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1.
Death Stud ; : 1-10, 2024 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-38185986

RESUMO

The Life Attitudes Schedule-Short Form (LAS-SF) is a measure of suicide proneness featuring various conceptual models. We tested four competing LAS-SF factor structures, as well as construct validity with mental health and suicide metrics. Community dwelling adults (N = 488) completed an online cross-sectional survey. Results supported a four factor (i.e., death-related, health-related, injury-related, and self-related subscales) LAS-SF structure with one higher order factor. Death-related, injury-related, and self-related subscales demonstrated moderate positive associations with mental health and suicidal ideation. Death-related and self-related subscales showed links with suicidal ideation, as well as suicide and depression risk (controlling for other factors). This study is important in highlighting suicide proneness theory may need to be refined. LAS-SF uses include possible risk screening in clinical settings and future focus on the psychological death aspects of the LAS-SF in prospective research. Study limitations include lack of sample diversity and cross-sectional design.

2.
J Pers Assess ; 106(2): 254-266, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37315196

RESUMO

Entrapment and defeat are empirically-supported suicide risk factors. Their measurement is the subject of some debate, however. Also, limited work exists examining sexual and gender minority (SGM) differences in these suicide risk factors despite overall elevated rates of suicidal thoughts and behaviors (STBs) for SGM persons. The present study examined (1) entrapment and defeat differences by sexual orientation and gender identity, (2) factor structure and criterion validity of the Entrapment Scale (E-Scale) and the Defeat Scale (D-Scale), and (3) measurement invariance by sexual orientation (subsamples were too small for gender identity). A sample of 1,027 adults living in the United Kingdom completed a cross-sectional online questionnaire assessing mental health. Analysis of Variance and Kruskal-Wallis testing revealed: (1) all sexual minority (i.e., gay/lesbian, bisexual, and other SM) persons reported higher internal and external entrapment, defeat, and suicidal ideation compared to their heterosexual counterparts, and; (2) gender minority (i.e., transgender and gender diverse) persons reported higher internal and external entrapment, defeat, and suicidal ideation compared to cisgender persons. Supported by suicide theory, confirmatory factor analysis showed modest support for a two-factor E-Scale (internal and external), and a one-factor D-Scale. All entrapment and defeat scores displayed significant moderate positive correlations with suicidal ideation. E- and D-scale scores displayed high intercorrelation, tempering confidence in conclusions regarding the facture structure findings. Item threshold-level responding varied by sexual orientation for the D-Scale but not the E-Scale. Results are discussed with respect to suicide theory and measurement, public health, and clinical practice.


Assuntos
Identidade de Gênero , Suicídio , Adulto , Humanos , Feminino , Masculino , Estudos Transversais , Ideação Suicida , Suicídio/psicologia , Reino Unido
3.
BMC Psychiatry ; 23(1): 904, 2023 12 05.
Artigo em Inglês | MEDLINE | ID: mdl-38053122

RESUMO

BACKGROUND: Suicide is a pressing matter for the military. Not only does it pose a health risk, but suicide also compromises operational readiness. Despite provision of suicide prevention clinical best practices, the Department of Defense suffers several challenges (e.g., clinician shortages) limiting the agency's ability to effectively respond to service member suicide. Implementation of evidence-based suicide-specific group therapy is a possible solution to service member well-being needs and system challenges. Service members can also gain coping skills useful beyond managing suicidal thoughts and behaviors. METHODS: This 2-arm non-inferiority randomized controlled trial compares a group therapy format of Brief Cognitive Behavioral Therapy (i.e., G-BCBT) with Dialectical Behavior Therapy (DBT) Skills Group. Both therapies are delivered in-person at a United States Naval Medical Center. Participants (N = 136) are active-duty service members with recent suicidal thoughts or suicidal behavior. Evaluation features electronically delivered questionnaires at baseline, after each treatment session, and at 3- and 6-month follow-up. DISCUSSION: The primary outcome concerns G-BCBT impacts on suicidal ideation. Secondary outcomes of interest are suicide attempt, psychological distress (e.g., symptoms of depression, anxiety), and self-regulatory skills (e.g., emotion regulation). We also examine self-regulatory skills as treatment moderators. Clinical trial strengths and limitations are reviewed. TRIAL REGISTRATION: This study was registered at Clinicaltrials.gov (protocol NCT05401838).


Assuntos
Terapia Cognitivo-Comportamental , Terapia do Comportamento Dialético , Militares , Humanos , Prevenção do Suicídio , Militares/psicologia , Terapia Cognitivo-Comportamental/métodos , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/psicologia , Ideação Suicida , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
Soc Psychiatry Psychiatr Epidemiol ; 57(1): 195-205, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34106286

RESUMO

PURPOSE: Suicidal thoughts and behaviors (STBs) remain a pressing public health problem for transgender and gender diverse (TGD) persons. The goal of this study was to apply social-ecological and minority stress frameworks to identify individual and interpersonal-level TGD-specific STB risk and protective factors. METHODS: This is a secondary analysis of the 2015 United States Transgender Health Survey, a comprehensive cross-sectional health assessment of a national sample of TGD adults (N = 27,658). Chi-square and Analysis of Variance (ANOVA) were used to identify bivariate correlates of 12-month and lifetime suicidal ideation (SI) and suicide attempt (SA). Logistic regression was employed to identify the strongest STB risk and protective factors across levels. RESULTS: Sexual minority identification, racial minority identification, and having a disability were lifetime STB risk factors. TGD identity, sexual minority identification, racial minority identification (SA only), lower education, lower income, military experience, having a disability, and being uninsured were 12-month STB risk factors. Psychological distress was the most robust STB risk factor. Workplace discrimination, family rejection, healthcare discrimination, and childhood bias-based victimization were lifetime STB risk factors. All forms of discrimination and victimization (with the exception of family rejection for SI) were 12-month STB risk factors. Family and coworker support were protective factors for lifetime SA (but not SI) and all 12-month STBs. Being less out about TGD identity was a protective factor for STBs (except for 12-month SI). CONCLUSION: Findings support social-ecological and minority stress STB risk frameworks. Recommendations are provided for a comprehensive approach to TGD suicide prevention.


Assuntos
Ideação Suicida , Pessoas Transgênero , Adulto , Criança , Estudos Transversais , Minorias Étnicas e Raciais , Identidade de Gênero , Humanos , Estados Unidos/epidemiologia
5.
Law Hum Behav ; 46(3): 227-243, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35113608

RESUMO

OBJECTIVE: We developed the Self-Injury Risk Assessment Protocol for Corrections (SIRAP-C) to meet legal mandates for self-directed violence (SDV) risk assessment standards in correctional settings. We focused on two empirical aims: (1) factor structure and internal consistency and (2) subscale associations with SDV and intervention recommendation outcomes. HYPOTHESES: We expected a multifactorial SIRAP-C structure with acceptable internal consistency. We further expected SIRAP-C subscales would distinguish history of SDV events while incarcerated, current SDV event category, and treatment recommendation. METHOD: We drew electronic health record data for adult incarcerated persons (N = 3,929) from state Division of Prisons records from 2016 to 2020. Clinical records included demographic and correctional institutional information, as well as SIRAP-C records. Factor analyses assessed Aim 1. Regression models tested Aim 2. RESULTS: Factor analyses supported a seven-factor SIRAP-C structure (27 items) comprising Depressive Symptoms, Reasons for Living, History of Self-Directed Violence, Current Suicidal Thinking, Family History of Self-Directed Violence, Coping Skills, and Social Connectedness. Subscales displayed acceptable internal consistency, with the exception of social connectedness in the confirmatory factor analysis subsample. Lower depressive symptoms and coping skills, as well as higher history of SDV, were associated with increased risk for a prior SDV assessment event while incarcerated. Lower depressive symptoms, current suicidal thinking, and coping skills and higher history of SDV marked worse risk for self-injurious behavior. Higher depressive symptoms and current suicidal thinking, as well as lower reasons for living, demarcated suicidal acts from self-injury. Higher history of SDV and lower coping skills indicated outpatient/residential treatment. Elevated depressive symptoms and history of SDV, as well as lower reasons for living and coping skills, were associated with inpatient hospitalization. CONCLUSIONS: The SIRAP-C represents a promising clinical approach advancing correctional SDV risk assessment. We offer future research, policy, and implementation recommendations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Comportamento Autodestrutivo , Adulto , Análise Fatorial , Humanos , Medição de Risco , Comportamento Autodestrutivo/diagnóstico , Ideação Suicida , Violência
6.
Mil Psychol ; 34(2): 237-251, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-38536295

RESUMO

US military Veterans are at greater risk for suicide than those who have never served in the US military. Recent federal calls include the need to investigate military-specific suicide risk and protective factors among military-affiliated populations. To date, no study has examined the link between military identity, self-stigma, and suicide risk. The current study used a nationally representative sample of post-Vietnam US military Veterans (N = 1,461) in order to determine relationships between military identity, self-stigma, and suicide risk. Idealism (OR = 0.86) with less odds of elevated suicide risk, whereas individualism (OR = 1.15) and military self-stigma (OR = 1.39) were associated with increased odds of elevated suicide risk. Military self-stigma was found to mediate the relationship between military identity components and suicide risk. Implications for conceptualization of military Veteran identity, suicide prevention, and future research are discussed.

7.
Curr Psychol ; : 1-11, 2022 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-35990200

RESUMO

The Hate Crime Beliefs Scale (HCBS) is an assessment of attitudes about hate crime laws, offenders, and victims. The original HCBS includes four subscales (negative beliefs, offender punishment, deterrence, and victim harm), while a shortened and modified version from the United Kingdom (UK; HCBS-UK) consists of three subscales (denial, sentencing, and compassion). We conducted a psychometric test of the HCBS in order to identify a best fitting structure with possible item reduction. A total of 463 participants completed the original HCBS, measures of social dominance orientation (SDO) and right-wing authoritarianism (RWA), and demographic questions. Factor analyses revealed good fit of the data for a Hate Crime Beliefs Scale-Short Form (HCBS-SF), largely modeled after the HCBS-UK. The three subscales were: denial (i.e., downplaying hate crime severity and low support for hate crime laws), sentencing (i.e., support for more punitive offender punishment), and compassion (i.e., understanding and concern for victims). All subscales possessed acceptable internal consistency. The denial subscale was positively associated with RWA subscale and SDO scores. The sentencing and compassion subscales were significantly negatively correlated with SDO and RWA subscale scores. Republicans held the least supportive views of hate crime laws, concern for victims, and punishment of offenders. Data underscore the importance of evaluating hate crime beliefs in public opinion and other contexts. The HCBS-SF better captures hate crime related attitudes than the previously developed longer version of the HCBS.

8.
BMC Public Health ; 21(1): 1918, 2021 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-34686175

RESUMO

BACKGROUND: Social capital, the potential for individuals to access resources through group memberships, is linked to a constellation of health outcomes. We modified a previously evaluated Constructed Family Social Capital Scale for gay, bisexual and other men who have sex with men who belong to constructed families to create a new measure of social capital within sexual minority men and gender minority individuals' social networks. METHODS: Participants were recruited from a Pride festival in Milwaukee, Wisconsin in 2018 to complete a cross-sectional survey. This analysis is restricted to 383 participants who identified as sexual minority men or gender minority individuals and completed nine items measuring social capital within their social networks. We conducted exploratory and confirmatory factor analyses to assess factor structure. Internal consistency was measured using Cronbach's alpha. RESULTS: Reliability was high, indicating the scale's utility to assess Network Social Capital among sexual minority men and gender minority individuals. A single-factor solution with high factor loadings was found for the nine-item scale. CONCLUSIONS: This study extended the psychometric properties of a preliminary social capital instrument modified from a prior study in a different population and context. The modified measure has implications for use among sexual minority men and gender minority individuals to measure social capital within social networks. Previous studies suggest that interventions to enhance social capital among sexual minority men and gender minority individuals may be beneficial for HIV prevention interventions. This tool may be relevant for the evaluation of social capital interventions within networks of sexual minority men and gender minority individuals.


Assuntos
Minorias Sexuais e de Gênero , Capital Social , Estudos Transversais , Homossexualidade Masculina , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Comportamento Sexual , Inquéritos e Questionários
9.
Aggress Behav ; 47(3): 343-353, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33586166

RESUMO

Sexual violence victimization is a prevalent public health concern. However, little research has investigated the factors linking sexual violence victimization to suicidal thoughts and behaviors (STBs). The current study tested the applicability of the psychological mediation framework, a coping-mental health model, for the prevention of STBs among victims of sexual youviolence. Furthermore, the current study explored whether sexual orientation moderated the progression from sexual violence victimization to STBs. Data were drawn from an online survey of victimization experiences and health (N = 2175). Bootstrap mediation tested whether the association of sexual violence victimization and STBs was mediated by emotion regulation strategies (cognitive reappraisal and expressive suppression) and psychopathology (anxiety, depression, and posttraumatic stress disorder). Multiple-groups analysis tested whether links within the mediation effects varied by sexual orientation. Bivariate findings showed that: (1) sexual minority persons were more likely to report sexual violence victimization and (2) cognitive reappraisal was more meaningfully associated with mental health among sexual minority persons. Sexual violence victimization was associated with STBs via a serial mediation through emotion regulation and psychopathology. The association between psychopathology and STBs was stronger among sexual minority compared with heterosexual respondents. Physical violence victimization was associated with STBs for heterosexual but not sexual minority persons in a follow-up model. Findings support an emotion regulation-mental health framework for the prevention of suicide among victims of sexual violence. Research and training implications are discussed.


Assuntos
Vítimas de Crime , Delitos Sexuais , Suicídio , Adaptação Psicológica , Feminino , Humanos , Masculino , Saúde Mental
10.
Health Promot Pract ; 22(4): 475-490, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-32698700

RESUMO

Disparities in the health services delivered to sexual and gender minority (SGM) individuals are widespread across health service disciplines. Many health service providers do not have the knowledge, comfort, or skills necessary to provide health services to SGM individuals. The objective of the current systematic review was to review the correlates of competency (defined as knowledge, attitude, and skill) that health service providers possess for working with SGM individuals. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was utilized to guide search and reporting strategies. PsycInfo/PsycArticles, PubMed/Medline, and Google Scholar databases were searched to find studies that addressed health service providers' competency working with SGM individuals. There were 31 studies included in the review. Approximately half of the studies utilized the full definition of competency (knowledge, attitude, and skill). The most common competency assessed was knowledge, and the least common was skill. The majority of the studies addressed health service providers in the social sciences. Health service education needs to emphasize competency working with SGM individuals. Of particular importance is developing skill sets, as many providers reported that they did not have the skills necessary to provide culturally competent health services to SGM individuals.


Assuntos
Minorias Sexuais e de Gênero , Atitude , Identidade de Gênero , Humanos , Comportamento Sexual
11.
Int Q Community Health Educ ; : 272684X211004685, 2021 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-33745397

RESUMO

The purpose of this study was to implement and assess an educational intervention for nursing students pertaining to perinatal depression (PD) screening and treatment. A single group (n = 59), repeated-measures design (i.e., pre- and post-intervention assessments) was used to assess the impact of an online intervention. Demographics, Theory of Planned Behavior constructs, intention to screen and treat PD, and PD-related knowledge were tested. The intervention resulted in positive gains in PD-related perceived behavioral control (PBC), attitudes, subjective norms, knowledge, intention to screen and treat PD, and perceived importance of screening and treating PD from pre- to post-intervention. PBC demonstrated a small-to-moderate positive association with perceived importance of screening and treating PD at post-intervention. Results from the current study suggest that the PD online educational intervention is effective in improving participants' PD-related PBC, attitudes, subjective norms, knowledge, and intention to screen and treat PD.

12.
Death Stud ; 44(6): 338-346, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30628858

RESUMO

This study assessed the unique explanatory power of denial of disordered eating in understanding non-suicidal self-injury (NSSI) and suicidality. Undergraduate women (N = 360) completed an online survey about NSSI, suicide risk, disordered eating behaviors, and denial of disordered eating. Denial of disordered eating was associated with NSSI and suicidality above and beyond engagement in disordered eating alone and demographic covariates. This study provided support that denial of disordered eating behaviors assists in understanding risk for NSSI and suicidality. Campus programing might include psychoeducation about the negative consequences of denial and emphasize the importance of disclosure to trusted confidants.


Assuntos
Autoavaliação Diagnóstica , Transtornos da Alimentação e da Ingestão de Alimentos , Comportamento Autodestrutivo , Estudantes , Adolescente , Adulto , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Masculino , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Universidades , Adulto Jovem
13.
J Trauma Dissociation ; 21(4): 484-504, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584707

RESUMO

Many of the more than 1 million military veterans who identify as lesbian, gay, bisexual, and/or transgender (LGBT) have encountered "rejecting experiences in the military" and stigma from prior "Don't Ask Don't Tell" policies. Associated minority stress and social isolation have been linked to a disproportionate risk for depression and suicide, as well as a reluctance to seek medical care at Veterans Health Administration (VHA) facilities. This paper describes feasibility and preliminary outcomes of the newly developed, Pride in All Who Served Health Education Group created to meet the unique needs of sexual and gender minority veterans. The 10-week, closed, health education group (e.g., continuums of identity, military culture) enables open dialogue, fosters social connectedness, and empowers veterans to be more effective self-advocates within the healthcare system. Feedback from formative evaluations (n = 29 LGBT veterans and n = 25 VHA stakeholders) was incorporated before conducting a small scale, non-randomized pilot. Preliminary pre-post surveys (n = 18) show promise (i.e., Cohen's d range ± 0.40 to 1.59) on mental health symptoms (depression/anxiety, suicidal ideation), resilience indicators (identity affirmation, community involvement, problem-focused coping), and willingness to access care within the VA system (satisfaction with VA services, perception of staff competence). Results suggest that the 10-week Pride Group may be an effective tool for addressing minority-related stress in LGBT veterans. A full-scale, randomized clinical trial of this intervention is needed to determine short and long-term impacts on clinical and healthcare access-related outcomes.


Assuntos
Educação em Saúde/organização & administração , Minorias Sexuais e de Gênero/psicologia , Veteranos , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Estados Unidos
14.
Mil Psychol ; 32(3): 261-272, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-38536326

RESUMO

Active duty military service members endure a unique constellation of stressors while deployed or at home. Yet, assessment of protective factors against these stressors among active duty service members represents an under studied area. The present study advances the assessment of protective factors through the psychometric evaluation of the Coping Self-Efficacy Scale (CSES) in a clinical sample of military service members in mental health or substance abuse treatment (n = 200). Cross-sectional data were drawn from military medical records and a supplemental self-report questionnaire. Data extracted included demographic (e.g., sex, age), military characteristics (e.g., rank, years in service), physical health and mental health (e.g., anxiety, depression), and coping self-efficacy. Findings suggest a 3-factor (i.e., problem-focused coping, thought-stopping, and getting social support) CSES structure with acceptable internal consistency. Further, there were small-to-moderate associations with physical and mental health outcomes, providing evidence of construct validity. There were few significant associations with military-related characteristics. Finally, controlling for covariates, thought-stopping beliefs explained unique variance in suicide-related behaviors. Together, findings support the use of the CSES to measure coping-related beliefs in military service members. Recommendations are offered for future research and practice with active duty service members.

15.
Arch Womens Ment Health ; 22(1): 25-36, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29968128

RESUMO

Postpartum depression affects approximately 11% of women. However, screening for perinatal mood and anxiety disorders (PMAD) is rare and inconsistent among healthcare professionals. When healthcare professionals screen, they often rely on clinical judgment, rather than validated screening tools. The objective of the current study is to review the types and effectiveness of interventions for healthcare professionals that have been used to increase the number of women screened and referred for PMAD. Preferred Reporting Items for Systematic Reviews and Meta-Analyses was utilized to guide search and reporting strategies. PubMed/Medline, PsychInfo/PsychArticles, Cumulative Index to Nursing, Allied Health Literature (CINAHL), and Health Source: Nursing/Academic Edition databases were used to find studies that implemented an intervention for healthcare professionals to increase screening and referral for PMAD. Twenty-five studies were included in the review. Based on prior quality assessment tools, the quality of each article was assessed using an assessment tool created by the authors. The four main outcome variables were the following: percentage of women screened, percentage of women referred for services, percentage of women screened positive for PMAD, and provider knowledge, attitudes, and/or skills concerning PMAD. The most common intervention type was educational, with others including changes in electronic medical records and standardized patients for training. Study quality and target audience varied among the studies. Interventions demonstrated moderate positive impacts on screening completion rates, referral rates for PMAD, and patient-provider communication. Studies suggested positive receptivity to screening protocols by mothers and providers. Given the prevalence and negative impacts of PMAD on mothers and children, further interventions to improve screening and referral are needed.


Assuntos
Transtornos de Ansiedade/diagnóstico , Transtornos do Humor/diagnóstico , Assistência Perinatal/métodos , Gestantes/psicologia , Depressão Pós-Parto/diagnóstico , Feminino , Pessoal de Saúde/normas , Humanos , Programas de Rastreamento/psicologia , Gravidez , Encaminhamento e Consulta
16.
Community Ment Health J ; 55(2): 257-266, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30074117

RESUMO

The present study evaluates of a competency-based suicide prevention training. A sample of community mental healthcare providers took part in a suicide risk assessment and prevention training, completing pre-post measures of knowledge, competency/skill and attitudes, as well as baseline interprofessional education (IPE) socialization. Training yielded moderate-to-large improvements in suicide-related knowledge, perceived risk assessment/prevention skills, attitudes toward helping patients, and professional capacity to work with suicidal patients. Small pre-post differences were observed recognizing the need for additional training. IPE socialization moderated impacts on professional capacity. This study offers support for the promising impacts of competency-based and IPE-specific training.


Assuntos
Competência Clínica , Agentes Comunitários de Saúde/educação , Educação Baseada em Competências/métodos , Conhecimentos, Atitudes e Prática em Saúde , Suicídio , Adulto , Atitude do Pessoal de Saúde , Agentes Comunitários de Saúde/psicologia , Centros Comunitários de Saúde Mental , Feminino , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-Idade , Medição de Risco , Inquéritos e Questionários
17.
J Healthc Manag ; 64(3): 157-166, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31999265

RESUMO

EXECUTIVE SUMMARY: Workplace violence in healthcare is a health and safety problem that can have a significant impact on the mission and effectiveness of organizations. To ascertain hospital approaches to address violence and experiences with guns and other weapons, we conducted a survey of International Association for Healthcare Security & Safety members. Although many hospitals have enhanced their security programs, many challenges persist. We found that armed security appears to be increasingly prevalent in hospitals, and the use of Tasers appears to be increasing the most in comparison to other weapons. Most of our survey respondents did not perceive officers losing control of their weapons during altercations in their healthcare facility as a real risk. In addition, roughly half of the respondents reported that portable metal detectors (including wands) were not used in their facilities. The disposition of weapons confiscated by security also raised concerns about how legally owned firearms can be safely returned to their owners while they are still on hospital property.


Assuntos
Serviço Hospitalar de Emergência , Armas , Violência no Trabalho , Estudos Transversais , Inquéritos e Questionários , Estados Unidos , United States Occupational Safety and Health Administration
18.
J Sport Rehabil ; 28(5): 476-480, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-29584525

RESUMO

Context: The modified Disablement in the Physically Active scale (mDPA) has become a commonly utilized patient-reported outcome instrument for physically active patients. However, the factor structure of this instrument has not been verified in individuals with chronic ankle instability (CAI). Furthermore, additional evidence examining the mDPA in individuals with CAI is warranted. Objective: The purpose of this study was to verify the factor structure of the mDPA and compare the physical summary component (PSC) and mental summary component (MSC) in those with and without CAI. Design: Cross-sectional. Setting: Laboratory. Participants: A total of 118 CAI and 81 healthy controls from a convenience sample participated. Intervention: Not applicable. Main Outcome Measures: All subjects completed the 16-item mDPA that included the PSC and MSC; higher scores represent greater disablement. To examine the model fit of the mDPA, a single-factor and 2-factor (PSC and MSC) structures were tested. Group differences were examined with independent t tests (P ≤ .05) and Hedges' g effect sizes (ESs). Results: Model fit indices showed the 2-factor structure to possess adequate fit to the data, χ2(101) = 275.58, P < .001, comparative-fit index = .91, root mean square error of approximation = .09 (95% confidence interval [CI], .08-.11), and standardized root mean square residual = .06. All items loaded significantly and in expected directions on respective subscales (λ range = .59-.87, all Ps < .001). The CAI group reported greater disablement as indicated from PSC (CAI: 11.45 [8.30] and healthy: 0.62 [1.80], P < .001, ES = 1.67; 95% CI, 1.33-1.99) and MSC (CAI: 1.75 [2.58] and healthy: 0.58 [1.46], P < .001, ES = 0.53; 95% CI, 0.24-0.82) scores. Conclusions: The 2-factor structure of the mDPA was verified. Individuals with CAI reported greater disablement on the PSC compared with healthy controls. The moderate ES on the MSC between groups warrants further investigation. Overall, these results indicate the mDPA is a generic patient-reported outcome instrument that can be utilized with individuals who have CAI.


Assuntos
Traumatismos do Tornozelo/fisiopatologia , Avaliação da Deficiência , Instabilidade Articular/fisiopatologia , Avaliação de Resultados em Cuidados de Saúde , Adolescente , Adulto , Doença Crônica , Estudos Transversais , Feminino , Humanos , Masculino , Qualidade de Vida
19.
Arch Sex Behav ; 47(4): 1251-1264, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29274018

RESUMO

The present study contributes to a growing body of literature developing psychometrically and theoretically grounded measures of sexual orientation minority identity. We tested psychometric properties and construct validity of a 27-item measure, the Lesbian, Gay, and Bisexual Identity Scale (LGBIS). The sample consisted of 475 adult (178 male, 237 female, 16 male-to-female, 14 female-to-male, and 30 gender queer persons) members of a special interest group, the National Coalition for Sexual Freedom. Participants completed a health needs questionnaire. Prominent findings included (1) confirmatory factor-analytic, internal consistency, and inter-correlation patterns support two LGBIS factor structures; (2) men, compared primarily to women, reported elevated scores on Acceptance Concerns, Concealment Motivation, Difficulty Process, and Negative Identity; (3) queer-identifying persons tended to report low Concealment Motivation, and high Identity Affirmation and Identity Centrality scores; (4) experimenting/fluid-identifying individuals tended toward higher Identity Uncertainty and Negative Identity, and lower Identity Centrality scores; (5) LGB community involvement was negatively associated with Concealment Motivation, Identity Uncertainty, and Negative Identity, and positively associated with Identity Superiority, Identity Affirmation, and Identity Centrality scores; and (6) Acceptance Concerns, Identity Uncertainty, and Internalized Homonegativity displayed significant positive associations with such mental health symptoms as general anxiety and posttraumatic stress. The LGBIS represents a useful approach to evaluating sexual orientation minority identity. Implications for identity theory, research, and practice are provided.


Assuntos
Minorias Sexuais e de Gênero , Inquéritos e Questionários , Adulto , Bissexualidade , Feminino , Identidade de Gênero , Homossexualidade , Humanos , Masculino , Saúde Mental , Psicometria , Autoimagem , Transexualidade
20.
Soc Psychiatry Psychiatr Epidemiol ; 53(11): 1253-1263, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30003311

RESUMO

PURPOSE: Public health and criminal justice stalking victimization data collection efforts are plagued by subjective definitions and lack of known psychosocial correlates. The present study assesses the question of stalking victimization prevalence among three groups. Psychosocial risk and protective factors associated with stalking victimization experiences were assessed. METHODS: Archival data (n = 2159) were drawn from a three-sample (i.e., U.S. nationwide sexual diversity special interest group, college student, and general population adult) cross-sectional survey of victimization, sexuality, and health. RESULTS: The range of endorsement of stalking-related victimization experiences was 13.0-47.9%. Reported perpetrators were both commonly known and unknown persons to the victim. Participants disclosed the victimization primarily to nobody or a family member/friend. Bivariate correlates of stalking victimization were female gender, Associates/Bachelor-level education, bisexual or other sexual orientation minority status, hypertension, diabetes, older age, higher weekly drug use, elevated trait aggression, higher cognitive reappraisal skills, lower rape myth acceptance, and elevated psychiatric symptoms. Logistic regression results showed the strongest factors in identifying elevated stalking victimization risk were: older age, elevated aggression, higher cognitive reappraisal skills, lesser low self-control, increased symptoms of suicidality and PTSD re-experiencing, and female and other gender minority status. CONCLUSIONS: Behavioral approaches to epidemiological and criminal justice stalking victimization are recommended. Victimization under reporting to healthcare and legal professionals were observed. Further research and prevention programming is needed to capitalize on data concerning personality and coping skills, sexual diversity, and trauma-related psychiatric symptoms.


Assuntos
Vítimas de Crime/estatística & dados numéricos , Revelação , Perseguição/epidemiologia , Estudantes/psicologia , Adolescente , Adulto , Agressão , Vítimas de Crime/psicologia , Estudos Transversais , Feminino , Amigos , Humanos , Modelos Logísticos , Masculino , Prevalência , Minorias Sexuais e de Gênero/psicologia , Perseguição/psicologia , Estados Unidos/epidemiologia
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