Problematic pornography use and suicidal thoughts: Results from cross-sectional and longitudinal analyses.

OBJECTIVE: There is a growing consensus that problematic pornography use (PPU), one of the most commonly reported compulsive sexual behaviors, is related to a number of internalizing psychiatric symptoms (e.g., anxiety, depression). However, little is known about the potential comorbidity of PPU and suicidal thoughts. Given known links between PPU and higher levels of guilt, shame, and moral disapproval, it may be that PPU may be related to suicidal thoughts. METHOD: Using two independent samples, we cross-sectionally (Sample 1: undergraduates, n = 422) and longitudinally (Sample 2: nationally representative sample of U.S. adults, n = 1,455) tested for associations between PPU and past-month suicidal ideation and perceived likelihood of suicidal behaviors, while controlling for frequency of pornography use, moral disapproval, moral incongruence, and religiousness. RESULTS: Cross-sectionally, PPU was related to higher levels of self-perceived likelihood of suicidal behaviors, but not past-month suicidal thoughts. Longitudinally, PPU was related to higher initial levels (i.e., intercept) of past-month suicidal thoughts and self-perceived likelihood of suicidal behaviors, but not changes in either (i.e., slope). The frequency of pornography use was statistically unrelated to each outcome for both samples, while moral beliefs about pornography use showed mixed relationships. CONCLUSIONS: Clinicians working with patients reporting PPU may consider ways it may contribute to suicidal thinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

LGBTQ+ cultural-competence training effectiveness: Mental health organization and therapist survey outcome results from a pilot randomized controlled trial.

Lesbian, gay, bisexual, transgender, queer/questioning and other sexual and gender diverse (LGBTQ+) persons frequently lack access to mental health service organizations (MHOs) and therapists who are competent with LGBTQ+ clients. Existing continuing education programmes to better equip therapists to work with LGBTQ+ clients are often not widely accessible or skills focused, evaluated for effectiveness and inclusive of MHO administrators who can address the organizational climate needed for therapist effectiveness. A virtual, face-to-face, multi-level (administrators and therapists) and multi-strategy (technical assistance, workshop and clinical consultations) LGBTQ+ cultural competence training-the Sexual and Gender Diversity Learning Community (SGDLC)-was tested in a pilot randomized controlled trial. Ten organizations were randomly assigned to the intervention (SGDLC plus free online videos) or control (free online videos only) group. Pretest/posttest Organization LGBTQ+ Climate Surveys (n = 10 MHOs) and pretest/posttest Therapist LGBTQ+ Competence Self-Assessments (n = 48 therapists) were administered. Results showed that at pretest, average ratings across organization LGBTQ+ climate survey items were low; twice as many items improved on average in the intervention (10/18 items) than control (5/18 items) group organizations. At pretest, therapist average scores (range 0-1) were highest for knowledge (0.88), followed by affirmative attitudes (0.81), practice self-efficacy (0.81), affirmative practices (0.75) and commitment to continued learning (0.69). Pretest/posttest change scores were higher for the intervention relative to the control group regarding therapist self-reported affirmative attitudes (cumulative ordinal ratio [OR] = 3.29; 95% confidence interval [CI] = 1.73, 6.26), practice self-efficacy (OR = 5.28, 95% CI = 2.00, 13.93) and affirmative practices (OR = 3.12, 95% CI = 1.18, 8.25). Average therapist and administrator satisfaction scores were high for the SGDLC. These findings suggest the SGDLC training can affect organizational- and therapist-level changes that may benefit LGBTQ+ clients.

Religion/Spirituality, Stress, and Resilience Among Sexual and Gender Minorities: The Religious/Spiritual Stress and Resilience Model.

Although many sexual and gender minorities (SGMs) consider themselves religious or spiritual, the impact of this religiousness or spirituality (RS) on their health is poorly understood. We introduce the religious/spiritual stress and resilience model (RSSR) to provide a robust framework for understanding the variegated ways that RS influences the health of SGMs. The RSSR bridges existing theorizing on minority stress, structural stigma, and RS-health pathways to articulate the circumstances under which SGMs likely experience RS as health promoting or health damaging. The RSSR makes five key propositions: (a) Minority stress and resilience processes influence health; (b) RS influences general resilience processes; (c) RS influences minority-specific stress and resilience processes; (d) these relationships are moderated by a number of variables uniquely relevant to RS among SGMs, such as congregational stances on same-sex sexual behavior and gender expression or an individual's degree of SGM and RS identity integration; and (e) relationships between minority stress and resilience, RS, and health are bidirectional. In this manuscript, we describe the empirical basis for each of the five propositions focusing on research examining the relationship between RS and health among SGMs. We conclude by describing how the RSSR may inform future research on RS and health among SGMs.

Affirming and nonaffirming religious beliefs predicting depression and suicide risk among Latter-Day Saint sexual minorities.

Sexual minorities (SMs) who are current/former members of the Church of Jesus Christ of Latter-day Saints (LDSs) report high levels of depression and risk for suicide. Recent research has suggested that specific LDS religious beliefs may be related to these negative mental health outcomes. Using two independent online samples of current/former LDS SMs (Sample 1 = 403; Sample 2 = 545), we tested associations of affirming/nonaffirming LDS beliefs with depression and suicide risk cross-sectionally (Sample 1), and then longitudinally (Sample 2) tested if religious/spiritual struggles and internalized stigma mediated these relationships. Cross-sectionally, nonaffirming LDS beliefs were associated with higher depression, but effects disappeared when religious/spiritual struggles and internalized stigma were entered in the model. Affirming LDS beliefs were unrelated to depression and suicide risk. Longitudinally, after including earlier levels of internalized stigma, religious/spiritual struggles, depression, and suicide risk as controls, nonaffirming beliefs indirectly predicted more depression 2 months later (Time 3) through internalized stigma at 1 month (Time 2). These results suggest LDS beliefs may play an important role in the development and experience of depression for LDS sexual minorities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Is Conservative Religiousness Inherently Associated with Poorer Health for Sexual Minorities?

Results of path analysis involving sexual minority participants (N = 1317) from diverse sociopolitical contexts revealed health outcomes to be associated with internalized homonegativity and the resolution of conflict between religious and sexual minority identities. Contrary to expectations, several markers of religiousness were not directly associated with either improved or worsened health outcomes for depression or anxiety. However, religious activity moderated the influence of internalized homonegativity (IH) on depression such that IH was less strongly related to depression among individuals who frequently attended religious services than among individuals who infrequently attended religious services. These findings have special salience for advancing a more accurate understanding of conservatively religious sexual minorities and directing culturally sensitive research, clinical services, and public policy.

Comparison of Lifetime Suicide Attempts and Recent Suicidal/Self-Harming Thoughts Among Sexual Minority and Heterosexual Utahns: Results from a Population-Based Survey.

OBJECTIVE: We sought to be the first published article to report differences in population-representative prevalence of suicidal thoughts and attempts by sexual orientation. METHOD: Data from Utah's Behavioral Risk Factor Surveillance System (BRFSS) collected for 2016 (N = 10,988) and 2017 (N = 10,251) were examined to determine differences in the prevalence of suicidal thoughts in the past 2 weeks and the lifetime prevalence of suicide attempts (i.e., any, single, and multiple) by sexual orientation. RESULTS: 3.5% of heterosexuals Utahns reported recent suicidal/self-harming thoughts in the last 2 weeks compared to 14.7% of LGB Utahns (OR = 4.73 95% CI [2.67, 8.36]). 5.8% of heterosexuals reported a lifetime prevalence of any suicidal attempts compared to 37.2% of LGB folx (OR = 9.58 95% CI [7.16, 12.81]) with similar differences occurring for single and multiple attempts. Comparing LG versus B, there was no difference in ideation or prevalence of any attempt, but bisexuals reported higher rates of multiple suicide attempts. CONCLUSION: LGB folx in Utah are drastically more likely to have thought about suicide/self-harming in the last 2 weeks and to have attempted suicide in their lifetime when compared to heterosexuals in Utah.

Suicidal ideation among active and nonactive/former Latter-day Saint sexual minorities.

Sexual minorities (SMs) in the Church of Jesus Christ of Latter-day Saints (LDS) experience a number of unique risks related to their religious/spiritual and SM experience that may increase their likelihood of experiencing suicidal ideation (SI) and ultimately dying by suicide. However, it is unclear which aspects of these experiences are responsible for elevated SI. It is further unclear whether religiousness/spirituality and minority stress relate to SI similarly for active and nonactive/former LDS SMs. To address this gap, we examined data from 602 active and nonactive/former LDS SMs. Active and nonactive LDS SMs reported similar degrees of SI and minority stress but differing degrees of religiousness/spirituality with active LDS SMs reporting more religiousness/spirituality than nonactive/former LDS SMs. Several variables were associated with increased SI in both groups including positive religious coping, interpersonal religious struggles, internalized homonegativity, and concealment. Other variables were associated with decreased SI in both groups including resolving conflict between sexual and religious identities, family support, and friend support. Our results suggest that whether LDS SMs are active in their faith is an important factor to consider when understanding how religiousness/spirituality and minority stress relate to SI.

Adverse Childhood Experiences, Suicidal/Self-Harming Thoughts, and Suicide Attempts Among LGB and Heterosexual Utahns.

Current research suggests that sexual minorities living in Utah may be at higher risk for experiencing suicidal/self-harming thoughts and suicide attempts than heterosexuals in Utah. However, to date no research has been conducted examining potential reasons sexual minorities living in Utah may be at higher risk. Using two representative samples of Utahns, we examine (a) disparities in adverse childhood experiences (ACEs) between sexual minorities and heterosexual Utahn, (b) how ACEs and sexual orientation may predict recent suicidal/self-harming thoughts and lifetime prevalence of suicide attempts, and (c) how sexual orientation and ACEs might interact to predict suicidal outcomes. Results with each sample showed that sexual minority Utahns reported higher levels of ACEs and suicidal/self-harming thoughts than heterosexual Utahns. Both sexual orientation and ACEs uniquely predicted suicidality when both were entered into regression models, but no interaction effects were found between these predictors.