Effects of sexual orientation-based prejudice and discrimination in family of origin on depressive symptoms and life satisfaction in a Chinese sample: Reciprocal and authoritarian filial piety as moderators.

Experiencing prejudice and discrimination from family has been found to be positively associated with mental health problems among sexual minorities. Emerging evidence also shows the value of contextualizing the internalization of minority stress by considering individual cultural factors, such as filial piety. We examined whether authoritarian filial piety (AFP) and reciprocal filial piety (RFP) moderated the link between distal stressors in one's family and mental health outcomes. A total of 362 (56.9% male; age: M = 24.55, SD = 6.60) Chinese lesbian, gay, bisexual, queer/questioning, and other non-heterosexual (LGBQ+) individuals participated in this study. They provided demographic information and completed a battery of measures for AFP and RFP, sexual orientation-based prejudice and discrimination in family of origin (SOPDF), depressive symptoms, and life satisfaction. Structural equation modeling results showed that SOPDF had a positive and negative link with depressive symptoms and life satisfaction, respectively. In addition, we identified AFP and RFP as significant moderators for the association between SOPDF and depressive symptoms, and the association between SOPDF and life satisfaction, respectively. Specifically, the positive effect of SOPDF on depressive symptoms was greater for participants with higher levels of AFP; the negative effect of SOPDF on life satisfaction was greater for participants who endorsed higher levels of RFP. Our findings corroborated past studies' conclusion about the detrimental impact of familial sexual stigma on LGBQ+ people's mental health. Furthermore, such impact on negative and positive mental health outcomes are respectively conditioned by the degree to which LGBQ+ individuals endorse AFP and RFP. These findings underscore the importance for therapists who endorse family therapy to help LGBQ+ clients navigate familial sexual stigma and consider the role of filial piety beliefs in shaping the impact of familial sexual stigma on these clients' mental health.

Mentorship for young gay men in Hong Kong: A pilot mixed-methods randomized controlled trial.

This study examined whether mentorship could promote young gay men's identities and well-being, and whether a mentor's sexual orientation matters. A randomized control trial compared outcomes across three conditions: Arm A (a mentee matched with a sexual minority mentor), Arm B (a mentee matched with a heterosexual mentor), and a control arm receiving psychoeducation only. A community sample of 60 mentees aged 18-25 years was randomly allocated to the three arms and completed questionnaires at baseline, 3 months into the intervention, and at the end of the 6-month program. Fifteen mentees recounted their mentoring experiences through in-depth interviews. Linear mixed effects models showed that for both intervention and control conditions, internalized homonegativity declined while resilience, loneliness, and body acceptance improved over time. No time and group interactions were found. Meanwhile, a mentor's sexual orientation did not drive differential quality and outcomes of mentorship. Interviewees cited various benefits of mentorship, including providing companionship, enriching connection with lesbian, gay, bisexual (LGB) communities, and adding knowledge and perspectives of LGB lives and identities. Although quantitative data did not support any exclusive benefits of mentorship, most mentees recognized mentorship as a vital source of affirmation and companionship. Implications for research and mentoring programs are discussed.

The Mental Health Costs of Online Heterosexism Among LGBTQ+ Individuals: Development and Initial Validation of the Perceived Online Heterosexism Scale.

Experiences of heterosexism are rampant online, where bias and harassment against LGBTQ+ individuals spread conveniently and widely. Yet, research has been limited in understanding the exposure to online heterosexism among LGBTQ+ individuals partly due to the lack of a quantitative measure to advance this research. Thus, the current study developed and examined the psychometric properties of the Perceived Online Heterosexism Scale (POHS). Items were developed via a literature review, a survey of social media platforms, and an expert review. Exploratory (N = 288) and confirmatory (N = 653) factor analyses yielded a 4-factor structure and produced a 20-item scale with the following subscales: (1) Heterosexist Cyberaggression (4 items), (2) Online Heterosexist Stereotyping (4 items), (3) Online Exposure to Systemic Heterosexism (8 items), and (4) Heterosexist Online Media (four items). Internal consistency estimates ranged from .91 to .96, and the POHS accounted for 65.9% of the variance. Examination of a second-order model suggested that a total scale score can also be used. Initial construct validity was evidenced as POHS scores were associated with an existing heterosexism measure, anxiety and depressive symptoms, internalized heterosexism, and LGBTQ+ community connectedness in line with theory and empirical evidence. Implications for research practice are discussed.

A curvilinear association between therapists' use of discourse particles and therapist empathy in psychotherapy.

This study investigates the relationships between therapists' use of discourse particles and therapist empathy. Discourse particles, commonly found in non-English languages, are verbal elements that constitute metacommunication by encoding speakers' emotions and attitudes, which are typically expressed by nonverbal behaviors (e.g., intonation, tone, facial expression, nodding). We hypothesize an inverted U-shaped curvilinear relationship between therapists' use of discourse particles and therapist empathy, given the notion that an optimal level of therapists' emotion in psychotherapy can facilitate clients' inner experiencing and self-expression. Four psychotherapy sessions each from 39 therapist-client dyads were analyzed. After each session, therapist empathy was rated by trained observers using the Therapist Empathy Scale (TES) and by clients using the Barrett-Lennard Relationship Inventory (BLRI). Multilevel modeling shows that both the person-level negative quadratic term and positive linear term for therapists' usage of discourse particles are significant in predicting mean TES with large effect sizes. The same predictors do not yield significant results in predicting mean BLRI but they trend in similar directions of associations with medium effect sizes. Our results suggest the optimal usage of discourse particles by therapists is around 20.3% (out of all utterances). The nonsignificant results in BLRI may be attributed to the relatively small sample size of our data and the noncommunication orientation of the client-rated measure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining the protective role of self-compassion in the links between daily sexual orientation salient experiences and affect.

Research has shown that minority stress is linked to poorer mental health across a variety of stigmatized populations, including lesbian, gay, bisexual, and queer (LGBQ) people. It is therefore essential to understand factors that can counteract minority stress. To date, most research on LGBQ people's resilience relied on retrospective reports of stressful identity-salient experiences. This limits the understanding about resilience factors that enable LGBQ people to thrive in the face of minority stressors as they occur on a day-to-day basis. The present study addressed this gap by using a daily diary design to test whether self-compassion protects LGBQ people's affective well-being from daily stressful sexual orientation-salient experiences (SOSEs). A sample of 235 LGBQ adults completed a baseline survey that assessed self-compassion, as well as brief online surveys twice daily for a maximum of 17 days that assessed SOSEs and affect, providing a total of 3,310 days of data. As anticipated, results of multilevel modeling showed that negative and positive SOSEs were linked to negative and positive evening affect, respectively, at both the daily and person levels. Self-compassion moderated the link between daily negative SOSEs and positive evening affect, such that daily negative SOSEs were linked to lower positive affect only among those with lower self-compassion. Moderation effect was not observed for negative evening affect as an outcome. Exploratory analysis suggested that the buffering effect of self-compassion could be impacted by contextual factors. Our study showed the importance of self-compassion and access to positive SOSEs for LGBQ people's well-being. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

LGBQ affirmative practice and psychological well-being in China.

Research has consistently shown the importance of affirmative practice when therapists work with lesbian, gay, bisexual, queer/questioning (LGBQ) clients. However, less is known about factors that may influence the extent to which clients benefit from affirmative practice. The present study intends to address this gap by examining whether LGBQ affirmative practice would be positively associated with psychological well-being, and whether individuals factors including internalized homophobia (IH), reciprocal filial piety (RFP; providing care and support for parents based on affective bonding), and authoritarian filial piety (AFP; showing unconditional obedience to parents based on parental authority) would moderate this relationship. A total of 128 Chinese LGBQ clients (50% male, 38.3% female, and 11.7% nonbinary/gender queer; age: M = 25.26 years, SD = 5.46) from 21 provinces and regions completed the online survey. Results revealed that LGBQ affirmative practice was positively associated with psychological well-being after controlling for LGBQ clients' pretherapy distress and therapists' credibility. Such association was greater for LGBQ clients who had higher levels of IH and AFP, whereas such effect did not vary with RFP. This study provides preliminary empirical evidence for the effectiveness of LGBQ affirmative practice in psychological health among Chinese LGBQ clients. Moreover, LGBQ affirmative practice might be more helpful for LGBQ clients with higher IH and AFP. These findings implicate that Chinese counselors and therapists should engage in LGBQ affirmative practice when they work with LGBQ clients, especially for those who have high levels of IH and AFP. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Prevalence, risk, and protective factors of self-stigma for people living with depression: A systematic review and meta-analysis.

BACKGROUND: People living with depression are subjected to widespread stigmatization worldwide. Self-stigma may negatively affect patients' treatment, recovery, and psychological well-being. This review aims to summarize and synthesize the evidence on the prevalence, risk, and protective factors of depression self-stigma. METHODS: Four online databases, PubMed, PsycINFO, Web of Science, and Embase, were searched to identify eligible studies. Fifty-six studies involving a total of 11,549 samples were included in the final analysis. Four reviewers independently screened the literature, extracted data, and assessed the risk of bias in eligible studies. Pearson's r was chosen as the effect size metric of risk and protective factors. RESULTS: The results showed that the global prevalence of depression self-stigma was 29 %. Levels of self-stigma varied across regions, but this difference was not significant. Two demographic factors were identified: ethnicity (r = 0.10, p < 0.05) and having a partner/married (r = -0.22, p < 0.001). Five risk factors were identified: depression severity (r = 0.33, p < 0.01), public stigma (r = 0.44, p < 0.001), treatment stigma (r = 0.46, p < 0.001), perceived stigma (r = 0.37, p < 0.001), and enacted stigma (r = 0.71, p < 0.001). Five protective factors were identified: quality of life (r = -0.38, p < 0.001), social relationship (r = -0.26, p < 0.05), self-esteem (r = -0.46, p < 0.001), extroversion (r = -0.32, p < 0.001), and social functioning (r = -0.49, p < 0.001). LIMITATIONS: Heterogeneity was observed in some of the results. Causality cannot be inferred due to the predominance of cross-sectional designs among the included literature. CONCLUSIONS: Risk and protective factors of depression self-stigma exist across many dimensions. Future research should examine the inner mechanisms and effectiveness of interventions to reduce stigma.

On the Link Between Reciprocal/Authoritarian Filial Piety and Internalized Homonegativity: Perceived Pressure to Get Married in a Heterosexual Marriage as a Mediator.

Previous research has revealed that filial piety belief plays a critical role in self-acceptance of sexual orientation, but studies have rarely examined whether and how reciprocal (i.e., providing care and support based on affective bonding) and authoritarian (i.e., showing unconditional obedience to parents because of parental authority) filial piety contribute to internalized homonegativity. A total of 477 Chinese lesbian, gay, bisexual, questioning/queer, or other non-heterosexual (LGBQ +) adults participated in this study. These participants completed a battery of measures for reciprocal and authoritarian filial piety, perceived internalized, social, and parental pressure to get married in a heterosexual marriage, internalized heteronormativity, socially oriented identity (i.e., negative beliefs about how others in society would negatively treat them because of their sexual orientation), and family-oriented identity (e.g., guilt related to filial piety and worries about present and future life). The results indicated that higher reciprocal filial piety was directly associated with higher internalized heteronormativity. Higher authoritarian filial piety had a direct link with higher family-oriented identity. In addition, authoritarian filial piety was positively associated with internalized heteronormativity through internalized pressure to get married; authoritarian filial piety had a positive link with socially oriented identity through perceived social pressure to get married; authoritarian filial piety was positively related to family-oriented identity through perceived parental pressure to get married. Conclusions: Authoritarian filial piety is a risk factor for internalized homonegativity, and perceived pressure to get married in a heterosexual marriage might be the underlying mechanism for the relationship between authoritarian filial piety and internalized homonegativity.

Beyond symptom reduction: Development and validation of the Complementary Measure of Psychotherapy Outcome (COMPO).

Most measures of psychotherapy outcome focus on symptomatic change. However, clients often report other changes through therapy, such as increased self-acceptance. This study reports on the development and validation of the Complementary Measure of Psychotherapy Outcome (COMPO) that assesses different areas of psychological functioning deemed important by clients and therapists. Items were written based on a literature review of client-reported change and feedback from experienced therapists. Exploratory factor analysis was conducted on the initial 42-item COMPO administered to 264 psychotherapy clients. Iterative item reduction resulted in the final 12-item, four-factor solution, with factors named self-acceptance, self-knowledge, relationship quality, and consideration of others. This factor structure, along with a bifactor model that contains a general factor and the four domain-specific factors, was replicated on a sample of 571 adults in the community. The 12-item COMPO exhibits convergent validity with measures of self-esteem, insight, social support, and empathy; demonstrates 2-week test-retest reliability; and predicts life satisfaction. The 12-item COMPO was further administered to 28 clients in short-term psychodynamic therapy for depression. Except for consideration of others, COMPO subscales and total scale scores improved from pre- to posttherapy. Posttherapy COMPO scores were also higher among clients who experienced clinically significant change compared to those who did not. The COMPO was negatively associated with depressive symptoms and impairments in functioning across the three samples. The brevity of the COMPO makes it a convenient tool to supplement symptom-based measures for a more comprehensive assessment of outcome in psychotherapy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

How far can stigma-based empathy reach? Effects of societal (in)equity of LGB people on their allyship with transgender and Black people.

The shared experience of societal discrimination and affirmation can provide a basis for empathy among members of different marginalized groups. However, the potential mechanisms and moderating conditions involved in this process have been little studied. This experiment examined how perceived societal (in)equity of one's own group may influence one's reaction to other marginalized groups. We randomly assigned 310 cisgender White lesbian, gay, and bisexual (LGB) adults to conditions varying in LGB (in)equity salience (discrimination, affirmation, control) and in the target outgroup identity (transgender, Black). Participants completed a survey assessing thoughts, feelings, and behaviors related to the outgroup, that is, indicators of allyship. Based on the emerging theory of stigma-based solidarity, we expected LGB discrimination to improve intergroup relations with transgender people (i.e. a group readily sharing a common superordinate identity with LGB people) but worsen relations with Black people (i.e. a group not readily sharing a common superordinate identity). Counter to expectations, allyship variables were not predicted by discrimination as a main effect or in interaction with outgroup identity. However, we found support for the mediating role of emotions in explaining the indirect effect of discrimination on allyship. For example, discrimination produced greater outgroup identification by elevating negative affect, but only when the outgroup was transgender people. Results for transgender and Black targets converged for outcomes requiring participants to consider societal injustice toward the outgroup. We observed only one effect for affirmation: It reduced LGB people's empathic anger for both transgender and Black people. Results may inform efforts of coalition building. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Fostering youth self-efficacy to address transgender and racial diversity issues: The role of gay-straight alliances.

Gay-Straight Alliances (GSAs) aspire to empower youth to address multiple systems of oppression, including those affecting transgender and racial/ethnic minority youth, yet there is little indication of factors contributing to youths' self-efficacy to do so. We examined individual and group factors predicting self-efficacy to address transgender and racial issues among 295 youth in 33 high school GSAs. Multilevel results indicated that level of GSA engagement, individual and collective involvement in transgender- and race-specific discussions, and in some cases intergroup friendships were associated with each form of self-efficacy. The association between GSA engagement and transgender self-efficacy was stronger for youth in GSAs with greater collective transgender-specific discussions. Associations with racial self-efficacy differed based on youths' race/ethnicity. Continued research needs to identify how GSAs and similar youth programs promote self-efficacy to address diversity issues. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Impact of perceived HIV stigma within men who have sex with men community on mental health of seropositive MSM.

Emerging evidence has suggested that seropositive men who have sex with men (MSM) do not only face biased treatment from the general public but also from members of the MSM community. We conceptualized such biases perpetuated within the MSM community as human immunodeficiency virus (HIV) in-group stigma. This study examined the pathways by which perceived HIV in-group stigma impacted the mental health of seropositive MSM in Hong Kong. Internalized HIV stigma, serostatus disclosure concerns, and negative reactions towards HIV stigma were hypothesized as intermediate factors. Based on 100 Chinese seropositive MSM who were on antiretroviral therapy, results of a path analysis partially supported our hypotheses. Only negative reactions towards HIV stigma within the MSM community was a significant intermediate factor. The findings highlight the importance of understanding seropositive MSM's different reactions to HIV stigma perpetuated within the MSM community. On top of stigma reduction research, further research may explore ways that help seropositive MSM cope with HIV in-group stigma and foster resilience.

Social media as social capital of LGB individuals in Hong Kong: its relations with group membership, stigma, and mental well-being.

Social media are found to facilitate social information exchange among lesbian, gay, and bisexual (LGB) individuals who are subjected to social stigma. This study tested the protective role of LGB-tailored social media uses and gratifications in promoting LGB group membership, which we hypothesized to reduce LGB stigma and enhance mental health among LGB individuals in Hong Kong. Based on a sample of 233 Chinese LGB individuals in Hong Kong, structural equation modeling showed evidence for our hypotheses, χ(df=62)(2)= 88.20, GFI = 0.95, CFI = 0.98, NNFI = 0.98, SRMR = 0.07, RMSEA = 0.04. Community surveillance, identity expression, and emotional support on social media may promote mental health by instilling a sense of group membership and reducing stigma. Social media may build camaraderie and bolster resilience among LGB individuals that may otherwise be difficult in conservative regions.

Beyond attributions: Understanding public stigma of mental illness with the common sense model.

The present study applied the common sense model (i.e., cause, controllability, timeline, consequences, and illness coherence) to understand public attitudes toward mental illness and help-seeking intention and to examine the mediating role of perceived controllability between causal attributions with public attitudes and help seeking. Based on a randomized household sample of 941 Chinese community adults in Hong Kong, results of the structural equation modeling demonstrated that people who endorsed cultural lay beliefs tended to perceive the course of mental illness as less controllable, whereas those with psychosocial attributions see its course as more controllable. The more people perceived the course of mental illness as less controllable, more chronic, and incomprehensible, the lower was their acceptance and the greater was mental illness stigma. Furthermore, those who perceived mental illness with dire consequences were more likely to feel greater stigma and social distance. Conversely, when people were more accepting, they were more likely to seek help for psychological services and felt a shorter social distance. The common sense model provides a multidimensional framework in understanding public's mental illness perceptions and stigma. Not only should biopsychosocial determinants of mental illness be advocated to the public, cultural myths toward mental illness must be debunked.

Risk and protective factors of same-sex intimate partner violence in Hong Kong.

Numerous studies have assessed risk and protective factors for intimate partner violence (IPV) among heterosexual couples around the globe. Nevertheless, few have addressed the same issue among same-sex couples, especially in cultures where same-sex intimate relationships have gained little acceptance. This exploratory study evaluated the substantial risk and protective factors for same-sex IPV based on gender-neutral theories. Three hundred and six Hong Kong residents who have been in a same-sex romantic relationship completed a web-based questionnaire. Logistic regression analyses indicated that relationship conflict and poor anger management were risk factors both of psychological and physical perpetration. Dominance and substance abuse were respectively associated with psychological aggression and physical battering despite their small effect sizes. Psychological aggression was also found to mediate the relationship between conflict and physical assault, and that between anger management and physical assault. Interventions related to the array of risk and protective factors were discussed and recommended.