Diversity in singlehood experiences: Testing an attachment theory model of sub-groups of singles.

OBJECTIVE: Relationship science has developed several theories to explain how and why people enter and maintain satisfying relationships. Less is known about why some people remain single, despite increasing rates of singlehood throughout the world. Using one of the most widely studied and robust theories-attachment theory-we aim to identify distinct sub-groups of singles and examine whether these sub-groups differ in their experience of singlehood and psychosocial outcomes. METHOD: Across two studies of single adults (Ns = 482 and 400), we used latent profile analysis (LPA) to identify distinct sub-groups of singles. RESULTS: Both studies revealed four distinct profiles consistent with attachment theory: (1) secure; (2) anxious; (3) avoidant; and (4) fearful-avoidant. Furthermore, the four sub-groups of singles differed in theoretically distinct ways in their experience of singlehood and on indicators of psychosocial well-being. CONCLUSIONS: These findings suggest that singles are a heterogeneous group of individuals that can be meaningfully differentiated based on individual differences in attachment security.

Affirmation-support, parental conflict, and mental health outcomes of transgender and gender diverse youth.

Background: Transgender and gender diverse young people (TGDY) are at higher risk of psychosocial distress relative to their cisgender counterparts. TGDY rely heavily on their parents to support their desired affirmation and to facilitate access to legal and medical affirmation. While it is well understood that parent conflict negatively impacts the well-being of children and young people, little is known about how parental conflict and parental affirmation support are related to TGDY well-being. Aims: The aim of the present study was to (1) explore affirmation experiences of TGDY, as reported by their parents, focusing in particular on parental support for affirmation and barriers to affirmation, and (2) test whether parental support and aspects of the coparenting relationship predicted TGDY mental health outcomes. Method: A sample of 63 parents (Mage = 45.71 years) of TGDY (aged 11 to 17 years) completed an online survey. Results: Almost 90% of the TGDY reported on had socially affirmed their gender, though fewer had taken steps to legally or medically affirm their gender. Parental support for affirmation was generally very high, and reported discrepancies between coparents were generally low; however, discrepancies were greatest for medical affirmation. Finally, parent support for affirmation was a strong predictor of lower TGDY depressive symptoms, though parental conflict did not predict TGDY mental health. Conclusion: Results highlight the important role of parental support for gender affirmation. Further research is needed to track the role of parental support and affirmation on TGDY well-being over time, and to ensure that such research is completed with more diverse samples.

A systematic review and research agenda of internalized sexual stigma in sexual minority individuals: Evidence from longitudinal and intervention studies.

Internalized sexual stigma is a well-established risk factor for poor mental health among sexual minority individuals. However, there has been no synthesis of the literature pertaining to risk and protective factors that influence the development of internalized sexual stigma over time. This systematic review presents findings from 31 studies addressing this question (n = 9192); 23 studies examined psychosocial and sociodemographic predictors of internalized sexual stigma among sexual minority individuals, and eight studies tested the effects of psychological interventions on internalized sexual stigma. Longitudinal studies highlight the stability of internalized sexual stigma over time, and the role of stigma and discrimination, proximal minority stressors (e.g., outness, concealment), and psychological factors (e.g., depressive and anxious symptoms, coping styles, and demoralization) in predicting subsequent internalized sexual stigma. Demographic factors appear to play only a limited role in predicting subsequent internalized sexual stigma. Finally, most intervention studies found no significant effects in reducing internalized sexual stigma, with three exceptions finding significant intervention effects among young sexual minority individuals. We conclude by outlining a theory-driven model of internalized stigma and a research agenda to test more nuanced models of internalized stigma that include multifactorial risk indices.

'It feels meaningful': How informal mental health caregivers in an LGBTQ community interpret their work and their role.

Many members of lesbian, gay, bisexual, trans and gender diverse, and queer (LGBTQ) communities provide informal mental health support to peers. This type of support is valuable for people who receive it - even helping to prevent suicide. It is also meaningful to those who provide it. In this article, we focus on how LGBTQ people derive meaning from their experiences of supporting peers. In-depth interviews with 25 LGBTQ people in Melbourne, Australia, indicate that those providing informal mental health support to fellow community members recognise their roles as meaningful in three main ways: in terms of self, relationships and communities. Recognising the meanings that LGBTQ caregivers derive from helping fellow community members provides useful information service providers and policymakers seeking to better address mental distress in LGBTQ communities and support caregivers. It is useful to understand this meaningful work in an LGBTQ context as caregiving that challenges gendered and heteronormative assumptions about what care is, and who provides it.

Prospective effects of internalized stigma on same-sex relationship satisfaction: The mediating role of depressive symptoms and couple conflict.

OBJECTIVE: Same-sex couples face unique minority stressors that affect relationship functioning, yet remarkably little research has examined the mechanisms by which individual and partner experiences of internalized stigma affect relationships over time. Using actor-partner interdependence models, the present study examined the effects of internalized stigma on relationship satisfaction, and whether depressive symptoms and couple conflict mediated these effects. Hypotheses were tested cross-sectionally and prospectively across a 5-year period. METHOD: Participants were 330 same-sex couples (n = 660 individuals; Mage = 39.5 years, SD = 10.8) who were assessed annually over a 5-year period. There were 109 male couples, 216 female couples, and five couples in which one partner did not identify with these labels. RESULTS: There was a significant actor effect of internalized stigma on lower relationship satisfaction cross-sectionally and prospectively, and significant indirect actor-actor and actor-partner effects of internalized stigma on satisfaction via couple conflict cross-sectionally and prospectively. Finally, there was a cross-sectional indirect actor-actor effect of internalized stigma on relationship satisfaction via depressive symptoms, though depressive symptoms did not mediate any effects over time. CONCLUSIONS: These findings highlight the importance of considering both individual and interpersonal mediators of minority stress, particularly when investigating partner effects of minority stress on relationship satisfaction. Implications for research and clinical practice with same-sex couples are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Nature and Impact of Informal Mental Health Support in an LGBTQ Context: Exploring Peer Roles and Their Challenges.

Background: Research shows that LGBTQ communities experience high levels of suicidality and mental ill health. They also face significant barriers to accessing adequate mental health treatment in service settings. In response to these factors, it is likely that LGBTQ community members turn to their peers for informal mental health-related support. Such support, however, is largely undefined, the extent of it poorly understood and its impacts on those who perform it underexplored. Methods: We explored the nature and impact of informal mental health-related support provided by peers in LGBTQ communities in Melbourne, Australia. Drawing on semi-structured in-depth interviews with 25 LGBTQ adults in 2020, we explored how and why peers provided mental health support to friends, partners, housemates and even strangers and the impact this had on them. Results: We found that participants performed support roles as extensions of their existing relationships. We demonstrate that the support roles of the safe friend, housemate and partner, among others, represent everyday relationships stretched-even to breaking point-to incorporate informal mental health support. Each of these support roles is distinct, but they can all potentially result in similar impacts on those performing them. One of the more significant of these is burnout. Conclusions: LGBTQ community members face a diverse range of challenges when they support peers with their mental health. Informal peer-support roles are a significant responsibility for those performing them. LGBTQ community members stepping up to support others should be better supported to help manage their roles and the impacts of performing them. Policy Implications: Findings can contribute to policy that not only addresses high levels of mental ill health in LGBTQ communities, but also seeks to help peers in support roles to prevent them from being negatively impacted.

Factors Associated with Self-Reported PTSD Diagnosis among Older Lesbian Women and Gay Men.

Lesbian women and gay men are at greater risk of post-traumatic stress disorder (PTSD) than heterosexual people, however few studies have examined PTSD in older lesbian women and gay men. This study examined predictors of having ever been diagnosed with PTSD, as well as relationships to current quality of life, among 756 lesbian women and gay men aged 60 years and older in Australia. Participants were surveyed on their sociodemographic characteristics, experiences of sexual orientation discrimination over their lifetime, whether they had ever been diagnosed with PTSD, whether they were currently receiving treatment for PTSD, and their current quality of life. After adjusting for sociodemographic variables, participants who reported having a PTSD diagnosis (11.2%) had significantly more frequent experiences of discrimination over their lifetime and were significantly less likely to currently be in a relationship. Older lesbian women were significantly more likely than older gay men to report ever having had a PTSD diagnosis. Additionally, having ever been diagnosed with PTSD significantly predicted current poorer quality of life. These findings suggest that a history of PTSD among older lesbian women and gay men is linked to experiences of discrimination and other factors, with associated links to current quality of life.

Prevalence and risk factors associated with perinatal depression in sexual minority women.

Perinatal depression is associated with wide-ranging negative outcomes for women and their families, though little research has examined perinatal depression in sexual minority women. We examined depression in sexual minority women in the perinatal period, and whether there were unique minority stress-related risk and protective factors that predicted perinatal depression. One hundred ninety-four perinatal sexual minority women aged 18 years and older were recruited from the US and Australia. Participants completed an online questionnaire incorporating the Edinburgh Postnatal Depression Scale (EPDS) and measures of minority stress and social support. Over one third (35.6%) of the sample scored in the clinical range on the EPDS. Experiences of discrimination were associated with greater depression symptoms via poor social support from family. Higher concealment motivation was associated with greater depression symptoms via poor family and partner support. There were no direct or indirect effects of internalized stigma on depression. Rates of clinically elevated perinatal depression symptoms among sexual minority women are high, extending previous research demonstrating mental health disparities between sexual minorities and their heterosexual counterparts to the perinatal period. The role of social support in mediating the relationships between minority stress and depression suggests that increasing partner and family support might be effective targets for therapeutic interventions during the perinatal period.

Use of Psychics for Stress and Emotional Problems: A Descriptive Survey Comparison with Conventional Providers and Informal Helpers.

Conventional mental health treatments do not meet the needs of all who seek help: some consult informal and alternative providers. Researching the use and perceived benefits of these non-conventional sources of help may contribute to understanding help-seeking behavior and inform mental health policy. We explored the experiences of people consulting psychics (a type of alternative provider) for mental health needs, through comparisons with experiences of people consulting conventional and informal providers. An online survey sought feedback on help seeking for stress or emotional problems from 734 adults who had consulted a psychologist or counsellor; doctor or psychiatrist who prescribed medication; friend or family member; or psychic or similar alternative provider. Analyses included descriptive and inferential statistics and content analysis of textual responses. Problems were commonly described in symptom or disorder terminology with considerable overlap across groups. Content analysis of reasons for choice of helper identified four main categories-functional, reasoned, emotional, and passive-which differed significantly across groups (Cramer's V = 0.26), with consulting psychics predominantly a reasoned choice. Ratings of overall effectiveness of help by those consulting psychics were greater than for the three other groups (d = 0.31 to 0.42), with very few adverse outcomes in any group. Help seeking for stress or emotional problems includes consultations with psychics or similar alternative providers, with self-reported outcomes better than for conventional providers. Further research is warranted to establish whether psychic consultations may serve a useful public health function.

Trans and Gender-Diverse peoples' experiences of crisis helpline services.

Crisis helplines are typically easily accessible and deliver interventions in a timely manner, regardless of geographical location. The efficacy and user experiences of these services are the subject of considerable interest within the field, but the experiences of trans and gender-diverse individuals remain unexplored despite high rates of mental ill health being documented in this population. A total of 134 trans and gender-diverse Australians were surveyed about their experiences of personal crises and of utilising crisis helplines. Within our sample, 84.2% (n = 113) of participants recognised at least one service - however, only 32.8% (n = 44) utilised a service to cope with a personal crisis. Participants cited poor recognition and understanding of the challenges specific to trans and gender-diverse individuals among helpline workers as a primary reason for avoiding these services, and articulated needs which were a poor fit for the one-off intervention model commonly employed by helpline services. In order for helpline services to be viable avenues of support for trans and gender-diverse individuals during a personal crisis, helpline workers must be sufficiently equipped to work with trans and gender-diverse callers and to facilitate their enrolment in 'traditional' mental health services.

Comfort Among Older Lesbian and Gay People in Disclosing Their Sexual Orientation to Health and Aged Care Services.

Being comfortable in disclosing one's sexual orientation to health and aged care providers is important for older lesbian and gay adults, given that nondisclosure is associated with poorer health and well-being outcomes. In a sample of 752 lesbian and gay adults aged 60 years and older living in Australia, we found only 51% of lesbian women and 64% of gay men felt fully comfortable to disclose their sexual orientation to health and aged care service providers. For both the women and the men, those who felt fully comfortable to disclose reported significantly less internalized homophobia; had fewer experiences of discrimination in the past year; and reported greater lesbian, gay, bisexual, transgender, and intersex (LGBTI) community connectedness. Feeling fully comfortable was also predicted by fewer experiences of lifetime discrimination among the men. These findings may help those seeking to assist older lesbian and gay people in feeling comfortable and being open with health and aged care service providers.

Minority Stress and Psychological Outcomes in Sexual Minorities: The Role of Barriers to Accessing Services.

Lesbian, gay, and bisexual (LGB) individuals are at higher risk for poor mental health than their heterosexual counterparts, and these disparities are largely accounted for by minority stressors. Less is known about the mechanisms underlying associations between minority stress and mental health. In a sample of 592 LGB adults (Mage = 29.39), we tested a model in which minority stress (internalized stigma, stigma consciousness, and lived discrimination) was associated with poor mental health when mediated by stigma-related barriers to accessing psychological services. Structural equation modeling revealed that minority stressors predicted more barriers to service use which, in turn, predicted poorer mental health outcomes. Internalized stigma was also directly associated with poor mental health. Results suggest that links between minority stress and poorer mental health in LGB individuals are at least partly explained by stigma-related barriers to accessing services. Future research is needed to investigate methods which may ameliorate these barriers.

Minority Stress and Same-Sex Relationship Satisfaction: The Role of Concealment Motivation.

Most lesbian, gay, and bisexual (LGB) people want a stable, satisfying romantic relationship. Although many of the predictors of relationship outcomes are similar to those of heterosexual couples, same-sex couples face some additional challenges associated with minority stress that also impact upon relationship quality. Here, we investigate the association between minority stressors and relationship quality in a sample of 363 adults (M age = 30.37, SD = 10.78) currently in a same-sex romantic relationship. Internalized homophobia and difficulties accepting one's LGB identity were each negatively associated with relationship satisfaction via heightened concealment motivation. We also examined the protective role of identity affirmation on relationship quality, finding a direct positive relationship between the two variables. Minority stressors were negatively associated with couple relationship satisfaction via heightened concealment motivation. The finding that identity affirmation directly predicted increased couple satisfaction also highlights the important role of protective factors in same-sex couple relationships.

La mayoría de las personas lesbianas, gais y bisexuales (LGB) desean una relación amorosa estable y satisfactoria. Aunque muchos de los predictores de las complicaciones en las relaciones son similares a los de las parejas heterosexuales, las parejas del mismo sexo enfrentan algunas otras dificultades asociadas con el estrés de las minorías que también repercuten en la calidad de la relación. Aquí investigamos la asociación entre los factores desencadenantes de estrés en las minorías y la calidad de la relación en una muestra de 363 adultos (edad promedio = 30.37, desviación estándar = 10.78) que están actualmente en una relación amorosa del mismo sexo. La homofobia internalizada y las dificultades para aceptar la identidad LGB propia estuvieron asociadas negativamente con la satisfacción en la relación mediante un incremento de la motivación por la ocultación. También analizamos el papel protector que desempeña la afirmación de la identidad en la calidad de la relación y encontramos una relación positiva directa entre las dos variables. Los factores desencadentantes de estrés en las minorías estuvieron asociados negativamente con la satisfacción en la relación de pareja mediante un incremento de la motivación por la ocultación. El hallazgo de que la afirmación de la identidad predijo directamente una mayor satisfacción en la pareja también destaca el papel importante que desempeñan los factores protectores de las relaciones de pareja del mismo sexo.

Adult attachment and long-term singlehood.

Rates of singlehood are increasing rapidly in the Western World. In the current paper, we discuss the phenomenon of long-term singlehood from an attachment perspective, outline three distinct sub-groups of singles (anxious, avoidant, and secure), and demonstrate the utility of these groups by highlighting their unique characteristics and possible life outcomes, including factors that may moderate these outcomes. Finally, we offer suggestions for future research to enhance our understanding of this vastly under-researched population.

Affirmative LGBT psychotherapy: Outcomes of a therapist training protocol.

Lesbian, gay, bisexual, and transgender (LGBT) people seek psychotherapy at high rates, and the importance of providing culturally appropriate and LGBT-affirmative psychotherapy has been widely acknowledged. Despite this, remarkably little research has investigated the effects of therapist training in LGBT-affirmative psychotherapy. Here we examined the effectiveness of a training protocol for LGBT-affirmative psychotherapy with 96 mental health professionals, ranging in therapeutic experience from <1 year to 37 years (M = 6.54 years). Across all outcomes, therapists reported increased knowledge and skills related to working with LGBT clients following the training. Therapists also displayed reductions in homo-negativity and trans-negativity. Therapists' characteristics did not influence the extent to which they benefited from training. Specifically, years of clinical experience, therapist religiosity, and therapist psychological flexibility were unrelated to changes in attitudes, knowledge, and skills. The results of this study clearly suggest that providing training in LGBT-affirmative psychotherapy can enhance therapists' attitudes, knowledge, and skills. Of particular importance is that the benefits associated with such training appear to hold regardless of therapists' characteristics. (PsycINFO Database Record

The Effects of Mindfulness on Sexual Outcomes: The Role of Emotion Regulation.

Individuals higher in dispositional mindfulness, a quality of non-judgmental attention to the present moment, fare better than their less mindful counterparts on a wide range of psychological and interpersonal outcomes. However, remarkably little is known about the potential influence of dispositional mindfulness on sexual outcomes. Here we investigated whether dispositional mindfulness was associated with a range of sexual outcomes, including sexual satisfaction, sexual hyperactivation (heightened sexual desire and worry), sexual deactivation (suppression of sexual desire and behavior), and problematic pornography use. We also tested whether capacity for emotion regulation was the mechanism underlying the mindfulness-sexual outcome association. These hypotheses were tested in two samples: a sample of adults in a committed romantic relationship (N = 407) and a group of adults who were long-term single (N = 400). Across both samples, dispositional mindfulness predicted more adaptive sexual outcomes, and emotion regulation generally mediated these associations. Of particular importance, the positive effects of dispositional mindfulness on sexual outcomes appear to generalize across relationship statuses, with both partnered and long-term single individuals displaying a similar pattern of results. These findings highlight that high dispositional mindfulness may predict a range of positive sexual outcomes in both partnered and single individuals.

The Role of Close Relationships in Terror Management: A Systematic Review and Research Agenda.

Terror management theory outlines how humans seek self-esteem and worldview validation to manage death-related anxiety. Accumulating evidence reveals that close relationships serve a similar role. However, to date, there has been no synthesis of the literature that delineates when close relationships buffer mortality concerns, under what conditions, on which specific outcomes, and for whom. This systematic review presents over two decades of research to address these questions. Findings from 73 reviewed studies revealed that close relationships serve an important role in buffering death-related anxiety. A range of dispositional and situational moderating factors influence either the activation or inhibition of relational strivings to manage heightened death awareness, the most influential being attachment, gender, and relationship-contingent self-esteem. These findings were integrated into an overarching model that highlights some of the conditions under which mortality salience (MS) influences relational outcomes. We conclude by highlighting a range of theoretical and methodological concerns to be addressed by future research.

A randomized waitlist control community study of Social Cognition and Interaction Training for people with schizophrenia.

OBJECTIVE: Social Cognition and Interaction Training (SCIT) has demonstrated effectiveness in improving social cognition and functioning of people with schizophrenia. This pilot study examines the acceptability, feasibility, and effectiveness of SCIT with individuals who have schizophrenia-spectrum disorders and are receiving care through a public mental health service. METHOD: In a pragmatic randomized waitlist controlled trial, 36 participants (aged 19-55 years) with a schizophrenia spectrum disorder were randomly allocated to SCIT or treatment as usual (TAU). Measures of theory of mind, emotion perception, attributional bias, social skills, quality of life, life skills, depression, anxiety, and stress were administered pre- and post-intervention with follow-up conducted 4 months later. All wait-list controls subsequently received the intervention and a secondary within-group analysis was conducted including these participants. RESULTS: While no significant differences were found between groups on any outcomes, there was strong engagement with the SCIT intervention. Of the 21 participants in the intervention group, the completion rate was 85.71% with a median attendance rate of 17 sessions. Within subject analyses of SCIT participants over time showed significant improvements in quality of life, emotion recognition, social skills, and a trend towards better life skills from pre- to post-intervention. These gains were sustained at the 4-month follow-up time. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Although this study showed limited benefits in outcomes associated with SCIT compared with TAU, it demonstrated the acceptability of SCIT to participants in a real world public health setting shown by high retention, attendance, and positive feedback. This pilot shows SCIT can be implemented in routine clinical practice and lays the foundation for a larger pragmatic study. PRACTITIONER POINTS: SCIT can be implemented successfully in a real-world community mental health setting. SCIT had high levels of acceptability to these participants. Limitations The small sample size meant there was insufficient power to detect differences between groups on outcome measures. The study did not include measures of psychiatric symptoms or neuropsychological functioning which may have influenced participants' capacity to benefit from SCIT.

An ecological model of mediators of change in Couple Relationship Education.

Couple Relationship Education (RE) seeks to enrich couples' relationships, and assist them to manage stressful life events [1]. In the current paper we present an ecological model of couple relationships intended to guide the practice of RE, analyze the mediators of RE effects, and suggest future research needs to assess moderators and mediators of RE effects in order to enhance the impact of RE.