood, and responded to, in a manner that is grounded in harm reduction and that considers the full spectrum of substances-inclusive of but not limited to alcohol-and associated benefits and risks that feature in young men's sexual lives. Specifically, sexual health and primary care providers working with young men should invite and open up meaningful conversation about how they may be using substances (including alcohol) with sex, while offering de-stigmatizing, sex-positive, and affirming education and supports to promote safer sex and substance use.
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Comportamento Sexual , Transtornos Relacionados ao Uso de Substâncias , Masculino , Gravidez , Feminino , Humanos , Pesquisa Qualitativa , Consumo de Bebidas Alcoólicas/epidemiologia , Inquéritos e Questionários , Homossexualidade MasculinaRESUMO
Men's illness vulnerabilities and resilience are two predominant and regularly linked constructs in the masculinities and men's health literature. There has been a steady stream of men's strength-based vulnerabilities in the form of illness testimonials amid critiques that such disclosures are mere props for bolstering patriarchal power. The current article presents secondary analyses of case studies with four participants who took part in wide-ranging qualitative health studies to detail diverse connections between masculinities and men's illness vulnerabilities and resilience. Prostate cancer-related vulnerabilities feature in the first case study where Arthur's resilience for reclaiming his erectile function post-prostatectomy mobilizes an objection masculinity contesting his marginality. In the second case study, Chuck's vulnerabilities are conceded as permanent flowing from his severe mental illness, a positionality situating resilience as obligatory for his survival. Here, Chuck embodies a resignate masculinity that accepts but works to manage the harms of his subordinate status. In the aftermath of his young son's suicide, Jack laments that he did not model vulnerabilities. Resilience for understanding his loss influences a reimagined masculinity where Jack contemplates changes to gender norms for his and other men's lives. Lastly, Sami replaces maladaptive actions for dousing vulnerabilities incurred through a partner-initiated separation with resilience for self-growth. Aspiring progress masculinity, Sami deconstructs his emotions and behaviors to positively change how he shows up as a man, father, and partner. The case studies reveal connections between objection, resignate, reimagined, and progress masculinities and men's illness vulnerabilities and resilience to advance empirical, gender theory and methodological insights.
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Masculinidade , Suicídio , Humanos , Masculino , Emoções , Homens/psicologia , Saúde do Homem , Resiliência PsicológicaRESUMO
Suicidal ideation (SI) is a known precursor to suicide among men. While loneliness and thwarted belongingness (TB) have been identified as key factors influencing SI, no study has reported on all three constructs to investigate whether loneliness is associated with SI by way of TB. Furthermore, it is not clear whether personality impairment has a moderating role on this process. The present study examined the impact of loneliness on SI among men and whether TB mediated this relationship. Additionally, the study investigated whether personality impairment (i.e., self-functioning, interpersonal functioning) moderated the relationship between loneliness and TB. Canadian men (N = 434) completed an online survey that included self-report assessments of the study constructs. Conditional process modeling was used to test the indirect effect of loneliness on SI via the mediating effect of TB. Findings indicated a significant association between loneliness and SI that was mediated by TB. Further, impairment in self-functioning moderated the relationship between loneliness and TB, indicating that the relationship was stronger among men with greater difficulties in self-functioning. The findings are important to consider within the COVID-19 context, as they point to the need to reduce the detrimental impacts of loneliness, thereby potentially mitigating male SI.
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COVID-19 , Ideação Suicida , Humanos , Masculino , Solidão , Relações Interpessoais , Canadá , Personalidade , Fatores de Risco , Teoria PsicológicaRESUMO
ABSTRACT: Self-reliance features as one of the notable male norms espoused by traditional masculine socialization. Strict adherence to a self-reliant attitude has been found to confer risk for depression and suicidality among men. Yet, little research has investigated the factors that may contribute to self-reliance having a negative impact for men. Using data from a large sample of Canadian men (N = 530), the present study examined the association between self-reliance and depression, while also assessing the roles of loneliness and not feeling understood as contributing factors in this process. Findings indicated that the moderated mediation model was significant, pointing to loneliness as a significant mediator in the association between self-reliance and depression. Furthermore, the findings revealed that not feeling understood moderated the relationship between self-reliance and loneliness, indicating that this association applies mainly to those men who do not feel understood by at least one important person in their life.
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Adaptação Psicológica , Depressão/psicologia , Solidão/psicologia , Homens , Adulto , Canadá , Estudos Transversais , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Análise de Regressão , Autorrelato , Ideação SuicidaRESUMO
OBJECTIVE: The purpose of this qualitative study was to explore working men's perspectives about sleep health and the intersecting influences of gender and work, describing participant's views on current and potential programming and organizational support to promote sleep health. METHODS: Twenty men employed in male-dominated industries in the north-central region of Alberta, Canada, participated in 4 consultation group discussions addressing motivators, facilitators and barriers to sleep health. RESULTS: Participants reported sleeping an average of 6.36 (SD ±1.1) hours per night, and the majority worked more than 40 hours per week. Data were analyzed using an inductive approach. The findings provided important insights. In normalizing sleep deprivation and prioritizing the need to "just keep going" on six or less hours of sleep, the men subscribed to masculine ideals related to workplace perseverance, stamina and resilience. Workplace cultures and practices were implicated including normative dimensions of overtime and high productivity and output, amid masculine cultures constraining emotions and conversations about sleep, the sum of which muted avenues for discussing, let alone promoting sleep. Challenges to good sleep were primarily constructed around time constraints, and worry about meeting work and home responsibilities. Men's preferences for workplace support included providing and incentivizing the use of sleep health resources, designing work for sleep health (e.g., shift schedules, overtime policies) and getting advice from experienced coworkers and experts external to the workplace organization. CONCLUSION: These findings hold potential for informing future gender-sensitive programming and organizational practices to support sleep health among working men.
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Sono , Local de Trabalho , Canadá , Identidade de Gênero , Humanos , Masculino , Pesquisa QualitativaRESUMO
Scholars have consistently documented the relationship between conformity to traditional masculine norms and maladaptive psychosocial outcomes among boys and young men. Given current social commentary, including debate around 'toxic masculinity', intervention is needed to encourage boys to embody healthy expressions and identities of masculinity. Whilst new approaches grounded in positive masculinity show promise, the construct requires further definition and phenomenological clarity. Here we review divergent perspectives on positive masculinity, and forward a refined definition, specific to psychosocial health promotion among boys and young men. We then outline the theoretical basis of a positive masculinity framework to guide the content of future interventions, aiming to achieve positive identity development among boys and young men for the good of all. This framework represents a necessary unification of scholarship around male adolescent development, education and health. Future health promotion interventions may benefit from applying the framework to support a positive psychosocial trajectory among boys and young men, with a focus on connection, motivation and authenticity.
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Masculinidade , Instituições Acadêmicas , Adolescente , Promoção da Saúde , Nível de Saúde , Humanos , Masculino , Comportamento SocialRESUMO
Deleterious effects of separation and divorce on men's mental health are well-documented; however, little is known about their help-seeking when adjusting to these all-too-common life transitions. Employing interpretive descriptive methods, interviews with 47 men exploring their mental health help-seeking after a relationship break-up were analyzed in deriving three themes: (1) Solitary work and tapping established connections, (2) Reaching out to make new connections, and (3) Engaging professional mental health care. Men relying on solitary work and established connections accessed relationship-focused self-help books, online resources, and confided in friends and/or family. Some participants supplemented solitary work by reaching out to make new connections including peer-based men's groups and education and social activities. Comprising first-time, returning, and continuing users, many men responded to relationship break-up crises by engaging professional mental health care. The findings challenge longstanding commentaries that men actively avoid mental health promotion by illuminating wide-ranging help resources.
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Masculinidade , Saúde Mental , Humanos , Masculino , Homens/psicologia , Saúde do Homem , Parceiros SexuaisRESUMO
The use of photovoice in men's health promotion research has grown significantly over the past 15 years. Initially mobilized as an elixir for men's talk about health practices and illness experiences, participant-produced photographs and accompanying narratives have grown significantly in reach, influence, and application. The current article highlights the gendered dimensions of photovoice in men's health promotion research across three studies addressing (1) psychosocial prostate cancer care, (2) fathers' tobacco reduction and smoking cessation, and (3) male suicidality. Insights drawn from the psychosocial prostate cancer care project emphasize the plurality of masculinities, and the implications for health promoters treating the common treatment side effect of erectile dysfunction. The relational nature of gender is central to the fathers' tobacco reduction and smoking cessation work whereby the well-being of partners and children strongly influenced men's behavior changes amid guiding adjustments to smoke-free policies. The male suicidality research highlights the unmuting powers of photovoice for making visible the interiority of men's mental illness, and the destigmatizing potentials for sharing participants' accompanying narratives. Evident across the three projects are the gendered dimensions of photovoice processes and products for advancing understandings of, and avenues toward, promoting the health of men and their families. After reflecting on these advances, we offer recommendations for future men's health promotion photovoice work.
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Saúde do Homem , Abandono do Hábito de Fumar , Criança , Promoção da Saúde/métodos , Humanos , Masculino , Masculinidade , Abandono do Hábito de Fumar/métodosRESUMO
ISSUE ADDRESSED: Health outcomes linked to men's relationships have the potential to both promote and risk the well-being of males and their families. The current scoping review provides a synthesis of men's relationship programs (excluding criminal court mandated services) in Australia, Canada and the United Kingdom to distil predominant program designs, access points, delivery modes and evaluative strategies. METHODS: Databases CINAHL, Medline, PsycInfo and Web of Science were searched for eligible articles published January 2010 and June 2020. The inclusion criteria consisted of empirical studies focussed on relationship programs for men. RESULTS: The review identified 21 articles comprising eight focussed on Fathering Identities as the Catalyst for Relationship Building and 13 targeting Men's Behaviour Change in Partner Relationships. Findings highlight the prevalence of group-based, in-person programs which men accessed via third party or self-referrals. Fathering programs highlighted the impact of men's violence on their children in appealing to attendees to strategise behavioural adjustments. Men's partner relationship programs emphasised self-control amid building strategies for proactively dealing with distress and conflict. Program evaluations consistently reported attendee feedback to gauge the acceptability and usefulness of services. CONCLUSIONS: That most men attending fathering and partner relationship programs were referred as a result of domestic violence and/or intimate partner violence underscores men's reticence for proactively seeking help as well as the absence of upstream relationship programs. There are likely enormous gains to be made by norming boys and men's relationship programs to prevent rather than correct violent and/or abusive behaviours.
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Saúde do Homem , Violência , Austrália , Criança , Humanos , Masculino , Violência/prevenção & controleRESUMO
ISSUE ADDRESSED: Many men are challenged by barriers to mental health help-seeking and engagement. For men who do access care, their pathways to engaging services can offer important insights to what might constitute gender-specific care. METHODS: Data were drawn from an online cross-sectional survey of N = 2009 Australian men (aged 16-85; M = 43.5) reflecting on their initial pathways to mental health services, including their reasons for help-seeking, how they first located a therapist and the source of any initial recommendation for engaging with services. Respondents were recruited with targeted advertisements via Movember's Facebook page. RESULTS: A relatively even age distribution was observed, with most respondents residing in metropolitan areas (60.4%), a majority employed full time (47.7%), and 25.7% identifying as gay or bisexual. Participants tended to be self-motivated to seek help, with referrals by general practitioners to specialist mental health services. The most common underpinning precipitant for seeking help was anxiety, particularly for younger men, whereas older men tended to have sought help more commonly for familial, relationship or work-related factors. Older men were also more likely to report self-motivated help-seeking, whereas younger men more commonly sought help on the recommendation of a family member. CONCLUSIONS: There are varied pathways for men's initial mental health help-seeking journeys that require an ongoing examination to ensure health promotion efforts are appropriately tailored and responding to men's needs. SO WHAT: As more men access mental health services, having a nuanced understanding of their likely pathways to care can inform the help-seeking efforts of other men as well as guide improved services and systems to reduce barriers.
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Serviços de Saúde Mental , Aceitação pelo Paciente de Cuidados de Saúde , Idoso , Austrália , Estudos Transversais , Humanos , Masculino , Homens/psicologia , Saúde do Homem , Aceitação pelo Paciente de Cuidados de Saúde/psicologiaRESUMO
BACKGROUND: Identification of masculine values associated with men's depression and suicide risk may generate new intervention targets for those with known static risk factors (e.g., exposure to childhood maltreatment). AIMS: To validate the factor structure of a measure of health-related masculine values and examine correlates relative to childhood maltreatment exposure. METHOD: Self-report data was collected from 530 Canadian men, mean age 47.91 years (SD = 14.51). RESULTS: Confirmatory factor analysis validated an abbreviated eight-item, two-factor model of the Intensions Masculine Values Scale (IMVS-8; CFI = .984, TLI = .977, RMSEA = .054, SRMR = .032). Cluster groups of low (n = 57), moderate (n = 206) and high (n = 267) adherence to these health-related masculine values were identified, equivalent on exposure to childhood maltreatment and previous mental health treatment. A multivariate group × maltreatment interaction was observed (p = .017) whereby males in the low cluster with a maltreatment history endorsed higher mood-related symptomology. This same pattern was observed in a univariate group × maltreatment interaction for suicide risk (p = .006). CONCLUSIONS: Health-related masculine values were associated with lower depression and suicide risk in men who have a history of childhood maltreatment. Future intervention studies should investigate whether development of health-related masculine values can reduce depression and suicide risk among men with a history of childhood maltreatment.
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Maus-Tratos Infantis , Suicídio , Canadá/epidemiologia , Criança , Depressão/epidemiologia , Depressão/psicologia , Humanos , Masculino , Masculinidade , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The prevalence of depression in men is significantly lower than women despite male suicide being higher. Therefore, improving the understanding and detection of depression in men is an important research and clinical aim. AIMS: To examine the prevalence of prototypic, externalising and mixed depressive symptoms and their relation to mental illness and suicide risk. METHODS: Quantitative data were obtained through a survey of N = 1000 Canadian males (median age = 49.63 years, SD = 14.60). A range of validated scales were incorporated including the PHQ-9, K6, SBQ-R and MDRS. RESULTS: Using established cut-off scores, the proportions classified into distinct symptom groups were: not depressed (69%), prototypical (8%), mixed (12%) and externalising (11%). Risk of mental illness and suicidal risk was significantly elevated in all depressed groups. Compared to the not-depressed group, those experiencing only externalising symptoms and those with mixed symptomology were at significantly increased risk of mental illness as well current suicide risk. CONCLUSION: These results highlight the clinical importance of considering a broad range of potential presentations of depression in men, all of which are associated with increased suicide risk.
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Angústia Psicológica , Prevenção do Suicídio , Canadá/epidemiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ideação Suicida , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To examine prostate cancer (PCa) survivors' sexual help-seeking intentions, behaviours, and unmet needs. METHODS: In this prospective cohort study, men who underwent active, non-hormonal treatment completed baseline (N = 558) and 6-month follow-up (N = 387) questionnaires. Theory of planned behaviour (TPB) constructs (sexual help-seeking intention, perceived behavioural control (PBC), subjective norm, attitude), masculine values (e.g., sexual importance/priority, emotional self-reliance), sex life and functioning, sexual supportive care needs, distress (anxiety, depression), and sexual help-seeking behaviour were assessed. RESULTS: Most men (M age = 64.6 years; M years post-diagnosis = 4.0) received prostatectomy (93%), reported severe erectile dysfunction (52%), ≥ 1 unmet sexual care need (66%), and sought help from a doctor (baseline 52%, follow-up 42%). Sexual care needs were significantly associated with poorer erectile function, reduced satisfaction with sex-life, valuing sex as important/integral to identity (masculine values), and increased depression (p ≤ 0.001). Sexual help-seeking intentions were significantly associated with valuing sex as important/integral to identity, recent help-seeking, greater confidence/control, perceiving support from important others, and positive attitudes, for sexual help-seeking (p < 0.001). Significant predictors of sexual help-seeking (follow-up) were baseline intentions, recent help-seeking (p < 0.001), and increased anxiety (p < 0.05). CONCLUSIONS: Men's unmet sexual care needs, sexual help-seeking intentions, and behaviour appear driven by the importance/value attributed to sex, distress, positive feelings, support from others, and confidence for help-seeking. Psychosocial providers are well-placed to address men's concerns, yet few sought their assistance. Interventions to improve men's access to effective sexual care are needed, particularly focused on reframing masculine values about the importance of sex and leveraging TPB-based predictors of help-seeking.