Unified Protocol Versus Self-Acceptance Group Therapy for Emotional Disorders in People With Severe Shame.

BACKGROUND: Severe shame is a distressing negative emotion, accompanied by intense feelings of worthlessness that contributes to a broad panoply of psychological disorders. This study aimed to compare the effects on shame dysregulation of two transdiagnostic treatments, the Unified Protocol (UP) and Self-Acceptance Group Therapy (SAGT). We additionally addressed the question of whether borderline personality disorder (BPD) can properly be regarded as an emotional disorder. The focus was on outcome measures, primarily shame that cut across individual diagnostic categories and capture emotional dysfunction broadly conceived. METHODS: Individuals suffering from a range of emotional disorders (including BPD) and high levels of shame were randomly allocated to treatment by either UP (N = 280) or SAGT (N = 282). Outcomes were measures of emotion dysfunction-shame, loneliness, neuroticism, emotional dysregulation, positive and negative affect-measured pre-treatment, post-treatment and at 3- and 6-month follow-ups. RESULTS: UP was superior to SAGT in showing better post-treatment retention of therapeutic gains on all outcome measures over the 6-month follow-up period. Compared with those without a BPD diagnosis, those diagnosed with BPD showed significantly higher neuroticism and emotion dysregulation at baseline and a similar post-treatment reduction in almost all outcomes. CONCLUSIONS: The results support the use of both the UP and SAGT in the treatment of severe shame. The superiority of the UP over SAGT in reducing negative emotionality is interpreted in terms of the specific mechanisms targeted by the UP. The results provide support for the theoretical rationale for the UP as a treatment for dysregulated shame and for emotional dysfunction generally.

Psychological Resources and Biomarkers of Health in the Context of Chronic Parenting Stress.

BACKGROUND: Epidemiological studies link psychological resources to better physical health. One reason may be that psychological resources are protective in stressful contexts. This study tested whether indeed psychological resources are protective against biological degradation for healthy mid-life women under the chronic stress of caring for a child with an autism spectrum disorder diagnosis ("caregivers"). METHODS: We tested whether five types of psychosocial resources (i.e., eudaimonic well-being, autonomy, purpose in life, self-acceptance, and mastery) were associated with biological indices of aging in a sample of mid-life women stratified by chronic stress; half were caregivers (n = 92) and half were mothers of neurotypical children (n = 91; controls). Selected stress and age related biological outcomes were insulin resistance (HOMA-IR), systemic inflammation (IL-6, CRP), and cellular aging (leukocyte telomere length). We tested whether each resource was associated with these biomarkers, and whether caregiving status and high parenting stress moderated that relationship. RESULTS: All the psychological resources except mastery were significantly negatively associated with insulin resistance, while none were related to systemic inflammation or telomere length. The relationships between eudaimonic well-being and HOMA-IR, and self-acceptance and HOMA-IR, were moderated by parental stress; lower resources were associated with higher insulin resistance, but only for women reporting high parental stress. The well-known predictors of age and BMI accounted for 46% of variance in insulin resistance, and psychological resources accounted for an additional 13% of variance.  CONCLUSION: These findings suggest that higher eudaimonic well-being and greater self-acceptance may be protective for the metabolic health of mid-life women, and particularly in the context of high parenting stress. This has important implications given the rising rates of both parental stress and metabolic disease, and because psychological interventions can increase eudaimonic well-being and self-acceptance.

Regulatory emotional self-efficacy and psychological distress among medical students: multiple mediating roles of interpersonal adaptation and self-acceptance.

BACKGROUND: Psychological distress (depression, anxiety and stress) is more common among medical students than in the general population, and is an important cause of insomnia, internet addiction, substance abuse, decreased academic performance and increased suicidality in medical students. METHODS: To examine the mechanism by which regulatory emotional self-efficacy affects medical students' psychological distress, a questionnaire of 539 medical students using an interpersonal adaptability scale, regulatory emotional self-efficacy scale, self-acceptance scale and depression-anxiety-stress scale was conducted. RESULTS: ① Regulatory emotional self-efficacy, interpersonal adaptability and self-acceptance are positively correlated, but they are negatively correlated with psychological distress. ② The mediation model shows that interpersonal adaptation and self-acceptance are the mediation variables of the effect of regulatory emotional self-efficacy on psychological distress, and the total mediation effect value is -0.37, accounting for 86.05% of the total effect (-0.43). Specifically, the effect involves three paths: first, regulatory emotional self-efficacy indirectly affects psychological distress through interpersonal adaptation (effect value-0.24); second, regulatory emotional self-efficacy indirectly affects psychological distress through interpersonal adaptation and self-acceptance (effect value-0.08); and third, regulatory emotional self-efficacy indirectly affects psychological distress through self-acceptance (effect value -0.05). CONCLUSIONS: Interpersonal adaptation and self-acceptance have a significant mediating effect between regulatory emotional self-efficacy and psychological distress, and the chain mediating effect of interpersonal adaptation and self-acceptance is also significant.

Down but Never Out! Narratives on Mental Health Challenges of Selected College Students During the COVID-19 Pandemic in the Philippines: God, Self, Anxiety, and Depression.

The COVID-19 pandemic is continuously causing serious effects on the mental health of college students due to the series of lockdowns and sudden shifting of face-to-face classes to fully online. The study aims to determine and explore the various themes that play a significant role in the development of this issue by an in-depth study of selected reflection papers submitted in class. These texts were interpreted and analyzed using interpretative phenomenological analysis. Findings revealed three major themes: anxiety and depression as serious effects of the pandemic, God/Higher Being as the first and/or last source of support and, the essentiality of self-awareness and self-acceptance in improving mental health. These themes which are contextualized in nature hope to contribute to future research in formulating effective interventions and strategies in the war against the negative effects of the pandemic most especially for the welfare of college students.

Emotion regulation and support from others: Buffering of body dysmorphic symptoms in adolescent and young adult men but not women.

INTRODUCTION: Adolescents and young adults who overemphasize the social values placed on an attractive appearance may develop body dysmorphic symptoms (BDS), defined as over-preoccupation with perceived appearance flaws and repetitive behaviors to conceal the flaws. Further, research has found that a heightened expectation of judgement and rejection by others because of appearance (i.e., appearance-based rejection sensitivity [appearance-RS]) is both a maintaining and an aggravating factor in BDS. This study focused on emotion regulation (ER), appearance-related support from others and self-acceptance, expecting they would buffer the negative impact of appearance-RS on BDS. METHODS: Participants included 782 Australian high school and young university students, aged 14-28 years (M = 17.94 years, 40% male) who completed a survey to report their BDS, appearance-RS, ER, appearance-related support from others and self-acceptance. RESULTS: Multiple regression analyses revealed that youth reported more BDS when they were higher in appearance-RS but reported less self-acceptance, ER, and support from others. Further, the association between appearance-RS and BDS was weaker when young people reported higher (relative to lower) ER and support from others. However, when three-way interactions with gender were tested, these buffering effects were only significant for young men. CONCLUSION: Findings suggest that ER and appearance-related support from important others are promising targets for intervention, given they could mitigate the risk of appearance-RS in young men. However, further research is needed to consider additional factors that buffer against the negative effects of appearance-RS on BDS for young women.

Associations among weight suppression, self-acceptance, negative body image, and eating disorder behaviors among women with eating disorder symptoms.

The present study aimed to clarify existing research that has inconsistently shown that weight suppression (differences between individuals' highest and current body weights) is associated with worse eating disorder (ED) behaviors and negative body image among women with lifetime EDs, by examining whether an understudied client-supported protective factor for ED pathology - self-acceptance - moderates these associations. Currently symptomatic women with lifetime EDs (N = 108) completed measures assessing self-acceptance and ED symptoms via an online survey. Moderated regressions examined whether self-acceptance moderated associations between weight suppression and both body image (weight/shape preoccupation, overvaluation, dissatisfaction) and ED behavior (dietary restraint, compensatory behaviors, binge eating) outcomes. Results indicated that weight suppression was associated with more severe negative body image and dietary restraint, but not compensatory behaviors or binge eating. In contrast, self-acceptance consistently emerged as a protective factor relative to all negative body image and ED behavior indices. This protective effect did not offset apparent risk factor associations between weight suppression, and negative body image and ED behavior outcomes. These results support further assessment of self-acceptance as an understudied protective factor for women's ED symptoms and as a mechanism of change in EDs intervention research. Women's weight suppression should be assessed during ED prevention initiatives.

"I forgive myself": The association between self-criticism, self-acceptance, and PTSD in women victims of IPV, and the buffering role of self-efficacy.

The effects of intimate partner violence (IPV) concerning specifically posttraumatic stress disorder (PTSD) symptomatology have been widely demonstrated, but the consequences of abuse are not the same for all victims. We know little about the psychological processes that limit these adverse consequences. Therefore, we explored the association between self-criticism felt by abused women and their PTSD, and we investigated self-acceptance as the underlying process explaining this relationship. We also examined self-efficacy as the protective (moderating) factor. The results indicated that self-criticism was indirectly associated with greater PTSD via lower self-acceptance. Critically, the indirect effect only emerged for individuals low in self-efficacy.

Orthorexic eating behavior and body dissatisfaction in a sample of young females.

PURPOSE: To analyze body dissatisfaction in relation to orthorexic eating behavior in a sample of young females to further investigate characteristic features of orthorexic eating behavior and its association with other eating disorders. METHODS: N = 197 young females (age: M = 29.59, SD = 10.85 years) completed an online survey with the following questionnaires: the Düsseldorf Orthorexia Scale to measure orthorexic eating behavior, the Eating Disorder Inventory-2 (EDI-2), measuring psychopathological aspects of disordered eating behavior, the Dresden Body Image Questionnaire (DKB-35) to measure five components of body image, and the Body Shape Questionnaire (BSQ), measuring body dissatisfaction. RESULTS: In the total sample, Pearson correlations revealed that orthorexic eating behavior was positively associated with drive for thinness and body dissatisfaction. An independent samples t-Test revealed that females with elevated levels of orthorexic eating behavior (n = 35) displayed higher levels of drive for thinness and body dissatisfaction and lower levels of self-acceptance in comparison to a randomized sample from the remaining females with low levels of orthorexic eating behavior (n = 35). According to a multiple regression analysis, drive for thinness and body dissatisfaction measured by the BSQ served as positive predictors for orthorexic eating behavior, whereas bulimia and body dissatisfaction measured by the EDI-2 served as negative predictors. CONCLUSIONS: Results reveal that orthorexic eating behavior is more closely related to psychopathological aspects of other eating disorders than previously assumed. Body dissatisfaction as another major feature of orthorexia nervosa should be taken into account in future studies. LEVEL OF EVIDENCE: III, case-control analytic study.

LGBQ+ Self-Acceptance and Its Relationship with Minority Stressors and Mental Health: A Systematic Literature Review.

Many individuals who identify as lesbian, gay, bisexual, queer, and with other non-heterosexual orientations (LGBQ+) experience stigma, prejudice, and/or discrimination because of their sexuality. According to minority stress and identity development theories, these experiences can contribute to difficulties with self-acceptance of sexuality. Lower self-acceptance is considered a risk factor for adverse mental health outcomes. The current review aims to investigate whether self-acceptance of sexuality is associated with minority stressors or difficulties with mental health in LGBQ+ individuals, as well as whether there are differences in self-acceptance between different sexual orientations. Five bibliographic databases were searched. Thirteen studies were identified which used quantitative methodology to investigate associations between self-acceptance, minority stressors, and/or mental health within LGBQ+ samples, or differences in self-acceptance between different sexual orientations. The results from these cross-sectional studies suggested that lower self-acceptance of sexuality was associated with higher levels of self-reported minority stressors, including a lack of acceptance from friends and family, a lack of disclosure to others, and internalized heterosexism. Lower self-acceptance of sexuality was associated with poorer mental health outcomes, including greater global distress, depression symptoms, and lower psychological well-being. There was no significant relationship with suicidality. Studies also found that LGBQ+ individuals had lower general self-acceptance compared to heterosexual participants, bisexual individuals had lower sexuality self-acceptance compared to lesbian/gay individuals, and lesbian women had lower sexuality self-acceptance compared to gay men. Given the potential importance of self-acceptance for LGBQ+ populations, further research is required with more robust methodology. Self-acceptance could be a potential target in clinical interventions for LGBQ+ individuals.

Perceived Attitudes Toward Lesbian, Gay, and Bisexual (LGB) Issues and Mental Health Among Taiwanese LGB Adults: The Mediating Role of Self-Acceptance.

Research on structural stigma has associated the poor mental health status among lesbian, gay, and bisexual (LGB) people with discriminatory institutions. Yet, less is known about the role of LGB adults' perceptions of social attitudes toward LGB issues. Moreover, the psychological mediation framework posits LGB people's self-acceptance as a mediator between a stigmatizing environment and individual mental health. This study investigated: (a) how perceived attitudes toward LGB issues from different social realms (society, heterosexual friends, and family members) were associated with LGB people's mental health; and (b) whether self-acceptance mediated the effects of perceived attitudes. In this cross-sectional study, 1527 Taiwanese LGB adults (812 men; 715 women) aged between 20 and 62 years were recruited via Facebook to complete an online survey. The majority of respondents self-identified as homosexual (1129) and 399 as bisexual. The survey consisted of assessment of respondents' mental health and questions to rate individual self-acceptance and perceptions of social attitudes. Path analysis showed that self-acceptance partially mediated the association between mental health and perceived societal acceptance of homosexuality and fully mediated the effect of perceptions of friends' acceptance of homosexuality on mental health. Self-acceptance fully mediated the effects of perceived support for same-sex marriage from friends and families. This research yielded evidence about the interplay between perceived social stigma, self-acceptance, and mental health, particularly in the context of public debate about same-sex marriage. The effects of public discourse about sexual diversity and marriage equality on LGB adults' mental health should be addressed by affirmative policies and practices.

Short report: the mediator effect of meaning in life in the relationship between self-acceptance and psychological wellbeing among gastrointestinal cancer patients.

Previous studies have shown that self-acceptance is associated with psychological well-being, including psychological symptoms and life satisfaction. The present study focused on gastrointestinal cancer patients and investigated the mechanism between self-acceptance and psychological well-being among those patients, by considering the mediator role of meaning in life. A total of 292 patients with gastrointestinal cancer were recruited to complete a series of questionnaires including Self-Acceptance Questionnaire (SAQ), Chinese version of Meaning in Life Questionnaire (CMLQ), General Health Questionnaire (GHQ) and Satisfaction with Life Scale (SWLS). Results showed that the proposed model fitted the data very well (χ2/df = 2.06, GFI = 0.980, CFI = 0.979, TLI = 0.956, RMSEA = 0.061). Further analyses revealed that, the meaning in life mediated the relation between self-acceptance and psychological well-being, including psychological symptoms (indirect effect = -0.094, 95% CI = -0.155~-0.035) and life satisfaction (indirect effect = 0.243, 95% CI = 0.154 ~ 0.330). Thus, this research supported that meaning in life acts as the mediator between self-acceptance and psychological wellbeing, which is measured by psychological symptoms and life satisfaction. Meaning in life played a critical role in the relation between self-acceptance and psychological well-being. Limitations, clinical implications, and directions for future research were discussed.

The effects of quantum psychological relaxation technique on self-acceptance in patients with breast cancer.

BACKGROUND: Psychological, as well as physical effects of a disease, and side effects of medications can influence the self-acceptance of patients. Low self-acceptance can lead patients to drop out of their therapy schedule and return to the hospital several months later in much worse condition. This study aimed to investigate the effects of quantum psychological relaxation technique on self-acceptance in breast cancer patients. METHODS: This study used a pre-post quasi-experimental design with a control group. The sample included 64 respondents selected using a consecutive sampling technique and divided into two groups: intervention group (n=32) and control group (n=32). The quantum psychological relaxation technique was administered in two phases with three sessions for each phase. Six sessions were estimated at 90-120 minutes and 15-20 minutes for each. The data on patients' self-acceptance were collected using the Acceptance of Illness Scale (AIS) questionnaire and were statistically analyzed using t-test and Wilcoxon test. RESULTS: Self-acceptance in the intervention group increased after being given the intervention with a p-value <0.001. However, in the control group there was no significant increase in self-acceptance with a p-value >0.005. CONCLUSIONS: The quantum psychological relaxation technique had an effect on the self-acceptance of breast cancer patients. RECOMMENDATION: Further studies of the effects of quantum psychological relaxation technique on depression and life quality of patients need to be conducted.

The Analysis of Spirituality of Patients with HIV/AIDS in Taking Lessons and Self-Acceptance.

CONTEXT: Nursing care on the spiritual aspect is focusing on the patients' acceptance of their diseases; thus, people living with HIV (PLWH) are able to accept their diseases and are able to take the lesson. PLWH do not only deal with the condition of the disease but also by discriminative social stigma. AIM: The aim of this study was to explore, describe, and interpret the experience of spirituality to self-acceptance in patients with HIV/AIDS. RESEARCH METHODOLOGY: This research is a qualitative approach by descriptive phenomenology of participants involving as many as 10 people, consisting of 5 men and 5 women. All paticipants are muslim with the education level range from junior high school to university. The ages ranged from 29 to 46 years. RESULTS: This research identified the two themes which are: (1) being able to take the lesson from their diseases, and (2) self acceptance as people living with HIV-AIDS. There were 10 participants participated in this study. A method of in-depth interviews and observation is a help of data collection. Data analysis used was Creswell method. CONCLUSION: Results of the study suggested the patients to get motivated and to develop aspects of spirituality so that it can help to ease in the process of self acceptance, asgetting closer to God through pray, read the Quran, fasting, etc.

A randomized clinical efficacy trial of a psychosocial intervention to strengthen self-acceptance and reduce HIV risk for MSM in India: study protocol.

BACKGROUND: Men who have sex with men (MSM) in India are a key group at risk for HIV acquisition and transmission. They are also an extremely marginalized and stigmatized population, facing immense psychosocial stressors including, but not limited to, stigma, homophobia, discrimination, criminalization, low self-esteem, low self-acceptance, distress, and, as a result, high rates of mental health problems. Although these multi-level psychosocial problems may put MSM at high risk for HIV acquisition and transmission, currently HIV prevention interventions in India do not address them. This paper describes the design of a psychosocial intervention to reduce HIV risk for MSM in India. METHODS: Funded by the National Institute of Mental Health, this study is a two-arm randomized clinical efficacy trial of a self-acceptance based psychosocial HIV prevention intervention, informed by the minority stress model and syndemic theory, that was developed with extensive community-based formative work and input from the Indian MSM community and key informants who are knowledgeable about the experiences faced by MSM in India. Participants are MSM in Chennai and Mumbai who endorsed recent sexual behaviors placing them at high risk for HIV/sexually transmitted infection (STI) acquisition and transmission. Enrolled participants are equally randomized to either 1) the experimental condition, which consists of four group and six individual counseling sessions and includes standard of care HIV/STI testing and counseling, or 2) the standard of care condition, which includes HIV/STI testing and counseling alone. The primary outcomes are changes in the frequency of condomless anal sex acts and STI incidence (syphilis seropositivity and urethral, rectal, and pharyngeal gonorrhea and chlamydia infection. Major study assessment visits occur at baseline, 4-, 8-, and 12-months. DISCUSSION: HIV prevention interventions that address the psychosocial stressors faced by MSM in India are needed; this study will examine the efficacy of such an intervention. If the intervention is successful, it may be able to reduce the national HIV/AIDS burden in India while empowering a marginalized and highly stigmatized group. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02556294 , registered 22 September 2015.

The relation between remembered parental acceptance in childhood and self-acceptance among young Turkish adults.

This study examined the relation between young adults' age and remembrances of parental acceptance in childhood, and their current self-acceptance. The study was based on a sample of 236 young adults in Turkey (139 women and 97 men). The adult version of the Parental Acceptance-Rejection/Control Questionnaire for mothers and fathers along with the Self-Acceptance subscale of the Psychological Well-Being Scale, and the Personal Information Form were used as measures. Results showed that both men and women tended to remember having been accepted in childhood by both their mothers and fathers. Women, however, reported more maternal and paternal acceptance in childhood than did men. Similarly, the level of self-acceptance was high among both men and women. However, women's self-acceptance was higher than men's. Correlational analyses showed that self-acceptance was positively related to remembrances of maternal and paternal acceptance among both women and men. Results indicated that age and remembered paternal acceptance significantly predicted women's self-acceptance. Age and remembered maternal acceptance made significant and independent contributions to men's self-acceptance. Men's remembrances of paternal acceptance in childhood did not make significant contribution to their self-acceptance. Finally, the relation between women's age and self-acceptance was significantly moderated by remembrances of paternal acceptance in childhood.

The effectiveness of a group-based educational program on the self-efficacy and self-acceptance of menopausal women: A randomized controlled trial.

This study aimed to assess the effectiveness of a group-based educational training on the self-efficacy and self-acceptance of Iranian menopausal women using the PRECEDE-PROCEED model. This Randomized Controlled Trial (RCT) was conducted on 80 menopausal women in the age range of 47-55 years residing in the northeast of Iran. The participants were divided randomly into a test group (n = 40) and a control group (n = 40). We found that designing and implementation of a group-based educational training according to the PRECEDE-PROCEED model can significantly enhance the knowledge and performance of the test group with regard to self-efficacy and self-acceptance.

Compassionate Self-Awareness: A Hidden Resource for Nurses for Developing a Relationship With Self and Patients.

Sometimes nurses are too harsh on themselves because they truly want to provide compassionate care for their patients. This attitude can lead to feelings of emptiness, hopelessness, incompetence, frustration, and despair. In such situations, nurses can improve their well-being by developing compassionate self-awareness-becoming aware of one's strengths and limitations without being over-critical and judgmental. This article describes the concept of compassionate self-awareness in light of the available anecdotal literature and personal experiences and argues that compassionate self-awareness can serve as a hidden resource for developing a therapeutic relationship with self and with patients.

Relationships between dispositional mindfulness, self-acceptance, perceived stress, and psychological symptoms in advanced gastrointestinal cancer patients.

OBJECTIVE: Previous studies have shown that dispositional mindfulness is associated with less psychological symptoms in cancer patients. The present study investigated how dispositional mindfulness is related to psychological symptoms in advanced gastrointestinal cancer patients by considering the roles of self-acceptance and perceived stress. METHODS: A total of 176 patients with advanced gastrointestinal cancer were recruited to complete a series of questionnaires including Mindfulness Attention Awareness Scale, Self-acceptance Questionnaire, Chinese Perceived Stress Scale, and General Health Questionnaire. RESULTS: Results showed that the proposed model fitted the data very well (χ2  = 7.564, df = 7, P = .364, χ2 /df = 1.094, Goodness of Fit Index (GFI) = 0.986, Comparative Fit Index (CFI) = 0.998, Tucker Lewis Index (TLI) = 0.995, Root Mean Square Error of Approximation (RMSEA) = 0.023). Further analyses revealed that, self-acceptance and perceived stress mediated the relation between dispositional mindfulness and psychological symptoms (indirect effect = -0.052, 95% confidence interval = -0.087 ~ -0.024), while self-acceptance also mediated the relation between dispositional mindfulness and perceived stress (indirect effect = -0.154, 95% confidence interval = -0.261 ~ -0.079). CONCLUSIONS: Self-acceptance and perceived stress played critical roles in the relation between dispositional mindfulness and psychological symptoms. Limitations, clinical implications, and directions for future research were discussed.

Self-acceptance and associated factors among Chinese women with breast cancer.

AIMS AND OBJECTIVES: To identify self-acceptance and associated socio-demographic and disease factors among Chinese women with breast cancer. BACKGROUND: Although it is recognised that breast cancer can affect a woman's feelings of self-acceptance, there are few studies concerning the level of self-acceptance among women with breast cancer and factors associated with self-acceptance in this population. DESIGN: Cross-sectional research design. METHODS: Data were collected using the convenience sampling method. A total of 308 women with breast cancer were investigated using the Self-Acceptance Questionnaire. RESULTS: The mean score on the Self-Acceptance Questionnaire was 39·79 ± 5·14, indicating that the women in this study had low levels of self-acceptance. Multiple regression analysis indicated that self-acceptance was positively associated with the time since diagnosis, household income and the presence of medical insurance/government-funded medical treatment, while Tumour, Lymph Node, Metastasis stage was negatively associated with self-acceptance. With respect to work status, retired patients had the highest levels of self-acceptance, those who had returned to work had moderate levels of self-acceptance and those who had not yet returned to work had the lowest levels of self-acceptance. CONCLUSIONS: This study demonstrates that the level of self-acceptance among women with breast cancer in China is low, and suggests that there is room to improve. Several factors are significantly associated with the self-acceptance of women with breast cancer. RELEVANCE TO CLINICAL PRACTICE: Medical staff should realise that the level of self-acceptance among women with breast cancer in China is low and has room to improve. It is important to conduct appropriate interventions to improve self-acceptance among these women, based on an understanding of the factors associated with self-acceptance.

Correlates of a Single-Item Indicator Versus a Multi-Item Scale of Outness About Same-Sex Attraction.

In this study, we investigated if a single-item indicator measured the degree to which people were open about their same-sex attraction ("out") as accurately as a multi-item scale. For the multi-item scale, we used the Outness Inventory, which includes three subscales: family, world, and religion. We examined correlations between the single- and multi-item measures; between the single-item indicator and the subscales of the multi-item scale; and between the measures and internalized homonegativity, social attitudes towards homosexuality, and depressive symptoms. In addition, we calculated Tjur's R (2) as a measure of predictive power of the single-item indicator, multi-item scale, and subscales of the multi-item scale in predicting two health-related outcomes: depressive symptoms and condomless anal sex with multiple partners. There was a strong correlation between the single- and multi-item measures (r = 0.73). Furthermore, there were strong correlations between the single-item indicator and each subscale of the multi-item scale: family (r = 0.70), world (r = 0.77), and religion (r = 0.50). In addition, the correlations between the single-item indicator and internalized homonegativity (r = -0.63), social attitudes towards homosexuality (r = -0.38), and depression (r = -0.14) were higher than those between the multi-item scale and internalized homonegativity (r = -0.55), social attitudes towards homosexuality (r = -0.21), and depression (r = -0.13). Contrary to the premise that multi-item measures are superior to single-item measures, our collective findings indicate that the single-item indicator of outness performs better than the multi-item scale of outness.