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)     

Minority stress and mental health among Dutch LGBs: Examination of differences between sex and sexual orientation.

Minority stress is often cited as an explanation for greater mental health problems among lesbian, gay, and bisexual (LGB) individuals than heterosexual individuals. However, studies focusing on sex or sexual orientation differences in level of minority stress and its impact on mental health are scarce, even more so outside the United States. Performing secondary analyses on the data of a Dutch population study on sexual health, the present study examines the robustness of the minority stress model by explaining mental health problems among men and women with mostly or only same-sex sexual attraction, and men and women who are equally attracted to same-sex and opposite-sex partners in the “gay-friendly” Netherlands (N = 389; 118 gay men, 40 bisexual men, 184 lesbian women, and 54 bisexual women). Results showed that minority stress is also related to mental health of Dutch LGBs. Participants with a higher level of internalized homonegativity and those who more often encountered negative reactions from other people on their same-sex sexual attraction reported more mental health problems. Such negative reactions from others, however, had a stronger link with mental health among lesbian/gay than among bisexual participants. Openness about one's sexual orientation was related to better mental health among sexual minority women, but not among their male counterparts. Suggestions for future research, implications for counseling, and other societal interventions are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Mental Health of Lesbian, Gay, Bisexual, and Heterosexual Siblings: Effects of Gender, Sexual Orientation, and Family.

Self-identified lesbian, gay male, and bisexual (LGB) individuals were recruited via convenience sampling, and they in turn recruited their siblings (79% heterosexual, 19% LGB). The resulting sample of 533 heterosexual, 558 lesbian or gay male, and 163 bisexual participants was compared on mental health variables and their use of mental health services. Multilevel modeling analyses revealed that sexual orientation predicted suicidal ideation, suicide attempts, self-injurious behavior, use of psychotherapy, and use of psychiatric medications over and above the effects of family adjustment. Sexual orientation was unrelated to current psychological distress, psychiatric hospitalizations, and self-esteem. This is the 1st study to model family effects on the mental health of LGB participants and their siblings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emerging issues in research on lesbians' and gay men's mental health: Does sexual orientation really matter?

Theoretical writings and research suggest that the onset, course, treatment, and prevention of mental disorders among lesbians and gay men differ in important ways from those of other individuals. Recent improvements in studies of sexual orientation and mental health morbidity have enabled researchers to find some elevated risk for stress-sensitive disorders that is generally attributed to the harmful effects of antihomosexual bias. Lesbians and gay men who seek mental health services must find culturally competent care within systems that may not fully address their concerns. The affirmative therapies offer a model for intervention, but their efficacy and effectiveness need to be empirically documented. Although methodological obstacles are substantial, failure to consider research questions in this domain overlooks the welfare of individuals who may represent a sizable minority of those accessing mental health services annually. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Tobacco, marijuana, and sensation seeking: Comparisons across gay, lesbian, bisexual, and heterosexual groups.

This study examined patterns of smoked substances (cigarettes and marijuana) among heterosexuals, gays, lesbians, and bisexuals based on data from the 2000 National Alcohol Survey, a population-based telephone survey of adults in the United States. We also examined the effect of bar patronage and sensation seeking/impulsivity (SSImp) on tobacco and marijuana use. Sexual orientation was defined as lesbian or gay self-identified, bisexual self-identified, heterosexual self-identified with same-sex partners in the past 5 years, and exclusively heterosexual (heterosexual self-identified, reporting no same-sex partners). Findings indicate that bisexual women and heterosexual women reporting same-sex partners had higher rates of cigarette smoking than exclusively heterosexual women. Bisexual women, lesbians, and heterosexual women with same-sex partners also used marijuana at significantly higher rates than exclusively heterosexual women. Marijuana use was significantly greater and tobacco use was elevated among gay men compared with heterosexual men. SSImp was associated with greater use of both of these substances across nearly all groups. Bar patronage and SSImp did not buffer the relationship between sexual identity and smoking either cigarettes or marijuana. These findings suggest that marijuana and tobacco use differ by sexual identity, particularly among women, and underscore the importance of developing prevention and treatment services that are appropriate for sexual minorities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns and predictors of mental health service use and mental illness among older and younger adults in the United States.

The present study examined patterns of serious mental illness (SMI), specific mental health syndromes, and service use among older (65+) and younger (18-64) adults throughout the United States, and the extent to which various factors predict SMI and the use and magnitude of mental health treatment. Despite recent developments designed to improve mental healthcare access and treatment for older adults, older individuals were found to receive outpatient mental healthcare at very low rates. Compared to younger adults, older adults were three times less likely to report receiving treatment. Although prevalence estimates for SMI and specific syndromes were markedly lower among older than younger adults, older individuals most in need of care were highly unlikely to report receiving treatment. Findings point to the importance of perceived need in mental healthcare use. Significantly, however, those older adults that made it into services typically reported benefiting considerably from treatment, at least as much as all other age groups. Several predisposing, enabling, and need factors related to mental illness and service use were identified that have important implications for how we plan for, design, and deliver mental health services to older and younger Americans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting intentions and desires among childless lesbian, gay, and heterosexual individuals.

Parenthood is one of the most universal and highly valued experiences of American adults. However, lesbian and gay adults in the United States are much less likely than heterosexual adults to be parents. Our goal was to explore the reasons why this is the case. Using nationally representative data from the 2002 National Survey of Family Growth (NSFG), we studied parenting intentions, desires, and attitudes of childless lesbian, gay, and heterosexual individuals 15 to 44 years of age. We found that gay men and lesbian women were less likely than matched heterosexual peers to express desire for parenthood. Moreover, gay men who expressed desire to become parents were less likely than heterosexual men to express the intention to become parents; this was not true for women. Despite being less likely to express parenting desires, gay and lesbian participants endorsed the value of parenthood just as strongly as did heterosexual participants. By exploring the psychology of family formation as a function of sexual orientation, these results inform ongoing debates about sexual orientation and parenthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital distress and mental health care service utilization.

Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for specific sectors of treatment providers, including psychiatrist, other mental health provider, other medical provider, and religious services provider. Interviews were used to assess past-year service utilization and presence of anxiety, mood, and substance use disorders. Results: Approximately 12% of married individuals sought help for problems with their emotions, nerves, or substance use during the 12 months preceding the interview. Marital distress was significantly associated with (a) overall mental health service utilization and service utilization provided by each of the sectors of providers when controlling for demographic variables and (b) overall mental health service utilization and receiving treatment from a psychiatrist when additionally controlling for past-year anxiety, mood, or substance use disorders. There was little evidence that the associations between marital distress and service utilization were moderated by gender or presence of psychiatric disorders. Conclusion: The finding that marital distress is associated with greater mental health care service utilization suggests that clinicians should assess both individual and relationship factors among individuals presenting for treatment. (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)     

Burden of psychiatric morbidity among lesbian, gay, and bisexual individuals in the California Quality of Life Survey.

In recent population-based surveys, minority sexual orientation has been identified as a potential risk indicator for psychiatric morbidity. However, methodological limitations in the studies to date have led to concerns that current estimates are biased due to inadequate measurement of sexual orientation and uncontrolled confounding from prevalent HIV infection. In the present study, the authors investigate associations between sexual orientation and mental health/substance use morbidity using information obtained from 2,272 individuals, including 652 sexual orientation minorities, age 18 to 72 years, interviewed in the California Quality of Life Survey. Results confirm that minority sexual orientation is a risk indicator for psychiatric morbidity. However, levels of increased risk vary within this subpopulation by both gender and patterns of sexual orientation expression. Among gay/bisexual men, much of this greater burden is related to concurrent HIV infection. Reducing excess mental health morbidity risk among sexual orientation minorities could result in possibly a 5% to 11% reduction in the burden of the disorders assessed here among the adult population. Sexual orientation represents an important, but relatively understudied, individual characteristic shaping risk for psychiatric morbidity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"I only read about myself on bathroom walls": the need for research on the mental health of lesbians and gay men

The very recent history of pathologizing homosexuality still has a strong impact on the public in general and mental health professionals in particular. In contrast to the early research on sexual reorientation of lesbians and gay men, there is relatively little empirical research on the mental health issues of lesbians and gay men. Whether researchers choose to define sexual orientation by sexual behavior, self-definition, or membership in lesbian and gay community groups will have an impact on the results. Research on mental health issues that include lesbians, gay men, and heterosexual women and men would allow an examination of the relative salience of gender versus sexual orientation. Finally, the experiences of lesbians and gay men in society may place them at increased risk for some mental health problems and may protect them from other mental health problems.     

Legal and social contexts and mental health among lesbian and heterosexual mothers.

This study examines the role of legal and social context (the level of legal and social support offered by one's country of residence) and sexual orientation in the mental health of lesbian and heterosexual mothers. Participants were sampled from the United States and Canada because the two countries have many similarities (North American location, reliance on English language, and democratic structures) but provide different legal and social rights to their lesbian citizens. The study included 52 lesbian mothers and 153 heterosexual mothers in the United States and 35 lesbian mothers and 42 heterosexual mothers in Canada. Although there were no differences between heterosexual mothers as a function of legal and social context, lesbian mothers from the United States reported more family worries about legal status and discrimination (but not more general family worries) and more depressive symptoms than did lesbian mothers in Canada. Results indicate that legal and social context moderates the role of sexual orientation in maternal mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health professionals versus non-mental-health professionals: Childhood trauma and adult functioning.

Research on childhood family environments of mental health professionals suggests that therapists are often raised in dysfunctional families and experience significant psychological distress in adult life. This study examined the prevalence of childhood trauma, family dysfunction, and current psychological distress among female mental health professionals (N?=?340) and compared it with the prevalence among women working in other professions (N?=?2,623). Psychotherapists reported higher rates of physical abuse, sexual molestation, parental alcoholism, psychiatric hospitalization of a parent, death of a family member, and greater family dysfunction in their families of origin than did other professionals. As adults, psychotherapists experienced less anxiety, depression, dissociation, sleep disturbance, and impairment in interpersonal relationships than did women in professions other than mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual orientation differences in cerebral asymmetry and in the performance of sexually dimorphic cognitive and motor tasks

With each of the tasks in the present studies we expected to find the reported sex difference between heterosexual women and heterosexual men and we predicted a sexual orientation effect with the performance of homosexual men being similar to that of heterosexual women and different from that of heterosexual men. Study 1 aimed to replicate earlier findings by recording the performance of a group of homosexual men on a visuospatial task, the Vincent Mechanical Diagrams Test (VMDT), a dot detection divided visual field measure of functional cerebral asymmetry, and on five subtests of the Wechsler Adult Intelligence Scale (WAIS). For each task the profile of scores obtained for the homosexual men was similar to that of heterosexual women in that they scored lower than heterosexual men on the VMDT, they showed less asymmetry, and they recorded a higher Verbal than Performance IQ on the WAIS. In Study 2, a male-biased targeted throwing task favored heterosexual men while, in contrast, on the female-biased Purdue Pegboard single peg condition heterosexual men were outperformed by heterosexual women and homosexual men. On neither of these two tasks did the performances of homosexual men and heterosexual women differ. One task, manual speed, yielded neither sex nor sexual orientation differences. Another, the Purdue Pegboard assemblies condition, revealed a sex difference but no sexual orientation difference. Failure to obtain a sexual orientation difference in the presence of a sex difference suggests that the sexual orientation effect may be restricted to a subset of sexually dimorphic tasks.     

Gender differences in experiences of sexual harassment: Data from a male-dominated environment.

The goal of this investigation was to examine gender differences in experiences of sexual harassment during military service and the negative mental health symptoms associated with these experiences. Female (n = 2,319) and male (n = 1,627) former reservists were surveyed about sexual harassment during their military service and current mental health symptoms. As expected, women reported a higher frequency of sexual harassment. Further, women had increased odds of experiencing all subtypes of sexual harassment. Being female conferred the greatest risk for experiencing the most serious forms of harassment. For both men and women, sexual harassment was associated with more negative current mental health. However, at higher levels of harassment, associations with some negative mental health symptoms were stronger for men than women. Although preliminary, the results of this investigation suggest that although women are harassed more frequently than men, clinicians must increase their awareness of the potential for sexual harassment among men in order to provide the best possible care to all victims of harassment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual orientation and the second to fourth finger length ratio: A meta-analysis in men and women.

The ratio of the lengths of the second and fourth fingers (2D:4D) may serve as a marker for prenatal androgen signaling. Because people are typically unaware of their 2D:4D, its use allows possible effects of early sex hormone regimes and socialization to be disentangled. We conducted a meta-analysis on relationships between 2D:4D and sexual orientation in men and women in 18 independent samples of men and 16 independent samples of women. Collectively, these samples comprised 1,618 heterosexual men, 1,693 heterosexual women, 1,503 gay men, and 1,014 lesbians. In addition to identifying the normative heterosexual sex difference in 2D:4D for both hands, we found that heterosexual women had higher (more feminine) left- and right-hand 2D:4D than did lesbians, but we found no difference between heterosexual and gay men. Moderator analyses suggested that ethnicity explained some between-studies variation in men. These results add to a literature suggesting that early sex hormone signaling affects sexual orientation in women, and highlight the need for further research exploring the relationships among 2D:4D, sexual orientation, and ethnicity in men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Large sexual-orientation-related differences in performance on mental rotation and judgement of line orientation tasks.

This study examined the performance of heterosexual and homosexual men and women on 2 tests of spatial processing, mental rotation (MR) and Benton Judgment of Line Orientation (JLO). The sample comprised 60 heterosexual men, 60 heterosexual women, 60 homosexual men, and 60 homosexual women. There were significant main effects of gender (men achieving higher scores overall) and Gender×Sexual Orientation interactions. Decomposing these interactions revealed large differences between the male groups in favor of heterosexual men on JLO and MR performance. There was a modest difference between the female groups on MR total correct scores in favor of homosexual women but no differences in MR percentage correct. The evidence suggests possible variations in the parietal cortex between homosexual and heterosexual persons. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Within-group differences in sexual orientation and identity.

The purpose of this investigation was to examine within-group differences among self-identified sexual orientation and identity groups. To understand these within-group differences, 2 types of analysis were conducted. First, a sample of 2,732 participants completed the Sexual Orientation and Identity Scale. Cluster analyses were used to identify 3 types of bisexual women, 3 types of bisexual men, 2 types of heterosexual women, and 2 types of gay men. Lesbians and heterosexual men were clustered into singular groupings. In addition, a subsample of 838 participants also completed measures of sexual identity development and lesbian, gay, and bisexual knowledge and attitudes. Within-group differences were found for bisexual men and women, gay men, and heterosexual women along these dimensions. Findings supported the existence of distinct subgroups of bisexual men, bisexual women, gay men, and heterosexual women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Functional cerebral asymmetry and sexual orientation in men and women.

Functional cerebral asymmetry was assessed in 32 gay men and 32 heterosexual men and in 30 lesbians and 30 heterosexual women with a linguistic dichotic listening test. All groups showed the typical greater right-ear accuracy and, by inference, left-hemisphere representation for language functions. As shown repeatedly in previous studies (e.g., M. P. Bryden, 1982), among heterosexuals, consistent-right-handers showed greater perceptual asymmetry than did nonconsistent right-handers. In contrast, gay men and lesbians did not show an association between hand preference and magnitude of perceptual asymmetry. The results indicate different patterns of functional cerebral asymmetry in gay men and lesbians compared with heterosexual people and, specifically, less association between motoric and linguistic components of cerebral asymmetry. This suggestion of atypical patterns of functional asymmetries is consistent with previous results of an increased prevalence of left-hand preference among gay men and lesbians compared with the heterosexual population. The finding of an association between aspects of functional asymmetry, a neurological characteristic likely present from birth, and sexual orientation suggests that a neurobiological factor is involved in the origins of sexual orientation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recollections of parental behaviour, adult attachment and mental health: mediating and moderating effects

BACKGROUND: Attachment theory posits links between early experiences with parents, adult relationships and adult mental health, but does not specify whether these are independent, mediating, or moderating effects. METHODS: Associations of parent's behaviour on the Parental Bonding Instrument, adult attachment styles and three dimensions of mental health were investigated in a large sample of women and men. RESULTS: Men and women with secure styles recalled higher levels of care from both parents than those with fearful styles. Maternal and paternal control were more consistent predictors of increased distress for men than for women. Fearful and preoccupied adult styles were associated with higher levels of distress in both men and women. While adult styles had few mediating effects on the association of parental behaviour and mental health, interactions between the fearful style and parental variables suggested that this form of insecurity sometimes accentuated the impact of high parental care or low paternal control on mental health in both men and women; among women, however, the secure style seemed to buffer somewhat the negative effect of high parental control. CONCLUSION: Although the amount of variance explained by either parental behaviour or adult styles was modest, patterns of moderating effects of adult styles on associations between parental behaviour and mental health suggested that both continuity and discontinuity principles can be applied to understanding these links.