A heavy burden: Associations between sexual minority status, mental health, and BMI in women.

BACKGROUND: Sexual minority women (SMW) are at increased risk of elevated body mass index (BMI) compared to heterosexual women, increasing their vulnerability to chronic diseases. Nonmonosexual SMW appear to be at additional risk for elevated BMI, likely due to unique sexual minority stressors. METHODS: A total of 437 SMW and heterosexual women completed a cross-sectional, online survey including self-report measures of sexual orientation dimensions, weight, psychological distress, and eating behaviors. We investigated relations among these variables to better understand disparities in self-reported BMI based on sexual orientation and sexual orientation discordance (SOD). RESULTS: SMW self-reported more psychological distress, more binge eating, and higher BMIs than their heterosexual peers, with nonmonosexual groups of SMW often reporting the highest values. SOD was positively associated with psychological distress. CONCLUSIONS: SMW-particularly nonmonosexual SMW-are at increased risk for psychological distress, binge eating, and elevated BMI relative to heterosexual peers. Future research should further elucidate mechanisms for these disparities.

Examining weight and eating behavior by sexual orientation in a sample of male veterans.

OBJECTIVE: Eating disorders are understudied in men and in sexual minority populations; however, extant evidence suggests that gay men have higher rates of disordered eating than heterosexual men. The present study examined the associations between sexual orientation, body mass index (BMI), disordered eating behaviors, and food addiction in a sample of male veterans. METHOD: Participants included 642 male veterans from the Knowledge Networks-GfK Research Panel. They were randomly selected from a larger study based on previously reported trauma exposure; 96% identified as heterosexual. Measures included the Eating Disorder Diagnostic Scale, the Yale Food Addiction Scale, and self-reported height and weight. RESULTS: Heterosexual and sexual minority men did not differ significantly in terms of BMI. However, gay and bisexual men (n=24) endorsed significantly greater eating disorder symptoms and food addiction compared to heterosexual men. CONCLUSIONS: Our findings that sexual minority male veterans may be more likely to experience eating disorder and food addiction symptoms compared to heterosexual male veterans highlight the importance of prevention, assessment, and treatment efforts targeted to this population.

Examining Associations of Sexual Attraction and Attitudes on Women's Disordered Eating Behavior.

OBJECTIVE: We aimed to expand the scant research on disordered eating in women identifying same-sex sexual attractions. METHOD: We used multiple linear regressions to explore potential mechanisms driving disordered eating--both explicit and implicit weight bias and heterosexism--in a cross-sectional, online-recruited community sample of women (N = 437). Participants endorsed a range of sexual attractions from exclusively opposite-sex (21.1%) to exclusively same-sex (19.5%) attraction. RESULTS: Findings revealed no associations between sexual attraction and disordered eating. Awareness of sociocultural norms valuing thinness accounted for disordered eating for all women, regardless of sexual attraction, and was influenced by attitudes regarding weight. Among women endorsing same-sex attractions, self-reported internalized heterosexism influenced disordered eating. DISCUSSION: Findings contradict long-held beliefs that same-sex attracted women are protected from disordered eating. They emphasize a universal risk, for all women, of sociocultural norms valuing thinness, as well as the risk of internalized heterosexism among same-sex attracted women.

The use of dialectical behavior therapy skills training as stand-alone treatment: a systematic review of the treatment outcome literature.

OBJECTIVE: Dialectical behavior therapy (DBT) skills training is currently being administered as stand-alone treatment across a variety of clinical settings, serving diverse client populations. However, there is little empirical support for this use. METHOD: In this systematic review, we identified 17 trials employing a treatment that included DBT skills training in the absence of the other DBT modalities. RESULTS: While the literature reviewed provides preliminary evidence of the utility of DBT skills training to address a range of mental health and behavioral problems, methodological limitations of published studies preclude us from drawing strong conclusions about the efficacy of skills training as a stand-alone treatment. CONCLUSION: We present an overview of the implementation of DBT skills training across clinical settings and populations. We found preliminary evidence supporting the use of DBT skills training as a method of addressing a range of behaviors. We provide recommendations for future research.

Patterns of disordered eating behavior in women by sexual orientation: a review of the literature.

Most disordered eating research has focused on White, heterosexual women. More empirical work is needed to better understand disordered eating among women of diverse backgrounds. Given evidence of disparities between heterosexual and sexual minority (i.e., non-heterosexual) women in other health behaviors (e.g., tobacco use) and outcomes (e.g., cardiovascular disease), it appears important to study disordered eating behaviors among sexual minority women. In this article, we review the extant literature on disordered eating behaviors in women across sexual orientations, with a focus on research examining potential mechanisms of disparities in disordered eating, including awareness and internalization of sociocultural norms.

Compensatory weight control behaviors of women in emerging adulthood: associations between childhood abuse experiences and adult relationship avoidance.

OBJECTIVE: To examine correlates of compensatory weight control behaviors among women in transition between adolescence and adulthood. PARTICIPANTS: The authors recruited a sample of undergraduate women (N = 759) at a large northwestern university during the 2009-2010 academic year. METHODS: Logistic regression was used to assess relations among childhood abuse, psychosocial functioning, adult dating relationship factors, and women's endorsement of compensatory weight control behaviors. RESULTS: The final model reliably distinguished between participants who endorsed versus denied use of compensatory behaviors (χ(2)[5, N = 747] = 36.37, p < .001), with global psychosocial functioning and relationship avoidance accounting for the most variance. CONCLUSIONS: These findings illustrate the importance of considering childhood abuse histories and adult relationships while assessing young women's compensatory weight control behaviors.

Patient-provider relationship predicts mental and physical health indicators for HIV-positive men who have sex with men.

We used secondary data analysis to examine associations among aspects of patient-provider relationships and mental and physical health indicators. Positive patient perceptions of patient-provider relationships were associated with fewer mental health symptoms in this outpatient sample of HIV-positive men who have sex with men (N = 171). Regression analyses revealed the role of anxiety and depression in explaining associations between two aspects of patient-provider relationships (i.e. quality of information offered and provider interactional style) and health-related quality of life. The findings demonstrated the importance of patient-provider relationships to improving physical health and functioning and maintaining engagement in care, among HIV-positive men who have sex with men.

Finding meaning after same-sex partner abuse: a content analysis of experiences of men with HIV.

Given the high rates of partner abuse (PA) among sexual minority men with HIV, it is surprising that this phenomenon remains largely understudied in this group. The extant literature reveals little about the lived experiences of the men who experience abuse in their primary relationships. Furthermore, the role of meaning making in recovery from PA remains unclear for any demographic group. Knowledge of such appraisals may provide insight into the ways that sexual minority men with HIV understand or assign value to their abuse experiences. Here, we aim to qualitatively explore the ways in which such men (N = 28) find meaning following their experiences of PA. In general, most men reported a sense of personal strength from having endured and survived PA. Surprisingly, the men did not link their postabuse recovery experiences to their sexual minority identity nor to their HIV status. Some men mentioned an increased sense of agency and attention to their own needs in their postabuse lives. With the exception of positive relationships with providers, the men described little use of peer or family support and ongoing social isolation.

A systematic review of dialectical behavior therapy for the treatment of eating disorders.

Dialectical behavior therapy (DBT) has been proposed as an effective treatment for eating disorders (EDs). We conducted a systematic literature review to locate refereed journal articles testing DBT for the treatment of EDs. We identified 13 studies empirically evaluating treatment efficacy across various settings. Findings, based on mostly uncontrolled trials, indicate that DBT treatments appear effective in addressing ED behaviors and other forms of psychopathology in ED samples. The expectation that improvements in emotion regulation capabilities drive reductions in ED pathology was not fully supported. Further research is necessary to confirm the efficacy of modified DBT treatments for EDs.

Psychosocial correlates of HIV-monoinfection and HIV/HCV-coinfection among men who have sex with men.

Rates of hepatitis C virus (HCV) among HIV-positive men who have sex with men (MSM) appear to be high and rising. In other demographic groups, HIV/HCV-coinfection is associated with poor physical and psychological outcomes. In this study, we examined health-related and psychosocial correlates of HIV/HCV-coinfection in a clinic sample of MSM. Cross-sectional data were collected from 171 MSM. One-third of the sample was coinfected. Higher rates of depressive and PTSD symptoms were observed in coinfected patients. Coinfected men were more likely to report perfect 30-day medication adherence, but exhibited lower CD4 cell counts and more past year emergency room visits. Despite consistent engagement with care and higher rates of medication adherence, HIV/HCV-coinfected MSM exhibited significantly more mental health problems. Medical and mental health providers should be especially attentive to the mental health status of HIV/HCV-coinfected MSM, despite adequate health behaviors and physical health status.