The Chinese Internalized Binegativity Scale: Measure development and cultural adaptation.

This article presents the development and psychometric evaluation of the Chinese Internalized Binegativity Scale (CIBS), the first Chinese-language measure available to examine internalized binegativity (IB) for bisexual people living in Mainland China, Hong Kong, and Taiwan. This measure is based on the translation and cultural adaptation (Sidani et al., 2010) of items from the (English language and U.S. developed) Bisexual Identity Inventory (Paul et al., 2014), as well as the development of novel items based on the prior literature and interviews with six bisexual experts and six bisexual laypersons who reside in Mainland China, Hong Kong, and Taiwan. Preliminary items were administered to 685 bisexual participants living in these three Chinese cultural regions. Exploratory factor analysis with a random subsample (n = 343) yielded a psychometrically robust measurement model consisting of six factors: illegitimacy, monosexism, aversion, irresponsibility, family shame, and identity affirmation, with internal consistency reliability estimates ranging from .76 to .91. This multidimensional factor structure was substantiated by confirmatory factor analysis with the second subsample (n = 342). Furthermore, the CIBS demonstrated satisfactory convergent validity through statistically significant correlations in theoretically predicted directions with the Chinese Internalized Homophobia Scale and Private Collective Self-Esteem subscale. Bifactor modeling was conducted to examine the utility of the scale scores for subsequent use. Higher levels of IB measured by the CIBS were associated with more depressive symptoms, more anxiety, lower levels of coming out to others, lower self-esteem, and lower global life satisfaction. Research implications and limitations are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reducing Internalized Homonegativity: Refinement and Replication of an Online Intervention for Gay Men.

We refined and replicated an efficacious brief intervention to reduce internalized homonegativity (IH) with a sample of gay and exclusively same-sex attracted men recruited from outside of LGBT community networks using Amazon Mechanical Turk. We sought to 1) determine if levels of IH differed between the original study's community-based sample and our non-community-based sample, 2) examine the efficacy of the replicated intervention, and 3) assess for longitudinal effects of the intervention at a 30-day follow-up. Four hundred eighty-four participants completed either the intervention or a stress management control condition. Mean levels of IH were higher in the current sample compared with the earlier study's community sample. The intervention was efficacious at reducing global IH, reducing personal homonegativity, and increasing gay affirmation. Ninety-six participants completed the follow-up; follow-up results were not significant and may have been affected by high rates of attrition. Implications for research and practice are discussed.

L or G or B or T: Matching Sexual and Gender Minorities with Subpopulation-Specific Interventions.

Sexual and gender minorities (SGM) may benefit from psychological interventions tailored to specific subpopulations (e.g., lesbians, gay men, bisexual people, transgender people) given differing experiences with stigma. However, determining the inclusion/exclusion process for subpopulation-specific interventions is challenging and recommendations for this process are scarce. We developed and evaluated a matching procedure to place 1183 SGM participants into four targeted online interventions designed to reduce internalized stigma for lesbian, gay, bisexual, and transgender people. We evaluated participant attrition, efficacy, satisfaction with placement, and qualitative feedback across the four interventions. Results indicated that our matching procedure was time-efficient and largely successful in terms of low attrition, high satisfaction, and reaching segments of the SGM population not usually captured with the LGBT acronym. Based on these findings, we offer six practical guidelines for devising the inclusion/exclusion process or matching procedure for future subpopulation-specific SGM interventions studies.

Syndemic behavioral risk and suicidality among bisexual adolescents: A latent class analysis.

OBJECTIVE: We explored the internal structure of within-group variation in the syndemic construct among bisexual adolescents, an understudied and highly vulnerable population known to experience health disparities compared with monosexuals (those attracted to a single gender). We sought to identify patterns of co-occurrence among three domains of high priority behavioral risks-sexual risk factors, substance use, and victimization-and their implications for suicidality. METHOD: We used a national sample of 1,053 ethnically/racially diverse, high school age bisexual adolescents drawn from the 2015 Youth Risk Behavior Surveillance System (YRBSS). We applied latent class analysis (LCA) to 15 indicators measuring the three aforementioned domains and modeled predictors and an outcome of class membership. RESULTS: Within-group variation in the syndemic construct appears categorical, systematic, and comprised of Low Risk (38%), Alcohol Use (20%), Peer-victimization (14%), Sexually Active (11%), Syndemic (11%), and Risk-taking (7%) classes. Classes were well-separated per classification statistics. The proportions of bisexual identification, sex, and race varied significantly across classes. Syndemic and Peer-victimization classes were equivalent and elevated in their suicidality risk, out of all classes. CONCLUSIONS: Results revealed multiple and diverging forms of conjoint behavioral risk that conferred differential health implications; illuminated the shape and functional form of the syndemic construct among bisexual adolescents; and illustrated the utility of LCA for classifying typologies of risky and normative health behavior patterns. Psychologists are recommended to carefully consider the comorbidly operant nature of behavioral risks in this population. Future directions include addressing replication, multiple-group invariance, additional auxiliary variables, and alternative mixture techniques. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

An online intervention to promote predictors of supportive parenting for sexual minority youth.

This article presents the Parent Resource for Increasing Sexual Minority Support (PRISMS), an interactive online intervention designed by the authors to promote parental self-efficacy and behavioral intentions for supporting a sexual minority child. The intervention was developed based upon psychological literature about parent support and feedback from parents of sexual minority youth and psychologists, and contains 5 interactive online modules: normalizing parent experiences, psychoeducation, reflection upon existing support, rehearsal of support, and affirmation. We assessed the feasibility and acceptability of PRISMS and collected pilot data to assess its efficacy. One hundred eighty-four U.S. parents of sexual minority youth Ages 13 to 18 were recruited from Amazon Mechanical Turk and were randomly assigned to complete either PRISMS (n = 92) or a control: an existing resource with psychoeducation about sexual orientation (n = 92). Analyses revealed that PRISMS was highly acceptable to participants and established the noninferiority of the intervention relative to the control in terms of credibility and affect at posttest. Two analyses of covariance did not establish significant associations between PRISMS and parental self-efficacy or behavioral intentions for supportive parenting, although we found small effect sizes (d = .31 and .21). Post hoc exploratory analyses offered preliminary support for the efficacy of PRISMS with parents who were highly distressed about their child's sexual orientation, suggesting that this might be an important population for future research. We discuss implications for research and practice, including the importance of interventions for parents of sexual minority youth. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Correction to: A Latent Profile Analysis of Bisexual Identity: Evidence of Within-Group Diversity.

This article has been corrected with the following revisions for errors unaddressed in the copy editing process. All of the revisions herein were technical in nature and did not substantively change any aspect of the content of the article, including main arguments and findings. The first author appreciates the understanding of the readers.

Microaggressions and social support among sexual minorities with physical disabilities.

PURPOSE: Prejudice and discrimination have been associated with mental and physical health disparities among people with disabilities (Emerson, 2010) and sexual minorities (American Psychological Association [APA], 2012b). Subtle everyday communications of prejudice, known as microaggressions, are one form of oppressive experience that contribute to minority stress among these groups. As sexual minority people with disabilities (SMPWDs) embody at least two marginalized statuses, they may face unique levels of risk. While social support has been posited to buffer against the negative effects of minority stress (Meyer, 2003), the relationship between microaggressions and perceived social support is currently unknown. This study is among the first to explore the relationship between microaggressions and social support in a multiply marginalized community. RESEARCH METHOD: One-hundred and 92 sexual minority (i.e., bisexual, gay, lesbian, pansexual, queer, questioning, same-sex/gender attracted) participants with physical disabilities completed measures related to microaggressions, social support, and mental health via an online survey. RESULTS: Results suggest that for SMPWDs, greater ableist microaggressions within sexual minority communities were associated with lower satisfaction with LGBTQ social supports. In addition, ableist and homonegative microaggressions within sexual minority and disability communities, respectively, were related to greater depressive symptoms. Social support was not found to moderate the relationship between microaggressions and mental health. IMPLICATIONS: Implications for practice, training, advocacy, and future research are discussed, such as raising critical consciousness about microaggressions and mental health, using an intersectional framework when working with SMPWDs, engaging in inclusive advocacy toward policy change, and future studies on microaggressions and social support using diverse samples. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Latent Profile Analysis of Bisexual Identity: Evidence of Within-Group Diversity.

Bisexual people experience unique psychosocial vulnerabilities and their mental health needs and social identity remain underserved and understudied, respectively. We report results from a latent profile analysis where we identified a preliminary typology of bisexual identity subgroups and its association with demographic and mental health variables. Bisexual+ adults (N = 292) residing in the U.S. were recruited from Amazon Mechanical Turk and administered a demographic survey, indicators of bisexual identity, and measures of internalizing symptoms and self-esteem. Joint consideration of statistical and substantive criteria in the modeling process yielded a well-differentiated and qualitatively distinctive three-profile solution comprised of Affirmative (e.g., having a positive orientation towards one's bisexuality), Vigilant (e.g., being significantly concerned about others' reactions to one's bisexuality), and Ambivalent (e.g., endorsing mixed but generally negative attitudes and beliefs about one's bisexuality) profiles of bisexual identity. Auxiliary analyses revealed conceptually and statistically significant associations among profile membership, demographic covariates, and mental health outcomes. Some key findings included that compared to the Affirmative profile, men and people of color were overrepresented in the Ambivalent profile, whereas men were overrepresented in the Vigilant profile. Bisexuals with a Vigilant profile displayed the poorest mental health constellation. Our findings highlight the categorically heterogeneous nature of bisexual identity, support the relevance of social identity to mental health among bisexuals, and represent the first attempt to model bisexual identity using mixture techniques. Future studies should consider larger and more demographically diverse samples, address replicability and generalizability, examine additional auxiliary variables, and investigate longitudinal developments in profiles.

A Mixed-Method Assessment of a Pilot Peer Advocate Intervention for Rural Gender and Sexual Minorities.

Mental health disparities affect lesbian, gay, bisexual, transgender, and queer (LGBTQ) people in rural America. There are few empirically-based mental health interventions for this population. This exploratory study uses a mixed-method approach to assess implementation issues related to the feasibility, acceptability, appropriateness, and preliminary impacts of a novel peer-based intervention designed to enhance support and treatment engagement among rural LGBTQ people with mental distress and/or addiction issues. Quantitative and qualitative results illuminate intervention strengths and areas for improvement. Strengths centered on enhancing social support, advocacy behaviors, and engagement in treatment. Implementation challenges and recommendations to advance the intervention model are discussed.

Development and evaluation of the Internalized Racism in Asian Americans Scale (IRAAS).

This article presents the development and psychometric evaluation of the Internalized Racism in Asian Americans Scale (IRAAS), which was designed to measure the degree to which Asian Americans internalized hostile attitudes and negative messages targeted toward their racial identity. Items were developed on basis of prior literature, vetted through expert feedback and cognitive interviews, and administered to 655 Asian American participants through Amazon Mechanical Turk. Exploratory factor analysis with a random subsample (n = 324) yielded a psychometrically robust preliminary measurement model consisting of 3 factors: Self-Negativity, Weakness Stereotypes, and Appearance Bias. Confirmatory factor analysis with a separate subsample (n = 331) indicated that the proposed correlated factors model was strongly consistent with the observed data. Factor determinacies were high and demonstrated that the specified items adequately measured their intended factors. Bifactor modeling further indicated that this multidimensionality could be univocally represented for the purpose of measurement, including the use of a mean total score representing a single continuum of internalized racism on which individuals vary. The IRAAS statistically predicted depressive symptoms, and demonstrated statistically significant correlations in theoretically expected directions with four dimensions of collective self-esteem. These results provide initial validity evidence supporting the use of the IRAAS to measure aspects of internalized racism in this population. Limitations and research implications are discussed. (PsycINFO Database Record

Development and Evaluation of Training for Rural LGBTQ Mental Health Peer Advocates.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) people in rural areas experience negative mental health consequences of minority stress, and encounter multiple barriers to accessing mental health and substance use treatment services. As part of a larger intervention study, we developed and piloted a unique training program to prepare peer advocates for roles as paraprofessionals who assist rural LGBTQ people with mental health needs. Thirty-seven people in New Mexico took part in either the initial training or a second revised training to improve their knowledge and skills to address LGBTQ mental health needs. Evaluation of this training consisted of self-administered structured assessments, focus groups, and open-ended interviews. Results for the initial training showed no significant increases from pre- and post-test scores on knowledge about LGBTQ people and their mental health issues, whereas significant increases were detected for the revised training. There also were significant increases in self-efficacy to perform tasks associated with the peer advocate role for all but a subset of tasks for the revised training. Qualitative data reveal that participants appreciated the opportunity to increase information and skills, especially concerning bisexual and transgender persons, and the opportunity to connect with others in the community who want to support LGBTQ people.

Coaching mental health peer advocates for rural LGBTQ people.

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals. We evaluated this process through iterative qualitative analysis of semi-structured interviews and written logs from coaches and advocates. The six major themes comprising the results centered on (1) coaching support, (2) peer advocate skills and preparation, (3) working with help seekers, (4) negotiating diversity, (5) logistical challenges in rural contexts, and (6) systemic challenges. We concluded that peer advocacy for LGBTQ people with mental distress offers an affirmative, community-based strategy to assist the underserved. To be successful, however, peer advocates will likely require ongoing training, coaching, and infrastructural support to negotiate contextual factors that can influence provision of community resources and support to LGBTQ people within rural communities.

A computer-based intervention to reduce internalized heterosexism in men.

Internalized heterosexism (IH) is a strong predictor of the psychological well-being of lesbian, gay, bisexual (LGB), or other same-sex attracted individuals. To respond to the call for interventions to address IH, the current study developed and tested an online intervention to reduce IH among gay, bisexual, and other same-sex attracted men. A total of 367 self-identified same-sex attracted adult males were recruited through various nationwide LGB-related sources and were assigned by birth month to either the experimental condition (focusing on IH reduction) or the control condition (a similarly structured invention focusing on stress management); 290 of these participants completed the intervention and all post-intervention measures. Mean levels of IH were compared by condition, indicating significant differences on the IH global score and 2 of the 3 IH subscale scores between the participants in the 2 conditions. The study findings support the promise of using the Internet to deliver IH interventions. Implications for research and practice are discussed.

Impact of instructor and course characteristics on the effectiveness of curriculum infusion.

OBJECTIVE: This study assessed the impact of Curriculum Infusion (CI) on undergraduates' knowledge, attitudes, and behaviors regarding alcohol and other drug (AOD) use. The related effects of students' perceptions of instructors' credibility and immediacy were also examined. PARTICIPANTS: Participants were 309 undergraduates enrolled in 14 CI classes between Winter 2003 and Spring 2004. METHODS: In a pretest-posttest design, participants were surveyed about their substance use, behavioral consequences of substance use, knowledge, and attitudes about alcohol, and their perceptions of the credibility and immediacy of their CI course instructors. RESULTS: Findings indicate that students who perceived their CI instructors as more credible and more immediate were more knowledgeable about alcohol and had healthier attitudes about substance use. Additionally, course size was found to contribute to CI's effectiveness. CONCLUSION: CI provides faculty with an effective way to make a difference not only in their students' education but also in their health and well-being.

Longitudinal evaluation of peer health education on a college campus: impact on health behaviors.

OBJECTIVE: The authors investigated the longitudinal impact of peer health education on the health behaviors of undergraduate students pertaining to alcohol and drug use, eating and nutrition, and sexual health. PARTICIPANTS: From fall 2003 to spring 2006, the authors annually administered a Web-based survey to a cohort of 2,000 randomly selected undergraduate students. RESULTS: Students who had contact with peer health educators were significantly more likely over time than other students to report less alcohol consumption and fewer related negative consequences. Results also show that students who had contact with peer health educators initially endorsed engaging in unhealthy weight management and fat talk behaviors during their first year but decreased these unhealthy behaviors by their third year. No significant differences in sexual health behaviors were found. CONCLUSIONS: Results indicate that peer health educators play an important role in promoting healthy behaviors in the areas of alcohol and drug use and in eating and nutrition.

Parents as protective factors in eating problems of college women.

This study examined how parents can protect their college-aged daughters from disordered eating. Specifically, the influence of the following variables on disordered eating was investigated: parental emotional availability and acceptance, parents' critical messages about weight and shape, acceptance of sociocultural attitudes about appearance, self-esteem, and early menarche. Participants included a random sample of 211 female undergraduates who completed an Internet questionnaire. Using multiple regression, messages heard from mothers and fathers were found to contribute to disordered eating, and sociocultural attitudes acted as a mediator for the effects of mothers' and fathers' messages on disordered eating. Implications are discussed.

Helpful and unhelpful therapy experiences of LGBT clients.

The purpose of this study was to identify a broad range of variables that characterize the helpful and unhelpful therapy experiences of lesbian, gay, bisexual, and transgender (LGBT) individuals. Interviews were completed with a diverse sample of 42 LGBT individuals who have been in therapy, and a content analysis was conducted. Results indicated that basic counseling skills and relationships were key determinants of the quality of LGBT clients' therapy experiences. Also important to the helpfulness of the therapy experience were therapist variables such as professional background and attitudes toward client sexual orientation/gender identity; client variables such as stage of identity development, health status, and social support; and environmental factors such as confidentiality of the therapy setting.