The Mental Health Costs of Online Heterosexism Among LGBTQ+ Individuals: Development and Initial Validation of the Perceived Online Heterosexism Scale.

Experiences of heterosexism are rampant online, where bias and harassment against LGBTQ+ individuals spread conveniently and widely. Yet, research has been limited in understanding the exposure to online heterosexism among LGBTQ+ individuals partly due to the lack of a quantitative measure to advance this research. Thus, the current study developed and examined the psychometric properties of the Perceived Online Heterosexism Scale (POHS). Items were developed via a literature review, a survey of social media platforms, and an expert review. Exploratory (N = 288) and confirmatory (N = 653) factor analyses yielded a 4-factor structure and produced a 20-item scale with the following subscales: (1) Heterosexist Cyberaggression (4 items), (2) Online Heterosexist Stereotyping (4 items), (3) Online Exposure to Systemic Heterosexism (8 items), and (4) Heterosexist Online Media (four items). Internal consistency estimates ranged from .91 to .96, and the POHS accounted for 65.9% of the variance. Examination of a second-order model suggested that a total scale score can also be used. Initial construct validity was evidenced as POHS scores were associated with an existing heterosexism measure, anxiety and depressive symptoms, internalized heterosexism, and LGBTQ+ community connectedness in line with theory and empirical evidence. Implications for research practice are discussed.

COVID-19 anti-Asian racism, perceived burdensomeness, thwarted belongingness, and suicidal ideation among Asian American Emerging Adults.

Since the start of the COVID-19 pandemic, there has been a significant surge in COVID-19 related anti-Asian racism and hate crimes. Given the ostracising and dehumanising narrative of COVID-19 related anti-Asian hate, we examined whether COVID-19 anti-Asian racism would be associated with suicidal ideation through increased thwarted belongingness and perceived burdensomeness among Asian American emerging adults. With data from 139 participants (Mage = 23.04), we conducted a path analysis of COVID-19 anti-Asian racism (four items) predicting suicidal ideation (item nine; Patient Health Questionnaire-9) via perceived burdensomeness and thwarted belongingness (Interpersonal Needs Questionnaire). COVID-19 anti-Asian racism significantly predicted suicidal ideation. The indirect effect through perceived burdensomeness was significant but not through thwarted belongingness; greater COVID-19 anti-Asian racism was associated with greater perceived burdensomeness, which in turn was associated with greater suicidal ideation. The significance of perceived burdensomeness was substantiated given the non-significant direct effect. The results suggest that the ongoing COVID-19 anti-Asian racism may be an alarming risk factor for suicidal ideation for Asian American emerging adults.

Profiles of online racism exposure and mental health among Asian, Black, and Latinx emerging adults in the United States.

Online racism is a digital social determinant to health inequity and an acute and widespread public health problem. To explore the heterogeneity of online racism exposure within and across race, we latent class modelled this construct among Asian (n = 310), Black (n = 306), and Latinx (n = 163) emerging adults in the United States and analysed key demographic and psychosocial health correlates. We observed Low and Mediated Exposure classes across all racial groups, whereas High Exposure classes appeared among Asian and Black people and the Systemic Exposure classes emerged uniquely in Asian and Latinx people. Generally, the High Exposure classes reported the greatest psychological distress and unjust views of society compared to all other classes. The Mediated and Systemic Exposure classes reported greater mental health costs than the Low Exposure classes. Asian women were more likely to be in the Mediated Exposure class compared to the Low Exposure class, whereas Black women were more likely to be in the Mediated Exposure class compared to both High and Low Exposure classes. About a third of each racial group belonged to the Low Exposure classes. Our findings highlight the multidimensionality of online racism exposure and identify hidden yet divergently risky subgroups. Research implications include examination of class membership chronicity and change over time, online exposure to intersecting oppressions, and additional antecedents and health consequences of diverse forms of online racism exposure.

Resisting and countering online racial hate: Antiracism advocacy and coping online with racism as moderators of distress associated with online racism.

The emerging literature highlights online racism (e.g., racist online interactions, exposure to racially traumatizing content) as a contemporary stressor among racially/ethnically minoritized adults. Thus, identifying factors that can help buffer the harmful impact of online racism are imperative. We examined engagement in antiracism advocacy and online coping as moderators that can potentially buffer the link between online racism and psychological distress. Using data from 395 racially/ethnically diverse adults (Mage = 34.12, SD = 11.19), we conducted latent moderated structural equation modeling to test individual and institutional antiracism advocacy, and online coping as moderators in the link between online racism and psychological distress. Individual antiracism advocacy was not a significant moderator. Both institutional antiracism advocacy and online coping were significant moderators. For both variables, the link between online racism and psychological distress was not significant at 1 SD below the mean but was significant at the mean and 1 SD above the mean. Thus, distress associated with online racism was not significant among those engaging in low levels of institutional antiracism advocacy and online coping but mean to high levels of institutional antiracism advocacy and online coping did not appear to be protective against distress. Implications for advancing the research on coping with online racism are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Gendered racism, family and external shame, depressive symptoms, and alcohol use severity among Asian American men.

OBJECTIVE: We investigated whether gendered racism predicts depressive symptoms and alcohol use severity among Asian American men (AAM) through indirect relations via culture-specific family and external shame. METHOD: We analyzed convenience data from 409 AAM. Sample age (M = 21.24), nativity, ethnicity, education, income, and self-reported social class were diverse and controlled for. We path modeled direct associations among gendered racism and depressive symptoms and alcohol use severity, and their indirect (mediated) associations through family and external shame. RESULTS: About 21% and 25% of the sample met the clinical cutoffs for depressive symptoms and risky alcohol use, respectively. Gendered racism predicted depressive symptoms indirectly via external shame, and predicted alcohol use severity directly and indirectly via family shame. The hypothesized model fits the data better than an alternative model with shame factors as predictors. CONCLUSION: Gendered racism is an insidious psychiatric risk factor for AAM and appears to exacerbate family and external shame, which may subsequently and divergently increase depressive symptoms and alcohol use severity. Findings highlight the role of cultural factors within gendered racism-related stress processes among AAM. Future research should consider longitudinal designs and additional mediating and outcome variables to examine the behavioral health sequelae of gendered racism among AAM. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Witnessing racism against racial minority individuals online and loneliness among White emerging adults: Anti-racism advocacy as a moderator.

Extant literature suggests that racism is associated with difficult emotional reactions and feelings of social disconnect among White individuals. These feelings of social disconnect may be particularly salient in today's digital era in which racism against racial minority individuals is conveniently and frequently witnessed via online platforms. Thus, we examined whether witnessing racism online may be associated with feelings of loneliness among White emerging adults. We also tested whether anti-racism advocacy buffered loneliness given its potential for relationship building and community organizing to promote racial justice and equity. Using data from 227 White emerging adults (Mage = 20.86, SD = 4.82), we conducted a latent moderated structural equation modeling to test individual and institutional anti-racism advocacy as moderators in the link between witnessing racism online (racial victimization of racial minority individuals in online interactions and online content on cultural devaluation/systemic racism against racial minority individuals) and loneliness. Greater exposure to online content on systemic racism and cultural devaluation of racial minority groups significantly predicted greater loneliness. Engagement in individual anti-racism advocacy (mean to high levels) buffered this link. White allies must engage in anti-racism practice to address racism in our society, and our findings advance our understanding of the associated psychosocial costs. Implications for research and practice are discussed.

Second-generation Asian American women's gendered racial socialization.

Utilizing an intersectional framework (Crenshaw, 1989) and socioecological theory (Bronfenbrenner, 1979), we investigated the gendered racialized messages Asian American women receive growing up, otherwise known as gendered racial socialization, from their family, peers, and mass media. Consensual Qualitative Research was used to analyze interview data from 12 second-generation Asian American women. The results demonstrated that (a) family socialization messages included gendered racial discrimination, body image and physical appearance, marital/dating attitudes, role responsibilities and expectations, and academic/work expectations, (b) peer socialization included oppressive messages (e.g., physical objectification, denial of identity, lack of presence) and affirming messages (e.g., positive self-concept messages), and (c) mass media socialization included oppressive messages (e.g., lack of representation, stereotypical depictions), and affirming messages (e.g., messages about empowerment). These messages impacted Asian American women's views on their body image and physical appearance, self-esteem, career/work, mental health, and critical consciousness. Implications and findings of the need to dismantle interlocking oppressive forces are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Center effects, therapist effects, and international student clients' drop out from psychotherapy.

In 2019-2020, 1,075,496 international students pursued higher education in the United States. Many of these students endure unique experiences of psychological distress that accompanies their shared experience of studying abroad in the United States. Researchers have explored clinical experiences within this diverse group, with some suggesting that international students are at greater risk than students from the United States for dropping out of psychotherapy. This issue is underexplored in the extant psychotherapy literature. Therefore, we used a large, national data set and multilevel analyses to test if international students are more likely than students from the United States to drop out of psychotherapy, defined in this study as failure to attend one's last scheduled session. Data from 65,293 clients (n = 3,970 international students), 2,735 therapists, and 131 university/college counseling centers were included in the analysis. Results revealed that (a) international students are no more likely to drop out than United States domestic students, (b) on average, centers (ICC = 0.045) and therapists (ICC = 0.071) are differentially effective at preventing drop out, and (c) therapist effects on drop out differ for international students. We discuss these findings with respect to therapist and center roles in international students' drop out from treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Therapist and counseling center effects on international students' counseling outcome: A mixed methods study.

We employed a convergent mixed methods design to examine therapist and counseling center effects on international student clients' (ISCs) counseling outcomes. Using the Center for Collegiate Mental Health (CCMH) data set (2015-2017), we conducted a three-level hierarchical linear model with clients (N = 85,110) nested in therapists (N = 1,267), and therapists nested in counseling centers (N = 111), with clients' international status predicting distress (DI) in their last sessions while controlling for initial DI. Compared to domestic students, the average last session DI was significantly higher among ISCs. Random effects were significant, suggesting that some therapists and centers were more effective in their work with ISCs than others. When the proportion of ISCs seen was accounted into the model, we found a cross-level interaction in which the last session DI differences between ISCs and domestic students were significant for centers seeing a small percentage of ISCs but not for centers with large percentages of ISCs in the caseload. Grounded theory analysis of qualitative data from 11 therapists with international backgrounds revealed therapist and center factors that converged with our quantitative findings. Participants reported adhering to general clinical frameworks when working with ISCs given the lack of training on international competence (which may help explain the effectiveness gap), but also noted nuanced culturally-informed components that likely contribute to more effectively working with ISCs. Findings around center effects were complemented by qualitative results emphasizing systemic representation and engagement with diversity, creative outreach efforts, and administrative/leadership support. Implications for practice and research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Benefits and harms of social media use: A latent profile analysis of emerging adults.

The rise in social media use among emerging adults in the United States has been well-documented, but researchers are still working on identifying how the type-not just the frequency-of use impacts psychological well-being. We identified "profiles" of social media use among young adults based on the frequency and purposes of use, and examined their associations with benefits and harms to psychosocial well-being, using data from 2828 incoming undergraduate students (M age = 18.29 years; age range: 17 to 25 years). Using Latent Profile Analysis, we identified three unique profiles of individuals who used social media with varying levels of intensity across different purposes: Active Users (32.4%), Passive Users (25.3%), and Average Users (42.4%). Each profile was associated with varying levels of beneficial and harmful psychosocial outcomes. Compared to Average Users, (a) Active Users reported significantly better psychosocial well-being, but also more harmful outcomes; and (b) Passive Users experienced significantly lower levels of perceived social media benefits and social connectedness, while also reporting less problematic social media use and social media stress. Implications of these findings for research and practice are discussed.

Do therapists improve in their ability to assess clients' satisfaction? A truth and bias model.

We used the truth and bias model to examine changes in tracking accuracy and under/overestimation (directional bias) on therapists' judgments about clients' satisfaction. We examined 3 factors of clinical experience that could moderate accuracy: (a) overall level of acquaintanceship with a client, operationalized as treatment length (i.e., less or more time seeing a client), (b) time point in therapy with a specific client, operationalized as session number (i.e., earlier or later in treatment with a client), and (c) order (1st client seen, 2nd client seen . . . last client seen across two years of training in a psychology clinic) in which clients were seen. We conducted a three-level hierarchical linear modeling using data on 6054 sessions, nested in 284 adult clients, nested in 41 doctoral student therapists providing open-ended psychodynamic individual psychotherapy. We found that therapists were able to accurately track client-rated session evaluations with less underestimation (i.e., lower tendency to estimate that clients were less satisfied than they actually were) as they gained experience (both treatment length and client order). Furthermore, therapists exhibited greater tracking accuracy gains over the span of shorter treatments and when working with clients earlier in their clinical training. In longer treatments and with clients seen later in training, tracking accuracy was stable and consistent. Implications for research and practice are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Social justice interdependence among students in counseling psychology training programs: Group actor-partner interdependence model of social justice attitudes, training program norms, advocacy intentions, and peer relationships.

Counseling psychologists have voiced the importance of nurturing social justice principles in the training of psychologists to better meet diverse people's psychological and social needs. Much of the research on training, however, has been focused on individual factors (e.g., self-efficacy, spirituality). Little empirical evidence exists on the mutual support among students and the role of shared social justice principles in counseling psychology training programs. Thus, we used the group actor-partner interdependence model (GAPIM) to test whether the advocacy intentions of a given student in the program (actor) would be related to the actor's and partner's (other students' aggregate scores in the program) social justice attitudes and perceptions of social justice norms in the training program (social justice norms among students and faculty). Peer relationship was also tested as a moderator of the associations. Structural equation modeling was used to test a series of GAPIMs with data from 178 doctoral students across 19 American Psychological Association accredited counseling psychology Ph.D. programs. Other students' collective attitudes and perceptions of the training program were stronger positive indicators of an individual student's advocacy intentions than actor variables (individual-level attitudes and perceptions). At the individual level, only actor social justice attitudes were significantly related to intentions with very small effect. Peer relationship was a significant moderator such that students in programs with closer peer relationships, who collectively perceived higher social justice norms, reported greater advocacy intentions. Implications for research and training are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The effectiveness of helping skills training for undergraduate students: Changes in ethnocultural empathy.

Using the Scale of Ethnocultural Empathy, we examined pre-post changes in empathy directed toward people from different racial/ethnic cultural groups than one's own for 189 undergraduate students from 20 sections of helping skills classes. We hypothesized that racial minority students and women would score higher than their respective counterparts in ethnocultural empathy at the beginning of the semester. We also expected that White students would grow more than racial minority students in ethnocultural empathy by the end of the semester. Using latent growth modeling, we found that racial minority women tended to report significantly higher initial levels than racial minority men and White students on all dimensions of ethnocultural empathy. In addition, race predicted ethnocultural empathy changes by the end of the semester, such that White women and men on average showed (a) more growth on the Empathic Feeling and Expression subscale than did racial minority women and men and (b) more growth on the Empathic Perspective Taking subscale than did racial minority women. Findings suggest that helping skills training may be particularly effective for helping White students gain empathic understanding and expression for individuals from different racial/ethnic backgrounds. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Group- and individual-level self-stigma reductions in promoting psychological help-seeking attitudes among college students in helping skills courses.

To promote psychological help-seeking, researchers have studied interventions to reduce self-stigma, a personally held belief that seeking psychological help would make one undesirable and socially unacceptable. We examined the differential impact of individual- and group-level changes in self-stigma on psychological help-seeking attitudes using data from 189 college students nested within 20 sections of a semester-long helping skills lab groups. We applied multi-level polynomial regression and response surface analysis to determine whether discrepancy between pre- and posttest self-stigma scores (i.e., reduction in self-stigma) predicted change in attitudes at the individual- and section-levels. Individual reduction in self-stigma did not predict psychological help-seeking attitudes but students who maintained consistently low to moderate levels of self-stigma throughout the course developed significantly more positive attitude toward psychological help-seeking. On the other hand, we found that greater section level reductions in self-stigma significantly predicted more positive psychological help-seeking attitudes, suggesting potential importance of group norm changes and effects in modifications of individual attitudes. Implications for research and stigma reduction strategies are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Gendered Racial Microaggressions Scale for Asian American Women: Development and initial validation.

Asian American women's (AAW's) mental health issues have received growing public attention; recent statistics suggest alarmingly high suicide rates among AAW. Yet, little research has examined the nuanced oppression that AAW face and the daily effects of compounded racism and sexism contributing to their mental health issues. Applying the intersectionality and microaggressions framework, we developed the Gendered Racial Microaggressions Scale for Asian American Women (GRMSAAW) using data collected from 564 AAW. Items were developed via literature review, focus group, and expert review. Exploratory (N = 304) and confirmatory (N = 260) factor analyses suggested a 4-factor structure and produced 22-item scales of frequency and stress appraisal with the following subscales: (a) Ascription of Submissiveness, (b) Assumption of Universal Appearance, (c) Asian Fetishism, and (d) Media Invalidation. Internal consistency estimates were .80 and above for frequency and stress appraisal scales, and the scales accounted for 52% and 60% of variance, respectively. Examination of a bifactor model containing one general factor and four group factors suggested that GRMSAAW could be represented unidimensionally (total scale score) for the purpose of applied measurement. Initial construct validity was established as GRMSAAW scores were associated with sexism, racial microaggressions, depressive symptoms, and internalized racism in ways consistent with theory. Implications for research and practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Practice recommendations for addressing racism: A content analysis of the counseling psychology literature.

Although racism persists as a significant public health issue that adversely impacts the mental health of people of color (U.S. Department of Health and Human Service, 2001), there has been very little systematic guidance for mental health professionals to address racism through practice (S. Harrell, 2000). Therefore, we conducted a content analysis of the peer reviewed counseling psychology literature-the first of its kind-to provide a summary and critique of the extant practice recommendations and facilitate the development and enhancement of practice efforts aimed at addressing racism. We reviewed racism-related articles published in the Journal of Counseling Psychology, The Counseling Psychologist, and Counseling Psychology Quarterly and identified 73 relevant articles, of which 51 provided practice recommendations. Based on our review of this literature, we identified eight general categories of recommendations for addressing racism: psychoeducation, validation, self-awareness and critical consciousness, critical examination of privilege and racial attitudes, culturally responsive social support, developing positive identity, externalize/minimize self-blame, and outreach and advocacy. We found that most recommendations within each category were at the individual level with far fewer at the group and systemic level. A critique of recommendations is provided along with suggestions for developing and bolstering practice, research, and consultation efforts aimed at addressing racism. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Racism in digital era: Development and initial validation of the Perceived Online Racism Scale (PORS v1.0).

The purpose of this study was to develop the Perceived Online Racism Scale (PORS) to assess perceived online racist interpersonal interactions and exposure to online racist content among people of color. Items were developed through a multistage process involving a comprehensive literature review, focus-groups, qualitative data collection, and survey of online racism experiences. Based on a sample of 1,023 racial minority participants, exploratory and confirmatory factor analyses provided support for a 30-item bifactor model accounted by the general factor and the following 3 specific factors: (a) personal experience of racial cyber-aggression, (b) vicarious exposure to racial cyber-aggression, and (c) online-mediated exposure to racist reality. The PORS demonstrated measurement invariance across racial/ethnic groups in our sample. Internal reliability estimates for the total and subscale scores of the PORS were above .88 and the 4-week test-retest reliability was adequate. Limitations and future directions for research are discussed. (PsycINFO Database Record

Moving beyond the binary with disordered eating research: a test and extension of objectification theory with bisexual women.

In predicting disordered eating, the core model of objectification theory (Fredrickson & Roberts, 1997) has been replicated and extended in research across most sexual minority groups (e.g., Haines et al., 2008; Wiseman & Moradi, 2010), but not bisexual women. The present study tested the tenets of objectification theory with a sample of 316 bisexual women and further extended this theory by examining the roles of 2 minority stressors-antibisexual discrimination and internalized biphobia-that are contextually salient for bisexual women. A latent variable structural equation model was conducted, and the model yielded a good fit to the data. Antibisexual discrimination and internalized biphobia (but not sexual objectification experiences) yielded significant unique links with internalization of sociocultural standards of attractiveness (internalization of CSA). Next, internalization of CSA yielded a significant unique link with body surveillance. In addition, antibisexual discrimination, internalization of CSA, and body surveillance yielded significant unique links with body shame. Finally, sexual objectification experiences, internalization of CSA, and body shame yielded significant unique links with eating disorder symptomatology. Beyond the direct relations, antibisexual discrimination yielded significant positive indirect links with body surveillance, body shame, and eating disorder symptoms. Internalization of CSA yielded significant positive indirect links with body shame and eating disorder symptoms. Lastly, body surveillance yielded a significant positive indirect link with eating disorder symptoms. Implications for research and practice with bisexual women are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

National trends of suicidality 1999-2020 among Asian American Pacific Islander young adults across sex.

This study analyzes 21 years of suicide trend among Asian American Pacific Islander (AAPI) young adults aged 18-25. Analyzing NCHS data (1999-2020) through the Joinpoint Regression, we examined temporal trends of suicide death across sexes and identified trend shifts. Findings indicate a significant and steady increasing trend in AAPI female suicides from 1999 to 2020. Alarmingly, AAPI males displayed a significant and sharp increasing trend of suicide from 2008 onwards. It is important to consider other risk factors of suicide, including cultural factors and gendered racial experiences, to understand the context of AAPI young adults' suicide patterns.

Racial Hate at the Intersection of Online and Offline Worlds: The Joint Impact of Online and Offline Racism on the Mental Health of Racially Minoritized Individuals.

With the everyday influence of social media and online platforms, racially minoritized individuals face the risk of experiencing racial discrimination in both offline and online contexts. Yet, there is scant research on how online and offline racism could jointly impact the mental health of racially minoritized individuals. Thus, the study examined online racism as a moderator in the link between offline racism and mental health issues. Using data from 651 racially minoritized emerging adults (Mage = 22.15, SD = 3.39), a moderation analysis was conducted using the PROCESS macro with bias-corrected bootstrapping (10,000 resamples). Experiencing more offline racism was significantly associated with greater mental health issues. Online racism was a significant moderator in the link between offline racism and mental health issues. The link between offline racism and mental health issues was not significant at low levels of online racism. However, the link was significant and strengthened at mean to high levels of online racism. The results suggest complex interactions in understanding the compounding impact of online and offline racism on mental health costs among racially minoritized individuals. Implications for future research on understanding the interplay between online and offline racism are discussed.