Stigma, Self-Care, and Intuitive Eating in Black Americans with Type 2 Diabetes.

Type 2 diabetes is prevalent among Black Americans. Stigma associated with type 2 diabetes, both in general and specific to weight, is damaging to self-care, which is crucial for the effective management of diabetes. Family relationships may buffer the negative impact of stress, especially among Black Americans who have historically relied on informal support networks. Our goal was to investigate how type 2 diabetes stigma (H1) and weight stigma (H2) were related to self-care and intuitive eating - a non-restrictive approach to nutrition; H3 predicted that family relationship satisfaction would moderate the relationships predicted in H1 and H2. Black Americans diagnosed with type 2 diabetes (N = 225) were recruited via Qualtrics panels to complete an online survey of self-report measures. We used multiple linear regression to test our hypotheses. Both chronic illness and weight stigma were related as predicted to one subscale of intuitive eating (eating for physical hunger). Our moderation analyses revealed that family relationship satisfaction was protective against the harms of stigma at moderate to high levels. Intuitive eating is a promising non-restrictive treatment option for type 2 diabetes.

Moral injury in post-9/11 combat-experienced military veterans: A qualitative thematic analysis.

War zone exposure is associated with enduring negative mental health effects and poorer responses to treatment, in part because this type of trauma can entail crises of conscience or moral injury. Although a great deal of attention has been paid to posttraumatic stress disorder and fear-based physiological aspects of trauma and suffering, comparatively less attention has been given to the morally injurious dimension of trauma. Robust themes of moral injury were identified in interviews with 26 post-9/11 military veterans. Thematic analysis identified 12 themes that were subsumed under four categories reflecting changes, shifts, or ruptures in worldview, meaning making, identity, and relationships. Moral injury is a unique and challenging clinical construct with impacts on the individual as well as at every level of the social ecological system. Recommendations are offered for addressing moral injury in a military population; implications for community public health are noted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Psychometric Properties of the Brief Resilience Scale Among Alternative Sexuality Community Members.

Assessing resilience among alternative sexuality (alt-sex; e.g., kink, polyamory) community members is imperative as alt-sex individuals often face discrimination and possess intersecting marginalized identities. The Brief Resilience Scale (BRS) has extensive psychometric support; however, prior research indicates both a one- and two-factor (i.e., succumbing and resilience) structure. Further, the psychometric properties of the BRS have not been examined among alt-sex community members. As such, the current study examined the BRS factor structure among alt-sex individuals and measurement invariance across demographic groups (i.e., sexual orientation, gender identity, and sexual assault history). Confirmatory factor analyses and multi-groups invariance analyses were conducted. The two-factor BRS model demonstrated better fit to the data. Model fit did not differ by sexual orientation or gender identity. Measurement invariance was observed by lifetime sexual assault history, with higher factor loadings on succumbing items among alt-sex community members with a lifetime history of sexual assault. Our findings support use of the BRS to measure resilience among alt-sex individuals. Succumbing, or weakened resilience, is a salient factor for alt-sex community members who are sexual assault survivors, warranting further attention.

Uncertainty Management in Online Sexual Health Forums.

Sexual health is critical to overall well-being, yet it is challenging and uncomfortable to discuss. Individuals frequently encounter uncertainty about their sexual health as they experience bodily changes, navigate romantic or sexual relationships, and explore their identities. In this study, we called on uncertainty management theory to guide an investigation of sexual health uncertainty. Specifically, we asked how people use social support to manage their sexual health uncertainty in online forums. Grounded theory analyses revealed that negative emotions, avoidance, and pursuing medical care prompted people to seek emotional and informational support online, and support served three functions: integrating information, assessing risk, and strategizing communication. The results point to stigma as a driving force in sexual health discussions online and imply practical recommendations for sexual education, communication about sexual topics, and patient-provider relationships.

Memorable Messages About Fat Bodies Before, During, and After Pregnancy.

Weight bias is prevalent for people in large bodies who are trying to conceive, pregnant, or postpartum. Using the theory of memorable messages as a framework, we explored the sources, valence, and content of messages that fat individuals (N = 237) recalled about their bodies before pregnancy through the postpartum stage. The most common source of memorable messages was healthcare providers, and most (77.2%) messages were negatively valenced. Thematic analysis revealed four overarching themes (fat mothers are bad mothers, denial of competent treatment, weight-normative commentary on fat bodies, and weight-inclusive counter-narratives). Our findings illuminate the significance of patient-practitioner communication across the pregnancy trajectory and highlight how counter-narratives can disrupt negative messages about fat pregnancy.

Military couples' experiences in the aftermath of a cancelled deployment.

Deployment requires considerable preparation for military families and changes to these plans may create notable stress. The current study leveraged data from a sample of military couples who experienced the cancellation of an overseas deployment to learn more about their experiences as they adjusted to this change. Guided by family stress and anticipatory stress perspectives, we analyzed qualitative data from 28 service members and their significant others (i.e., spouses or cohabitating partners) to understand their overall reactions to the deployment cancellation. We identified three overall reactions (positive, negative, and ambivalent) that were based on participants' appraisals of-and preparations for-deployment, as well as ambiguity about family roles and relationships. Further, participants across groups experienced uncertainty about whether or not the deployment would occur, and altered timelines for other life events. Together, our findings highlight the post-cancellation period as a significant time of stress and transition for military families. However, our findings also signify the need to help all military families cope with uncertainty about when or if deployments will occur given that the military's priorities are often in flux. We therefore describe coping efforts that may be particularly adaptive for families to engage in as they prepare for uncertain, anticipated stressors.

La comisión militar exige una preparación considerable para las familias de militares, y los cambios en estos planes pueden generar bastante estrés. En el presente estudio se utilizaron datos de una muestra de parejas de militares a quienes se les suspendió una comisión fuera del país para averiguar más acerca de sus experiencias mientras se adaptaban a este cambio. Guiados por las perspectivas de estrés familiar y de estrés anticipatorio, analizamos datos cualitativos de 28 miembros del servicio militar y sus parejas (p. ej.: cónyuges o concubinos) para comprender sus reacciones generales a la suspensión de la comisión militar. Identificamos tres reacciones generales (positiva, negativa y ambivalente) que se basaron en las apreciaciones de la comisión y en los preparativos para esta que hicieron los participantes, así como en la ambigüedad acerca de los roles y las relaciones familiares. Además, los participantes de los distintos grupos sintieron incertidumbre acerca de si se produciría o no la comisión y cambiaron programas por otros acontecimientos de la vida. Juntos, nuestros resultados destacan el periodo posterior a la suspensión como un momento de estrés considerable y de transición para las familias de militares. Sin embargo, nuestros resultados también indican la necesidad de ayudar a todas las familias de militares a afrontar la incertidumbre acerca de cuándo ocurrirán las comisiones o de si estas ocurrirán, dado que las prioridades de los militares generalmente cambian constantemente. Por lo tanto, describimos los esfuerzos de afrontamiento que pueden ser particularmente adaptables para las familias mientras se preparan para factores desencadenantes de estrés anticipados e inciertos.

Struggling Together: Examining the Narratives of Interdependence and Healing Within Romantic Relationships After Stroke.

The consequences of a brain injury can introduce ripple effects within a family for years after the initial event. In this study, we focused on the experiences of couples negotiating their relationship after stroke. We specifically concentrated on the changes to couples' interdependence and the relational ramifications of those changes. Interview data from 41 participants (including 20 people who have had a stroke and 21 caregiving partners) suggest that as individuals noticed changes in themselves and their partner, they also noted significant changes within their relationship. As couples encountered their new relational dynamic, they had to manage various struggles including how to provide assistance, how to communicate effectively, and how to reframe their situation. Overall, couples relayed a trajectory of post-stroke life that involved a level of mutual influence that did not seem to exist prior to stroke.

Communal Coping and Self-Care in Black and White Individuals Living with Type 2 Diabetes.

Type 2 diabetes mellitus is both prevalent and profoundly impactful, and how people cope with the illness is related to a variety of individual and relational outcomes. The goal of this investigation was to test the logic of the recently extended Theoretical Model of Communal Coping (TMCC), a communication theory that argues that race (in this study, Black and White) moderates the relationship between communal coping and disease-related outcomes (i.e., glucose, diet, and exercise self-care). In general, survey data from 348 participants (n = 224 Black participants, n = 124 White participants) revealed that although communal coping was directly and positively related to self-care, the relationship between communal coping and self-care was stronger for Black participants than White participants. The results of the study have implications for the TMCC and for researchers, families managing type 2 diabetes, and healthcare practitioners.

Testing a Dimensional Versus a Typological Approach to the Communal Coping Model in the Context of Type 2 Diabetes.

The impact of type 2 diabetes (T2D) is far reaching, influencing the lives of both patients and their families. The communal coping model argues that people cope with stress in the context of their relationships, including family relationships, and that coping responses are both cognitive and behavioral in nature. According to the model, communal coping exists along two continuous dimensions: (a) appraisal, which assesses whether people's cognitions are individual or shared, and (b) action, which pertains to whether people engage in sole or joint behavior to diminish the negative effects of their stress. Theoretically, the dimensions of communal coping cross to create four distinct types of coping. However, this typology has not been statistically tested in existing research, so one goal of this study was to test the typology. A second goal was to assess how the dimensions and types of communal coping are related to family cohesion and individual T2D outcomes. In partial support of the communal coping model, three types of coping emerged, and overall, coping together was beneficial for patient outcomes.

Explicating the Appraisal Dimension of the Communal Coping Model.

The communal coping model argues that people cope with stress in the context of their relationships and that coping responses are both cognitive and behavioral in nature. However, the cognitive dimension of the model (appraisal) has not been explicated in extant research. The purpose of this study is to fill that gap by conceptualizing the appraisal dimension of communal coping in the context of families managing one member's type 2 diabetes. Analysis of interviews with individuals with type 2 diabetes and their family members (N = 28) revealed that appraisal consists of problem ownership and perceived problem influence and that appraisals are influenced by knowledge of the disease and changing health status. Theoretical and practical implications are discussed.

Taking Control: The Efficacy and Durability of a Peer-Led Uncertainty Management Intervention for People Recently Diagnosed With HIV.

HIV creates substantial uncertainty for people infected with the virus, which subsequently affects a host of psychosocial outcomes critical to successful management of the disease. This study assessed the efficacy and durability of a theoretically driven, one-on-one peer support intervention designed to facilitate uncertainty management and enhance psychosocial functioning for patients newly diagnosed with HIV. Using a pretest-posttest control group design, 98 participants received information and training in specific communication strategies (e.g., disclosing to friends and family, eliciting social support, talking to health care providers, using the Internet to gather information, and building social networks through AIDS service organizations). Participants in the experimental group attended six 1-hour sessions, whereas control participants received standard of care for 12 months (after which they received the intervention). Over time, participants in the intervention fared significantly better regarding (a) illness uncertainty, (b) depression, and (c) satisfaction with social support than did those in the control group. Given the utility and cost-effectiveness of this intervention and the uncertainty of a multitude of medical diagnoses and disease experiences, further work is indicated to determine how this program could be expanded to other illnesses and to address related factors, such as treatment adherence and clinical outcomes.

What do high school students say when they talk to their friends about substance use? Exploring the content of substance-use-specific communication with friends.

In this study, we examined the content of adolescents' conversations with their friends about substance use, adolescents' reactions to such conversations, and reasons why some adolescents did not engage in such conversations. Based on 25 semistructured interviews with high school students, we identified three themes: informational, persuasive, and relational messages. Informational messages included discussing how many peers use substances and clarifying rumors about a friend's substance use. Persuasive messages involved direct anti-substance-use messages (e.g., warning), direct pro-substance-use messages (e.g., legalizing marijuana), indirect anti-substance-use messages (e.g., disliking their substance-use experience), and indirect pro-substance-use messages (e.g., intentions to use substances). Relational messages included joking about substance use and establishing code words for use. Adolescents reacted to their conversations in several ways, such as shock and increased relational closeness. When adolescents did not talk about substance use with their friend, they offered several reasons, including low response efficacy and fear of ruining the friendship.

Measuring Alcohol-Specific Communication with Friends: Conceptualizing and Operationalizing Communication as Multidimensional.

According to primary socialization theory, adolescents develop beliefs about alcohol by interacting with peers, as well as other socialization agents. Although communication is essential to this belief-formation process, few studies have identified the specific alcohol-related messages that adolescents exchange with their peers, and more specifically friends, that lead to certain anti- and/or pro-alcohol-related beliefs. Consequently, the goal of this study was to develop a multidimensional measure of alcohol-specific communication with friends. Based on survey data from 259 high school students, the results indicated that communication with friends involving warnings against drinking alcohol, disapproval of alcohol consumption, and making fun of others for drinking alcohol was negatively related to pro-alcohol beliefs and intentions. Communication with friends involving rumors, teasing each other about drinking alcohol, intentions to drink alcohol, different types of alcohol, experiences with alcohol, and talking about how many peers drink alcohol was positively related to pro-alcohol beliefs and intentions.

A Grounded Theory of Students' Long-Distance Coping With a Family Member's Cancer.

In this study, we explore how family members cope with one source of stress-cancer diagnosis and treatment. We suggest that coping away from one's family is characterized by constraints that are not common to proximal coping. We conducted six focus groups with college students (N = 21) at a university in the United States to investigate their long-distance coping experiences and used grounded theory methods to develop a model of college students' long-distance coping. Negotiating the tension between being here (at school) and being there (at home) was central to their experiences. Participants described four manifestations of their negotiation between here and there (i.e., expressing/hiding emotion, longing to care for the patient there/avoiding responsibility here, feeling shock at degeneration there/escaping degeneration by being here, and lacking information from there) and three strategies they used to cope (i.e., being here and withdrawing, being here and doing school, and seeking/not seeking support).