Loneliness in Sexual Minority Individuals in the Southeastern United States: The Role of Minority Stress and Resilience.

Health disparities in the sexual minority population may be exacerbated by the loneliness experienced due to minority stress. Using a minority stress framework, this study examined minority stress, protective variables, and mental health as correlates of loneliness in sexual minority individuals in a small metropolitan area in the southeastern United States. Participants (n = 273) were a subsample of sexual minority individuals from a broader sample of LGBTQ adults in the Central Savannah River area who completed a health needs assessment. Bivariate correlations were calculated to assess for degree of significant relationships between loneliness and barriers to health care, minority stress, and mental health. Hierarchical linear regression was conducted to examine the relative importance of the study variables' associations with loneliness. A multiple regression model found household income, assault victimization, depressive symptoms, and sense of community to be significant correlates of loneliness. Interventions to decrease loneliness in this population will need to consider these interconnected, multi-level influences.

Differences in Health Care Access, Utilization, and Experiences Among LGBTQ+ Subgroups in the Southern United States.

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals experience health inequities and barriers to accessing appropriate, affirming care. Little is known about differing health care experiences within the LGBTQ+ population, particularly among individuals living in underserved areas. This study explored health care experiences and utilization among LGBTQ+ subgroups: lesbian and gay cisgender individuals (n = 258), bisexual+ cisgender individuals (n = 71), and transgender and gender-diverse individuals (n = 80). Participants were recruited from a geographic region in South Carolina and Georgia and completed an online survey regarding negative health care experiences, barriers to care, and utilization of different health care venues and services. Results revealed significant differences between LGBTQ+ subgroups, with transgender and gender-diverse participants reporting more discriminatory experiences and greater barriers to care. Bisexual+ cisgender individuals also experienced some disparities compared with lesbian and gay cisgender individuals. Most participants endorsed a need for more competent providers. Findings and recommendations are considered within the context of the Southeastern United States for addressing access and utilization disparities among LGBTQ+ communities.

Predictors of anxiety among sexual minority individuals in the Southern US.

Sexual minority individuals experience a disproportionate burden of mental health issues, particularly in less populous cities of the southern United States. Unique identity-related stressors may explain these disparities. The current study examines relationships between sexual minority stress, identity, and anxiety in sexual minority individuals from a small metropolitan area of the South. Sexual minority individuals (N = 249) from the Central Savannah River Area completed a survey assessing minority stress (i.e., identity-based discrimination, internalized homophobia), identity (i.e., outness comfort, community connectedness) and history of anxiety as part of a larger lesbian, gay, bisexual, transsexual, queer community health needs assessment. All minority stress variables were significantly, positively associated with an anxiety history whereas community connectedness was significantly, negatively associated with anxiety history at the bivariate level. A multiple logistic regression model revealed that assault history was significantly associated with increased odds of anxiety history, whereas community connectedness was associated with decreased odds of anxiety history. These results demonstrate an influence of discriminatory experiences on anxiety in sexual minority individuals of the South and the protective value of community connectedness. Providers and advocates should work at the individual, community, and systemic levels to eliminate lesbian, gay, bisexual discrimination and facilitate community involvement, thereby reducing mental health disparities. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Mental Health Correlates of Cigarette Use in LGBT Individuals in the Southeastern United States.

BACKGROUND: Smoking prevalence for lesbian, gay, bisexual, and transgender (LGBT) individuals is higher than for heterosexual, cisgender individuals. Elevated smoking rates have been linked to psychiatric comorbidities, substance use, poverty, low education levels, and stress. OBJECTIVES: This study examined mental health (MH) correlates of cigarette use in LGBT individuals residing in a metropolitan area in the southeastern United States. METHODS: Participants were 335 individuals from an LGBT health needs assessment (mean age 34.7; SD = 13.5; 63% gay/lesbian; 66% Caucasian; 81% cisgender). Demographics, current/past psychiatric diagnoses, number of poor MH days in the last 30, the Patient Health Questionnaire (PHQ) 2 depression screener, the Three-Item Loneliness Scale, and frequency of cigarette use were included. Analyses included bivariate correlations, analysis of variance (ANOVA), and regression. RESULTS: Multiple demographic and MH factors were associated with smoker status and frequency of smoking. A logistic regression indicated that lower education and bipolar disorder were most strongly associated with being a smoker. For smokers, a hierarchical regression model including demographic and MH variables accounted for 17.6% of the variance in frequency of cigarette use. Only education, bipolar disorder, and the number of poor MH days were significant contributors in the overall model. Conclusions/Importance: Less education, bipolar disorder, and recurrent poor MH increase LGBT vulnerability to cigarette use. Access to LGBT-competent MH providers who can address culturally specific factors in tobacco cessation is crucial to reducing this health disparities.

Fitness, Sleep-Disordered Breathing, Symptoms of Depression, and Cognition in Inactive Overweight Children: Mediation Models.

OBJECTIVES: We used mediation models to examine the mechanisms underlying the relationships among physical fitness, sleep-disordered breathing (SDB), symptoms of depression, and cognitive functioning. METHODS: We conducted a cross-sectional secondary analysis of the cohorts involved in the 2003-2006 project PLAY (a trial of the effects of aerobic exercise on health and cognition) and the 2008-2011 SMART study (a trial of the effects of exercise on cognition). A total of 397 inactive overweight children aged 7-11 received a fitness test, standardized cognitive test (Cognitive Assessment System, yielding Planning, Attention, Simultaneous, Successive, and Full Scale scores), and depression questionnaire. Parents completed a Pediatric Sleep Questionnaire. We used bootstrapped mediation analyses to test whether SDB mediated the relationship between fitness and depression and whether SDB and depression mediated the relationship between fitness and cognition. RESULTS: Fitness was negatively associated with depression ( B = -0.041; 95% CI, -0.06 to -0.02) and SDB ( B = -0.005; 95% CI, -0.01 to -0.001). SDB was positively associated with depression ( B = 0.99; 95% CI, 0.32 to 1.67) after controlling for fitness. The relationship between fitness and depression was mediated by SDB (indirect effect = -0.005; 95% CI, -0.01 to -0.0004). The relationship between fitness and the attention component of cognition was independently mediated by SDB (indirect effect = 0.058; 95% CI, 0.004 to 0.13) and depression (indirect effect = -0.071; 95% CI, -0.01 to -0.17). CONCLUSIONS: SDB mediates the relationship between fitness and depression, and SDB and depression separately mediate the relationship between fitness and the attention component of cognition.

The Child PTSD Symptom Scale: An Investigation of Its Psychometric Properties.

The current study addresses the need for accurate measurement of posttraumatic stress disorder (PTSD) symptoms in youth by investigating the psychometric properties of the Child PTSD Symptom Scale (CPSS). The factor structure, reliability, and concurrent and discriminant validity of the CPSS were investigated in a sample of 206 6th- to 12th-grade adolescents. Exploratory and confirmatory factor analysis supported a single-factor structure, which was contrary to the hypothesized three-factor structure. Scores comprising this one-factor structure were also associated with high reliability (α = .93), and tests of concurrent and discriminant validity were also strong. The implications of these findings are discussed, with particular emphasis on future directions for research on self-report measures for adolescent PTSD symptoms.

Measuring social desirability across language and sex: A comparison of Marlowe-Crowne Social Desirability Scale factor structures in English and Mandarin Chinese in Malaysia.

Malaysia is a Southeast Asian country in which multiple languages are prominently spoken, including English and Mandarin Chinese. As psychological science continues to develop within Malaysia, there is a need for psychometrically sound instruments that measure psychological phenomena in multiple languages. For example, assessment tools for measuring social desirability could be a useful addition in psychological assessments and research studies in a Malaysian context. This study examined the psychometric performance of the English and Mandarin Chinese versions of the Marlowe-Crowne Social Desirability Scale when used in Malaysia. Two hundred and eighty-three students (64% female; 83% Chinese, 9% Indian) from two college campuses completed the Marlowe-Crowne Social Desirability Scale in their language of choice (i.e., English or Mandarin Chinese). Proposed factor structures were compared with confirmatory factor analysis, and multiple indicators-multiple causes models were used to examine measurement invariance across language and sex. Factor analyses supported a two-factor structure (i.e., Attribution and Denial) for the measure. Invariance tests revealed the scale was invariant by sex, indicating that social desirability can be interpreted similarly across sex. The scale was partially invariant by language version, with some non-invariance observed within the Denial factor. Non-invariance may be related to differences in the English and Mandarin Chinese languages, as well as cultural differences. Directions for further research include examining the measurement of social desirability in other contexts where both English and Mandarin Chinese are spoken (i.e., China) and further examining the causes of non-invariance on specific items.

Assessment of Meaning in Adolescents Receiving Clinical Services in Mississippi Following the Deepwater Horizon Oil Spill: An Application of the Purpose in Life Test-Short Form (PIL-SF).

OBJECTIVES: This study's purpose was to assess perceived meaning in adolescents. Specifically, our goals were to examine the psychometric properties of the Purpose in Life test-Short Form (PIL-SF) and its ability to predict psychological outcomes in an adolescent sample. METHOD: Aspects of well-being (self-efficacy, life satisfaction, and resilience) and psychological distress (posttraumatic stress, depression, anxiety, and general stress) were assessed in a sample of adolescents (N = 91; 58.2% female; mean age = 14.89) receiving clinical services following the Deepwater Horizon Oil Spill. RESULTS: Meaning was positively associated with life satisfaction, self-efficacy, and resilience, and negatively associated with posttraumatic stress and depression. Meaning was not significantly related to anxiety or general stress. Females reported significantly more meaning than males, while no significant differences were noted by race/ethnicity. CONCLUSIONS: The PIL-SF is a useful measure with adolescents. Moreover, meaning is an important concept to consider with respect to disasters.

The Deepwater Horizon Oil Spill and the Mississippi Gulf Coast: Mental health in the context of a technological disaster.

A significant percentage of disaster survivors experience negative psychological, physical, and social outcomes after a disaster. The current study advances the literature concerning the Deepwater Horizon Oil Spill (the Gulf Oil Spill) while addressing weaknesses of previous research. The current study includes a clinical sample of 1,119 adults receiving mental health services in the coastal counties of Mississippi after the Gulf Oil Spill. The levels of clinical symptoms reported on the Depression Anxiety Stress Scales (DASS-21) and PTSD Checklist (PCL-S) were examined in relation to other domains of functioning potentially affected by the spill (finances, social relationships, and physical health). Participants reported substantial worsening of their functioning across each life domain. Furthermore, chronic problems in living related to the Gulf Oil Spill were significantly associated with higher levels of psychological distress, although the pattern differed somewhat for persons living above and below the poverty line, with lower income individuals reporting a higher level of overall distress. These data support the perspective that the experience of the Gulf Oil Spill is strongly associated with a deleterious effect on mental health symptoms.

The Development and Psychometric Investigation of the Cyberbullying Scale.

Accurate assessment of cyberbullying is essential for intervention planning and evaluation. Limitations to many currently available self-report measures of cyberbullying victimization include a lack of psychometric information and a limited scope (i.e., not assessing multiple electronic mediums of cybervictimization). To address these limitations, we developed and investigated the psychometric properties of a broad self-report measure of cyberbullying, the Cyberbullying Scale (CBS). We examined the factor structure and reliability of the CBS across 736 students in Grades 6 to 12 in six Northern Mississippi schools. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) results indicated that the structure of the CBS was best represented by a one-factor model. The finding of a single-factor structure suggests that cyberbullying is a unidimensional construct, which is consistent with previous research. In the current sample, the CBS demonstrated strong psychometric properties, including excellent internal consistency (Cronbach's α = .94) and significant positive correlations with related constructs of anxiety, depression, and loneliness. Results from the present study provide initial support for the CBS as a measure of cybervictimization among adolescents.

Prevalence and sociodemographic correlates of lifetime substance use among a rural and diverse sample of adolescents.

BACKGROUND: Data are limited regarding the prevalence of substance use among adolescents in rural and ethnically diverse communities. This study examined rates and sociodemographic correlates of lifetime substance use among adolescents in Mississippi, a rural state that is the poorest in the country (21.3% poverty rate) and has the largest proportion of African Americans per capita (36.3%). METHODS: Participants in this cross-sectional study were 6349 adolescents (6th through 12th grade) who reported on lifetime tobacco, alcohol, marijuana, cocaine, inhalant, hallucinogen, and methamphetamine use. RESULTS: Lifetime smoking (10.2% to 44.5%), alcohol (23.2% to 72.0%), and marijuana use (7.9% to 39.2%) increased steadily when comparing students in 6th to 12th grade. Substances with more serious abuse potential (cocaine [6.7% to 11.1%], inhalants [12.2% to 17.9%], hallucinogens [4.4% to 12.1%], and methamphetamine [3.0% to 6.7%]) displayed more modest increases across grade. Adolescents who classified their race/ethnicity as "Other" (i.e., not white, black/African American, Asian, or Hispanic/Latino/Latina) demonstrated more than 2-fold increased likelihood of methamphetamine use (odds ratio [OR] = 2.42), and increased risk for use of any illicit substance (OR = 1.49). In general, males demonstrated an increased risk for use across substances (OR = 1.15-1.94), and higher income was associated with a decreased likelihood of illicit substance use (OR = 0.51-0.67). Living in a more populated area was associated with an increased likelihood of alcohol (OR = 1.43), marijuana (OR = 2.11), and cocaine use (OR = 2.06), and use of any illicit substance (OR = 1.54). CONCLUSIONS: Mississippi adolescents reported higher rates of lifetime cocaine, inhalant, hallucinogen, and methamphetamine use across all grade levels compared with national surveys. Male gender, low income, and residence in more populated areas were associated with increased use of several substances. Findings demonstrate the need for prevention and intervention programs targeting impoverished rural and ethnically diverse communities.

The Loneliness Questionnaire-Short Version: an evaluation of reverse-worded and non-reverse-worded items via item response theory.

Although reverse-worded items have often been incorporated in scale construction to minimize the effects of acquiescent reporting biases, some researchers have more recently begun questioning this approach and wondering whether the advantages associated with incorporating reverse-worded items is worth the complexities that they bring to measures (e.g., Brown, 2003 ; Marsh, 1996 ). In this study, we used item response theory (IRT) to determine whether there is statistical justification to eliminate the reverse-worded items (e.g., "I have lots of friends") from the Loneliness Questionnaire (LQ; Asher, Hymel, & Renshaw, 1984) and retain only the non-reverse-worded items (e.g., "I'm lonely") to inform the provision of a shortened LQ version. Using a large sample of children (Grades 2-7; n = 6,784) and adolescents (Grades 8-12; n = 4,941), we examined the psychometric properties of the 24-item LQ and found support for retaining the 9 non-reverse-worded LQ items to make up a shortened measure of loneliness in youth. We found that the non-reverse-worded items were associated with superior psychometric properties relative to the reverse-worded items with respect to reliability and IRT parameters (e.g., discrimination and item information). A 3-point Likert-type scale was also found to be more suitable for measuring loneliness across both children and adolescents compared to the original 5-point scale. The relative contributions of reverse-worded and non-reverse-worded items in scale development for youth instruments are also discussed.

The importance of modeling method effects: resolving the (uni)dimensionality of the loneliness questionnaire.

This study sought to resolve the dimensionality of the Loneliness Questionnaire (LQ; Asher, Hymel, & Renshaw, 1984) by applying recommended confirmatory factor analytic procedures that control for method effects (Brown, 2003). This study was needed given that inconsistent findings have been reported recently regarding the structure of this instrument (Bagner, Storch, & Roberti, 2004) and all models to date have not accounted for method effects due to the non-reversed-worded and reversed-worded items of this instrument. Using a large sample of youth in Grades 2 through 12 (N = 11,725), we compared the previously reported 1- and 2-factor models with a newly posited 1-factor model that incorporated correlated error terms to account for method effects. We found that the 1-factor model that included correlated error terms fit the data best, and that this factor structure evidenced measurement invariance across boys and girls in childhood, but not in adolescence. The meaning of the LQ indicators was also consistent for boys across development, but evidenced differences for girls in childhood versus adolescence. More generally, it was demonstrated that modeling method effects is vital to accurately understanding the dimensionality of loneliness when reversed-worded and non-reversed-worded items are used as indicators. The measurement and clinical implications of these findings are discussed.