Pride in our community: Reflecting on LGBTQ publications in the American Journal of Community Psychology.

In this Virtual Special Issue (VSI), we curate and discuss a set of 28 articles previously published in the American Journal of Community Psychology (AJCP) focused on lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities. The purpose of this VSI is to bring visibility to this body of scholarship in AJCP and to reflect on how the strengths of our field have been used throughout this work in pursuit of supporting LGBTQ wellbeing. In this VSI, we first discuss articles that help to set the historical background for publications in AJCP. We then discuss papers under the broad themes of HIV/AIDS, identities within ecological context, and social activism among LGBTQ communities. We then reflect on opportunities for our field to further leverage our strengths in contributing to LGBTQ scholarship. Overall, this VSI celebrates the contributions to LGBTQ research already present in AJCP, and we hope inspires future contributions to the pages of AJCP and beyond.

Looking back, moving forward: 50 years of the American Journal of Community Psychology.

The American Journal of Community Psychology (AJCP) was founded in 1973 and has since its inception has been the flagship journal for the Society of Community Research and Action. AJCP publishes leading scholarship in community psychology and social action research. This special issue celebrates the 50 years of scholarship in AJCP by curating and assembling previously published articles in virtual special issues (VSIs) with accompanying commentaries. Nine VSIs were compiled as part of this special issue. Each of these VSIs were organized around themes that are of critical importance to community psychology and each VSI summarizes what has been learned from their included articles and future directions for the field. In this paper, we introduce this special issue on this collection of VSIs, discussing how each of these VSIs endeavor to push the field forward.

Contradictions in change: Ecological factors in the implementation of outer layer sexual violence prevention.

This study examined the adoption and implementation process in early efforts to implement ecological ("outer layer") sexual violence (SV) prevention strategies. Interviews with 28 preventionists from 26 local sites within a large, midwestern state, were conducted to examine individual preventionists' problem definitions of SV and ecological factors surrounding implementation. Findings suggest that SV prevention in the state is primarily implemented at the individual-level; when preventionists described engaging in or anticipating outer layer interventions, they were often tertiary (i.e., responding after perpetration; e.g., Sexual Assault Response Teams). A majority expressed problem definitions rooted within the individual (e.g., perpetration due to a lack of consent education), and a majority of implemented efforts matched this individual-level conceptualization. Yet, contradictions between problem definitions (e.g., SV stemming from oppression) and implemented activities (e.g., single-session educational interventions) emerged. Such contradictions may be best understood in light of contextual implementation influences: diverse preventionist job responsibilities, less training/support for outer layer prevention, preventionist autonomy, leadership messaging, time requirements, partner reticence, and extensive work with schools. Inner layer influences, including identification with job roles, preference for, and a sense of urgency toward inner layer work, appeared to interact with contextual factors. Implications across community psychology domains are discussed.

Mixed methods in community psychology: A values-forward synthesis.

Mixed methods research (MMR) combines multiple traditions, methods, and worldviews to enrich research design and interpretation of data. In this virtual special issue, we highlight the use of MMR within the field of community psychology. The first MMR studies appeared in flagship community psychology journals over 30 years ago (in 1991). To explore the uses of MMR in the field, we first review existing literature by identifying all papers appearing in either Journal of Community Psychology or American Journal of Community Psychology in which the word "mixed" appeared. A total of 88 publications were identified. Many of these papers illustrate the pragmatic use of MMR to evaluate programs and to answer different research questions using different methods. We coded articles based on Green et al.'s classifications of the purpose of the mixing: triangulation, development, complementarity, expansion, and initiation. Complementarity was the most frequently used purpose (46.6% of articles), and nearly a quarter of articles mixed for multiple purposes (23.86%). We also coded for any community psychology values advanced by the use of mixed methods. We outline three themes here with corresponding exemplars. These articles illustrate how MMR can highlight ecological analysis and reconsider dominant, individual-level paradigms; center participant and community member experiences; and unpack paradoxes to increase the usefulness of research findings.

Incivility and interpersonal harm in organizational context: A qualitative exploration of values in STEM training programs.

This study investigates science, technology, engineering, and math (STEM) PhD students' perceptions of organizational values and incivility. Interviews with 26 STEM PhD students elicited examples of and perceptions surrounding incivility and related harms. Productivity, prestige, expertise, objectivity, self-sufficiency, and collaboration values were identified. Each included aspects deemed useful (e.g., productivity fueling discovery; expertise facilitating learning) as well as potentially contributing to harm when weaponized (e.g., productivity appeared in incivility stories when one "looked down" on those who did not work long days; expertise appeared when people gossiped about intelligence). Some aspects of collaboration (e.g., long-lasting working relationships fueling scientific discovery) may be protective. Organizational values such as productivity appeared to supersede considerations such as well-being. Current framing of these values may bolster refusal to engage in or support social justice and mental health efforts, which some participants identified as needed. Implications across settings are discussed.

Characteristics of Sexual Assault Among Men Receiving a Forensic Medical Examination.

Sexual assault is a form of violence disproportionately perpetrated against women by men; however, men also experience high rates of sexual victimization. While recent research exploring victimization of sexual assault among men does exist, little is known about situational characteristics and consequences surrounding men's assault experiences. Therefore, the current study examines narratives of men's sexual assault to further understand the unique experiences of men receiving a sexual assault medical forensic examination. To accomplish this, we conducted a retrospective medical chart review of sexual assault narratives from N = 45 men receiving a sexual assault medical forensic examination at a large academic medical institution in the southeastern United States. Three general constructs were identified within the records: a) Perpetrator use of coercive tactics, b) Memory loss, and c) Contextual factors. Nested within these constructs, five specific themes emerged, including: a1) Use of weapons and physical force; a2) Tactical administration of alcohol and drugs; b1) Difficulties remembering assault; c1) Consensual sexual activity turned non-consensual; c2) Incarceration. Findings from the present study common identified characteristics of sexual assaults among men receiving a sexual assault medical forensic examination, including coercive tactics used by perpetrators, consequences of sexual assault, and high-risk settings for male victimization.

Associations between residual hyperarousal and insomnia symptoms in veterans following a 2-week intensive outpatient program for posttraumatic stress disorder.

Many returning military service members and veterans who were deployed following the September 11, 2001, terrorist attacks (9/11) suffer from posttraumatic stress disorder (PTSD) and insomnia. Although intensive treatment programs for PTSD have shown promise in the treatment of PTSD symptoms, recent research has demonstrated that sleep disturbance shows little improvement following intensive trauma-focused treatment. The aim of the present study was to evaluate changes in self-reported insomnia symptoms among veterans and service members following participation in a 2-week intensive program for PTSD. We further aimed to investigate if residual PTSD symptoms, specifically hyperarousal, were associated with residual insomnia symptoms. Participants (N = 326) completed self-report assessments of insomnia, PTSD symptoms, and depressive symptoms at pre- and posttreatment. At pretreatment, 73.9% of participants (n = 241) met the criteria for moderate or severe insomnia, whereas at posttreatment 67.7% of participants (n = 203) met the criteria. Results of paired t tests demonstrated statistically significant differences between pre- and posttreatment Insomnia Severity Index scores; however, the effect size was small, d = 0.34. Analyses revealed that posttreatment hyperarousal symptoms were associated with posttreatment insomnia. These findings suggest that although an intensive program for service members and veterans with PTSD may significantly reduce insomnia symptoms, clinically meaningful residual insomnia symptoms remain. Further research is warranted to elucidate the association between residual hyperarousal and insomnia symptoms following intensive trauma-focused treatment.

Intensive outpatient treatment of PTSD and complicated grief in suicide-bereaved military widows.

We report on a novel 2-week intensive outpatient treatment program (IOP) for 24 widows bereaved by the suicide death of their veteran spouse. We targeted symptoms of posttraumatic stress disorder (PTSD) and complicated grief (CG) concurrently in three separate cohorts. All patients either witnessed the death or discovered the body of their deceased partner, who was a veteran of the United States military. PTSD, CG, and depression symptom severity decreased significantly from pre- to post-treatment, with effect sizes of 0.85, 1.21, and 1.35, respectively. These outcomes provide preliminary support for an IOP to treat co-occurring PTSD and CG among widowed survivors of veteran suicide.

The effect of intimate partner violence on treatment response in an intensive outpatient program for suicide-bereaved military widows.

Suicide-bereaved military widows can struggle with posttraumatic stress disorder (PTSD) and prolonged grief. Intimate partner violence survivors (IPV) are particularly at risk. We examined whether IPV impacts outcomes in a two-week intensive outpatient program for N = 50 suicide-bereaved military widows. Mixed-model regressions were employed to examine the effects of IPV, time, and their interaction on symptoms. Thirty-four percent experienced IPV perpetrated by their deceased veteran. Symptoms improved at post-treatment (ps < .001), one-month (ps < .01), and three-month follow-up (ps< .001). There was no significant effect of IPV or significant interaction (ps > .05), indicating that IPV survivors also benefitted from treatment.

Veterans' Prospective Attitudes About Mental Health Treatment Using Telehealth.

The current study examined Veterans' attitudes about the potential use of telepsychiatry for mental health treatment in routine clinical settings. Data were collected from Veteran outpatients (N = 253) who completed a series of self-report screening measures as part of their initial evaluation at an outpatient clinic providing care to Veterans with deployment-related mental health problems. Using a de-identified data repository, symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, and stress, as well as attitudes and level of comfort with receiving treatment through telehealth were assessed. Overall interest in telepsychiatry was mixed, with 25.7% of patients being "not at all comfortable" and 13.4% being "extremely comfortable" using telepsychiatry from home. Approximately one third (32.8%) of participants indicated a clear preference for telepsychiatry compared to in-person mental health visits. There were no differences in telepsychiatry preferences by symptom severity, demographic variables, rural versus urban location, or endorsed barriers to care. Although telepsychiatry may be a viable means of increasing access, patient preference should be considered, as a substantial percentage of Veterans in this study preferred in-person visits. [Journal of Psychosocial Nursing and Mental Health Services, 57(9), 38-43.].

Military and Veteran Caregivers' Perspectives of Stressors and a Mind-Body Program.

There are over one million post-9/11 military caregivers in the United States who face a variety of stressors inherent to caring for an incapacitated loved one. Mind-body interventions, such as the Stress Management and Resilience Training Relaxation Response Resiliency Program (SMART-3RP), have been shown to reduce stress and improve overall health and functioning. The present qualitative study aims to explore stressors experienced by military caregivers in their caregiving role and to assess attitudes towards the virtual delivery of the SMART-3RP. We conducted two focus groups with a total of 13 caregivers [M (SD) age = 41.25 (11.49); 92% female], and participants subsequently completed a survey on their caregiving experiences. Focus groups were conducted remotely via Google Hangouts by two doctoral-level clinicians, transcribed verbatim, and coded using inductive thematic analysis. Themes related to stressors of caregiving included: logistical stressors faced by caregivers, demands of the caregiving role, concerns about children, worries about the future, exacerbation of the caregiver's physical/mental health concerns, social dynamics, sacrifices made for their veteran in the caregiving role, and relationship dynamics between the veteran and caregiver. Military caregivers found the SMART-3RP logical and felt as though it could be helpful to them. Caregivers expressed interest in a brief, virtual version of the SMART-3RP. Using the findings from the current study, we are adapting the SMART-3RP to be administered virtually as a podcast-based intervention.

Preventing sexual violence in sexual orientation and gender diverse communities: A call to action.

Background: Members of the lesbian, gay, bisexual, transgender, queer, and other sexual orientation and gender diverse (SOGD) communities are at disproportionately higher risk for sexual violence compared to cisgender heterosexual people. Despite this elevated risk, relatively few sexual violence prevention efforts effectively reduce these victimization disparities based on sexual orientation or gender identity.Objective: This narrative review provides an overview of the prevalence of sexual violence in the SOGD communities, delineates risk factors for sexual victimization among SOGD community members, and reviews and evaluates existing prevention efforts for the SOGD communities. We outline specific recommendations for ensuring that prevention efforts meet the needs of the SOGD communities.Method: Drawing on ecological systems theory and public health approaches to sexual violence prevention, we outline current approaches and opportunities for preventionists and scholars to push the field forward.Results: There have been promising prevention programmes designed to be implemented within SOGD communities specifically; however, it is important that general primary prevention programmes endeavour to specifically address sexual violence perpetrated against SOGD people. While many packaged programmes that endeavour to prevent sexual violence across all gender identities and sexual orientations are inclusive of SOGD participants, more programming is needed that integrates anti-oppression training to target social norms that perpetuate SOGD-specific rape myths and normalize sexual violence against SOGD community members.Conclusion: Ecological prevention strategies in line with a public health approach for primary prevention may be particularly valuable for reducing victimization disparities based on SOGD status and identity. Comprehensive sexual education and anti-discrimination policies should be considered front-line prevention programming. To assess if these strategies are effective, the implementation of large-scale surveillance surveys that use comprehensive assessments of sexual orientation, gender identity, and sexual violence are needed. Using theoretically grounded implementation strategies for prevention programmes can ensure effective programme delivery.

Despite their increased vulnerability, relatively few prevention strategies that specifically aim to reduce sexual violence among sexual and gender diverse (SOGD) communities and existing packaged programmes are less effective for preventing victimization among SOGD than for cisgender, heterosexual groups.Packaged prevention programmes should continue adapting with the specific aims to reduce these SOGD-based disparities.Broader changes at the outer layer of the social-ecological model (e.g. anti-discrimination, anti-bullying, inclusive sex-education) are critical primary prevention approaches to reduce SOGD-based sexual violence disparities.

The impact of the COVID-19 pandemic on gender-based violence in the United States: Framework and policy recommendations.

OBJECTIVE: In response to the 2019 novel coronavirus pandemic, portions of the U.S. government implemented social distancing policies that, while necessary, yield unintended consequences. This article explores how risk for gender-based violence (GBV) has been exacerbated across the social-ecological model (SEM; e.g., by increasing economic stress and decreasing social support) and highlights differential impact across social locations (e.g., considering race, gender, social class). METHOD: Drawing on gender-based violence prevention and response research, considerations for researchers, policymakers, and practitioners are delineated. RESULTS: A comprehensive framework adapting an intersectional lens and the SEM is used to explain the changes in risk and protective factors for GBV. Policy recommendations that serve to augment (not replace) social distancing policies are proposed. CONCLUSION: The pandemic has uprooted life in a way that impacts GBV prevention and response. Yet, this is also an opportunity to define a new way forward rather than return to "business as usual"; psychologists should strive to improve social services by utilizing the SEM and intersectionality. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Suicidal Ideation Among Transgender and Gender Expansive Youth: Mechanisms of Risk.

Purpose: Suicide is a leading public health concern among transgender and gender expansive adolescents, although little research has examined mechanisms through which gender identity is associated with suicidal ideation. This study examined the indirect effects of peer victimization, dating violence, substance use (SU), SU problems, and depressive symptoms in the relationship between gender identity and suicidal ideation. Methods: Secondary data analysis was conducted from a 2018 statewide survey, including 4464 adolescents who identified as male, female, transgender, or gender expansive (n=1116 per gender). The sample was frequency matched on grade, race, geographic region, and free/reduced lunch status. Mediation analyses were performed. Results: Reports of suicidal ideation were highest among transgender (49.29%) and gender expansive (41.31%) adolescents compared with male (10.82%) and female adolescents (19.08%). Using the Karlson, Holm, and Breen approach, 50.45% of the effect of being transgender on suicidal ideation was mediated through peer victimization, dating violence, and depressive symptoms, and 39.29% through SU, SU problems, and depressive symptoms. The mediation through the same pathways for being gender expansive was 46.37% and 39.89%, respectively. Across both models, depressive symptoms predominately accounted for the mediating effect. Conclusion: Transgender and gender expansive youth are at alarming risk for suicidal ideation, which illustrates the critical need for suicide prevention within this population. Programs that promote mental health and work to prevent bullying, dating violence, SU, and SU problems are crucial; although longitudinal research is needed, targeting these mechanisms may play a critical role in reducing suicidal ideation and risk.

Dating Violence and Peer Victimization Among Male, Female, Transgender, and Gender-Expansive Youth.

BACKGROUND AND OBJECTIVES: Transgender adolescents experience disproportionately high rates of dating violence and peer victimization. However, research has relied on small samples of transgender youth and has not captured victimization experiences of gender-expansive youth (who do not identify as male, female, or transgender). In the current study, we address these limitations, comparing victimization by gender. METHODS: We examined a subsample of 4464 male, female, transgender, and gender-expansive youth (1116 per group) from the 2018 Illinois Youth Survey who were frequency matched on grade, race, geographic region, and free or reduced lunch status. Prevalence of self-reported verbal, physical, and cyber peer victimization and physical and psychological dating violence was calculated. Adjusted prevalence ratios were obtained by using log-binomial regression. RESULTS: The highest rates across all forms of victimization were reported among transgender (15.6%-51.6%) and gender-expansive (13.2%-41.4%) youth. Transgender youth had a 2.09 to 2.96 times higher frequency of victimization than male youth and a 1.34 to 2.65 times higher frequency of victimization than female youth. Transgender youth also had higher frequencies of specific forms of victimization than gender-expansive youth. Gender-expansive youth had a 1.83 to 2.61 times higher frequency of victimization than male youth and 1.18 to 2.35 times higher frequencies of most forms of victimization than female youth. CONCLUSIONS: Disparities in dating violence and peer victimization rates exist among transgender and gender-expansive adolescents compared with male and female youth. The distinct experiences of transgender and gender-expansive youth should be considered in school policies and violence prevention programs.

Comparative effectiveness of prolonged exposure and cognitive processing therapy for military service members in an intensive treatment program.

OBJECTIVE: While the comparative efficacy of prolonged exposure (PE) and cognitive processing therapy (CPT) has been examined in outpatient settings, there is a dearth of literature on the relative effectiveness of these interventions when adapted for an intensive treatment format. In an expanded secondary analysis of a previous study, we sought to examine the comparative effectiveness of PE and CPT delivered in the naturalistic setting of an intensive treatment format including maintenance of outcomes through a 6-month follow-up period. METHOD: A sample of 296 veterans with posttraumatic stress disorder (PTSD) received either PE (n = 186) or CPT (n = 90), alongside other trauma-informed interventions, in a 2-week intensive clinical program. Treatment selection was determined collaboratively between patient and therapist. Our primary outcome was self-reported PTSD symptom severity (i.e., PTSD Checklist for DSM-5, PCL-5); secondarily, we examined self-reported depression (i.e., Patient Health Questionnaire) symptom severity outcomes. RESULTS: A mixed-model regression controlling for age and gender revealed a significant effect of time from baseline to endpoint (p < .001), 3-month (p < .001), and 6-month follow-up (p < .001) on PCL-5 scores but no significant effect of treatment or effect of treatment by time interaction (all ps > .05; model: Wald's χ² = 232.38, p < .001). Results were similar for depression outcomes. Attrition at posttreatment was not significantly different between groups: 7.2% for CPT and 6.5% PE (z score = 0.22). CONCLUSIONS: Both PE and CPT are associated with comparable improvements when delivered as part of a 2-week intensive outpatient program. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Acceptability of an adjunct equine-assisted activities and therapies program for veterans with posttraumatic stress disorder and/or traumatic brain injury.

OBJECTIVE: Equine-assisted activities and therapies (EAATs) have been a growing adjunctive integrative health modality, as they allow participants to practice mindfulness, emotional regulation, and self-mastery or self-esteem building skills. Preliminary evidence suggests that these programs may be helpful in reducing posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms. The current study examines the acceptability of integrating an EAAT program as part of a two-week, intensive clinical program for veterans with PTSD and/or traumatic brain injury (TBI). METHODS: A family member or support person could accompany veterans and participate in the program. One hundred and six participants (veteran n = 62, family n = 44) left the urban environment in an intensive outpatient program (IOP) to attend a two-day, weekend EAAT in rural New Hampshire. Satisfaction surveys were conducted on the last day of the program and examined using thematic analysis. RESULTS: The following themes were reported in the surveys: ability of horses to catalyze emotional rehabilitation, effectiveness of immersion in equine-assisted activities, program's ability to foster interpersonal relationships and necessity of education about PTSD for staff. Participants also reported enjoying the program as highlighted by qualitative feedback, a mean score of 9.76 (standard deviation [SD] = 0.61) as reported by veterans and a mean score of 9.91 (SD = 0.29) as reported by family members on a 10-point visual analog scale with higher scores indicating a greater overall experience. CONCLUSION: These data offer preliminary evidence that an adjunct EAAT program is acceptable for veterans with PTSD and/or TBI participating in an IOP.