The Role of Gender and Sexuality in the Experience, Internalization, and Mental Health Correlates of Sexual Victimization Stigma.

The stigma associated with sexual victimization (SV) can add to the psychological burden on survivors. We compared experiences of SV and SV stigma by survivor gender and sexuality and evaluated the relevance of public and internalized sources of this stigma to their psychological functioning. An online survey containing measures of SV type (sexual harassment and assault), public SV stigma, internalized SV stigma (self-blame, self-shame, anticipated-shame), and psychological functioning (depression, anxiety, stress, and post-traumatic stress disorder [PTSD] symptomatology) was completed by 877 women and 211 men aged 18 to 66 years (M = 30.2, SD = 8.06), of whom 73.9% were heterosexual and 26.1% identified as a sexual minority (same-sex-attracted, bisexual, pansexual, or asexual). Sexual harassment and assault were more prevalent in women and sexual minority men. Analysis of Covariance (ANCOVA) with age and SV frequency as covariates also revealed poorer psychological functioning in sexual minority men, and higher levels of SV stigma in sexual minority women and men. Multigroup path analyses further showed that exposure to public stigma was associated with poorer psychological functioning, that internalized stigma partly mediated these associations, and that the magnitude of the associations (particularly those involving self-shame and anticipated shame) was often greater in men and sexual minorities. The results add to our understanding of the role of gender and sexuality in the experience, internalization, and psychological impact of SV-related stigma on survivors. The results also highlight the need for societal shifts toward acknowledging and validating experiences of SV in men and sexual minorities, alongside women, and the development of intersectionality-informed interventions for SV stigma in survivors.

Coming Out to Family and Friends in the Trans and Gender Diverse Context.

Despite the risks of rejection and discrimination, "coming out" can be an important psychological milestone for transgender (trans) and gender diverse people (TGD). We evaluated the dimensions of identity that predict coming out to family and friends, and the role of social support in explaining the psychosocial benefits associated with coming out. An online survey was completed by 951 TGD adults, 516 (54.3%) who identify as gender binary (164 transwomen and 352 transmen) and 435 (45.7%) who identify as nonbinary. Overall, gender binary TGD people were more likely than nonbinary people to disclose their identity to family and friends. Hierarchical binary logistic regressions further revealed that appearance congruence and strength of TGD identity are associated with disclosure to family, whereas positive TGD identity is associated with disclosure to friends. Path analyses confirmed that coming out is associated with improved resilience, psychological adjustment, and wellbeing, and that social support is a partial mediator of these associations. The results highlight the importance of coming out in the TGD context and suggest that greater access to social support may account for some of these benefits.

Rumination and threat-biased interpretation mediate posttraumatic stress and growth responses to military stressors.

We examined the role of rumination and threat-biased interpretation in stress and growth responses to military stressors. Two online surveys were completed by 183 (survey 1) and 393 (survey 2) currently serving or retired military personnel. The surveys measured exposure to potential military stressors (exposure to combat, witnessing the consequences of war, and perceived moral injury), posttraumatic stress symptomatology (PTSS), posttraumatic growth (PTG), and personal wellbeing, with survey 1 including measures of rumination, and survey 2 including a measure of threat-biased interpretation. Path analyses revealed that indirect paths from both witnessing the consequences of war and experiencing betrayal to PTSS were mediated by intrusive rumination and threat-biased interpretation, and that indirect paths from both betrayal and transgressions by others to PTG were mediated by deliberate rumination and threat-biased interpretation. The results reveal the idiosyncratic nature of military stressors, their differential involvement with cognitions that underpin rumination about past events and interpretation of current events, and their relevance to posttraumatic stress and growth in military personnel.

Cognitive distortions mediate relationships between early maladaptive schemas and aggression in women and men.

Difficult childhood experiences can lead to the development of early maladaptive schemas (EMS) that cause emotional and behavioral problems later in life. The present study examined the role of cognitive distortions in mediating relationships between EMS and aggression in adults as a function of sex. Participants were 59 women (Mage = 34.7 years, standard deviation [SD] = 8.0) and 86 men (Mage = 39.3 years, SD = 13.2) who completed the Young Schema Questionnaire-Short Form-V3, the How I Think Questionnaire of cognitive distortions, and the Buss-Warren Aggression Questionnaire. Multiple mediation analysis identified EMS domain impaired limits to be uniquely and directly related to aggression, and the domain impaired autonomy to be indirectly related via a range of cognitive distortions. Multigroup analyses revealed no sex differences in these relationships, and analysis of covariance with age as a covariate revealed no sex differences in levels of EMS, cognitive distortion, or aggression. The results suggest that impaired limits and impaired autonomy are EMS domains of relevance to aggression regardless of sex. Furthermore, in the case of impaired autonomy, self-serving, proaggression cognitive distortions appear to be involved. Interventions for aggression may thus benefit by focusing on clients with entitlement/grandiosity traits indicative of impaired limits, and vulnerability/dependence traits indicative of impaired autonomy, and in the latter case consider addressing the self-serving cognitions that enable the expression of aggression in these clients.

Posttraumatic stress, visual working memory, and visual imagery in military personnel.

Posttraumatic stress disorder (PTSD) is characterized by disruptions to cognitive functioning. Two studies were conducted to examine the relevance of military-related PTSD to two cognitive functions - visual working memory and visual imagery. Participants were military personnel who reported their PTSD diagnosis history and completed a self-administered screening tool for PTSD, the PTSD Checklist - Military Version. In Study 1, 138 personnel also completed a memory span task and a 2-back task using colored words in which Stroop interference was introduced via the semantic content of the words. In Study 2, a separate group of 211 personnel completed measures of perceived imagery vividness and spontaneous use of visual imagery. Interference effects on working memory in PTSD-diagnosed military personnel were not replicated. However, ANCOVA and structural equation modelling revealed that PTSD-intrusions were associated with poorer working memory whereas PTSD-arousal was associated with spontaneous use of visual imagery. We interpret these results as evidence that intrusive flashbacks disrupt working memory performance not by limiting memory capacity nor by interfering directly with memory functions such as inhibition, but by adding internal noise in the form of task-irrelevant memories and emotions. Visual imagery appears to be unrelated to these flashbacks but with arousal symptoms of PTSD, perhaps in the form of flashforwards about feared/anticipated threats.

Evaluating an online self-distancing intervention to promote emotional regulation and posttraumatic growth during the COVID-19 pandemic.

OBJECTIVES: Three online studies were conducted to elucidate the role of emotional regulation (ER) in posttraumatic growth (PTG), evaluate the ability of an online self-distancing intervention to achieve ER, and test whether increasing the use of ER strategies promotes PTG. DESIGN: Cross-sectional (Study 1) and longitudinal randomized controlled trials (RCT) (Studies 2 and 3). METHOD: In Study 1, 626 adults completed measures of ER, PTG, and psychosocial functioning during the COVID-19 pandemic. In Study 2, 149 adults participated in a five-week RCT comparing self-immersed, spatially self-distanced, and temporally self-distanced reflection in their ability to regulate negative affect. In Study 3, 117 adults replicated the RCT of Study 2 and completed the measures from Study 1 a week pre- and post-intervention. RESULTS: Path analyses confirmed that ER strategies were relevant to COVID-19-related PTG. MANOVAs revealed that self-distancing was effective in regulating state negative affect. However, ANOVAs suggest that this was not due to increased use of ER strategies and did not improve PTG or psychosocial functioning. CONCLUSIONS: These findings support further research into the relevance of ER to PTG, and provide a foundation to understand PTG and develop PTG-promoting interventions within a broader stress-coping framework.

Growth from adversity in trans and gender diverse people of color.

Background: Trans-negativity and gender-based discrimination negatively impact on the wellbeing and mental health in transgender (trans) and gender diverse people (TGD). There is limited research on TGD people thriving under adversity, and no research to date has considered TGD people of color in this context. Method: We used the Post-Traumatic Growth Inventory (PTGI-X) to survey 125 TGD people of color and 625 white TGD adults (18 to 68 years old, M = 26.0, SD = 9.2) about their experiences of growth from adversity. Confirmatory factor analysis (CFA), using sub-sampling to compensate for our unequal sample sizes, supported a five-factor structure of the PTGI-X consisting of growth in relating to others, finding new possibilities, personal strength, greater appreciation of life, and spiritual/existential change. Measurement invariance tests confirmed configural, metric, and scalar invariance of this structure across the two TGD subgroups. Results: A MANOVA revealed that growth from adversity in TGD participants was generally greater than that reported by people who have recently been exposed to a traumatic event. T-tests revealed that TGD people of color experienced more growth in terms of relating to others and more personal strength than white TGD participants. Subsequent hierarchical regressions revealed that race moderated associations between PTGI-X scores and personal well-being, with TGD people of color reporting more benefits (more well-being) at high levels of growth but also more deficits (less well-being) at low levels of growth than the white TGD subgroup. Conclusion: The results support the use of the PTGI-X with TGD populations and across racial TGD subgroups and indicate that growth from adversity is not only prevalent in TGD people but also relevant to positive outcomes, particularly in TGD people of color.

Development of the Trans and Gender Diverse Social Anxiety Scale.

Objectives: We develop and evaluate a Trans and Gender Diverse Social Anxiety Scale (TSAS) suitable for use with trans and gender diverse (TGD) people. Methods: We evaluate the TSAS on a sample of 171 TGD adults (40 transmen, 80 transwomen, and 51 gender nonbinary). We test the TSAS's construct validity against measures of perceived and enacted anti-trans stigma, and in comparison to a generic (i.e., non-TGD-specific) measure of social anxiety, the Liebowitz Social Anxiety Scale (LSAS). Results: Factor analyses reveal a four-factor structure consisting of fear and avoidance of (i) social interactions with familiar people, (ii) public scrutiny, (iii) interactions with organizations, and (iv) interactions with religious people or religious authority. Hierarchical regressions confirm that although symptoms of social anxiety assessed by the TSAS overlap with symptoms of generic social anxiety, responses to the TSAS target social situations specifically related to anti-trans stigma. MANOVAs of TSAS score by TGD gender subgroups also reveal that transmen report more social anxiety than either gender nonbinary TGD people or transwomen. Conclusions: The TSAS is a brief instrument that can be used to measure social anxiety in TGD people in social situations in which anti-trans stigma is commonly encountered.

Reliability and validity of self-reported sitting and breaks from sitting in the workplace.

OBJECTIVES: Prolonged sitting is a health risk factor which is ubiquitous to the workplace, and breaking up prolonged sitting is widely recommended. This study evaluated the test-retest reliability and concurrent validity of a self-report measure of duration of sitting and breaks from sitting in the workplace. DESIGN: Cross-sectional study. METHODS: Fifty-nine workers who reported spending most of their work time sitting wore an activPAL inclinometer and the ActiGraph accelerometer for eight consecutive days, and completed single-item measures of duration of sitting (min/work hour) and breaks from sitting (frequency/per work hour), twice, seven days apart. RESULTS: Participants reported sitting at work for a median of 420min/day (Interquartile Range=360-450min/day) and taking one break (Interquartile Range=1.0-2.0) from sitting per work hour. For reported duration of workplace sitting, test-retest reliability was adequate (Intra-Class Correlations=0.78, 95% Confidence Intervals [CI]=0.65, 0.86), and concurrent validity fair against the activPAL (Spearman's Rho=0.24, CI-1.0,0.47) and the ActiGraph (Rho=0.39, CI=0.15, 0.68). For reported breaks from sitting (frequency/per work hour), test-retest reliability was adequate (Intra-Class Correlations=0.65, CI=0.48, 0.78) and concurrent validity fair against the activPAL (Spearman's Rho=0.39, CI=0.25, 0.74) and the ActiGraph (Spearman's Rho=0.30, CI=0.15, 0.69). Self-reported duration of sitting was biased toward over-reporting compared to the activPAL (median=45.4min) and under-reporting compared to the ActiGraph (median=21.7min). CONCLUSIONS: This study found adequate reliability and fair validity for self-reported duration of sitting (min/work day) and breaks from sitting (frequency/per work hour). Further validity research is needed using the inclinometer.

Ecological Model of Australian Indigenous Men's Health.

This study was designed to examine the health behaviors as well as the enablers and barriers to health behaviors among Indigenous Australian men. One hundred and fifty Indigenous Australian men in rural, regional, and urban locations were interviewed about their health behaviors. The results revealed several themes of importance: (a) role of community activities, (b) the Indigenous man as a leader and role model, (c) negative impact of discrimination/racism, (d) importance of partner and family, (e) positive and negative role of peer relationships, (f) central role of culturally appropriate health care facilities, and (g) association between employment and health care problems. These findings highlight the importance of broad community-based (rather than individualistic) approaches to promoting health behavior in Indigenous men.

Factors influencing women's choice of weight-loss diet.

We developed a typology of eight minimally overlapping weight-loss diet methods and used it to survey 151 women dieters on their choice of diet in the previous 12 months, their motivations to diet, and their eating disorder symptomatology. Canonical correlations revealed a potentially problematic "thin, quick, and easy" association of methods and motives, as well as a more healthful "thin, natural, life-style" association. Both featured the pursuit of thinness but not health. In fact, health was rated by dieters as the poorest motivator of dieting. The results highlight the importance to women dieters of short-term aesthetic concerns over long-term health.

Sociocultural influences on strategies to lose weight, gain weight, and increase muscles among ten cultural groups.

This study determined how sociocultural messages to change one's body are perceived by adolescents from different cultural groups. In total, 4904 adolescents, including Australian, Chilean, Chinese, Indo-Fijian, Indigenous Fijian, Greek, Malaysian, Chinese Malaysian, Tongans in New Zealand, and Tongans in Tonga, were surveyed about messages from family, peers, and the media to lose weight, gain weight, and increase muscles. Groups were best differentiated by family pressure to gain weight. Girls were more likely to receive the messages from multiple sociocultural sources whereas boys were more likely to receive the messages from the family. Some participants in a cultural group indicated higher, and others lower, levels of these sociocultural messages. These findings highlight the differences in sociocultural messages across cultural groups, but also that adolescents receive contrasting messages within a cultural group. These results demonstrate the difficulty in representing a particular message as being characteristic of each cultural group.

Increased left hemisphere impairment in high-functioning autism: a tract based spatial statistics study.

There is evidence emerging from Diffusion Tensor Imaging (DTI) research that autism spectrum disorders (ASD) are associated with greater impairment in the left hemisphere. Although this has been quantified with volumetric region of interest analyses, it has yet to be tested with white matter integrity analysis. In the present study, tract based spatial statistics was used to contrast white matter integrity of 12 participants with high-functioning autism or Aspergers syndrome (HFA/AS) with 12 typically developing individuals. Fractional Anisotropy (FA) was examined, in addition to axial, radial and mean diffusivity (AD, RD and MD). In the left hemisphere, participants with HFA/AS demonstrated significantly reduced FA in predominantly thalamic and fronto-parietal pathways and increased RD. Symmetry analyses confirmed that in the HFA/AS group, WM disturbance was significantly greater in the left compared to right hemisphere. These findings contribute to a growing body of literature suggestive of reduced FA in ASD, and provide preliminary evidence for RD impairments in the left hemisphere.

Avatar body dimensions and men's body image.

Two online surveys examined the significance of the visual analogues, or 'avatars', men (total N=266) create and use online. Two-dimensional (adiposity×muscle) somatomorphic matrices revealed that avatars are generally thinner than their creator's actual body and similar to their ideal, but more muscular than either their actual or ideal. Men's ratings of the importance of their avatar's appearance correlated with their actual weight and muscle concerns, and disparity between their avatar and actual body dimensions predicted their offline context body change concerns additional to that accounted for by disparity between their ideal and actual bodies. Together with the observation that men also reported higher self-esteem, less social interaction anxiety and less social phobia while online (which correlated with the time they spent online), these results suggest that the physical dimensions of avatars used in social interactions online may serve a compensatory function.

A test of the resource security and the body mass index reference point hypotheses of body dissatisfaction amongst adolescents in eight countries.

OBJECTIVE: This study aimed to identify cultural-level variables that may influence the extent to which adolescents from different cultural groups are dissatisfied with their bodies. DESIGN: A sample of 1730 male and 2000 female adolescents from Australia, Fiji, Malaysia, Tonga, Tongans in New Zealand, China, Chile, and Greece completed measures of body satisfaction, and the sociocultural influences on body image and body change questionnaire, and self-reported height and weight. Country gross domestic product and national obesity were recorded using global databases. RESULTS: Prevalence of obesity/overweight and cultural endorsement of appearance standards explained variance in individual-level body dissatisfaction (BD) scores, even after controlling for the influence of individual differences in body mass index and internalization of appearance standards. CONCLUSIONS: Cultural-level variables may account for the development of adolescent BD.

Brief report: maltreatment in childhood and body concerns in adulthood.

OBJECTIVE: We examined the relationship between maltreatment in childhood and body concerns in adulthood. METHOD: A community sample of 156 women and 143 men completed measures of maltreatment - frequency of sexual abuse, physical abuse, physical neglect, emotional abuse and emotional neglect - in childhood. They also reported current dissatisfaction with body weight and shape and drive for thinness and drive for muscle. RESULTS AND CONCLUSIONS: Childhood maltreatment was associated with drive for muscle in women and body dissatisfaction and drive for thinness in men. The results provide some evidence that adverse conditions in childhood can be associated with gender-atypical body concerns in adulthood.

An evaluation of equivalence in body dissatisfaction measurement across cultures.

We evaluated gender-based and cross-cultural equivalence of the Body Dissatisfaction Scale of the Body Change Inventory in a sample of 4,005 adolescents from 7 cultures that represent diverse body image ideals and response styles. Results of multigroup confirmatory factor analyses demonstrated equivalence of the scale across gender but not across cultures. Follow-up analyses identified small but significant cross-cultural differences in response styles (specifically, acquiescence and middle response option endorsement) as the source of this noninvariance. We recommend use of this scale for gender-based comparisons but caution that researchers should evaluate the presence of response biases before making substantive conclusions about cross-cultural differences in body dissatisfaction.

Promoting fit bodies, healthy eating and physical activity among Indigenous Australian men: a study protocol.

BACKGROUND: Overall the physical health of Indigenous men is among the worst in Australia. Research has indicated that modifiable lifestyle factors, such as poor nutrition and physical inactivity, appear to contribute strongly to these poor health conditions. To effectively develop and implement strategies to improve the health of Australia's Indigenous peoples, a greater understanding is needed of how Indigenous men perceive health, and how they view and care for their bodies. Further, a more systematic understanding of how sociocultural factors affect their health attitudes and behaviours is needed. This article presents the study protocol of a community-based investigation into the factors surrounding the health and body image of Indigenous Australian men. METHODS AND DESIGN: The study will be conducted in a collaborative manner with Indigenous Australian men using a participatory action research framework. Men will be recruited from three locations around Australia (metropolitan, regional, and rural) and interviewed to understand their experiences and perspectives on a number of issues related to health and health behaviour. The information that is collected will be analysed using modified grounded theory and thematic analysis. The results will then be used to develop and implement community events in each location to provide feedback on the findings to the community, promote health enhancing strategies, and determine future action and collaboration. DISCUSSION: This study will explore both risk and protective factors that affect the health of Indigenous Australian men. This knowledge will be disseminated to the wider Indigenous community and can be used to inform future health promotion strategies. The expected outcome of this study is therefore an increased understanding of health and health change in Indigenous Australian men, the development of strategies that promote healthy eating and positive patterns of physical activity and, in the longer term, more effective and culturally-appropriate interventions to improve health.

Primary and secondary control over eating behaviors.

The relationships between subjective control, body image, and eating behaviors were examined within the framework of the Optimization in Primary and Secondary Control model (OPS model; Heckhausen, 1999). This model characterizes control as an adaptive and strategic process in which the target of control includes internal as well as external states, and in which the purpose is either to facilitate goal pursuit by engaging with the goal or managing the consequences of goal failure by disengaging from the goal. A convenience sample of 180 Australian women (age: M=26.49, SD=5.03) completed the Optimization of Primary and Secondary Control Scale (OPS scale Heckhausen, 1999), as well as measures of attitudinal and behavioral factors comprising Stice's (1994) dual-pathway model of bulimia. A series of path analyses revealed that the control strategies involved in goal engagement are directly associated with increased dietary restraint and purging, whereas the control strategies involved in goal disengagement are indirectly associated with these factors, and with negative affect, by way of reduced body dissatisfaction and reduced frequency of appearance comparisons. These results suggest that goal engagement strategies, which are typically adaptive in other contexts, are associated with potentially hazardous attitudes and behaviors in the context of the body. The results also suggest that an ability to disengage from body weight goals is associated with a reduced likelihood of developing disordered eating.

Acculturation, body image, and eating behaviours in Muslim-Australian women.

The relationship between western acculturation, body dissatisfaction, and eating behaviours was examined in a sample of 101 Muslim-Australian women between 18 and 44 years of age (M=27.3, SD=7.5). A questionnaire was completed containing measures of cultural identification (heritage and mainstream), body dissatisfaction and disordered eating (dietary control, bingeing and purging), internalization of the thin ideal, and self-esteem. A series of path analyses identified significant positive relationships between mainstream identification and the measures of body dissatisfaction and disordered eating that were mediated by thin-ideal internalization. Path analyses also identified significant negative relationships between heritage identification and the measures of body dissatisfaction and disordered eating that were mediated by self-esteem. These results are indicative of the potential risks to body image incurred by women who adopt Western values, and of the benefits in retaining heritage cultural values that promote a positive self image.