Disclosure, minority stress, and mental health among bisexual, pansexual, and queer (bi+) adults: The roles of primary sexual identity and multiple sexual identity label use.

Bisexual people are at increased risk for anxiety and depression compared to heterosexual and gay/lesbian people, but little is known about people who use other labels to describe attractions to more than one gender (e.g., pansexual, queer; collectively "bi+"). In addition, some people use more than one label to describe their sexual orientation, but research has yet to examine whether using one versus multiple labels is associated with identity-related experiences or mental health. To address these gaps, we explored potential differences in disclosure, minority stress, and mental health among bi+ adults based on primary sexual identity and multiple label use. As part of a larger project, 669 bi+ adults completed an online survey. Primary sexual identities included bisexual (53.2%), pansexual (26.3%), and queer (20.5%), and 55.2% used multiple labels. Compared to bisexual participants, pansexual participants reported higher disclosure, discrimination from heterosexual people, and depression. Pansexual participants also reported higher anxiety and lower internalized binegativity, but these associations became non-significant after adjusting for demographics. Queer participants reported higher disclosure, discrimination from heterosexual people, and anxiety, but only the difference in disclosure remained significant in adjusting analyses. Finally, participants who used multiple labels reported higher disclosure and discrimination from heterosexual and gay/lesbian people, but only the difference in discrimination from gay/lesbian people remained significant in adjusted analyses. Findings highlight the heterogeneity of bi+ individuals and the importance of considering bisexual, pansexual, and queer individuals as unique groups as well as considering whether bi+ individuals use one or multiple sexual identity labels.

Examining the relationship between genetic risk for depression and youth episodic stress exposure.

BACKGROUND: Offspring of depressed mothers have elevated risk of developing depression because they are exposed to greater stress. While generally assumed that youth's increased exposure to stress is due to the environmental effects of living with a depressed parent, youth's genes may influence stress exposure through gene-environment correlations (rGEs). To understand the relationship between risk for depression and stress, we examined the effects of polygenic risk for depression on youth stress exposure. METHODS: We examined the relations of a polygenic risk score (PRS) for depression (DEP-PRS), as well as PRSs for 5 other disorders, with youth stress exposure. Data were from a longitudinal study of a community sample of youth and their parents (n = 377) focusing on data collected at youth's aged 12 and 15 assessments. RESULTS: Elevated youth DEP-PRS was robustly associated with increased dependent stress, particularly interpersonal events. Exploratory analyses indicated that findings were driven by major stress and were not moderated by maternal nor paternal history of depression, and of the 5 additional PRSs tested, only elevated genetic liability for bipolar I was associated with increased dependent stress-particularly non-interpersonal events. LIMITATIONS: Like other PRS studies, we focused on those of European ancestry thus, generalizability of findings is limited. CONCLUSION: Polygenic risk contributes to youth experiencing stressful life events which are dependent on their behavior. This rGE appears to be specific to genetic risk for mood disorders.

Introduction to the special issue of the Journal of Consulting and Clinical Psychology: "Best practices" in prevention and treatment for racial and ethnic minority people.

The authors developed this special issue of the Journal of Consulting and Clinical Psychology (JCCP) that focuses broadly on "best practices" as they relate to prevention and treatment for racial and ethnic minority people. Their goal was to compile a diverse set of articles with regard to type (i.e., empirical, theoretical, review) and methodology (i.e., quantitative, qualitative, mixed methods), so as not to be limited by the typical formats and standards that characterize articles usually published in JCCP, and that can maintain existing structural practices that can limit novel discovery and potentially obstruct diversity, equity, and practice efforts. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Bi+ adults' daily wellbeing: The roles of relationship status and partner gender.

This study examined whether relationship involvement and partner gender were associated with between-person differences and within-person fluctuation in positive and negative affect and alcohol use among people who are attracted to more than one gender or regardless of gender (e.g., bisexual, pansexual, queer; bi+). 198 bi+ individuals (M age 26.97; 73.1% non-Latinx White) completed a 28-day diary study. Multilevel regression analyses modeled between-person differences in daily affect and alcohol use as a function of relationship status and partner gender. ANCOVAs were conducted to examine differences in within-person fluctuation. Results partially support past findings that relationship involvement may not confer benefits for bi+ people, and that mixed-gender partnerships could be particularly challenging. Future research directions are discussed.

Bisexual+ visibility attempts: Associations with minority stress, affect, and substance use in a daily diary study.

The efforts of bisexual+ people to make their sexual orientation visible are associated with positive and negative outcomes, but little is known about the temporality or directionality of these associations. Using data from a 28-day diary study with 208 bi+ individuals, we found that bi+ visibility attempts were concurrently associated with more positive affect, higher identity affirmation, less depressed/anxious affect, as well as more anti-bisexual experiences and rejection sensitivity. Prospectively, the likelihood of consuming alcohol (but not marijuana) was higher the day after making a visibility attempt, and positive affect was higher the day before making an attempt. Making visibility attempts in contexts that may have been more supportive (e.g., with friends, partners, and lesbian/gay individuals) was associated with more positive outcomes (e.g., more positive affect), while making attempts in contexts that may have been less supportive (e.g., with family, strangers, people who are unaccepting of bi+ identities, and heterosexual people) was associated with more negative outcomes (e.g., higher rejection sensitivity and more discrimination). These findings suggest that the contexts in which visibility attempts are made may play an important role in the impact that bi+ visibility attempts have on stigma-related stress and wellbeing.

The Affective Consequences of Minority Stress Among Bisexual, Pansexual, and Queer (Bi+) Adults: A Daily Diary Study.

Bisexual, pansexual, and queer (bi+) individuals are at increased risk for depression and anxiety. These disparities are hypothesized to be due to the unique, minority-specific stressors that they experience. Prior research supports that bi+ stressors are associated with depression and anxiety, but nearly all studies have been cross-sectional, limiting our understanding of how experiencing bi+ stress influences individuals' levels of depression and anxiety as they occur in their day-to-day lives. To address this gap, we examined the daily associations between bi+ stressors (discrimination, internalized stigma, rejection sensitivity, and identity concealment) and depressed/anxious mood in a 28-day diary study. Participants were 208 bi+ individuals who completed daily measures of bi+ stressors and depressed/anxious mood. We tested unlagged (same-day) and lagged (next-day) associations, and we also tested whether internalized stigma, rejection sensitivity, and identity concealment functioned as mechanisms underlying the daily associations between discrimination and depressed/anxious mood. Participants reported higher depressed/anxious mood on days when they reported higher discrimination, internalized stigma, rejection sensitivity, and identity concealment. There were significant unlagged indirect effects of discrimination on depressed and anxious mood via internalized stigma and rejection sensitivity, and there was also a significant unlagged indirect effect of discrimination on anxiety via identity concealment. However, none of the lagged associations were significant. Results suggest that bi+ stress is related to same-day, but not next-day, depressed/anxious mood. The nonsignificant lagged associations could reflect that bi+ individuals are using adaptive coping skills in response to bi+ stress, or that other experiences throughout the day have stronger influences on next-day mood.

Stability, growth, and inclusiveness: An editorial.

In this editorial, Davila reflects on the principles and goals that guided her as an editor and how they have shaped the direction of the journal these past 6 years. She discusses in detail the topics of stability, growth, and inclusiveness. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Use of different strategies to make one's bisexual+ identity visible: Associations with dimensions of identity, minority stress, and health.

Bisexual+ people (i.e., those who are attracted to more than one gender or regardless of gender) use a variety of strategies to make their identity visible to others, but little is known about the extent to which using different strategies is related to other dimensions of identity, minority stress, and health. To address this, we surveyed 715 bi+ people about their use of five different types of visibility strategies (direct communication, indirect communication, community engagement, gender-based visual displays, and public behavioral displays). Results indicated that people who used visibility strategies more often (aggregated across types) reported higher identity centrality and affirmation, and lower internalized bi-illegitimacy and internalized binegativity. However, they also reported more discrimination from heterosexual and gay/lesbian individuals and higher depression and anxiety. When we examined the unique associations between each of the five types of visibility strategies and our other variables, we found different patterns of associations for different strategies. For example, direct communication was uniquely associated with more discrimination from gay/lesbian individuals, while indirect communication, gender-based visual displays, and public behavioral displays were uniquely associated with more discrimination from heterosexual individuals. Only indirect communication was uniquely associated with higher depression and anxiety, while community engagement was uniquely associated with lower anxiety. Finally, public behavioral displays were uniquely associated with more alcohol use problems and a higher likelihood of cigarette use. These findings highlight the importance of examining the specific strategies that people use to make their bi+ identity visible in order to understand their experiences and health.

Inviting ASPPB to address systemic bias and racism: Reply to Turner et al. (2021).

Turner et al. (2021) subtly relapse in conceptualizing the Examination for Professional Practice in Psychology (Part 2-Skills) exam as a competency evaluation despite Association of State and Provincial Psychology Boards' (ASPPB) prior concession that Part 2 measures only the knowledge of skills (not skill competency). They do not address the purpose of redundant evaluation or the other concerns raised in Callahan et al. (2020). Instead, Turner et al. remain narrowly focused on defense of content validity and a reliance on outdated standards that fail to meet contemporary expectations for assessment of health care professionals. The adopted processes and procedures, albeit time consuming and effortful, are known to be methodologically inadequate. ASPPB's methods demonstrably foster linguistic biases and systemic racism that constricts licensure of diverse individuals as psychologists. Specific suggestions are offered, and ASPPB is urged to take drastic corrective action. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

How, When, and Why do Bisexual+ Individuals Attempt to Make Their Identity Visible?

There is ample evidence of and concern about the invisibility of bisexual+ individuals, which results from the tendency to deny or ignore their identities. Recent research has begun to examine whether and how bisexual+ individuals (an umbrella term that includes all individuals who are attracted to more than one gender, regardless of the specific identity label they use) attempt to make their identity visible to others. This study builds on prior research by exploring novel questions regarding how, when, and why bisexual+ individuals attempt to make their identity visible, using data from an internet survey of 715 individuals who reported attractions to more than one gender. Results indicated that participants were most likely to use bi+ visibility attempt strategies involving indirect forms of communication (e.g., sharing things related to their identity on social media) and direct forms of communication (e.g., telling others in person), though they perceived indirect communication as less successful at communicating their identity to others than direct communication. They were most likely to make bi+ visibility attempts in situations with other bisexual+ individuals or in LGBT contexts, as well as with partners or when single, and they did so for reasons related to a sense of activism or pride. Future directions for research and barriers to bi+ visibility are discussed.

Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action.

COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Adolescent romantic relationships as a tug of war: The interplay of power imbalance and relationship duration in adolescent dating aggression.

The present study investigates the link between power imbalance within the romantic couple and psychological, relational and physical adolescent dating aggression (ADA) perpetration, considering also the role of relationship duration as an indicator of the developmental stage of the relationship. This is the first investigation into whom is perceived to have power in the relationship (the partner or the subject him/herself) by distinguishing between male and female adolescents. Participants were 805 Italian adolescents (36.1% males; 63.9% females) aged 14-20 years (Mage = 17.16 years, SDage = 1.34), all reporting having been in a romantic relationship currently or within the past 6 months. Males perceiving a balanced relationship reported lower levels of psychological ADA perpetration, and they perpetrated more relational ADA in longer relationships where the partner is perceived to have the power. No significant findings emerged regarding physical ADA. Females perceiving themselves as having the power in the relationship reported higher levels of psychological and physical ADA perpetration. They perpetrated more relational ADA when they perceived the partner as having the power in the relationship. Also, females in longer relationships in which power was not perceived as equally shared between partners reported higher physical ADA perpetration. Finally, for both males and females, longer relationships were characterized by higher levels of ADA toward the partner. Findings highlight the importance of studying the interplay between power imbalance and relationship duration on ADA perpetration, and provide the way to understand possible functions of ADA within a romantic relationship.

Gay-Specific and General Stressors Predict Gay Men's Psychological Functioning Over Time.

Gay men experience various stressors, including gay-specific stressors such as discrimination and internalized homonegativity as well as general stressors such as occupational and financial strain. While a robust literature has examined how gay-specific stressors are associated with negative mental health outcomes among gay men, less attention has been paid to the association between general stress and gay men's psychological functioning or to how different types of stressors may interact to affect functioning. The current study sought to address this gap by examining the unique and combined associations between gay-specific external stress (discrimination), gay-specific internal stress (rejection sensitivity, internalized homonegativity, sexual identity concealment), and general stressors (e.g., academic difficulties) and negative affect and alcohol use over time. A total of 147 self-identified gay men living in the greater New York City area participated in a baseline assessment and a 7-week diary study. Univariate and multivariate results revealed that gay-specific external stress, gay-specific internal stress, and general stress were each positively and uniquely associated with higher mean levels of and greater fluctuations in negative affect over time, and general stress was positively associated with greater fluctuations in alcohol use over time. Multiplicative analyses indicated that individuals reporting high levels of stress in multiple domains experienced particularly high mean levels of negative affect. These findings highlight the unique contribution of general stress to gay men's functioning over time and underscore the importance of considering multiple forms of stress (i.e., gay-specific and general stress) and their interactions to better understand gay men's psychological functioning.

The enhanced examination for professional practice in psychology: A viable approach?

Health disciplines have increasingly required competency-based evaluations as a licensure prerequisite. In keeping with this trend, the Association of State and Provincial Psychology Boards (ASPPB) has begun to develop a second part to the Examination for Professional Practice in Psychology (EPPP). The resulting 2-part examination is collectively referred to as the Enhanced EPPP. Part 1 of the Enhanced EPPP, which consists of the current exam, is designed to be an assessment of knowledge. Part 2 of the Enhanced EPPP is newly developed and intended to address the need for a competency-based evaluation. To date, ASPPB has addressed some standard facets of validity for the EPPP Part 2, but not others. In addition, the EPPP Part 2 has yet to be subjected to a broader validation process, in which the suitability of the test for its intended purpose is evaluated. Implementation of the EPPP Part 2 before validation could have negative consequences for those seeking to enter the profession and for the general public (e.g., potential restriction of diversity in the psychology workforce). For jurisdictions implementing the EPPP Part 2, failure to gather and report the evidence required for use of a test in a forensic context may also open the door for legal challenges. We end with suggestions for feasible research that could significantly enhance the validation process for the EPPP Part 2 and offer jurisdictions concrete suggestions of features to look for in determining whether and when to implement the Enhanced EPPP. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Motivations for sexual identity concealment and their associations with mental health among bisexual, pansexual, queer, and fluid (bi+) individuals.

Bisexual and other non-monosexual (bi+) people are at increased risk for depression and anxiety compared to both heterosexual and gay/lesbian people. Bi+ people are also more likely to conceal their sexual orientation than gay/lesbian people are, and concealment is generally associated with negative mental health outcomes. Despite evidence that concealment is a particularly salient stressor for bi+ people, there has been a lack of attention to their motivations for concealment. As such, the goal of the current study was to examine the associations among concealment, motivations for concealment, and depression and generalized anxiety symptoms in a sample of 715 bi+ people who completed an online survey. Nearly half of participants endorsed purposely trying to conceal their bi+ identity in their day-to-day life, and concealment was significantly associated with higher levels of depression and generalized anxiety. Using exploratory factor analysis, we identified two motivations for concealment: intrapersonal motivations (e.g., one's bi+ identity not being a central part of one's overall identity, not being comfortable with being bi+) and interpersonal motivations (e.g., concern about being judged or treated negatively, concern about putting oneself at risk of physical harm). Interpersonal motivations were significantly associated with higher levels of depression and generalized anxiety, whereas intrapersonal motivations were not. In sum, while concealment may generally be associated with negative mental health outcomes, this may only be the case for those who conceal out of concern for discrimination and victimization. These findings highlight the importance of examining bi+ people's motivations for concealing their sexual orientation in order to understand the extent to which they experience negative mental health outcomes.

Early Childhood Psychopathology Prospectively Predicts Social Functioning in Early Adolescence.

Psychopathology in school-age children predicts impairment later in development. However, the long-term psychosocial consequences of early childhood psychopathology are less well known. The current study is the first to prospectively examine how a range of diagnoses and symptoms in early childhood predict psychosocial functioning across specific domains during early adolescence 6-9 years later. A community sample (N = 595; 44.9% female; 88.7% White, 12.6% Hispanic) was assessed for psychopathology at ages 3 and 6 using the Preschool Age Psychiatric Assessment. Diagnoses and dimensional scores for depressive, anxiety, attention-deficit/hyperactivity (ADHD), and oppositional defiant disorders (ODD) were examined. When children were 12 years old, children and parents completed the UCLA Life Stress Interview for Children, a semistructured interview assessing functioning in multiple domains (academic, behavior, close friends, broader peers, maternal relationship, paternal relationship). Having a diagnosis in early childhood predicted greater impairment in all domains in early adolescence, except paternal relationship. Externalizing disorders predicted impairment in more domains than internalizing disorders. Most of the associations between early childhood psychopathology and poorer functioning in adolescence persisted after taking into account adolescent psychopathology. Moreover, the majority of bivariate associations with depressive, ODD, and ADHD symptoms, but not anxiety symptoms, persisted in a subsample of children who did not meet criteria for a diagnosis in early childhood. Early childhood psychopathology has long-lasting deleterious effects on several domains of psychosocial functioning, often beyond the effects of continuing or recurring adolescent psychopathology. Findings thereby highlight the validity and clinical significance of early psychopathology.

Stressful life events moderate the effect of neural reward responsiveness in childhood on depressive symptoms in adolescence.

BACKGROUND: Reward processing deficits have been implicated in the etiology of depression. A blunted reward positivity (RewP), an event-related potential elicited by feedback to monetary gain relative to loss, predicts new onsets and increases in depression symptoms. Etiological models of depression also highlight stressful life events. However, no studies have examined whether stressful life events moderate the effect of the RewP on subsequent depression symptoms. We examined this question during the key developmental transition from childhood to adolescence. METHODS: A community sample of 369 children (mean age of 9) completed a self-report measure of depression symptoms. The RewP to winning v. losing was elicited using a monetary reward task. Three years later, we assessed stressful life events occurring in the year prior to the follow-up. Youth depressive symptoms were rated by the children and their parents at baseline and follow-up. RESULTS: Stressful life events moderated the effect of the RewP on depression symptoms at follow-up such that a blunted RewP predicted higher depression symptoms in individuals with higher levels of stressful life events. This effect was also evident when events that were independent of the youth's behavior were examined separately. CONCLUSIONS: These results suggest that the RewP reflects a vulnerability for depression that is activated by stress.

Best practices in research mentoring in clinical science.

The growth of clinical science as a field depends on the work of engaged mentors nurturing future generations of scientists. Effective research mentoring has been shown to predict positive outcomes, including greater scholarly productivity, reduced attrition, and increased satisfaction with training and/or employment, which ultimately may enhance the quality of the clinical-science research enterprise. Barriers to effective research mentoring, however, pose significant challenges for both mentees and mentors, as well as for labs, training programs, and/or departments. We discuss some key issues as they apply to clinical-science mentoring and note how they are affected across different developmental levels (undergraduate, postbaccalaureate, doctoral, internship, postdoctoral associates, and early career faculty). Although we do not proclaim expertise on these issues-and have struggled with them in our own careers-we believe an open discussion around best mentoring practices will enhance our collective effectiveness and help mentees and our field to flourish. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Moderators of the Association Between Community Connectedness and Internalizing Symptoms Among Gay Men.

Sexual minorities are exposed to various gay-related and general stressors that increase risk of mental and physical health problems. Yet, less attention has been paid to positive factors such as ameliorative coping strategies and social supports that reduce risk of mental health difficulties in this population. The current study sought to address this gap by examining the association between gay community connectedness and internalizing symptoms (i.e., general psychological distress, anxiety, and depression) in a sample of 147 self-identified gay men living in the greater New York City area, as well as the conditions under which gay community connectedness is associated with better mental health. Data were collected between 2013 and 2014. Findings indicated that gay community connectedness was associated with lower levels of internalizing symptoms among gay men, consistent with minority stress theory and other work examining the benefits of community coping resources. This association was strongest for non-White gay men, those whose gay identity was more central to their overall identity, and those with higher levels of femininity. These findings underscore the need to consider multiple aspects of gay men's identity (e.g., race/ethnicity, centrality, femininity) in order to fully understand the factors associated with mental health outcomes in this population.

Development and Validation of a Brief Version of the Anti-Bisexual Experiences Scale.

Experiencing anti-bisexual discrimination has been linked with numerous negative consequences, such as internalized stigma and symptoms of anxiety and depression. A commonly used measure of anti-bisexual discrimination in research is the Anti-Bisexual Experiences Scale (ABES). While this scale has been instrumental in advancing knowledge about discrimination against bisexual individuals, its length presents challenges to widespread use and it remains unknown if its psychometric properties are consistent across diverse genders and non-monosexual identities. To address these limitations, the current study developed and validated a brief version of the ABES. Using confirmatory factor analysis, we reduced the number of items by more than half, while retaining the full measure's associations with other stigma- and identity-related constructs as well as mental health. Invariance testing indicated that the Brief ABES functioned similarly across diverse genders (i.e., cisgender men, cisgender women, and gender minorities) and sexual identities (i.e., bisexual and other non-monosexual identities). These findings provide initial validation of the Brief ABES and demonstrate that it can be used with bisexual and other non-monosexual (e.g., pansexual, queer) individuals, including cisgender and gender minority individuals.