Potentially Traumatic Events and the Association Between Gender Minority Stress and Suicide Risk in a Gender-Diverse Sample.

Transgender and gender diverse (TGD) individuals are at an elevated risk of trauma exposure and other negative mental and physical health outcomes. The present study examined the interaction between minority stressors, reported potentially traumatic events (PTEs), and suicide risk (i.e., ideation and behavior) in a TGD sample. A convenience sample of 155 self-identified TGD individuals completed questionnaires assessing distal (e.g., gender-related discrimination) and proximal (e.g., internalized transphobia) gender identity-related stressors, lifetime PTE history, and suicide risk. The results of a mediation analysis demonstrated that proximal stressors partially mediated the association between distal stressors and suicide risk, B = 1.12, t(152) = 3.72, p < .01, 95% CI [0.53, 1.72], and the results of a moderated mediation analysis showed that the interaction term was not significant, and that the number of PTEs did not moderate the mediation model that examined proximal stressors as a mediator of the association between distal stressors and suicide risk, F(3, 151) = 18.74, MSE = 0.75, R2 = 0.27, B = 0.07, t(151) = 0.89, p = .371, 95% CI [-0.08, 0.21]. These findings suggest that minority stressors may contribute to suicide risk in a TGD population above and beyond the impact of trauma exposure. Risk reduction efforts for suicide risk may be enhanced by attending to minority stressors in addition to PTEs.

To Disclose, Not Disclose, or Conceal: A Qualitative Study of HIV-Positive Men with Multiple Concealable Stigmatized Identities.

People living with HIV (PLHW) and other concealable stigmatized identities (CSIs) face continual decisions about the degree of openness they are willing to allow for their identities in different social contexts. Disclosing or concealment of CSIs describes potential stigma management strategies that may have distinct psychosocial consequences. This study aimed to examine disclosure processes in a sample of sexual minority men (SMM) with intersecting CSIs, who use substances and were suboptimally engaged in HIV care. Interviews (N = 33) were initially double coded following thematic analysis, which identified disclosure as a theme. Subsequently, content analysis and additional selective double coding were used to iteratively identify and refine subthemes related to disclosure decisions. Illustrative quotes and frequencies of the invoked subthemes and identities were recorded for each participant. The majority of participants discussed experiences of disclosure and nondisclosure (N = 31, 94%). Among these, a spectrum of related behaviors and preferences emerged, including active disclosure, passive disclosure, passive nondisclosure, and concealment. Across disclosure-related content, in addition to HIV status, the majority of participants also described navigating decisions about disclosure of sexual orientation (71%), substance use (61%), and multiple identities at once (55%). Findings from this study highlight the fluid and multi-dimensional nature of identity-related disclosure processes in SMM with multiple CSIs. Participants in this study possessed interlocking stigmatized identities and described being varying degrees of "out" across identities and time. Moreover, these findings challenge common beliefs that disclosure is a binary construct associated with positive gain.

Differences in mental health symptom severity and care engagement among transgender and gender diverse individuals: Findings from a large community health center.

Mental health disparities among transgender and gender diverse (TGD) populations have been documented. However, few studies have assessed differences in mental health symptom severity, substance use behavior severity, and engagement in care across TGD subgroups. Using data from the electronic health record of a community health center specializing in sexual and gender minority health, we compared the (1) severity of self-reported depression, anxiety, alcohol use, and other substance use symptoms; (2) likelihood of meeting clinical thresholds for these disorders; and (3) number of behavioral health and substance use appointments attended among cisgender, transgender, and non-binary patients. Participants were 29,988 patients aged ≥18 who attended a medical appointment between 2015 and 2018. Depression symptom severity (F = 200.6, p < .001), anxiety symptom severity (F = 102.8, p < .001), alcohol use (F = 58.8, p < .001), and substance use (F = 49.6, p < .001) differed significantly by gender. Relative to cisgender and transgender individuals, non-binary individuals are at elevated risk for depression, anxiety, and substance use disorders. Gender was also associated with differences in the number of behavioral health (χ2 = 51.5, p < .001) and substance use appointments (χ2 = 39.3, p < .001) attended. Engagement in treatment among certain gender groups is poor; cisgender women and non-binary patients assigned male at birth were the least likely to have attended a behavioral health appointment, whereas transgender men and cisgender women had attended the lowest number of substance use appointments. These data demonstrate the importance of (1) assessing gender diversity and (2) addressing the barriers that prevent TGD patients from receiving affirming care.

Physical and sexual violence on college campuses: considerations for international students.

OBJECTIVE: Physical and sexual violence are pervasive concerns on college campuses. Previous research indicates minority populations may be at increased risk for exposure to violence, therefore, international students may represent a vulnerable population. The present study examined differences between international and domestic students regarding the experience of violence and variables related to violence intervention. Participants: Domestic and international colleges students (n = 829) at a Midwestern university in the United States participated in an online survey. Method: Questions assessed experiences of physical and sexual violence, rape myth acceptance, bystander confidence, and readiness to help. Descriptive statistics, chi squares, and independent sample t-tests were conducted to determine differences between groups. Results: Analyses showed no association between international student status and lifetime exposure to violence. Differences were found on acceptance of rape myths and bystander confidence. Conclusions: This study demonstrates the potential benefit of tailored violence prevention and intervention efforts.

Addressing Diversity in PTSD Treatment: Clinical Considerations and Guidance for the Treatment of PTSD in LGBTQ Populations.

PURPOSE OF REVIEW: Trauma exposure is widespread but is especially common among lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. LGBTQ individuals also experience higher rates of discrimination, victimization, and minority stress which can complicate posttraumatic stress disorder (PTSD) treatment but also represent independent intervention targets. In this review, we highlight existing evidence-based practices, current limitations, and provide recommendations for care in the absence of established guidelines for treatment PTSD among LGBTQ patients. RECENT FINDINGS: Trauma-focused therapies (e.g., CPT, PE) and medications (e.g., SSRIs, SNRIs) have shown benefit for people with PTSD. However, evaluations of these interventions have failed to examine the role of LGBTQ identities in recovery from trauma, and existing PTSD treatments do not account for ongoing threat to safety or the pervasive minority stress experienced by LGBTQ patients. In addition, many LGBTQ patients report negative experiences with healthcare, necessitating increased education and cultural awareness on the part of clinicians to provide patient-centered care and, potentially, corrective mental health treatment experiences. SUMMARY: Providers should routinely assess trauma exposure, PTSD, and minority stress among LGBTQ patients. We provide assessment and screening recommendations, outline current evidence-based treatments, and suggest strategies for integrating existing treatments to treat PTSD among LGBTQ patients.

Treating Substance Abuse and Trauma Symptoms in Incarcerated Women: An Effectiveness Study.

Incarcerated women report high rates of trauma exposure and substance use. The present study evaluated an integrated treatment program, Helping Women Recover/Beyond Trauma (HWR/BT), supplemented with additional modules on domestic violence, relapse prevention, and a 12-step program. The HWR/BT combined treatment program was compared with a matched comparison sample that did not receive the target treatment. Self-report measures were collected from 95 incarcerated women, with 56 women in the completer sample. Women in the treatment condition attended a 4-month group treatment. Results indicated statistically significant between-group differences, favoring the treatment condition, for negative posttraumatic cognitions. Pre-post, but not between-group, differences were also observed for posttraumatic stress disorder (PTSD) symptoms and substance-related self-efficacy, whereas no differences were observed for depression, dissociation, tension reduction, or anxious arousal. The present study indicates some promise for specific aspects of the treatment, although results question the overall benefit of the program over standard prison services.

Phase grating design for a dual-band snapshot imaging spectrometer.

Infrared spectral features have proved useful in the identification of threat objects. Dual-band focal-plane arrays (FPAs) have been developed in which each pixel consists of superimposed midwave and long-wave photodetectors [Dyer and Tidrow, Conference on Infrared Detectors and Focal Plane Arrays (SPIE, Bellingham, Wash., 1999), pp. 434-440]. Combining dual-band FPAs with imaging spectrometers capable of interband hyperspectral resolution greatly improves spatial target discrimination. The computed-tomography imaging spectrometer (CTIS) [Descour and Dereniak, Appl. Opt. 34, 4817-4826 (1995)] has proved effective in producing hyperspectral images in a single spectral region. Coupling the CTIS with a dual-band detector can produce two hyperspectral data cubes simultaneously. We describe the design of two-dimensional, surface-relief, computer-generated hologram dispersers that permit image information in these two bands simultaneously.