Recommendations for the assessment of sexual and gender minority status in serious mental illness research and clinical care.

Sexual and gender minority (SGM) groups experience exposure to minority stress, including discrimination, prejudice, microaggressions, and internalized stigma. Despite the sizable portion of the United States' population that identifies as SGM, relatively little research has been done to comprehensively understand the mental health consequences of SGM stress-particularly as they relate to serious mental illnesses (SMIs)-and SGM status is rarely reported in published studies. This article provides an overview of SGM research among people with SMIs as well as other relevant disorders. Findings show that sizable gaps remain in our knowledge of whether SGM groups experience higher rates or greater severity of SMIs, including schizophrenia-spectrum and bipolar disorders, though findings related to depressive and trauma-related disorders may be able to inform research and treatment for those with SMIs. To increase our understanding of potential mental health disparities for those with SMIs, researchers are encouraged to include measures to assess SGM identity, report upon this demographic information within their manuscripts, and examine differences in rates and severity of SMIs between these groups. Clinicians are encouraged to incorporate demographic questions into their standard intake batteries and initiate discussion of SGM status and minority stressors early on in treatment to promote more positive outcomes for this group. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sexual Assault History May Moderate Posttraumatic Cognition and Posttraumatic Stress Among Trauma-Exposed Sexual Minority Women.

Sexual minority women (SMW) are highly vulnerable to trauma exposure and posttraumatic stress disorder (PTSD) symptoms following trauma exposure. Negative posttraumatic cognitions (i.e., negative cognitions about self, world, and self-blame following trauma exposure) are hypothesized to exacerbate and maintain the relationship between trauma exposure and PTSD symptoms. Posttraumatic cognitions are particularly important to examine in relation to PTSD symptoms among trauma-exposed SMW given their elevated risk for trauma exposure and PTSD. It is also important to understand whether the strength of this relationship differs as a function of trauma type to elucidate potentially differential pathways for risk by trauma type in this population. The current study explored whether trauma type (sexual assault vs. nonsexual trauma) moderated the relationship between negative posttraumatic cognitions and PTSD symptom severity among a sample of trauma-exposed SMW. Participants were SMW (n = 516) users of an online survey platform, Prolific. Data were collected via 20-minute online survey. Results indicated that trauma type moderated the relationship between negative posttraumatic cognitions and PTSD symptom severity, such that the relationship was stronger among those who had experienced at least one sexual assault in their lifetime. Results suggest that negative posttraumatic cognitions may be more strongly related to PTSD symptom severity among SMW who have experienced at least one sexual assault. Notably, this difference was in magnitude only, as the posttraumatic cognition-PTSD symptom relationship remained significant among nonsexual trauma survivors. Negative posttraumatic cognitions may be an especially relevant treatment target among SMW survivors of sexual assault.

Considering the Impact of High School Sexual Education on Past Sexual Victimization and Rape Myth Acceptance in a College Sample.

Sexual victimization is a serious public health crisis affecting college students, with high rates reported among both women and men. Sexual consent education is crucial as it defines sexual assault and is linked to reduced risk of victimization. Rape myths and stereotyped beliefs shifting blame to survivors are established risk factors for sexual violence. Comprehensive sexual education can mitigate these attitudes, fostering a supportive environment for survivors. However, most high school students in the United States receive abstinence-based or abstinence-plus education, which uses unstandardized protocols and often lacks information about sexual consent. The following study explores the influence of high school sexual education on past sexual victimization and rape myth acceptance in college students. Six hundred sixty-four undergraduate students participated in an online survey through a university participant pool. Results show that those who received comprehensive sexual education were more likely to understand sexual consent and were less likely to endorse past sexual victimization. In contrast, students without comprehensive sexual education reported lower satisfaction with their sexual education and greater acceptance of rape myths. Despite limitations in the study's sample and reliance on self-reporting, this research highlights the importance of implementing comprehensive sexual education, including consent education, in high schools. Policymakers and educators must recognize the influence of comprehensive sexual education in promoting healthy relationships and combating sexual assault. As a significant public health concern, incorporating standardized sexual consent education into high school curricula can equip students with the knowledge and skills to make informed decisions about their sexual health and relationships. Future research should explore diverse populations and the mediating role of related factors that may further influence these relationships. These efforts will contribute to fostering a safer environment within educational institutions and combating sexual assault.

The Indirect Effects of Proximal Stressors Associated with Posttraumatic Stress Symptoms Severity among Sexually Victimized Sexual Minority Women: A Cross-Sectional Path Analysis.

Sexual minority women (SMW) are at risk for sexual victimization and stressors specifically related to their minority identity (e.g., discrimination). However, SMW experience posttraumatic stress disorder (PTSD) at rates beyond what may be explained by elevated risk for sexual victimization alone. This study aimed to examine the impact of stigma on PTSD symptoms among SMW survivors of sexual victimization. Results indicate that in relation to minority-specific distal stressors (i.e., heterosexist experiences), both minority-specific and general proximal stressors (i.e., internalized heterosexism, negative posttraumatic cognitions) indirectly affected PTSD symptom severity among this cross-sectional sample of sexually victimized SMW.

Differences in Anxiety Sensitivity Among Black and White Veterans.

Black Americans are at greater risk for more severe and enduring consequences of anxiety disorders than White Americans, highlighting the need to identify malleable risk and maintenance factors. The current study aimed to examine racial differences in anxiety sensitivity and anxiety sensitivity facets between Black and White veterans (N = 285; 58% Black, 77% Male; Mage = 43.51, SD = 11.87) presenting to a PTSD specialty clinic at a Veterans Affairs (VA) hospital. In addition to a diagnostic interview, veterans were asked to complete a brief battery of self-report questionnaires to assist with diagnostic clarification and treatment planning. Results revealed a significant difference in anxiety sensitivity total scores between Black (M = 44.5, SD = 17.2) and White veterans (M = 36.1, SD = 17.7), such that Black veterans evinced higher levels. When examining anxiety sensitivity subfacets, Black veterans also evinced elevated levels of physical (M = 14.4, SD = 6.6) and cognitive concerns (M = 15.2, SD = 6.5) compared to White veterans (M = 9.8, SD = 6.2; M = 11.7, SD = 6.6, respectively). Results indicate that anxiety sensitivity is a relevant risk factor among Black veterans. Future studies should examine the extent to which anxiety sensitivity is modifiable in such populations.

Sexual Victimization and Suicide Ideation: An Atemporal Indirect Effects Model.

INTRODUCTION: Suicide is a major public health concern among young adults. Moreover, college students are at elevated risk for sexual victimization, which is associated with elevated suicide risk. Nonetheless, not all college student survivors of sexual victimization think about suicide. Previous research has used the interpersonal psychological theory of suicide (IPTS) as a framework for understanding the association between interpersonal violence victimization and suicide ideation The current study aimed to replicate and extend the results of Poindexter et al. AQ1] by testing the serial indirect effects of IPTS constructs in the relationship between sexual victimization and suicide ideation among a sexually-victimized sample of college students. It was expected that depressive symptoms, thwarted belongingness, and perceived burdensomeness, in that order, would indirectly affect the association between cumulative sexual victimization history and suicide ideation in the past month. METHOD: Data were collected from 796 college students via online survey. After exclusion criteria, 236 college students who reported at least one lifetime experience of sexual victimization were included in analysis. RESULTS: Results indicated that the relationship between cumulative sexual victimization and past-month suicide ideation frequency was indirectly affected by depressive symptoms, thwarted belongingness, and perceived burdensomeness, in serial. DISCUSSION: Results indicated that the indirect effects model proposed by Poindexter et al. was significant in that more frequent lifetime sexual victimization related to more frequent past-month suicide ideation, and this relationship was strengthened indirectly by depressive symptoms, TB, and PB, in that order. Results underscore the importance of screening survivors of sexual victimization for suicide ideation and associated risk factors, specifically depressive symptoms, TB, and PB.

Resilience Mediates the Relationship Between PTSD Symptoms and Disordered Eating in College Women Who Have Experienced Sexual Victimization.

It is widely known that sexual assault disproportionately affects women, and college-aged women are particularly at risk. Sexual assault can occur at any age and may have a varying range of emotional consequences for survivors, including pathological coping mechanisms such as disordered eating behaviors. This study examined the mediating effect of resilience on the relationship between posttraumatic stress disorder (PTSD) symptoms and disordered eating behavior in a sample of women who reported experiencing sexual assault in adulthood. The sample included 312 undergraduate women who identified as majority White (81.4%) and heterosexual (77.9%). Participants completed measures assessing history of sexual experiences, PTSD symptoms, disordered eating behavior, and resilience. Only those who reported experiences of sexual victimization since age 14+ were included in analyses. Results confirmed the hypothesis, as resilience significantly mediated the relationship between PTSD symptoms and disordered eating behavior in a sample of women with a history of sexual victimization. These results highlight the importance of resilience as a mitigating factor in recovery from sexual trauma. Other research indicates that resilience may have emotion-regulatory benefits that mitigate the development of disordered eating behavior. However, the specific functionality of resilience as a protective factor after sexual victimization is unclear. Further research should focus on ways to foster resilience in a clinical setting for those with a history of sexual victimization. Limitations of this study include underrepresentation of racial and ethnic minorities, as well as use of entirely self-report measures.

Exploring the indirect effects of acute dissociation on capability and suicide risk: A multi-method investigation with augmented reality.

INTRODUCTION: The current study aimed to explicate the role of dissociation in the capability and suicide relationship by examining how lifetime and state-based acute dissociation contributes to capability for suicide using a multi-method approach of self-report and augmented reality (AR) laboratory tasks. METHOD: Participants (N = 145) were students recruited for course credit at a southern university. Participants completed self-report and laboratory AR dissociative induction tasks. Correlations and mediation analyses were conducted to test hypotheses using SPSS v. 26 and PROCESS Macro. RESULTS: There was a significant indirect effect on capability and suicidal ideation via acute dissociation (ß = 0.035, SE = 0.02, 95% CI = 0.001, 0.095). Additionally, there was a significant indirect effect on capability and suicide attempt(s) via dissociation (ß = 0.19, SE = 0.10, 95% CI = 0.044, 0.449). CONCLUSIONS: As prior theories suggest, dissociation may augment feeling disconnected from the body and may temporarily impact capability to render a suicidal act as more probable. The presence of dissociation after a painful and provocative attempt may increase capability and pain tolerance. Implications of these findings include the consideration of dissociation as a pertinent factor in the assessment and treatment of suicide and the role of AR in aiding the exploration of suicide correlates.

Toward an integrative model of transdiagnostic risk factors and suicide: A network comparison of psychiatric outpatients.

Predictive models using traditional statistical methods have largely failed to describe suicide etiology. Network theory, which conceptualizes factors as mutually interacting, reinforcing elements of a complex outcome, can model relationships between transdiagnostic and neurocognitive vulnerability factors. The present study used a network approach to produce an atheoretical model of psychological factors and their interrelationships within a population of ideators and non-ideators. We developed two network models (i.e., suicidal ideators and psychiatric controls) describing the relationships between a diverse set of risk factors and symptom measures for a population of psychiatric outpatients. We compared networks using three measures of network structure (i.e., network structure invariance, global strength invariance, edge invariance) and described the differences. Network structures for ideators (N = 229) and non-ideators (N = 454) were stable and accurate. In non-ideators, cognitive-affective depression symptoms (Expected Influence [EI]: 2.06), trauma avoidance (EI: 1.08), and negative affect (EI: 0.81) were most influential to the psychological network. In ideators, cognitive-affective depression symptoms (EI: 1.77), intolerance of uncertainty-negative self-referent implications (EI: 1.29), and negative affect (EI: 1.19) were most influential. Invariance testing did not indicate significant differences in overall network structure between ideators and non-ideators (p = .111), but did indicate significant differences in node strength (p = .013). Significant differences in node EI were detected for intolerance of uncertainty-negative self-referent implications, anxiety sensitivity physical concerns, thwarted belongingness, worry, and negative affect. These findings indicated differences in network structures for suicidal psychiatric outpatients and provide crucial directions for future research on therapeutic targets for suicidal thoughts and behaviors.

Examining Nonsuicidal Self-Injury Features as Motivational Moderators in the Relationship Between Hopelessness and Suicide Ideation.

OBJECTIVE: Nonsuicidal self-injury (NSSI) is a robust predictor of suicide ideation and attempts, but it is not clear how and why this connection is so strong. Using the Integrated Motivational-Volitional Model of suicide as a framework, select features of NSSI were examined as motivational moderators between hopelessness and suicide ideation. METHOD: Data were collected from 420 emerging adults (mean age = 18.9; 84% female, 92% white), all of whom had past-year NSSI. Participants completed self-report measures that assessed NSSI and suicide history, effectiveness of NSSI in achieving functions, and hopelessness; they also completed the self-injury Implicit Association Test (IAT). RESULTS: Moderation analyses revealed that none of the interactions were significant. Additional analyses tested unconditional effects of all predictor variables and found hopelessness, self-rated future likelihood of engaging in NSSI, effectiveness of NSSI in achieving intrapersonal functions, and self-injury IAT scores were each significantly associated with suicide ideation. CONCLUSIONS: These results reinforce the important role of hopelessness, perceived effectiveness of NSSI in achieving intrapersonal functions, acknowledgement of future NSSI, and self-identification with NSSI as potential indicators of increased suicide risk, while also emphasizing further study of other possible moderating factors.HIGHLIGHTSFeatures of NSSI did not moderate the hopelessness-suicide ideation relationship.Features of NSSI did associate with increased suicide ideation frequency.Future likelihood of, implicit association with, and intrapersonal effectiveness of NSSI were important.