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)     

Sexual orientation, sexual behaviors, and pregnancy among American Indian adolescents

PURPOSE: A recent study found a disproportionate number of pregnancies among Euro-American lesbian and bisexual adolescents compared to heterosexual peers. American Indian adolescents have reported higher prevalence of gay/lesbian/bisexual orientations than Euro-Americans; do they also report higher prevalence of pregnancy? METHODS: The study assessed prevalence of teen pregnancy and related factors by sexual orientation among sexually experienced, reservation-based American Indian adolescent males (n = 2056) and females (n = 1693) who participated in a national school-based survey in 1991. Self-reported orientation was classified as heterosexual, gay/lesbian/bisexual, and "unsure" of orientation. RESULTS: Gay/bisexual males were more likely than other males to report early heterosexual intercourse (<14 years), more consistent contraception, and a higher prevalence of abuse and running away (p < 0.05 to p < 0.0001). Likewise, lesbian/bisexual females were more likely to report early onset of heterosexual intercourse, more frequent intercourse, and running away. Sexual or physical abuse did not vary by orientation for females. Prevalence of pregnancy also did not vary by orientation (males, 18.6% gay/bisexual vs. 10.4% "unsure" vs. 11.8% heterosexual; females, 25.0% lesbian/bisexual vs. 22.1% "unsure" vs. 21.9% heterosexual). For lesbian/bisexual females, no variables were significantly associated with pregnancy history; for "unsure" females, pregnancy was associated with contraceptive frequency and early onset of heterosexual activity. For heterosexual females, age, intercourse frequency, and physical abuse were associated. For gay/bisexual males, intercourse frequency, ineffective contraception, and physical abuse were associated with involvement in a pregnancy; for "unsure" and heterosexual males, most items except ineffective contraception were related to pregnancy involvement history. CONCLUSIONS: Although prevalence of pregnancy is similar, findings show group differences in associated risk factors by sexual orientation. Interventions to reduce pregnancy among American Indian adolescents should include assessment of sexual orientation and behavioral risk factors.     

Childhood abuse and mental health indicators among ethnically diverse lesbian, gay, and bisexual adults.

Objective: Prior research has established that lesbian, gay, and bisexual (LGB) people experience higher rates of childhood abuse than heterosexuals. However, there has been little research on the mental health impact of these experiences or how race/ethnicity might influence prevalence and mental health impact of childhood abuse in this population. The study's objective was to examine the relationships between race/ethnicity, childhood abuse, and mental health indicators in a national sample of LGB adults. Method: Participants were recruited via the Internet through snowball and targeted sampling methods. Six hundred and sixty-nine LGB adults, 21% of whom were people of color, participated in an online survey. Participants completed the Childhood Trauma Questionnaire–Short Form, the Center for Epidemiologic Studies Depression Scale, the Patient Health Questionnaire Generalized Anxiety Disorder Scale, the Posttraumatic Stress Disorder (PTSD) Checklist–Civilian Version, and the Perceived Stress Scale–Short Form. Results: Latina/o and Asian American participants reported the highest levels of physical abuse (p     

Incidence and mental health impact of sexual orientation victimization of lesbian, gay, and bisexual youths in high school.

This study examined victimization during high school based on sexual orientation of 350 lesbian, gay, or bisexual (lgb) youths aged 21 and younger. Experiences of direct victimization as well as knowledge of other lgb youths' victimization were assessed. Over half reported verbal abuse in high school because of their sexual orientation, and 11% said they had been physically assaulted. Youths who were more open in high school about their sexual orientation and who had a history of more gender atypical behavior were victimized more often. Male youths were targeted significantly more often than females, Youths' current mental health symptoms, especially traumatic stress reactions, were associated with having experienced more verbal abuse in high school. (PsycINFO Database Record (c) 2011 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)     

Relationship of childhood sexual, physical, and combined sexual and physical abuse to adult victimization and posttraumatic stress disorder

OBJECTIVE: Prior research has suggested that women who experience childhood sexual abuse are at increased risk for sexual victimization and Posttraumatic Stress Disorder (PTSD) in adulthood. However, previous studies have paid insufficient attention to the overlap of childhood sexual and physical abuse. In the present study we disentangled the separate and combined effects of childhood sexual and physical abuse by comparing groups of participants who reported contact childhood sexual abuse only (SA), sequelae of childhood physical abuse only (PA), combined childhood sexual and physical abuse (CA), or no child abuse (NA). METHOD: A sample of 475 female college students completed measures of sexual and physical abuse in childhood (before age 15) and adulthood (after age 15), PTSD and trauma symptoms, and demographic variables. Of these participants, 27 were assigned to the SA group, 53 to the PA group, 31 to the CA group, and 211 to the NA group. RESULTS: The highest rate of adult sexual and/or physical victimization was reported by the CA group, followed by the PA group, with lower rates reported by the SA and NA groups. Using adult victimization as a covariate, the analyses revealed that the CA group reported significantly higher rates of PTSD and trauma symptoms compared to the NA group. CONCLUSIONS: The results suggest that prior reports of differences in rates of adult victimization and PTSD between women who experienced childhood sexual abuse and women who did not may be attributable to the inclusion of participants with a history of combined childhood sexual and physical abuse in childhood sexual abuse groups. The importance of separating physical and combined forms of victimization from sexual abuse is discussed.     

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)     

Extreme right-handedness, older brothers, and sexual orientation in men.

Two of the most consistent correlates of sexual orientation in men are handedness and fraternal birth order (i.e., number of older brothers). In the present study, the relationship among handedness, older brothers, and sexual orientation was studied in 4 samples of heterosexual and gay or bisexual men (N = 944). Unlike previous studies, which have only observed an increased rate of non-right-handedness in gay or bisexual men relative to heterosexual men, an elevated rate of extreme right-handedness was found in gay or bisexual men relative to heterosexual men. The results also demonstrated that older brothers moderate the relationship between handedness and sexual orientation. Specifically, older brothers increase the odds of being gay or bisexual in moderate right-handers only; in both non-right-handers and extreme right-handers, older brothers do not affect (or decrease) the odds of being gay or bisexual. The results have implications for an early neurodevelopmental origin to sexual orientation in men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial concerns of sexual minority youth: Complexity and caution in group differences.

This investigation tested a large adolescent sample (n = 14,439) for significant group differences on psychosocial concerns on the basis of intersecting identities of sexual orientation (lesbian, gay, bisexual, questioning/less certain, heterosexual), race (Whites, racial minorities), and gender (boys, girls). A significant 2-way interaction between sexual orientation and gender was identified on victimization. Boys reported higher victimization than did girls among heterosexual and questioning/less certain students. Furthermore, significant 3-way interactions between sexual orientation, race, and gender were identified for substance use and depressed/suicidal thoughts. Questioning/less certain youth generally reported the highest levels of victimization, substance abuse, and suicidal thoughts. However, results suggest that, on the basis of small effect sizes for most comparisons, significant differences should be interpreted with caution. Results indicate the need to consider the diversity of subgroups within the sexual minority youth community and that intervention efforts might be more effective if tailored to the unique needs of specific subgroups. (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)     

Lesbian, gay, and bisexual victimization in the military: An unintended consequence of “Don't Ask, Don't Tell”?

The integration of lesbian, gay, and bisexual (LGB) individuals into the U.S. military is a long-standing and politically and socially divisive issue. Exclusionary and pseudo-inclusionary policies that restrict openly LGB individuals from military service are also of long duration. Yet LGB servicemembers have continued to serve covertly in the military for many decades. Moreover, political issues and social conventions associated with “Don't Ask, Don't Tell” (DADT) have diverted focus from imperative research issues, such as LGB servicemembers and incidents of victimization in the military. Research is reviewed to evaluate such victimization, which is conceptualized as resulting from a convergence of sexual stigma, conservative gender role beliefs, and sexual prejudice. DADT, in combination with overarching difficulties intrinsic to sexual orientation research, serves to augment LGB victimization and reduce victim reports and help seeking. Consequently, there is a deficient evidence base for assisting LGB servicemembers and for advancing research, prevention efforts, and policy changes. Implications of repealing DADT are discussed, as are future directions for LGB military research. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Sexual orientation of adult sons of gay fathers.

The sexual development of children of gay and lesbian parents is interesting for both scientific and social reasons. The present study is the largest to date to focus on the sexual orientation of adult sons of gay men. From advertisements in gay publications, 55 gay or bisexual men were recruited who reported on 82 sons at least 17 yrs of age. More than 90% of sons whose sexual orientations could be rated were heterosexual. Furthermore, gay and heterosexual sons did not differ on potentially relevant variables such as the length of time they had lived with their fathers. Results suggest that any environmental influence of gay fathers on their sons' sexual orientation is not large. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence of mental disorders, psychological distress, and mental services use among lesbian, gay, and bisexual adults in the United States.

Recent estimates of mental health morbidity among adults reporting same-gender sexual partners suggest that lesbians, gay men, and bisexual individuals may experience excess risk for some mental disorders as compared with heterosexual individuals. However, sexual orientation has not been measured directly. Using data from a nationally representative survey of 2,917 midlife adults, the authors examined possible sexual orientation-related differences in morbidity, distress, and mental health services use. Results indicate that gay-bisexual men evidenced higher prevalence of depression, panic attacks, and psychological distress than heterosexual men. Lesbian-bisexual women showed greater prevalence of generalized anxiety disorder than heterosexual women. Services use was more frequent among those of minority sexual orientation. Findings support the existence of sexual orientation differences in patterns of morbidity and treatment use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Betrayal and revictimization: Preliminary findings.

The link between childhood sexual abuse and subsequent sexual, emotional, and physical revictimization has been widely reported. The literature is limited, however, in its exploration of the extent to which the level of betrayal inherent in a given childhood traumatic experience affects the likelihood of experiencing similar revictimization in adolescence and adulthood. This study assessed revictimization within a betrayal trauma framework among a sample of 271 college students. As predicted, individuals who reported experiencing high-betrayal trauma at any time point (childhood, adolescence, or adulthood) were more likely to report experiences of trauma high in betrayal during adolescence and adulthood. Relative risk ratios suggest that those who experience childhood trauma high in betrayal are 4.31 times more likely to be victimized in adolescence and 5.44 times more likely to be victimized in adulthood. Logistic regression analyses identified rate of childhood high-betrayal traumas and high levels of traumatic symptoms as significant predictors of high-betrayal trauma victimization in adolescence. Finally, participants’ responses to an exploratory self-report measure examining the relationship among revictimization, awareness for interpersonal betrayals, and response to betrayals in interpersonal contexts were analyzed. Preliminary findings indicate that revictimization risk may be linked to inaccurate identification of specific intimate partner betrayals and the inability to engage in proper self-protection. Suggestions for future research and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood physical abuse, internalized homophobia, and experiential avoidance among lesbians and gay men.

This study explored relations among childhood physical abuse, internalized homophobia, experiential avoidance, and current psychological symptoms in a community sample of 122 adult lesbians and 115 adult gay men. Childhood physical abuse predicted depression and posttraumatic stress disorder (PTSD) symptoms. Furthermore, for gay men, internalized homophobia completely mediated the relation between childhood physical abuse and depression symptoms and partially mediated the relation between childhood physical abuse and PTSD symptoms. However, experiential avoidance did not mediate these relations. In contrast, experiential avoidance partially mediated the relation between childhood physical abuse and PTSD symptoms among lesbians; however, internalized homophobia did not mediate these relations. These findings suggest that internalized homophobia and experiential avoidance may have differential mediating roles in predicting psychological symptoms among lesbians and gay men who have experienced childhood physical abuse. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Self-acceptance and self-disclosure of sexual orientation in lesbian, gay, and bisexual adults: An attachment perspective.

A model linking attachment variables with self-acceptance and self-disclosure of sexual orientation was tested using data from 489 lesbian, gay, and bisexual (LGB) adults. The model included the following 4 domains of variables: (a) representations of childhood attachment experiences with parents, (b) perceptions of parental support for sexual orientation, (c) general working model of attachment, and (d) LGB variables. Results generally supported the proposed model. For example, attachment avoidance and anxiety were associated with self-acceptance difficulties, and avoidance was associated with low levels of outness in everyday life. Parental attachment had an indirect effect on identity and outness through its associations with parental LGB support and general attachment. Some results varied depending on participants' gender and parental religious affiliation. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A follow-up study of girls with gender identity disorder.

This study provided information on the natural histories of 25 girls with gender identity disorder (GID). Standardized assessment data in childhood (mean age, 8.88 years; range, 3-12 years) and at follow-up (mean age, 23.24 years; range, 15-36 years) were used to evaluate gender identity and sexual orientation. At the assessment in childhood, 60% of the girls met the Diagnostic and Statistical Manual of Mental Disorders criteria for GID, and 40% were subthreshold for the diagnosis. At follow-up, 3 participants (12%) were judged to have GID or gender dysphoria. Regarding sexual orientation, 8 participants (32%) were classified as bisexual/homosexual in fantasy, and 6 (24%) were classified as bisexual/homosexual in behavior. The remaining participants were classified as either heterosexual or asexual. The rates of GID persistence and bisexual/homosexual sexual orientation were substantially higher than base rates in the general female population derived from epidemiological or survey studies. There was some evidence of a "dosage" effect, with girls who were more cross-sex typed in their childhood behavior more likely to be gender dysphoric at follow-up and more likely to have been classified as bisexual/homosexual in behavior (but not in fantasy). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence, course, and predictors of multiple problem behaviors among gay and bisexual male adolescents.

Multiple problem behaviors, stress, and personal resources were assessed over 2 yrs among 136 mainly Black and Hispanic gay and bisexual male adolescents (aged 14–19 yrs). Whereas sexual risk acts, substance abuse, conduct problems, and emotional distress were common, the risk acts did not form a multiple problem behavior cluster, compared with previous findings with heterosexual youths. Problem behaviors were stable over time: Only 20–30% of the youths changed their pattern of problem behaviors over 2 yrs. For each individual, the pattern of change in one behavior problem was not related to patterns of change in other problem behaviors over 2 yrs. At baseline, personal resources were associated with less alcohol use and emotional distress, and stress was associated with delinquent behaviors. The pattern of results was similar whether youths labeled themselves as gay or bisexual, suggesting that problem behaviors among mainly Black and Hispanic gay and bisexual youths may follow different developmental pathways than among heterosexual youths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The African-American Health Project (AAHP): study overview and select findings on high risk behaviors and psychiatric disorders in African American men

The AAHP investigated the neurobehavioral and psychosocial sequelae of HIV-1 and substance use in urban African American men. A community resident sample of 502 African American men stratified by HIV-1 serostatus, drug use and sexual orientation were recruited. A comprehensive battery of measures of neurobehavioral and health status, lifestyle and psychosocial characteristics were administered to all participants, and a stratified sub-sample of 120 participants were tested using state of the art brain imaging techniques to investigate differences in the functional and neurophysiologic effects of HIV-1 and substance use. An overview of the methodology of the AAHP and results on high risk sexual and substance use behaviors, and psychiatric disorders are presented and discussed. The sample was primarily HIV-negative (63%), heterosexual (49% gay or bisexual) and a high percentage used substances during the past year (56% used drugs and 30% moderate/heavy drinkers). High-risk sexual practices were relatively prevalent, and a high percentage reported a history of STDs and other infections. Finally, 25% had a current psychiatric disorder, with gays/bisexuals and HIV-seropositives evidencing greater psychiatric vulnerability. More research is needed to further explore the apparent greater risk for psychiatric disorders among gay and bisexual men, and to determine whether being African American and lower social class exacerbate this risk.     

Disclosure of sexual orientation and subsequent substance use and abuse among lesbian, gay, and bisexual youths: Critical role of disclosure reactions.

Research on whether disclosure of sexual orientation promotes lower substance use among lesbian, gay, and bisexual (LGB) individuals has been inconsistent. One reason for this may be that disclosure results in accepting and rejecting reactions. The current report longitudinally examines whether the types of reactions to disclosure are associated with substance use and abuse among 156 LGB youths (ages 14–21). Neither the number of disclosures nor the numbers of accepting or neutral disclosure reactions were associated with substance use or abuse. However, the number of rejecting reactions to disclosure was associated with current and subsequent alcohol, cigarette, and marijuana use, even after controlling for demographic factors, social desirability, and emotional distress. Further, accepting reactions were found to moderate or protect youths from the negative role of rejecting reactions on alcohol use, but not other substances. This research indicates that, rather than disclosure per se, it is the number of accepting and rejecting reactions in response to disclosure that are critical to understanding substance use among LGB youths. Further, the results suggest that to be maximally effective, substance use prevention and treatment efforts should address rejecting reactions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)