Perceived group devaluation, depression, and HIV-risk behavior among Asian gay men.

[Correction Notice: An erratum for this article was reported in Vol 27(3) of Health Psychology (see record 2008-08834-013). In the aforementioned article, the second sentence of the Results portion of the abstract should read: Among participants most attracted to Whites, group devaluation was associated with higher levels of nonprimary partner UAI; but was associated with lower levels of nonprimary partner UAI among those most attracted to non-Whites.] Objective: This study examined depressive mood and HIV-risk behavior in relation to perceived group devaluation and group identity. Design: Cross-sectional survey of 192 Asian gay men. Main Outcome Measures: Depressive mood assessed using the Centers for Epidemiological Studies Depression Scale (CES-D) and self-reported receptive or insertive unprotected anal intercourse (UAI) in the past 3 months. Results: Group devaluation was positively associated with depressive mood. Among participants most attracted to Whites, group devaluation was associated with higher levels of nonprimary partner UAI, among those most attracted to non-Whites. Among participants reporting higher levels of group devaluation, those with more positive personal evaluations of the Asian gay community had lower levels of total UAI compared to those with more negative personal evaluations of the Asian gay community. Conclusions: Results suggest that group devaluation is associated with higher levels of depressive mood among Asian gay men. Asian gay men most attracted to non-Whites or hold more positive evaluations of their group may be buffered from the influence of high perceived group devaluation on UAI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of disengagement coping with HIV risk on unprotected sex among HIV-negative gay men in New York City.

Objective: This study examined how disengagement coping with HIV risk mediated the association between internalized homophobia and unprotected anal intercourse (UAI) and how sexual encounters in public venues (public sex) and drug use moderated the association between disengagement coping and UAI among HIV-negative gay men. Disengagement coping included fatalistic beliefs about maintaining HIV-negative seronegative serostatus (fatalism), optimistic attitudes toward medical seriousness of HIV infection and reduced concern about HIV risk due to highly active anti-retroviral therapies (optimism), and negative affective states associated with sexual risk (anxiety). Design: A survey was conducted among 285 HIV-negative gay men at an HIV prevention counseling program in New York City. Main Outcome Measures: Sexual risk was defined as having had UAI with nonprimary partners in the past 6 months. Results: In addition to the positive association between internalized homophobia, disengagement coping, and UAI, fatalism mediated the association between internalized homophobia and UAI; and optimism mediated the association between anxiety and UAI. A significant moderation effect of public sex was found between fatalism and UAI. Conclusions: The findings highlight the importance of understanding disengagement coping as it affects sexual risk practices among HIV-negative gay men in the continuing epidemic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Repeated bereavement, depressed mood, and immune parameters in HIV seropositive and seronegative gay men.

The relationships among bereavement, depressed mood, and immunologic patterns prognostic for the development of AIDS were determined in a sample of HIV seropositive gay men and a comparison group of HIV seronegative gay men. Immunologic parameters were assessed in 45 men who had recently experienced the deaths of close friends and 45 matched nonbereaved men. No immune differences were found between bereaved and nonbereaved men. Among the HIV seropositive nonbereaved men, higher depressed mood was significantly associated with fewer CD4 (helper/inducer) T lymphocytes, more activated CD8 (suppressor/cytotoxic) T cells, and lower proliferative responses to the mitogen phytohemagglutinin. In summary, HIV seropositive men who reported higher levels of depressed mood not associated with bereavement demonstrated immunologic patterns consistent with HIV activity and progression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms: Results from a prospective study of bereaved gay men.

Objective: Minority stress is the most frequently hypothesized risk factor for the increased rates of adverse behavioral and mental health outcomes among sexual minorities. However, there is a paucity of longitudinal research addressing this hypothesis. Design: Prospective, community-based cohort of 74 bereaved gay men. Participants were assessed before the partner or close friend died of AIDS and then at 1, 6, 13, and 18 months postloss. Main Outcome Measures: HIV risk behavior (unprotected anal intercourse), substance use and abuse symptoms, and depressive symptoms. Results: Hierarchical Linear Modeling analyses revealed that changes in internalized homophobia, discrimination experiences, and expectations of rejection were differentially associated with HIV risk behavior, substance use, and depressive symptoms, respectively. In contrast to the significant effects of minority stress, bereavement-related stressors (e.g., length of partner illness, quality of relationship with deceased) were largely unrelated to these outcomes. Conclusion: The results provide evidence for the predictive validity of minority stress, even in the context of a major life stressor, and suggest the importance of targeting minority stress experiences in HIV and mental health interventions with gay men. Future studies are needed to assess the mechanisms through which minority stress is associated with adverse health outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health and substance use disorders among Latino and Asian American lesbian, gay, and bisexual adults.

Growing evidence suggests that lesbian, gay, and bisexual adults may be at elevated risk for mental health and substance use disorders, possibly due to anti-gay stigma. Little of this work has examined putative excess morbidity among ethnic/racial minorities resulting from the experience of multiple sources of discrimination. The authors report findings from the National Latino and Asian American Survey (NLAAS), a national household probability psychiatric survey of 4,488 Latino and Asian American adults. Approximately 4.8% of persons interviewed identified as lesbian, gay, bisexual, and/or reported recent same-gender sexual experiences. Although few sexual orientation-related differences were observed, among men, gay/bisexual men were more likely than heterosexual men to report a recent suicide attempt. Among women, lesbian/bisexual women were more likely than heterosexual women to evidence positive 1-year and lifetime histories of depressive disorders. These findings suggest a small elevation in psychiatric morbidity risk among Latino and Asian American individuals with a minority sexual orientation. However, the level of morbidity among sexual orientation minorities in the NLAAS appears similar to or lower than that observed in population-based studies of lesbian, gay, and bisexual adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, coping, and high-risk sexual behavior.

Examined the relation between stress, coping, and a high-risk sexual behavior (unprotected anal intercourse [UAI]) in 398 nonmonogamous gay and bisexual men. UAI during the previous month, the amount of stress experienced during the previous month in each of 10 domains, 6 types of coping, and spiritual beliefs and activities were assessed through self-report. There was no relation between stress and UAI, but there was between coping and UAI. Ss who reported UAI used sex more to help cope with stressful situations. UAI was negatively associated with seeking social support and spiritual activities and positively associated with self-controlling coping, which involves keeping one's feelings to oneself, and positive reappraisal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Victimization Over the Life Span: A Comparison of Lesbian, Gay, Bisexual, and Heterosexual Siblings.

Lifetime victimization was examined in a primarily European American sample that comprised 557 lesbian/gay, 163 bisexual, and 525 heterosexual adults. Lesbian, gay, and bisexual (LGB) participants were recruited via LGB e-mail lists, periodicals, and organizations; these participants recruited 1 or more siblings for participation in the study (81% heterosexual, 19% LGB). In hierarchical linear modeling analyses, sexual orientation was a significant predictor of most of the victimization variables. Compared with heterosexual participants, LGB participants reported more childhood psychological and physical abuse by parents or caretakers, more childhood sexual abuse, more partner psychological and physical victimization in adulthood, and more sexual assault experiences in adulthood. Sexual orientation differences in sexual victimization were greater among men than among women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Binge drinking in Chinese, Korean, and White college students: Genetic and ethnic group differences.

Studies of Asian college students have found that rates of binge drinking are associated with variation in the aldehyde dehydrogenase (ALDH2) gene. Chinese and Koreans have different prevalence rates of the ALDH2?*?2 allele, alcohol use, and alcoholism. The association of ALDH2 status and ethnic group with binge drinking was examined in 328 Chinese, Korean, and White college students. Ethnic group differences were found, with Whites having the highest rate of binge drinking, followed by Koreans and then Chinese. Among Asian participants, ALDH2 status and ethnicity related to binge drinking in an additive manner. Possessing an ALDH2?*?2 allele and being Chinese were protective factors, and being White and being Korean without an ALDH2?*?2 allele were risk factors for binge drinking. These results suggest that ALDH2 status, as well as other factors that differ in Koreans and Chinese, but do not interact with ALDH2, are associated with binge drinking among Asians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized clinical trial of a brief, mailed intervention for symptoms of depression.

This research evaluated the efficacy of a brief, mailed personalized feedback intervention designed to alleviate depressed mood and antecedents (ineffective coping and hopelessness). College students (N = 177) were randomly assigned to intervention or control group following a baseline assessment. A week after completing the baseline assessment, participants in the intervention condition were mailed feedback and information detailing their mood, coping strategies, as well as suggestions for enhancing mood. Results indicated that feedback was effective in reducing depressive symptoms, hopelessness, and among men, increasing willingness to use coping strategies at the 1-month follow-up. Hopelessness mediated reductions in depressive symptoms. Results support the use of personalized feedback as a low-cost, initial intervention for college students suffering from symptoms of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping and physical health during caregiving: The roles of positive and negative affect.

The associations among coping, mood, and health variables were examined prospectively over 2 years in 86 HIV positive (HIV+) and 167 HIV negative (HIV-) gay men undergoing the stress of AIDS-related caregiving. Path models suggested that including both positive and negative mood and the men's associated coping strategies increases understanding of why some people suffer adverse health effects during times of stress. Among the HIV- caregivers, higher levels of social coping predicted increases in positive affect, which in turn resulted in lower levels of physical symptoms. In contrast, higher levels of cognitive avoidance predicted increases in negative affect, which in turn resulted in higher levels of physical symptoms. Self-injurious forms of avoidance coping predicted higher levels of physical symptoms independent of mood among the HIV+ caregivers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Butch, femme, or straight acting? Partner preferences of gay men and lesbians.

On average, gay men are somewhat feminine and lesbians somewhat masculine, but there is variation within each group. The authors examined the consequences of this variation for gay men's and lesbians' desirability as romantic partners. In 2 studies the authors analyzed personal advertisements. Homosexual people were more likely than heterosexual people to mention traits related to sex typicality and more likely to request sex-typical than sex-atypical partners. In 2 studies the authors assessed partner preferences directly. On average, gay men preferred men who described themselves as masculine rather than feminine, but this preference was weaker among men who rated themselves as relatively feminine. Lesbians preferred women who described themselves as feminine looking but did not discriminate against women calling themselves masculine acting. The authors discuss implications of the results for theories of sexual orientation and the adjustment of sex-atypical homosexual people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress and coping among gay men: Age and ethnic differences.

Previous studies suggest that perceived stigmatization of sexual minority status, ethnicity, and age are associated with negative mental health outcomes, and other studies suggest that coping styles may influence these outcomes. However, no studies have examined these relationships among gay men of varying ethnicities and age groups. Three hundred eighty-three Black and White, younger, middle-aged, and older adult gay men completed measures of perceived stigmatization, coping style, and mental health outcomes. Black older adult gay men reported significantly higher levels of perceived ageism than the older White group, significantly higher levels of perceived racism than the younger Black group, significantly higher levels of homonegativity than the younger Black and the White groups, and were more likely to use disengaged coping styles than White gay men. However, Black older adult gay men did not experience significantly higher levels of negative mental health outcomes. Results suggest that further research should examine how older Black gay men, who perceive higher levels of stigma while reporting greater use of less effective coping styles, do not appear to be experiencing more negative mental health outcomes as a result. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical health problems, depressive mood, and cortisol secretion in old age: Buffer effects of health engagement control strategies.

Objective: This study examined the protective role played by control behaviors aimed at overcoming physical health problems (health engagement control strategies; HECS) in the associations between older adults' physical health problems, depressive mood, and diurnal cortisol secretion. It was expected that adaptive levels of HECS would buffer the adverse effects of physical health problems on depressive mood and diurnal cortisol secretion. Design and Measures: Physical health problems and HECS were measured in a cross-sectional sample of 215 community-dwelling older adults. In addition, participants' depressive mood and patterns of diurnal cortisol secretion were assessed across 3 days. Results: The findings demonstrate that physical health problems predicted high levels of depressive mood and diurnal cortisol secretion, but only among older adults who reported low levels of HECS (and not among older adults who reported high levels of HECS). Moreover, depressive mood completely mediated the buffering effect of HECS on the association between physical health problems and cortisol secretion. Conclusion: The results suggest that adaptive levels of HECS represent a psychological mechanism that can protect older adults from experiencing the adverse emotional and biological consequences of physical health problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The association of level and stability of self-esteem and depressive symptoms in the acute inpatient stroke rehabilitation setting.

Purpose: Explore the relationship of level and stability of self-esteem with self-reported depressive symptoms during acute inpatient stroke rehabilitation. Research Method: A consecutive sample of 79 participants was administered measures of state self-esteem and mood twice a day for 4 consecutive days. The Geriatric Depression Scale (GDS) was administered at the end of the 4 days. Self-esteem level was calculated by averaging the total self-esteem scores across the assessments, and self-esteem stability was operationalized as the standard deviation of self-esteem total scores. Mood level and stability were calculated likewise. Results: Regression analysis indicated that self-esteem stability moderated self-esteem level in predicting GDS scores, with stable lower self-esteem level associated with the most reported depressive symptoms. Unstable higher self-esteem levels were associated with more depressive symptoms than stable higher self-esteem. This interaction was demonstrated after controlling for mood level and stability, suggesting the independence of self-esteem stability from mood characteristics. Conclusion: Self-esteem stability may be an important variable in identifying individuals at risk for emotional disturbance following stroke. Further exploration of self-esteem stability correlates in this setting is warranted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Issues in mapping genes for eating disorders

The purpose of this study was to obtain information about the prevalence of depressive symptoms in a representative sample of elderly subjects aged 85 years and over. The study was carried out as a population-based interview study in the City of Vantaa in Finland. The Zung Depression Status Inventory (DSI) was used to evaluate various depressive symptoms in this study population. The DSI scores range from 20 to 80; the higher the score, the more severe the disturbance. In subjects interviewed (n = 467, 362 women, 105 men), the prevalence estimates of depression with cutoff scores used in earlier studies (40 and 48) were very low: 5.2% and 1.1%. Also, the mean DSI score (SD) was very low, 27.9 (6.4). The scores tended to decrease with age, although the differences were not statistically significant. The DSI means were 28.0 (6.1) for women and 27.3 (7.2) for men (p = .0349). Women had a greater risk of being classified as depressed on the DSI (odds ratio: 1.60, 95% confidence interval: 1.00-2.57, p = .049). Feelings of emptiness, personal devaluation, and depressive mood were the most common depressive symptoms. In conclusion, the present population-based study shows that subjective experience of depression is very rare in Finnish people aged 85+. Our results suggest that optimistic mood might give some protection against death.     

Effect of depressive symptoms on smoking abstinence and treatment adherence among smokers with a history of alcohol dependence.

This study examined the effect of depressive symptoms on smoking abstinence and treatment adherence among smokers with a past history of alcohol dependence. Participants (24 women, 27 men) were randomly assigned to behavioral counseling (BC) or behavioral counseling plus cognitive-behavioral mood management training (CBT). The Hamilton -Rating Scale for Depression (HRSD; A Hamilton, 1967) was administered to assess baseline depressive symptoms. Participants who received CBT and had higher HRSD scores were more likely to achieve short-term abstinence from smoking and attend more treatment sessions than those with lower depression scores, whereas for BC participants the effect of HRSD scores was the opposite. Smokers with a history of alcohol dependence reporting high levels of depressive symptoms may benefit from a mood management intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postbereavement depressive mood and its prebereavement predictors in HIV+ and HIV– gay men.

Prebereavement predictors of the course of postbereavement depressive mood were examined in 110 gay men who were their partner's caregiver until the partner's death of AIDS. In all, 37 HIV+ and 73 HIV– bereaved caregiving partners were assessed bimonthly throughout a 10-month period beginning 3 months before and ending 7 months after the partner's death. Throughout the 10 months, mean Centers for Epidemiology Scale-Depression (CES-D) scores on depressive mood were above the cutoff for being at risk for major depression. CES-D scores decreased for 63% of bereaved caregivers over the 7 postbereavement months, and 37% showed little change from high CES-D scores or increasing CES-D scores. High prebereavement CES-D scores and finding positive meaning in caregiving predicted diminishing depressive mood; HIV+ serostatus, longer relationships, hassles, and use of distancing and self-blame to cope predicted unrelieved depressive mood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Decomposing depression: On the prospective and reciprocal dynamics of mood and sleep disturbances.

Sleep disturbances are among the most common and debilitating aspects of major depressive disorder. In a sample of unmedicated adults experiencing a current depressive episode (N participants = 99, N data points = 428), the authors examined the longitudinal dynamics of sleep disturbances and mood symptoms across a 17-week acupuncture treatment study using latent difference score structural equation modeling. Results indicated that changes in sleep and mood disturbances could be characterized as a single bivariate system where low levels of mood symptoms lead to increases in sleep disturbances, whereas high levels of sleep disturbance exert a dampening effect on mood symptoms. Movement of the bivariate system toward or away from better outcomes depended on the precise combination of sleep-mood symptoms; without knowing the state and trajectory of both variables, predicting change in either sleep or mood symptoms was limited. The results have implications for better understanding the complexity and reciprocity of sleep-mood associations, as well as the dynamic, time-based predictors of depressive treatment response. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression ratings, reported sexual risk behaviors, and methamphetamine use: Latent growth curve models of positive change among gay and bisexual men in an outpatient treatment program.

Although the cessation of substance use is the principal concern of drug treatment programs, many individuals in treatment experience co-occurring problems such as mood disruptions and sexual risk behaviors that may complicate their recovery process. This study assessed relationships among dynamic changes tracked over time in methamphetamine use, depression symptoms, and sexual risk behaviors (unprotected anal intercourse) in a sample of 145 methamphetamine-dependent gay and bisexual males enrolled in a 16-week outpatient drug treatment research program. Participants were randomly assigned into 1 of 4 conditions: contingency management (CM), cognitive behavioral therapy (CBT; the control condition), combined CM and CBT, and a tailored gay-specific version of the CBT condition. Using latent growth curve models, the authors assessed the relationship of means (intercepts) and the slopes of the 3 measures of interest over time to test whether changes in methamphetamine use predicted declining rates of depression and risky sexual behavior in tandem. Participants with the greatest downward trajectory in methamphetamine use (urine verified) reported the greatest and quickest decreases in reported depressive symptoms and sexual risk behaviors. The control group reported the most methamphetamine use over the 16 weeks; the tailored gay-specific group reported a more rapidly decreasing slope in methamphetamine use than the other participants. Findings indicate that lowering methamphetamine use itself has a concurrent and synergistic effect on depressive symptoms and risky sexual behavior patterns. This suggests that some users who respond well to treatment may show improvement in these co-occurring problems without a need for more intensive targeted interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mood regulation expectancies, coping responses, depression, and sense of burden in female caregivers of Alzheimer's patients

This study focused on the role of generalized expectancies for negative mood regulation in coping among caregivers to Alzheimer's disease patients. Self-report measures were used to obtain information on expectancies, hassles, coping strategies, depressive symptoms, and sense of burden from 73 female primary caregivers in support groups. Stronger expectancies for negative mood regulation were associated with less severe depressive symptoms, even with stress levels and coping responses controlled. These expectancies were also associated with less avoidant coping, but were unrelated to active coping. Burden and depressive symptoms were strongly related, but correlated differently with other variables.