An Examination of Empathy and Interpersonal Dominance in BDSM Practitioners.

BACKGROUND: Recent research has indicated that participation in BDSM (bondage-discipline, dominance-submission, and/or sadism-masochism) is not associated with psychological distress or psychopathology but that sexual roles may be associated with personality characteristics, specifically interpersonal dominance and empathy. AIM: The present study examined potential differences between those who identify as dominant, switch, and submissive on interpersonal dominance and empathy. METHODS: Individuals who identified as members of the BDSM community were recruited online via a social networking site. MAIN OUTCOME MEASURES: Self-reported demographic variables, the Personality Assessment Inventory, Dominance subscale, and the Interpersonal Reactivity Index Empathic Concern subscale. RESULTS: Participants were well distributed across sexual roles (n = 279; 25.4% dominant, 38% submissive, 36.6% switch), identified as primarily female (59.5%), primarily heterosexual (53.4%), and the most common age group was 25-34 years (27.2%). BDSM role was associated with scores on the Dominance subscale; dominant BDSM practitioners scored significantly higher on the Dominance scale than switches, who in turn scored significantly higher than submissives (dominant mean [M] = 61.44, standard deviation [SD] = 8.26; switch M = 53.99, SD = 11.18, P < .01; submissive M = 49.41, SD = 11.46, P < .01). There were no differences on the measure of empathy between dominant, submissive, and switch BDSM practitioners. On average, individuals who identified as submissives and switches scored in the average range on the Dominance scale compared with the normative sample, and individuals who identified as dominants scored higher but not in the markedly elevated range. CLINICAL IMPLICATIONS: The study provides information on the relationship between interpersonal dominance as a personality trait and dominance as a sexual role and has implications for reducing stigma related to these practices. STRENGTHS AND LIMITATIONS: The study contributes to the growing literature suggesting that while BDSM roles may correspond with specific personality characteristics, they are not indicative of personalities significantly different than the general population's. The study also included individuals who identified as switch, a group often excluded from quantitative research in the BDSM community. The sample was, however, recruited exclusively online, and findings may not be applicable to all BDSM practitioners. CONCLUSION: These findings suggest that there are no differences in empathy between BDSM practitioner roles, and although there are differences in interpersonal dominance, these characteristics are not likely to be prominent in individuals' everyday interactions. Jansen KL, Fried AL, Chamberlain J. An Examination of Empathy and Interpersonal Dominance in BDSM Practitioners. J Sex Med 2021;18:549-555.

Perceived Barriers to HIV Prevention Services for Transgender Youth.

PURPOSE: Many transgender youth lack access to transgender affirming care, which may put them at risk for HIV. This study explored transgender youth's perceptions regarding encounters with primary care providers (PCPs) related to gender and sexual minority (GSM) identity and sexual health. METHODS: Youth ages 14-21 (N = 228; 45% trans masculine, 41% trans feminine, 14% gender nonbinary) completed a survey on GSM identity disclosure and acceptance, gender-affirming services, sexual health attitudes and behaviors, and interactions with PCPs involving GSM identity and concerns about stigma and confidentiality. RESULTS: A factor analysis yielded three scales: GSM Stigma, Confidentiality Concerns, and GSM-Sexual Health Information. Items from the GSM Stigma scale showed that nearly half of respondents had not disclosed their GSM identity to their PCP due to concern about an unaccepting PCP. One-quarter of youth were less inclined to discuss GSM identity and sexual health with their PCP due to concern that their provider would disclose this information to parents; these concerns were greater among adolescents <18 and those not out to parents about their gender identity. Only 25% felt their PCP was helpful about GSM-specific sexual health issues. Youth who were out to parents about their gender identity and had received gender-affirming hormone therapy were more likely to report receiving GSM-specific sexual health information. CONCLUSIONS: Transgender youth may not discuss their GSM identity or sexual health with PCPs because they anticipate GSM stigma and fear being "outed" to parents. PCPs should receive transgender-inclusive training to adequately address youths' sexual health needs and privacy concerns.

"Free Testing and PrEP without Outing Myself to Parents:" Motivation to participate in oral and injectable PrEP clinical trials among adolescent men who have sex with men.

BACKGROUND: Adolescent men who have sex with men (AMSM) account for disproportionately high numbers of new HIV diagnoses. Non-adherence to daily use limiting the effectiveness of oral PrEP (Truvada) has led to current trials with adult MSM testing Cabotegravir, a long-term injectable medication. Once comparative studies with young adult MSM have established relative safety and efficacy of these medications, there will be a need for such comparative trials involving adolescents. Trends in state laws and IRB protocol review indicate that many of these studies will permit youth to provide independent consent for participation. Understanding the motivations of AMSM to participate in HIV biomedical prevention studies is important to ensure their agreement is voluntary without misunderstanding and undue influence. This study examined AMSM attitudes toward participation in oral/injectable PrEP RCTs to inform protections of youth's rights and welfare in future studies. METHODS: We administered to 198 ethnically diverse U.S. AMSM, 14-17 years, a web-based survey including demographic and sexual health questions, description of a year-long oral versus injectable PrEP RCT and 26 Likert-type and one open-ended item assessing motivations for and against participation including: perceived benefits and risks of PrEP; free HIV/STI testing and counseling; confidentiality concerns; random assignment; and benefit to others. RESULTS: Sixty-two percent indicated they were likely to participate in the study. The majority endorsed daily HIV protection, free HIV/STI testing, sexual health counseling, not having to rely on partner's condom use, and altruism as reasons to participate. Reasons against participation included medication side effects, concern taking the pill daily and clinic visits would reveal their sexual orientation and behaviors to parents. Over half erroneously assumed they would be assigned to the condition best for them and 39% indicated free access to services would lead them to participate even if they did not want to. Multiple regression indicated these factors accounted for 55% of the variance in participation choice. Nether age or ethnicity yielded significance. CONCLUSIONS: Results suggest future biomedical HIV prevention research will need to develop procedures to address AMSM's confidentiality concerns, enhance youth's understanding of random assignment, the continued importance of medication adherence and partner condom use during trial participation, and availability of alternative sexual health services to avoid the potentially undue influence of access to free sexual health services.

Patient-Provider Communication Barriers and Facilitators to HIV and STI Preventive Services for Adolescent MSM.

Adolescent males who have sex with males (AMSM) are at increased risk of contracting HIV/AIDS and other sexually transmitted infections (STIs). Healthcare providers are a critical source of HIV/STI prevention, yet little is known about AMSM patient-provider sexual health communications and services. To explore this issue, we surveyed a national sample of 198 AMSM 14-17 years. Four online psychometrically validated scales indicated over half the youth avoided communicating their sexual orientation and sexual health concerns to providers due to fear of heterosexist bias, concern their sexual health information would be disclosed to parents, and a general belief that sexual minority youth do not receive equitable treatment in health care settings. Youth who reported their physicians had initiated discussion about their sexual orientation were significantly more likely to have received HIV/STI preventive services and testing. Discussion includes the importance of medical training that meets the unique sexual health needs of AMSM.

Facilitators and Barriers to Participation in PrEP HIV Prevention Trials Involving Transgender Male and Female Adolescents and Emerging Adults.

Despite the disproportionate burden of HIV facing transgender youth, they continue to be under-represented in studies to provide an empirical basis for pre-exposure prophylaxis (PrEP) programs that can meet the unique needs of this population. This study examined facilitators and barriers to participation in a PrEP adherence study, determined through an online survey administered to 90 transgender male and 60 transgender female 14-21-year-olds attracted to cisgender male sexual partners. Approximately 50% reported likely to participate in the PrEP study. Participation facilitators included prior sexual and health service experiences and study access to PrEP and health services. Participation barriers included lack of concern about HIV, potential medication side effects, the logistics of quarterly meetings, remembering to take PrEP daily, and reluctance to discuss gender identity with study staff. Results suggest that successful recruitment and retention of transgender youth in PrEP prevention studies warrant protocols designed to address these barriers.

Moral Stress and Job Burnout Among Frontline Staff Conducting Clinical Research on Affective and Anxiety Disorders.

There has been increased attention on job-related stress and burnout experienced by clinicians working with vulnerable and at-risk populations, including effects on personal mental health, therapeutic decision-making, and job effectiveness. Little is known, however, about the job-related stressors and symptoms of burnout experienced by clinical research staff working with similar populations, especially in terms of moral stress they may experience when adherence to scientific procedures appears to conflict with their personal commitment to address the clinical needs of their research participants or role as health care provider. In this national study, 125 frontline research workers conducting clinical research studies with individuals diagnosed with affective and anxiety disorders completed an online survey including measures assessing research work related moral stress, job burnout, organizational ethics climate and organizational research support. Results indicated that younger research workers, those whose research work was part of a graduate assistantship and perceptions of higher participant research risk were associated with higher levels of moral stress and job burnout. Supportive organizational climates were associated with lower levels of moral stress and job burnout. Recommendations for clinical research workers, supervisors and clinical training directors are discussed.

Moral Stress, Moral Practice, and Ethical Climate in Community-Based Drug-Use Research: Views From the Front Line.

BACKGROUND: The role of front-line researchers, those whose responsibilities include face-to-face contact with participants, is critical to ensuring the responsible conduct of community-based drug use research. To date, there has been little empirical examination of how front-line researchers perceive the effectiveness of ethical procedures in their real-world application and the moral stress they may experience when adherence to scientific procedures appears to conflict with participant protections. METHODS: This study represents a first step in applying psychological science to examine the work-related attitudes, ethics climate, and moral dilemmas experienced by a national sample of 275 front-line staff members whose responsibilities include face-to-face interaction with participants in community-based drug-use research. Using an anonymous Web-based survey we psychometrically evaluated and examined relationships among six new scales tapping moral stress (frustration in response to perceived barriers to conducting research in a morally appropriate manner); organizational ethics climate; staff support; moral practice dilemmas (perceived conflicts between scientific integrity and participant welfare); research commitment; and research mistrust. RESULTS: As predicted, front-line researchers who evidence a strong commitment to their role in the research process and who perceive their organizations as committed to research ethics and staff support experienced lower levels of moral stress. Front-line researchers who were distrustful of the research enterprise and frequently grappled with moral practice dilemmas reported higher levels of moral stress. CONCLUSION: Applying psychometrically reliable scales to empirically examine research ethics challenges can illuminate specific threats to scientific integrity and human subjects protections encountered by front-line staff and suggest organizational strategies for reducing moral stress and enhancing the responsible conduct of research.

Measures of Mentoring, Department Climate, and Graduate Student Preparedness in the Responsible Conduct of Psychological Research.

Drawing upon two independent national samples of 201 and 241 psychology graduate students, this article describes the development and psychometric evaluation of 4 web-based student self-report scales tapping student socialization in the responsible conduct of research (RCR) with human participants. The Mentoring the Responsible Conduct of Research Scale (MRCR) is composed of 2 subscales assessing RCR instruction and modeling by research mentors. The 2 subscales of the RCR Department Climate Scale (RCR-DC) assess RCR department policies and faculty and student RCR practices. The RCR-Preparedness Scale (RCR-P) and the RCR Field Integrity scale (RCR-FI) measure respectively students' confidence in their ability to conduct research responsibly and their belief in the RCR integrity of psychology as a discipline. Factor analysis, coefficient alphas, correlations and multiple regression analyses demonstrated each of the scales had good internal consistency and concurrent and construct validity.

Graduate Socialization in the Responsible Conduct of Research: A National Survey on the Research Ethics Training Experiences of Psychology Doctoral Students.

Little is known about the mechanisms by which psychology graduate programs transmit responsible conduct of research (RCR) values. A national sample of 968 current students and recent graduates of mission-diverse doctoral psychology programs, completed a web-based survey on their research ethics challenges, perceptions of RCR mentoring and department climate, their ability to conduct research responsibility, and whether they believed psychology as a discipline promotes scientific integrity. Research experience, mentor RCR instruction and modeling, and department RCR policies predicted student RCR preparedness. Mentor RCR instruction, department RCR policies, and faculty modeling of RCR behaviors predicted confidence in the RCR integrity of the discipline. Implications for training are discussed.

Development and validation of the college drinking influences survey.

OBJECTIVE: The authors developed and validated measures of college drinking expectations, psychosocial influences, and values. PARTICIPANTS: Freshmen at college entry (N = 320) and the end of freshman year (N = 420) participated. METHODS: The College Drinking Influences Survey, administered in paper and Web-based versions, consists of 3 distinct scales: (1) the College Drinking Expectations Scale assesses expectations for drinking norms and consequences; (2) the Psychosocial Drinking Inventory evaluates social influences, stress, and sensation seeking; and (3) the Drinking Values Scale assesses drinking decisions based on personal choice, social responsibility, and institutional obligation. RESULTS: Factor analysis, interitem reliability, and correlations with existing instruments demonstrated validity and reliability. Differences between the sexes were in predicted directions, and multiple regression using subscale scores as predictors accounted for significant variance in drinking behaviors across the freshman year. CONCLUSIONS: Data support the usefulness of the scales for identifying student alcohol risk and protective factors.

Capacity of persons with mental retardation to consent to participate in randomized clinical trials.

OBJECTIVE: Adults with mental retardation have histories of cognitive and adaptive deficits posing unique ethical challenges for research consent assessment. This study examined the capacity of persons with mental retardation to consent to participate in randomized clinical trials. METHOD: A total of 150 adults (50 each with mild and moderate mental retardation and 50 comparison subjects without mental retardation) responded to a set of consent questions for a hypothetical randomized clinical trial testing a medication for aggressive disorders. Intelligence, adaptive behavior, medical treatment history, and consent history were evaluated. Univariate and multivariate methods were used to compare performance across and within groups. RESULTS: Comparison subjects scored significantly higher on measures of consent capacity than participants with mild mental retardation, who scored higher than those with moderate mental retardation. Most subjects with mental retardation were able to make a participation choice, and many understood research methods and appreciated the protagonist's disorder and the consequences of participation. Almost half of those with mild mental retardation understood human subject protections. Performance was weakest on understanding the purpose of research and reasoning about whether to participate, suggesting vulnerability to the therapeutic misconception. Psychiatric and experiential factors did not predict consent capacity. CONCLUSIONS: While adults with mental retardation as a group showed consent deficits, many attained consent capacity scores comparable to those of comparison subjects. Investigators should consider individual differences and a consent format suited to deficits in language, memory, and attention before restricting consent opportunities for persons with mental retardation.