Victimization and Resilience: Experiences of Rural LGBTQ+ Youth Across Multiple Contexts.

LGBTQ+ youth experience higher rates of interpersonal violence, such as peer-based bullying and identity-based harassment, than their counterparts. Experiences of victimization can occur across different social contexts including family, school, peers, and community. LGBTQ+ youth in rural communities may be at increased risk for identity-based victimization due in part to geographic isolation and an often conservative value system that may create a hostile environment to LGBTQ+ individuals. However, few studies have examined the experiences of rural LGBTQ+ youth from their perspectives, and how the rural context may affect their experiences with victimization and social support. This qualitative study explores the victimization experiences of rural LGBTQ+ youth, the supports available to them, and ways they show resilience. We conducted qualitative interviews with a sample of 11 young people ages 12-21, recruited in partnership with a local LGBTQ+ agency across a rural five county region in the Southeastern United States. Four themes emerged related to how rural youth navigate bullying, harassment, and victimization across different social contexts and the support that is available to them: (1) conflicting family messages, (2) navigating personal safety at school, (3) connecting through technology, and (4) confronting negative religious sentiment. A fifth theme captures the strengths of young people in the mid of victimization: (5) demonstrating individual and collective resilience. Although rural LGBTQ+ youth experience victimization in similar ways to urban and suburban youth, rural youth may have less access to social supports that buffer effects of victimization. This study highlights the strengths in rural LGBTQ+ young people as well as their commitment to supporting one another and seeing change in their communities. Findings illustrate a need for greater support for LGBTQ+ youth in rural areas while leveraging existing strength of the youth and their community for sustainable support and resources.

Adverse childhood experience patterns, major depressive disorder, and substance use disorder in older adults.

OBJECTIVES: This article investigates distinct patterns of adverse childhood experiences (ACEs) in a representative sample of US older adults, and how the ACEs patterns relate to major depression and substance use disorder (SUD). METHODS: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions III. The study sample consisted of older adults aged 55 or older (N = 11,386). The dependent variable was past-year SUD measuring any DSM-5 diagnosis for alcohol, tobacco, cannabis, and other illicit drugs. The independent variables were the classes of ACEs identified using 11 types of early adversities. The mediating variable was past-year major depressive disorder. We conducted a latent class analysis (LCA) to identify latent classes of ACEs, estimated the relationships between the ACEs classes, major depressive disorder, and SUD, and tested mediation by major depression. RESULTS: Results of the LCA identified four classes of ACEs: High Adversity (6%), Low Adversity (69%), Child Abuse (16%), and Parental Substance Use (8%). The three classes of High Adversity, Child Abuse, and Parental Substance Use showed significantly higher rates of SUD than the Low Adversity class. The High Adversity and Child Abuse classes were more likely to have major depression compared to the Low Adversity class. In addition, major depression mediated the association between ACEs and SUD for those two classes. CONCLUSION: The findings provide evidence for a long-term impact of ACEs on mental health and SUD later in life and emphasize trauma-informed care principles in interventions for older adults with SUD.

Pregnant adolescent women's perceptions of depression and psychiatric services in the United States.

PROBLEM: Adolescent mothers and their children are at high-risk for depression and the associated negative educational, social, health, and economic outcomes. BACKGROUND: However, few pregnant adolescent women with depression receive psychiatric services, especially low-income or racial/ethnic minority adolescent women. AIM: This qualitative study explores perceptions of depression, psychiatric services, and barriers to accessing services in a sample of low-income, pregnant racial/ethnic minority adolescent women. Our goal was to better understand the experiences of depression during pregnancy for these vulnerable adolescent women, and thereby improve their engagement and retention in services for perinatal depression. METHODS: We recruited 20 pregnant adolescent women who screened positive for depression from 2 public health prenatal clinics in the southeastern United States. Participants were low-income and primarily racial/ethnic minority women between 14 and 20 years old. Data were collected through individual in-depth, ethnographically informed interviews. FINDINGS: Generally, participants lacked experience with psychiatric services and did not recognize their symptoms as depression. However, participants perceived a need for mood improvement and were interested in engaging in services that incorporated their perspective and openly addressed stigma. DISCUSSION: Participants reported practical and psychological barriers to service engagement, but identified few cultural barriers. Family perceptions of psychiatric services served as both a barrier and support. CONCLUSION: Adolescent women are more likely to engage in psychiatric services if those services reduce practical and psychological barriers, promise relief from the symptoms perceived as most meaningful, and address underlying causes of depression. Culture may affect Latina adolescent women's perceptions of depression and services.