Real-time associations between discrimination and anxious and depressed mood among sexual and gender minorities: The moderating effects of lifetime victimization and identity concealment.

Background: Sexual and gender minorities (SGM) experience higher rates of depression and anxiety, which are linked to higher rates of discrimination and victimization. SGM individuals may conceal their SGM identities to decrease discrimination and victimization exposure; however, these experiences still occur, and concealment itself is often associated with greater anxiety and depression. However, it remains unclear whether lifetime victimization and identity concealment moderate the effect of day-to-day discrimination, which we evaluated in the current study using ecological momentary assessment (EMA).

Ecological momentary assessment of daily discrimination experiences and nicotine, alcohol, and drug use among sexual and gender minority individuals.

Objective: Sexual and gender minority (SGM) individuals experience elevated rates of minority stress, which has been linked to higher rates of nicotine and substance use. Research on this disparity to date is largely predicated on methodology that is insensitive to within day SGM-based discrimination experiences, or their relation to momentary nicotine and substance use risk. We address this knowledge gap in the current study using ecological momentary assessment (EMA).

Minority stress, psychological distress, and alcohol misuse among sexual minority young adults: A resiliency-based conditional process analysis.

Background: Sexual minority young adults experience elevated rates of distal stress (discrimination, victimization), and related psychological distress and alcohol misuse. However, few studies have examined the degree to which personality trait differences confer risk/resilience among sexual minority young adults. We hypothesized that psychological distress would mediate the relationship between distal stress and alcohol misuse, but that these relationships would be moderated by personality trait differences.

Missing data in substance abuse research? Researchers' reporting practices of sexual orientation and gender identity.

Background: Lesbian, gay, bisexual, and transgender individuals are at higher risk for substance use and substance use disorders than heterosexual individuals and are more likely to seek substance use treatment, yet sexual orientation and gender identity are frequently not reported in the research literature. The purpose of this study was to identify if sexual orientation and gender identity are being reported in the recent substance use literature, and if this has changed over time.

Method: The PsycINFO and PubMed databases were searched for articles released in 2007 and 2012 using the term "substance abuse" and 200 articles were randomly selected from each time period and database.

The role of personality in predicting drug and alcohol use among sexual minorities.

Research consistently demonstrates that sexual minority status is associated with increased risk of problematic substance use. Existing literature in this area has focused on group-specific minority stress factors (e.g.

Experiences of ex-ex-gay individuals in sexual reorientation therapy: reasons for seeking treatment, perceived helpfulness and harmfulness of treatment, and post-treatment identification.

Therapy meant to change someone's sexual orientation, or reorientation therapy, is still in practice despite statements from the major mental health organizations of its potential for harm. This qualitative study used an inductive content analysis strategy (Patton, 2002) to examine the experiences of thirty-eight individuals (31 males and seven females) who have been through a total of 113 episodes of reorientation therapy and currently identify as gay or lesbian. Religious beliefs were frequently cited as the reason for seeking reorientation therapy.

Factors predicting development of opioid use disorders among individuals who receive an initial opioid prescription: mathematical modeling using a database of commercially-insured individuals.

Background: Prescription drug abuse in the United States and elsewhere in the world is increasing at an alarming rate with non-medical opioid use, in particular, increasing to epidemic proportions over the past two decades. It is imperative to identify individuals most likely to develop opioid abuse or dependence to inform large-scale, targeted prevention efforts.

Methods: The present investigation utilized a large commercial insurance claims database to identify demographic, mental health, physical health, and healthcare service utilization variables that differentiate persons who receive an opioid abuse or dependence diagnosis within two years of filling an opioid prescription (OUDs) from those who do not receive such a diagnosis within the same time frame (non-OUDs).

Reducing risk for illicit drug use and prescription drug misuse: High school gay-straight alliances and lesbian, gay, bisexual, and transgender youth.

Previous research suggests that lesbian, gay, bisexual, and transgender (LGBT) youth are at elevated risk for using illicit drugs and misusing prescription drugs relative to heterosexual youth. Previous research also indicates that LGBT youth who attend high schools with a gay-straight alliance (GSA) report having fewer alcohol problems and lower levels of cigarette smoking. The present study investigates whether the absence of a GSA is associated with risk for illicit drug use and prescription drug misuse in a sample of 475 LGBT high school students (M age=16.

Veterans administration health care utilization among sexual minority veterans.

According to recent census reports, nearly a million veterans have a same-sex partner, yet little is known about them or their use of Veterans Health Care Administration (VHA) services. Gay, lesbian, and bisexual (GLB) veterans recruited from the community (N = 356) completed an on-line survey to assess their rates of VHA utilization and whether they experience specific barriers to accessing VHA services. Andersen's model of health care utilization was adapted to provide an analytic and conceptual framework.

Mental health characteristics of sexual minority veterans.

This study examines the mental health characteristics of sexual minority (lesbian, gay, and bisexual, or LGB) veterans, compared these characteristics to those of an existing Veterans Affairs (VA) sample, and examined the relationship between mental health and anxiety around concealment of LGB identity while in the military. Data regarding LGB veterans' (n = 409) military experiences and current mental health were collected via an online survey; comparison data (n = 15,000) were retrieved from a VA data warehouse. LGB veterans were more likely to screen positive for posttraumatic stress disorder (PTSD), depression, and alcohol problems than the comparison sample.

Does the impact of anti-drinking and driving Public Service Announcements differ based on message type and viewer characteristics?

The purpose of this study was to inform future Public Service Announcement (PSA) development by examining the potential effectiveness of different types of anti-driving under the influence (DUI) PSAs for persons with different characteristics. PSAs utilizing empathy, fear, and informational approaches were shown to persons recruited from psychology courses (n = 137) and individuals that were mandated to treatment following a DUI offense (n = 17). The empathy approach was perceived to be the most effective and evoked the most negative affect, followed by fear and informational approaches.

Reasons underlying treatment preference: an exploratory study.

Very little is known about what factors influence women's treatment preferences after a sexual assault. To learn more about these factors, data were collected from 273 women who read a standard "if this happened to you, what would you do" scenario describing a sexual assault and subsequent trauma-related psychiatric symptoms. After reading standardized treatment options for a pharmacotherapy (sertraline) and a psychotherapy (cognitive behavioral treatment), participants made a hypothetical treatment choice and reported the main reasons for their choice.

Substance abuse treatment providers' explicit and implicit attitudes regarding sexual minorities.

Lesbian, gay, bisexual, and transgender (LGBT) individuals have been found to have elevated rates of substance use disorders when compared with heterosexuals. However, little is known about the challenges a sexual minority might face in presenting for substance use treatment. In this study, treatment providers' attitudes toward LGBT individuals were assessed among a sample of 46 substance abuse treatment counselors who provide publicly funded treatment.

Do specialized services exist for LGBT individuals seeking treatment for substance misuse? A study of available treatment programs.

Substance abuse research has demonstrated that client sexual orientation influences treatment outcomes. Consequently, many substance user treatment programs offer services for lesbian, gay, bisexual, and transgender (LGBT) individuals. In a recent search of SAMHSA treatment listings, 11.

Differentiating LGBT individuals in substance abuse treatment: analyses based on sexuality and drug preference.

In a prior study (Cochran & Cauce, 2006), LGBT individuals seeking treatment demonstrated greater substance use severity, more psychosocial stressors, and increased use of psychiatric services when compared to their heterosexual counterparts. That study, and similar to others in the field of LGBT research, collapsed LGBT individuals into a single category and did not examine individual differences within this category. The present study utilizes the same sample of LGBT clients (N = 610); however, an exploratory cluster analysis was conducted, based on drug preference, to determine which subcategories exist within this unique sample.

Characteristics of lesbian, gay, bisexual, and transgender individuals entering substance abuse treatment.

Previous research has suggested that lesbian, gay, bisexual, and transgender (LGBT) individuals enter treatment for substance abuse with more severe problems than heterosexual individuals. However, methodological difficulties, particularly the difficulty of obtaining a representative sample, have limited the ability to draw conclusions about LGBT individuals who receive services for substance abuse. This study took advantage of a unique opportunity to examine a representative sample of openly LGBT clients receiving publicly funded substance abuse treatment by using data gathered by treatment providers in Washington State.

Victimization and posttraumatic stress disorder among homeless adolescents.

Objective: To examine street victimization and posttraumatic stress symptoms among urban homeless adolescents and to test whether emotional numbing and avoidance represent distinct posttraumatic stress disorder (PTSD) symptom clusters.

Method: Structured, private interviews were conducted with homeless adolescents (N = 374) in the Seattle metropolitan area (95% response rate) from 1995 to 1998.

Results: Eighty-three percent of street youths were physically and/or sexually victimized after leaving home.

Sequential progression of substance use among homeless youth: an empirical investigation of the gateway theory.

We examined the sequence of substance-use initiation in 375 street youth (age 13-21) who were interviewed from 1994-99 in Seattle, Washington. Based on the "gateway theory," participants were categorized into six profiles to describe the order in which they initiated use of various substances (i.e.

Challenges faced by homeless sexual minorities: comparison of gay, lesbian, bisexual, and transgender homeless adolescents with their heterosexual counterparts.

Objectives: The goal of this study was to identify differences between gay, lesbian, bisexual, and transgender (GLBT) homeless youths and their heterosexual counterparts in terms of physical and mental health difficulties.

Methods: A sample of 84 GLBT adolescents was matched in regard to age and self-reported gender with 84 heterosexual adolescents. The 2 samples were compared on a variety of psychosocial variables.

Cultural and contextual influences in mental health help seeking: a focus on ethnic minority youth.

In this article, a mental health help-seeking model is offered as a framework for understanding cultural and contextual factors that affect ethnic minority adolescents' pathways into mental health services. The effects of culture and context are profound across the entire help-seeking pathway, from problem identification to choice of treatment providers. The authors argue that an understanding of these help-seeking pathways provides insights into ethnic group differences in mental health care utilization and that further research in this area is needed.