Mental health disparities between German lesbian and bisexual women and a population-based sample.

Lesbians are at greater risk of mental health problems than heterosexual women, and bisexual individuals are even more likely to report mental health problems. No study has yet tested whether there are any mental health differences between German lesbians, bisexual women, and female controls. We tested for mental health differences between matched groups of 161 lesbian and bisexual women and 161 women in the general population, as well as between matched groups of 79 lesbians and 79 bisexual women. Lesbian and bisexual women reported more mental health problems than population-based women. In contrast, bisexual women did not differ in mental health from lesbians. Therefore, German lesbian and bisexual women constitute a risk group for mental health problems. To improve lesbian and bisexual women's mental health, attempts should be made to lower the frequency of minority stressors, and best-practice mental health interventions made available.

Gay men's stress response to a general and a specific social stressor.

Gay men show altered psychobiological stress responses and exhibit a higher prevalence of mental disorders than their heterosexual counterparts. Both of these findings are likely due to gay-specific discrimination. Since it has not yet been determined whether gay-specific stress is more noxious than general stress, we tested whether gay men react more strongly to gay-specific socially stressful stimuli than to general socially stressful stimuli. N = 33 self-identified gay men (mean = 26.12 years of age, SD = 5.89), 63.6% of whom were in a relationship with a man, participated in an experimental within-group study, in which they were exposed to the Trier Social Stress Test (TSST) as well as a gay-specific TSST in a randomized order. Salivary cortisol and testosterone were assessed at five time points during the laboratory tests and perceived stress was assessed at four time points. According to psychobiological and perceived stress indices, the participants reacted similarly to a gay-specific and general social stressor. There were no significant differences in the outcomes, either when looking at pre-post-test differences or when comparing the overall stress responses. Given that the response to a gay-specific social stressor was equally pronounced as the one to a general social stressor, programs aiming to decrease minority stress but overlooking general stress are likely to yield only partial improvements in gay men's mental health. Instead, we suggest helping gay men cope with both forms of stress through building social support, assertiveness, and mindfulness skills, as well as decreasing emotional dysregulation.

Body image disturbance in children and adolescents with anorexia nervosa and bulimia nervosa: a systematic review.

PURPOSE: While several meta-analyses and reviews revealed a worse body image disturbance (BID) in adults with anorexia nervosa (AN) or bulimia nervosa (BN) than in controls, no systematic evidence is available on BID in children and adolescents. Since the usual onset of AN and BN is before the age of 21 years, being aware of BID in children and adolescents is crucial for preventing and treating eating disorders. This systematic review aims to provide an initial overview of differences in the BID components perception, global subjective satisfaction, affect/cognition, and behavior between children and adolescents with AN and BN and healthy controls. METHODS: We conducted a systematic data search in PubMed and PsycINFO based on a priori eligibility criteria (AN or BN group; gender-matched healthy control group; each group n ≥ 20; maximum age 19 years; BID outcome compared between groups; published in English or German). RESULTS: We were able to include k = 8 records. Compared to healthy controls, children and adolescents with AN and BN scored higher in the BID components perception, global subjective satisfaction, affect/cognition, and behavior. CONCLUSIONS: As previously found in adults, BID in children and adolescents is associated with AN and BN. Interventions and treatments are needed to alleviate BID in children and adolescents with BN and AN. We also noted that we need more investigations on BID differences in children and adolescents to improve the database. LEVEL OF EVIDENCE: Level I, Systematic review.

Testing the Cross-Cultural Robustness of the Minority Stress Model in Gay and Bisexual Men.

The study tests the cross-cultural robustness of the minority stress model using a most different systems approach. Data from Western European, Eastern European (including Russian), Indian, Philippine, and Thai gay and bisexual men was obtained online. The final sample consisted of N = 90,467 participants who reported their level of satisfaction with life, victimization, felt stigma, and internalized homonegativity, as well as their disclosure status and sociodemographic details. Stepwise linear regressions were conducted on reported levels of satisfaction with life. Higher levels of victimization, felt stigma, and internalized homonegativity predicted lower satisfaction with life in all groups. Disclosure was associated with higher satisfaction with life in Western Europe as well as the Philippines and Thailand. Minority stressors explained far more variance in participants' satisfaction with life (13% to 24%) than sociodemographics alone (1% to 3%). The findings suggest that the minority stress theory is a useful cross-cultural explanatory model for satisfaction with life.

Mental health differences between German gay and bisexual men and population-based controls.

BACKGROUND: International studies have revealed that gay and bisexual men present more mental health problems than the general male population. Furthermore, there is evidence that minority stress predicts mental health problems in gay and bisexual men. The aim of the present study is to provide initial data on mental health differences in Germany and to analyze the effect of minority stress. METHODS: Mental health data on n = 1903 German gay and bisexual men and n = 958 men from a population-based sample were assessed using a shortened version of the SCL-90-S. The mental health of the two samples was compared. Furthermore, a linear regression was conducted for the gay and bisexual sample: mental health was used as the criterion and minority stressors as predictors. RESULTS: As compared to our population sample, gay and bisexual men demonstrated more mental health problems with a moderate effect size. In the regression, minority stress predicted mental health problems in the gay and bisexual sample. CONCLUSIONS: We observed pronounced mental health differences between gay and bisexual men versus the population sample. These differences could be at least partly due to the minority stress gay and bisexual men face. Research should focus on how to reduce and cope with minority stress.

How Do Discrepancies between Victimization and Rejection Expectations in Gay and Bisexual Men Relate to Mental Health Problems?

Introduction: Victimization and rejection expectations predict mental health problems in gay and bisexual men. Furthermore, it was shown that victimization predicts rejection expectations. Nevertheless, the levels of these two variables do not necessarily correspond as indicated by low inter-correlations, resulting in the question "How do discrepancies in the two variables relate to mental health problems?" This study tests if non-corresponding levels of victimization and rejection expectations in gay and bisexual men relate to mental health problems differently than corresponding levels of victimization and rejection expectations. It furthermore tests for linear and curvilinear relationships between victimization, rejection expectations, and mental health problems. Methods: Data from N = 1423 gay and bisexual men were obtained online. Victimization and rejection expectations were tested for discrepant values (differing 0.5 SD or more) and those that were in agreement (differing less than 0.5): 33.7% of participants were in agreement, 33.0% reported higher rejection expectations than victimization, and 33.3% v.v. Then, a polynomial regression and a surface analysis were conducted. Results: Discrepant values in victimization and rejection expectations or the direction of the discrepancy did not relevantly predict mental health problems. Findings indicate that victimization and rejection expectations predict mental health problems linearly as well as convexly (upward curving) in gay and bisexual men. Discussion: This study replicates findings that gay and bisexual men with more experiences of victimization and rejection expectations demonstrated more mental health problems. Furthermore, this study is the first one to find a convex relationship between these predictors and mental health problems, implicating that disproportionally high mental health problems exist in those gay and bisexual men with high levels of victimization and rejection expectations. On the other hand, discrepancies between these two variables do not predict mental health problems. Future studies are needed to test for replication of our findings.

Effects of Minority Stress, Group-Level Coping, and Social Support on Mental Health of German Gay Men.

OBJECTIVE: According to epidemiological studies, gay men are at a higher risk of mental disorders than heterosexual men. In the current study, the minority stress theory was investigated in German gay men: 1) it was hypothesized that minority stressors would positively predict mental health problems and that 2) group-level coping and social support variables would moderate these predictions negatively. METHODS: Data from 1,188 German self-identified gay men were collected online. The questionnaire included items about socio-demographics, minority stress (victimization, rejection sensitivity, and internalized homonegativity), group-level coping (disclosure of sexual orientation, homopositivity, gay affirmation, gay rights support, and gay rights activism), and social support (gay social support and non-gay social support). A moderated multiple regression was conducted. RESULTS: Minority stressors positively predicted mental health problems. Group-level coping did not interact with minority stressors, with the exception of disclosure and homopositivity interacting marginally with some minority stressors. Further, only two interactions were found for social support variables and minority stress, one of them marginal. Gay and non-gay social support inversely predicted mental health problems. In addition, disclosure and homopositivity marginally predicted mental health problems. CONCLUSIONS: The findings imply that the minority stress theory should be modified. Disclosure does not have a relevant effect on mental health, while social support variables directly influence mental health of gay men. Group-level coping does not interact with minority stressors relevantly, and only one relevant interaction between social support and minority stress was found. Further longitudinal or experimental replication is needed before transferring the results to mental health interventions and prevention strategies for gay men.