Hate crimes against lesbians and gay men: Issues for research and policy.

Antigay hate crimes (words or actions that are intended to harm or intimidate individuals because they are lesbian or gay) constitute a serious national problem. In recent surveys, as many as 92% of lesbians and gay men report that they have been the targets of antigay verbal abuse or threats, and as many as 24% report physical attacks because of their sexual orientation. Assaults may have increased in frequency during the last few years, with many incidents now including spoken references to the acquired immunodeficiency syndrome (AIDS) by the assailants. Trends cannot be assessed, however, because most antigay hate crimes are never reported and no comprehensive national surveys of antigay victimization have been conducted. Suggestions are offered for research and policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the special section: Mental health of lesbians and gay men.

There has been little focus on the mental health of lesbians and gay men in the 2 decades since homosexuality was removed as a diagnostic category from the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; American Psychiatric Association, 1980). This special section contains articles on research methodology on lesbian and gay mental health; the practice and ethics of sexual orientation conversion therapy; the mental health results of the National Lesbian Health Care Survey; ethnicity and sexual orientation; sexual orientation as a factor in research on eating disorders and body dissatisfaction; and verbal and physical abuse as stressors in the lives of lesbian and gay youths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The challenge of health care social work with gay men and lesbians

Inflammation in the subarachnoid space represents the pathological hallmark of bacterial meningitis. The intrathecal accumulation of leukocytes, in response to bacterial pathogens, and the subsequent release of endogenous inflammatory mediators are associated with a breakdown of the blood-brain barrier function and poor prognosis. Complement has been shown to play a major role in the inflammatory response within the intrathecal compartment in bacterial meningitis. In the present review, we provide an outline of the current understanding of the involvement of the complement system in the pathophysiology of bacterial meningitis, and propose future directions of investigation.     

The relation of job satisfaction and degree of openness about one''s sexual orientation for lesbians and gay men

Previous studies have shown that cardiovascular patients benefit from exercise. The explanations are partly physical and partly psychological, yet evidence for the latter is contradictory, possibly because only selected samples start and maintain prolonged exercising. The authors examined psychological effects of short-term exercise started as soon as possible after myocardial infarction, focusing on the motivation for health of 62 male and female patients who had had a myocardial infarction 7 to 10 days earlier. Patients were divided into those who exercised for a week in a recovery camp, those who merely stayed for a week in the camp, and those who did not stay in the camp. Results of before and after tests indicated that two scores of the motivation for health (goals and norms) of patients in the exercise group increased, even when complications, former exercising, and infarct location were considered. A month later, 53 of the patients completed a cardiological adjustment questionnaire. The exercise group scored higher than the others on 8 of 9 domains, including subjective health state, sexuality, and work. Even short-term supervised exercise, if done immediately after infarction, has a great potential for beneficial psychological effects, the authors concluded.     

The disclosure dilemma for gay men and lesbians: "Coming out" at work.

This study examined disclosing sexual orientation at work for 220 gay men and 159 lesbians. Self-acceptance, the centrality of one's identity, how "out" one is to friends and family, employer policies, and perceived employer gay-supportiveness were associated with disclosure behaviors at work for gay/lesbian employees. Disclosing at work and working for an organization perceived to be more gay supportive was related to higher job satisfaction and lower job anxiety. Reactions of coworkers to gay or lesbian workers mediated the relationship between disclosure and gay/lesbian workers' job attitudes. Implications and solutions for management are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The need for research that is designed to support decisions in the delivery of mental health services

M.E.P. Seligman (1995) argued that traditional approaches to mental health services research fail to provide useful information to consumers and practitioners, particularly in an environment increasingly dominated by managed care. The authors recommend 4 guidelines for designing a research program so that the results can support the decisions of the major stakeholders (clients-families, practitioners, service managers, and policymakers): (a) Research must be targeted and programmatic and encompass a strategy of complementary efficacy, effectiveness, and cost-effectiveness studies; (b) study design and measure selection must be sensitive to describe who, and in what context, is best served by which intervention; (c) the design must inform stakeholders as to the type and amount of effort that is required to achieve a behavioral criteria; and (d) the strategy should inform researchers how information should be formatted to best support the decisions of the key stakeholders.     

"The myth of mental illness:" continuing controversies and their implications for mental health professionals

Since the publication of "The Myth of Mental Illness" in 1960, there has been an ongoing debate about Thomas Szasz's ideas concerning mental illness. In this paper, Szasz's views are summarized, as are the views of Szasz's critics. Specifically, the following areas are addressed: Szasz's definition of disease, his notions regarding the unconscious and rationality, his beliefs regarding culpability, his proposed differences between psychiatry and other branches of medicine, the uses of the term "mental illness," and the possibility of implicating physical lesions in some mental illnesses. With this discussion as a backdrop, the importance of these issues to mental health practitioners is addressed.     

"Cancer patients and health care professionals perceptions of the need for oral health education"

Reported studies indicated a need for oral health education for oncology patients. In a recent study it was concluded that septicaemia in immunosuppressed patients was attributed to an oral source in 25-50% of cases (Oral surg Jrnl 1992). "Increased susceptibility to infection accompanies both the cancer disease and treatment. The mouth provides a pool of opportunistic infection which may lead to life-threatening systemic infection in individuals whose immune system is already compromised by disease and/or treatment" (Griffiths and Boyle 1992).     

Linking level of care to level of need: Assessing the need for mental health care for nursing home residents.

What are the mental health status and active treatment needs of nursing home residents? A stratified random sample of 828 residents in 25 facilities serving Medicaid recipients was assessed for levels of physical and psychosocial functioning. Although 91.2% had sufficiently high levels of medical and physical care needs to justify nursing home placement, 79.6% also had moderate to intense needs for mental health care. Older residents, relative to their younger counterparts, had more intense medical and mental health care needs. It was also found that psychiatric diagnosis was a poor indicator of mental health service needs, particularly among elderly individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence.

In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Basic behavioral science research for mental health: Vulnerability and resilience.

Presents factors in basic behavioral science research on the nature of and variations in personality as sources of the differences in the vulnerability and resilience to stress. Individual genetic predispositions, expressed as temperament, personality, and intelligence, social skills and self-esteem are viewed as factors which, in turn, are shaped by a variety of environmental influences. The advances made in behavioral science research and key findings revealing the sources of vulnerability and strength in several areas of investigation are described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Basic behavioral science research for mental health: Thought and communication.

The key to human intelligent behavior lies in the capacity for thinking, reasoning, and problem solving and an inability to communicate through language. These abilities are often seriously impaired in people with mental disorders, and their language may reveal delusions and scattered, incoherent thoughts as well as "word" salad and idiosyncratic words. Depressed and anxious individuals often reveal self defeating thoughts and inappropriate reasoning, such as regarding minor slip-ups as catastrophes and dwellling on the negative aspects of experiences that are generally positive. Cognitive research seeks to understand how thinking, reasoning, and using language develop and function nomally, how they are represented in the brain, and how they can break down in aging, brain injury, and various mental disorders. Aspects of this research inform the work of therapists as they challenge irrational beliefs and dysfunctional reasoning, encourage clients to re-evaluate their problems, and aid people in overcoming the aftereffects of brain injury and disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence of depressive symptoms among rural elderly: Examining the need for mental health services.

Reexamined the prevalence of depressive symptoms among 1,724 rural, noninstitutionalized older adults (aged 59–99 yrs) and documented the need for mental health services as they relate to depression and potential barriers to receiving needed services. A telephone survey was conducted in North Dakota, with a random sample drawn from each of 8 human service districts. Instruments included the Geriatric Depression Scale and the CAGE. Results indicate that the prevalence of depression was relatively low. Controlling for potential alcohol abuse, cognitive impairment, and medical problems, the study found that 5% of older adults reported current depressive symptomatology. When using a cutoff score that is likely to correspond to a diagnosis of major depression, the study found a prevalence rate of 1.6%. Of those reporting significant levels of depression, only 27.6% were currently being treated for an emotional problem. The survey data suggested that cost, transportation, and concern about stigma are not major barriers to receiving needed mental health services. Rather, lack of awareness of available services and a lack of routine contact with mental health service providers are important factors that limit service utilization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Protease inhibitor combination therapies and perceptions of gay men regarding AIDS severity and the need to maintain safer sex

BACKGROUND: Advances in the treatment of HIV disease with protease inhibitor combination therapies have been widely documented in the media. OBJECTIVES: To investigate perceptions concerning the severity of HIV/AIDS and the need to maintain safer sex practices in the light of recent HIV treatment advances. METHODS: A survey eliciting demographic characteristics, HIV serostatus and treatment information, and HIV/AIDS severity and safer sex perceptions was administered to a community sample of 379 homo-/bisexual men who reported awareness of combination therapy regimens. RESULTS: Ten per cent of all respondents agreed or strongly agreed with the statement that 'AIDS is now very nearly cured' and 13% felt that the threat of AIDS is less serious than in the past. HIV-positive men were more likely to perceive AIDS as a less serious threat or as very nearly cured. Overall, 8% of men in the sample indicated that they practice safer sex less often since new AIDS treatments came along; 18% of HIV-positive men on combination therapy regimens said they practice safer sex less frequently since treatments have advanced. Regardless of serostatus, nearly 20% of men indicated they would stop practicing safer sex if an AIDS cure was announced. CONCLUSION: It is essential to integrate behavior change counseling into HIV treatment programs and to temper optimism concerning treatment advances with recognition that the threat of HIV/AIDS remains great.     

The impact of victimization on the mental health and suicidality of lesbian, gay, and bisexual youths.

Lesbian, gay, and bisexual youths (aged 15–21 yrs) were studied to determine the impact of verbal abuse, threat of attacks, and assault on their mental health, including suicide. Family support and self-acceptance were hypothesized to act as mediators of the victimization and mental health-suicide relation. Structural equation modeling revealed that in addition to a direct effect of victimization on mental health, family support and self-acceptance in concert mediated the victimization and mental health relation. Victimization was not directly related to suicide. Victimization interacted with family support to influence mental health, but only for low levels of victimization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Basic behavioral science research for mental health: Sociocultural and environmental processes.

Provides a selective overview of sociocultural research investigating the role of culture in the course of mental illness and suggests promising directions for future research. Sociocultural variation in basic psychological processes and experiences including identity, self-esteem, attribution, and motivation are discussed. The role of race, ethnicity, SES, changing work roles, and communities in mental health across the life span are also explored. Possible directions for future research include cross-cultural research on universal vs culturally specific aspects of behavior, the expression and effects of ethnic discrimination, and factors mediating the effects of SES on the mental health of children and adults (0 ref). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Migrant mental health: A model for indicators of mental health and health care consumption.

Objective: This study explores the relationship between mental health and health care consumption among migrants in the Netherlands. Design: Samples of the Turkish (n = 648), Moroccan (n = 102), and Surinamese (n = 311) populations in Amsterdam were examined. The study tested a hypothesized model of risk factors for psychiatric morbidity, indicators of well-being, and indicators of health care consumption. The model was specified on the basis of information from earlier research on the sample and literature on the topic. The model was tested and refined using structural equation modeling. Main outcome measures: Psychiatric morbidity and well-being measures were assessed with the CIDI 1.1 and MOS-sf-36 subscales, respectively. Health care consumption was assessed by the question "Have you ever consulted one or more of these professionals or health care facilities with respect to mental health problems or problems related to alcohol or drugs usage?" Results: The primary result of this study was the confirmation that health care consumption among migrants is predicted by need and predisposition factors, such as health condition and sociodemographic characteristics. In addition, mental health care consumption of migrants is predicted by acculturation characteristics. This result suggests an effect of cultural and migrant-specific factors in help-seeking behavior and barriers to mental health care facilities. Conclusions: Findings confirm the existence of migrant-specific mechanisms in health care consumption. Mental health care professionals should be aware of these. However, ignoring common ground for interventions unnecessarily creates distance between migrant groups and between migrant and indigenous Dutch groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)