A Conditional Process Analysis of Microaffirmations, Microaggressions, and Mental Health Among Thai Sexual Minorities.

Sexual orientation (SO) microaggressions contribute to mental health issues among sexual minorities. Microaffirmations may mitigate these effects, with internalized heterosexism and SO concealment proposed as mediators. A community sample of 307 Thai sexual minorities completed measures assessing SO microaggressions, microaffirmations, internalized heterosexism, SO concealment, and mental health concerns. Serial mediation analysis using Hayes' PROCESS macro model 6 tested indirect effects through proposed mediators. Conditional process analysis using PROCESS model 85 examined the moderating role of microaffirmations. These models tested hypothesized moderated serial mediation relationships among study variables. SO microaggressions had a total effect on mental health concerns, directly and indirectly through increased SO concealment. The internalized heterosexism → SO concealment sequence mediated this relationship. Microaffirmations moderated the direct microaggressions-mental health link, reducing this association at higher levels of microaffirmations. The full model accounted for 31.6% of the variance (R2 = 0.316) in mental health concerns. The Johnson-Neyman technique identified 0.613 as the microaffirmations value above which the effect of SO microaggressions on mental health was no longer significant. Findings elucidate mechanisms linking SO microaggressions to mental health issues and microaffirmations' protective role among Thai sexual minorities. These results could inform efforts to mitigate minority stress impacts.

Developing and Validating Thai Sexual Orientation Microaggression and Microaffirmation Scales.

Mental health disparities exist for sexual minority populations globally. Microaggressions and microaffirmations related to sexual orientation may negatively or positively impact well-being. Culturally validated tools are needed to assess these constructs among LGBQ+ (lesbian, gay, bisexual, queer/questioning) individuals in Thailand's high-context culture. This study aimed to develop and validate the Thai Sexual Orientation Microaggressions Scale (T-SOMG) and the Thai Sexual Orientation Microaffirmations Scale (T-SOMF) to quantify experiences among LGBQ+ Thais. A mixed-methods approach was utilized. Initial scale items were derived from a literature review, expert consultation, and interviews with LGBQ+ Thais. Exploratory factor analysis (n = 164) refined the item pools. Confirmatory factor analysis (n = 200) confirmed the factor structures. Reliability and validity were examined. The final 18-item T-SOMG contained two subscales-Interpersonal and Environmental Microaggressions. The 13-item T-SOMF contained Interpersonal and Environmental Microaffirmations subscales. All scales demonstrated good model fit, reliability, convergent validity, and discriminant validity. The T-SOMG and T-SOMF are culturally valid tools for assessing microaggressions and microaffirmations among LGBQ+ Thais. These localized scales can enable research on factors impacting LGBQ+ well-being. Further validation in diverse samples is warranted.

Intention to Enact and Enactment of Gatekeeper Behaviors for Suicide Prevention: an Application of the Theory of Planned Behavior.

Gatekeeper training for suicide prevention was evaluated on a college campus to examine the impact of training on gatekeeper enactment of behaviors in support of suicide prevention and identify predictors of enactment of gatekeeper behaviors. Trained gatekeepers (N = 216) displayed greater perceived knowledge and self-efficacy for suicide prevention and reported higher rates of self-reported actual gatekeeper behaviors, including inquiring about suicidal ideation and referring for mental health treatment when they encountered someone in distress, compared to their untrained counterparts (N = 169). Consistent with the Theory of Planned Behavior, SEM results indicated that attitudes, self-efficacy, and perceived knowledge explained intentions to engage in gatekeeper behaviors, accounting for 59% of the variance in intentions to inquire about suicidal ideation and supporting the role of attitudes and perceived behavioral control in intentions to act. These intentions explained self-reported actual gatekeeper behaviors among participants who encountered someone in distress, with each one-point increase in intention associated with nearly twice the likelihood of both inquiring about suicidal ideation and referring someone for mental health care. On the other hand, self-reported situational barriers were associated with a decreased likelihood of referral behavior, indicating the role of actual behavioral control over volitional actions. Findings support the value of gatekeeper training for promoting factors that influence the likelihood of action on behalf of suicide prevention.

Validation of the Coping with Discrimination Scale in sexual minorities.

The Coping With Discrimination Scale (CDS) shows promise as a self-report measure of strategies for coping with racial discrimination. To assess the psychometric properties of the measure for use with sexual minorities (i.e., gay, lesbian, bisexual, or GLB persons), a nonprobability sample of 371 GLB adults completed the instrument along with several standardized, self-report measures. Confirmatory factor analyses supported the five-factor structure of the original scale with the exclusion of five items. Adequate internal consistency reliability was found. Internalization, drug and alcohol use, and detachment subscales were correlated positively with measures of psychological distress and negatively with a measure of life satisfaction, providing evidence of construct validity. The education/advocacy and resistance subscales were largely unrelated to concurrently administered validation measures, consistent with prior findings. Coping strategy use varied as a function of primary sources of social support. The CDS appears to be a psychometrically sound measure of several discrimination coping strategies for use with sexual minorities.

The attitudes toward transgendered individuals scale: psychometric properties.

Gay, lesbian, bisexual, and transgendered individuals are sexual and gender minorities subject to stigma in a heteronormative culture with binary gender role norms. Although much research has examined sexual stigma in the form of homophobia, or negative attitudes and reactions to homosexuals and homosexuality, little is known about the stigma experienced by transgendered individuals. Transgendered people are those whose gender identity (sense of oneself as a man or a woman) or gender expression (expression of oneself as a man or a woman in behavior, manner, and/or dress) differ from conventional expectations for their physical sex. Although a scale exists to measure transphobia or negative attitudes and reactions to transgendered individuals, it includes items tapping into overt behavioral expression of this stigma, or gender-bashing, and fails to identify or define transgendered persons as the attitudinal target of the items. A new scale was developed and evaluated in an effort to assess transgender-related stigma, separately from discrimination and violence, among members of the general population. Using two separate samples of college students ranging in age from 18-64 years, exploratory (N = 134) and confirmatory factor analyses (N = 237) were performed. The resulting 20-item, self-report measure demonstrated a single-factor structure, high internal consistency reliability, and evidence of convergent and discriminant construct validity.

Demographic and social factors associated with homophobia and fear of AIDS in a community sample.

Examinations of demographic and social factors associated with homophobia and fear of AIDS are limited by the frequent use of homogeneous, college student samples and limited examination of interrelationships among variables. The present study examined community attitudes toward homosexuality and fear of HIV/AIDS as a function of age, education, race/ethnicity, religious affiliation, political party affiliation, and personal contact with homosexual individuals and persons living with HIV/AIDS. A community sample of 463 adults completed standardized measures of homophobia and fear of AIDS as well as demographic and social background items. When examined separately, each demographic and social factor assessed, with the exception of race/ethnicity, was associated with homophobia and all but race/ethnicity and political party affiliation were associated with fear of AIDS. However, when entered into multiple regression analyses, 24% of the variance in homophobia was predicted by a single variable, including only personal contact with homosexual individuals, while 18% of the variance in fear of AIDS was accounted for by five variables, including personal contact with homosexual individuals, religious affiliation, political affiliation, education, and personal contact with someone living with HIV/AIDS. Findings suggest that it is important to consider intercorrelations among social and demographic factors, particularly when considering homophobia.

Negative affect and risk for human immunodeficiency virus: one size may not fit all.

PURPOSE: Research examining the relationship between human immunodeficiency virus (HIV)-related risk behavior and negative affective states has netted mixed findings. The present study examined the potential moderating role of gender and sexual orientation on negative affect and HIV-related risk behavior. DESIGN: Measures of depression, anxiety, and HIV-related risk behavior were collected from participants at the time of pretest counseling. Analysis of variance was used to examine HIV-related risk behavior as a function of negative affect levels and gender and behavioral sexual orientation. SETTING: The study was conducted through a community-based, anonymous HIV counseling and testing site. SUBJECTS: Participants included 185 consecutively recruited men and women presenting for HIV testing. MEASURES: Participants completed a structured interview regarding HIV-related risk behavior, the Center for Epidemiological Studies Depressed Mood Scale, and the Beck Anxiety Inventory. RESULTS: Greater HlV-related risk behavior was associated with high levels of anxiety and moderate or high levels of depression for bisexual women. Greater HIV-related risk behavior was also associated with low levels of anxiety and mild to moderate levels of depression for bisexual men. CONCLUSIONS: The relationship between negative affective states and HIV-related risk behavior may vary as a function of gender and behavioral sexual orientation. Better understanding of the relationship between negative affect and risk behavior may be achieved through consideration of these sources of variation.