John Henryism Active Coping as a Cultural Correlate of Substance Abuse Treatment Participation among African American Women

The rates of illicit drug use among African American women are increasing, yet African American women are least likely to participate in treatment for substance use disorders when compared to women of other racial groups. 

The current study examined family history of substance use, perceived family support, and John Henryism Active Coping (JHAC) as correlates to seeking treatment for substance abuse. The underlying theoretical frame of JHAC (James et al., 1983) suggests that despite limited resources and psychosocial stressors, African Americans believe that hard work and self-determination are necessary to cope with adversities. 

The current study is a secondary data analyses of 206 drug-using African American women (N=104 urban community women with no criminal justice involvement and N=102 women living in the community on supervised probation) from urban cities in a southern state. It was expected that African American women with a family history of substance abuse, higher levels of perceived family support, and more active coping skills would be more likely to have participated in substance abuse treatment. 

Step-wise logistic regression results reveal that women on probation, had children, and had a family history of substance abuse were significantly more likely to report participating in substance abuse treatment. 

Perceived family support and active coping were significant negative correlates of participating in treatment. Implication of results suggests coping with psychosocial stressors using a self-determined and persistent coping strategy may be problematic for drug-using women with limited resources.

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By:  Stevens-Watkins D1, Knighton JS2, Allen K3, Fisher S2, Crowell C2, Mahaffey C2, Leukefeld C2, Oser C2.

• 1University of Kentucky. Electronic address: d.stevenswatkins@uky.edu.
• 2University of Kentucky.
• 3Florida State University. 
• J Subst Abuse Treat. 2016 Apr;63:54-60. doi: 10.1016/j.jsat.2016.01.004. Epub 2016 Jan 15.

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Effects of Minority Stress, Group-Level Coping, and Social Support on Mental Health of German Gay Men

Objective

According to epidemiological studies, gay men are at a higher risk of mental disorders than heterosexual men. In the current study, the minority stress theory was investigated in German gay men: 1) it was hypothesized that minority stressors would positively predict mental health problems and that 2) group-level coping and social support variables would moderate these predictions negatively.

Methods

Data from 1,188 German self-identified gay men were collected online. The questionnaire included items about socio-demographics, minority stress (victimization, rejection sensitivity, and internalized homonegativity), group-level coping (disclosure of sexual orientation, homopositivity, gay affirmation, gay rights support, and gay rights activism), and social support (gay social support and non-gay social support). A moderated multiple regression was conducted.

Results

Minority stressors positively predicted mental health problems. Group-level coping did not interact with minority stressors, with the exception of disclosure and homopositivity interacting marginally with some minority stressors. Further, only two interactions were found for social support variables and minority stress, one of them marginal. Gay and non-gay social support inversely predicted mental health problems. In addition, disclosure and homopositivity marginally predicted mental health problems.

Conclusions

The findings imply that the minority stress theory should be modified. Disclosure does not have a relevant effect on mental health, while social support variables directly influence mental health of gay men. Group-level coping does not interact with minority stressors relevantly, and only one relevant interaction between social support and minority stress was found. Further longitudinal or experimental replication is needed before transferring the results to mental health interventions and prevention strategies for gay men.

Below:  Hypothesized Minority Stress Model

Full article at:   http://goo.gl/3Zdq27

By:  

Frank A. Sattler, Hanna Christiansen 
Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany

Ulrich Wagner 

Department of Social Psychology and Center for Conflict Studies, Philipps University Marburg, Marburg, Germany

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Information, Motivation, and Behavioral Skills of High-Risk Young Adults to Use the HIV Self-Test

HIV self tests (HIVST) have the potential to increase testing among young adults. However, little is known about high-risk young adults' perception of the HIVST as a risk reduction tool and how they would use the HIVST in their everyday lives. 

Our study sought to examine these factors. Twenty-one ethnically diverse participants (ages 18-24) used the HIVST at our study site, completed surveys, and underwent an in-depth interview. Descriptive statistics were used to analyze the survey responses, and interview data were coded using constructs from the information-motivation-behavioral skills model. Information deficits included: how to use the HIVST and the "window period" for sero-conversion. 

Motivations supporting HIVST use included: 

• not needing to visit the clinic, 
• fast results, 
• easy access, and 
• use in non-monogamous relationships. 

Behavioral skills discussed included: 

• coping with a positive test, 
• handling partner violence after a positive test, and 
• accessing HIV services. 

These findings can inform the use of the HIVST for improving HIV testing rates and reducing HIV risk behavior.

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By:  Brown W 3rd1,2, Carballo-Diéguez A1,3, John RM4, Schnall R5.

• 1HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, USA.
• 2Biomedical Informatics, College of Physicians and Surgeons, Columbia University, New York, USA.
• 3Psychiatry, Mailman School of Public Health, Columbia University, New York, USA.
• 4School of Nursing, Columbia University, 617 West 168th Street, New York, NY, 10023, USA.
• 5School of Nursing, Columbia University, 617 West 168th Street, New York, NY, 10023, USA. rb897@columbia.edu. 

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Being Sexually Attracted to Minors: Sexual Development, Coping with Forbidden Feelings & Relieving Sexual Arousal in Self-Identified Pedophiles

This article aims to provide more insight into pedophilic attraction and risk and protective factors for offending in nonclinical pedophiles. Fifteen participants were interviewed about sexuality, coping, and sexual self-regulation. 

Many participants struggled with acknowledging pedophilic interest in early puberty and experienced psychological difficulties as a result. Furthermore, many committed sex offenses during adolescence when they were still discovering their feelings. 

Early recognition of risk factors and early start of interventions seem vital in preventing offending. Moreover, results suggest that risk for offending can be diminished by creating more openness about pedophilia and by providing pedophiles with social support and control...

Background Characteristics

Nine participants were highly educated (i.e., had either a bachelor's or master's degree), two received intermediate vocational education, two only finished high school, and two had less than a high school education. Three were married or in a relationship at the time of the interviews, and two were divorced. Five participants had never been involved in a serious adult relationship. Three participants reported having children.

Two of the 15 participants could better be described as having hebephilic feelings. Aside from the distinction between being attracted to prepubescent or pubescent children, there was still large variation in preferred sexual age orientation between participants. For example, some participants with an interest in prepubescent minors acknowledged being sexually attracted to children from 5 years old, whereas others preferred minors who were in the transition to puberty. Furthermore, not all participants had an exclusive sexual interest in children; nine were also attracted to adult males and/or adult females. Finally, eight participants were solely attracted to boys, three to girls, and four were attracted to both sexes.

Seven participants had experienced mental health problems. They were often troubled with feelings of anxiety, depression, and inferiority. For three participants, mental health issues started after the age of 16. The remaining four had already experienced mental health issues early in life.

Sexual Development

Onset of Pedophilic Feelings

Eleven participants described becoming aware of their sexual attraction to minors as a gradual process. Their sexual development started relatively “normal” at early puberty, when they were still interested in their same-aged peers. However, as they became older, most (11) recognized becoming different from others because their sexual age preference remained stable. Others (four) became aware of their sexual attraction quite suddenly, for example during contact with minors either in real life or by seeing a picture. Since that moment, all except one (see section Coping with Forbidden Feelings) had felt the presence of this sexual attraction during their lives, indicating a stable sexual preference.

Content of Sexual Interest

Ten participants acknowledged that their attraction to minors was not solely sexual, but that romantic feelings were also present. They reported falling in love with a child, and/or had fantasies about having a real romantic relationship with a minor. Also, when asked what they found particularly attractive in minors, eight acknowledged that it was a combination of both physical characteristics, such as “their beauty” or “bodily shapes,” and behavior, such as “openness,” “spontaneity,” “honesty,” or “naïveté,” whereas only four referred solely to children's appearances... 

Full article at:  http://goo.gl/MDgvv1

By:  Houtepen JA1, Sijtsema JJ1, Bogaerts S1.

• 1 Department of Developmental Psychology Tilburg University , Tilburg , The Netherlands.
• J Sex Marital Ther. 2016 Jan 2;42(1):48-69. Epub 2015 Jun 22. 

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Stress and Coping with Racism and Their Role in Sexual Risk for HIV among African American, Asian/Pacific Islander, and Latino Men Who Have Sex with Men

The deleterious effects of racism on a wide range of health outcomes, including HIV risk, are well documented among racial/ethnic minority groups in the United States. However, little is known about how men of color who have sex with men (MSM) cope with stress from racism and whether the coping strategies they employ buffer against the impact of racism on sexual risk for HIV transmission. 

We examined associations of stress and coping with racism with unprotected anal intercourse (UAI) in a sample of African American (N = 403), Asian/Pacific Islander (N = 393), and Latino (N = 400) MSM recruited in Los Angeles County, CA during 2008-2009. Almost two-thirds (65 %) of the sample reported being stressed as a consequence of racism experienced within the gay community. 

Overall, 51 % of the sample reported having UAI in the prior 6 months. After controlling for race/ethnicity, age, nativity, marital status, sexual orientation, education, HIV serostatus, and lifetime history of incarceration, the multivariate analysis found statistically significant main effects of stress from racism and avoidance coping on UAI; no statistically significant main effects of dismissal, education/confrontation, and social-support seeking were observed. None of the interactions of stress with the four coping measures were statistically significant. Although stress from racism within the gay community increased the likelihood of engaging in UAI among MSM of color, we found little evidence that coping responses to racism buffered stress from racism. Instead, avoidance coping appears to suggest an increase in UAI. 

Below:  Stress from Racism Experienced in the Gay Community, by Race/Ethnicity (%)

Below:  Coping Strategies Employed to Deal with Racism, by Race/Ethnicity: Mean Scale Scores¹

1. Range: 1 = “strongly disagree” to 4 = “strongly agree”

Full article at:   http://goo.gl/78mRbc

By:   Han CS1, Ayala G, Paul JP, Boylan R, Gregorich SE, Choi KH.

• 1Department of Sociology and Anthropology, Middlebury College (http://www.middlebury.edu/academics/soan), Middlebury, VT, 05753, USA, chongsukhan@gmail.com.
• Arch Sex Behav. 2015 Feb;44(2):411-20. doi: 10.1007/s10508-014-0331-1. Epub 2014 Jul 25. 

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Trauma History in African-American Women Living with HIV: Effects on Psychiatric Symptom Severity and Religious Coping

Women living with HIV (WLHIV) have rates of post-traumatic stress disorder (PTSD) up to 5 times higher than the general population. Individuals living with HIV and a concurrent diagnosis of PTSD have poorer HIV-related outcomes; however, the prevalence and impact of PTSD on African-American WLHIV seeking mental health treatment is unknown. 

The aim of this study is to examine the associations between PTSD symptoms with psychiatric symptom severity and psychological/religious coping strategies in African-American WLHIV who are seeking mental health treatment. This is a cross-sectional study of 235 African-American WLHIV attending an urban community mental health clinic. Bivariate analyses were conducted to evaluate associations between a PTSD symptoms scale (PSS≥21 versus PSS<21) and (1) psychiatric severity, (2) coping strategies, and (3) religious coping strategies. 

Thirty-six percent reported symptoms consistent with PTSD (PSS≥21). These women were significantly more likely to have worse mental health symptoms and were more likely to employ negative psychological and religious coping strategies. On the contrary, women with a PSS<21 reported relatively low levels of mental health symptoms and were more likely to rely on positive psychological and religious coping strategies. 

Over one-third of African-American WLHIV attending an outpatient mental health clinic had symptoms associated with PTSD. These symptoms were associated with worse mental health symptoms and utilization of dysfunctional religious and nonreligious coping strategies. 

Untreated PTSD in WLHIV predicts poorer HIV-related health outcomes and may negatively impact comorbid mental health outcomes. Screening for PTSD in WLHIV could identify a subset that would benefit from evidence-based PTSD-specific therapies in addition to mental health interventions already in place. PTSD-specific interventions for WLHIV with PTSD may improve outcomes, improve coping strategies, and allow for more effective treatment of comorbid mental health disorders.

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By:   Brownley JR1, Fallot RD, Wolfson Berley R, Himelhoch SS.

• 1 Department of Psychiatry , University of Maryland School of Medicine, Baltimore , MD , USA. 

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Healing Pathways: Longitudinal Effects of Religious Coping & Social Support on PTSD Symptoms in African American Sexual Assault Survivors

African American women are at a slightly increased risk for sexual assault (A. Abbey, A. Jacques-Tiaura, & M. Parkhill, 2010). However, because of stigma, experiences of racism, and historical oppression, African American women are less likely to seek help from formal agencies compared to White women (Lewis et al., 2005; S. E. Ullman & H. H. Filipas, 2001) and/or women of other ethnic backgrounds (C. Ahrens, S. Abeling, S. Ahmad, & J. Himman, 2010). Therefore, the provision of culturally appropriate services, such as the inclusion of religion and spiritual coping, may be necessary when working with African American women survivors of sexual assault. Controlling for age and education, the current study explores the impact of religious coping and social support over 1 year for 252 African American adult female sexual assault survivors recruited from the Chicago metropolitan area. Results from hierarchical linear regression analyses reveal that high endorsement of religious coping and social support at Time 1 does not predict a reduction in posttraumatic stress disorder (PTSD) symptoms at Time 2. However, high social support at Time 2 does predict lower PTSD at Time 2. Also, it is significant to note that survivors with high PTSD at Time 1 and Time 2 endorse greater use of social support and religious coping. Clinical and research implications are explored...

[F]indings of the present research among African American survivors of sexual assault support are important as they underscore the need for longitudinal studies. The earlier cross-sectional findings of reduction in PTSD for those using social support did not manifest over a 1-year follow-up period. This is critical for clinicians and researchers to understand and explore further, as it points to the potential devastating effects of sexual assault that coping alone may not address. It is important to consider additional factors such as revictimization and other contextual factors in understanding and addressing the mental health outcomes of survivors. The use of religion to ameliorate distress and post-traumatic symptoms can be attributed to historical and/or present experiences of racism and discrimination, which may make African American women less likely to seek help from organized institutions and mental health providers, and more likely to turn to religious and spiritual supports for healing. The use of religion may also be reflective of greater stigma in the African American community towards mental health services (Farris, 2007), in which case efforts, such as public mental health campaigns with culturally respected spokespersons, should be made to reduce the stigma of such services and to provide culturally appropriate services that incorporate spiritual and/or religious coping. Additionally the development of spiritual/religious cultural competence is important for clinicians, as they should not overlook the presence of faith traditions of numerous African American clients. Instead, it is important for clinicians to assess for and recognize the presence of spiritual/religious beliefs and practices among clients.

Full article at:   http://goo.gl/O4Is9p

By:   Thema Bryant-Davis, PhD, Sarah Ullman, PhD, Yuying Tsong, PhD, Gera Anderson, MA, Pamela Counts, MA,Shaquita Tillman, PhD, Cecile Bhang, MA, and Anthea Gray, MA

Thema Bryant-Davis, Pepperdine University;

Contributor Information.

Correspondence regarding this manuscript should be addressed to Thema Bryant-Davis, PhD; Pepperdine University; GSEP: 16830 Ventura Blvd.; Encino, CA 91436. Email: ude.enidreppep@tnayrbt

Authors’ Complete Mailing Addresses

Thema Bryant-Davis, PhD; Pepperdine University; GSEP: 16830 Ventura Blvd.; Encino, CA 91436

Sarah Ullman, PhD; University of Illinois, Chicago; Department of Criminal Justice (M/C 141) 1007 West Harrison St.; Chicago IL 60607-7140

Yuying Tsong, PhD; California State University, Fullerton; Department of Human Services; Health Promotion Research Institute; 800 N. State College Blvd., KHS 115B; Fullerton, CA 92831-3599

Gera Anderson; Pepperdine University; GSEP: 16830 Ventura Blvd.; Encino, CA 91436

Pamela Counts; Pepperdine University; GSEP: 16830 Ventura Blvd.; Encino, CA 91436

Shaquita Tillman; Pepperdine University; GSEP: 16830 Ventura Blvd.; Encino, CA 91436

Cecile Bhang; Pepperdine University; GSEP: 16830 Ventura Blvd.; Encino, CA 91436

Anthea Gray, MA; Pepperdine University; GSEP: 16830 Ventura Blvd.; Encino, CA 91436

J Trauma Dissociation. 2015 Jan-Feb; 16(1): 114–128. doi:  10.1080/15299732.2014.969468 

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HIV-Related Stigma, Shame & Avoidant Coping: Risk Factors for Internalizing Symptoms among Youth Living with HIV?

Youth living with HIV (YLH) are at elevated risk of internalizing symptoms, although there is substantial individual variability in adjustment. 

We examined perceived HIV-related stigma, shame-proneness, and avoidant coping as risk factors of internalizing symptoms among YLH. Participants (N = 88; ages 12-24) completed self-report measures of these potential risk factors and three domains of internalizing symptoms (depressive, anxiety, and PTSD) during a regularly scheduled HIV clinic visit. 

Hierarchical regressions were conducted for each internalizing symptoms domain, examining the effects of age, gender, and maternal education (step 1), HIV-related stigma (step 2), shame- and guilt-proneness (step 3), and avoidant coping (step 4). HIV-related stigma, shame-proneness, and avoidant coping were each correlated with greater depressive, anxiety, and PTSD symptoms. Specificity was observed in that shame-proneness, but not guilt-proneness, was associated with greater internalizing symptoms. 

In multivariable analyses, HIV-related stigma and shame-proneness were each related to greater depressive and PTSD symptoms. Controlling for the effects of HIV-related stigma and shame-proneness, avoidant coping was associated with PTSD symptoms. 

The current findings highlight the potential importance of HIV-related stigma, shame, and avoidant coping on the adjustment of YLH, as interventions addressing these risk factors could lead to decreased internalizing symptoms among YLH.

Purchase full article at:  http://goo.gl/kdwSKF

By:  Bennett DS1, Hersh J2, Herres J3, Foster J4.

• 1Department of Psychiatry, GLAD Program, Drexel University, 4700 Wissahickon Avenue, Philadelphia, PA, 19144, USA. david.bennett@drexelmed.edu.
• 2Psychology Department, Immaculata University, Immaculata, PA, USA.
• 3Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA.
• 4Government Affairs, Gilead Sciences Inc., Philadelphia, PA, USA. 

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Three Sides of a Coin in the Life of People Living with HIV (PLWH)

Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) is a global epidemic, a major challenge as a health care problem of modern times. As the survival of life increases from the time of an HIV-positive diagnosis, growing concern for the quality of the life has been extended.

To assess and correlate the coping, social support and quality of life.

A descriptive cross-sectional study was conducted at antiretroviral therapy (ART) clinic of AIIMS, New Delhi. The sample comprised people living with HIV/AIDS (PLWHA) who were seropositive for last six months. The tools used to assess the coping, social support and quality of life were BREF COPE, MOS social support survey and WHO QOL-HIV BREF, respectively. Permission was taken from the authors of the tools. The ethical permission was taken from the center. The coping, social support and quality of life were assessed and their association was observed. Data were analyzed using SPSS 17.

The most commonly used coping styles were acceptance and religion. The social support used by most of PLWHA was tangible support and affectionate support, while the least used support was positive social interaction. The lowest quality of life is seen in social relations, followed by physical quality of life. There was positive association seen between coping and quality of life as well as social support and quality of life.

There was positive association between coping, social support and quality of life.

Below:  Showing baseline coping strategies adopted by PLWH

Below:  Bar graph showing domains of QOL of PLWH HIV/AIDS

Below: Association of baseline QOL with the Social Support of PLWH

Full article at: http://goo.gl/VxF2ge

By: Deepika Cecil Khakha,1 Bimla Kapoor,2 Manju,1 and Singh K Sharma3

²Former Director and Professor, Indira Gandhi Open University, New Delhi, India

³

1Lecturer, College of Nursing, All India Institute of Medicine Sciences (AIIMS), New Delhi, India

2Former Director and Professor, Indira Gandhi Open University, New Delhi, India

3Prof. and Head Department of Medicine, All India Institute of Medical Sciences, New Delhi, India

1Lecturer, College of Nursing, All India Institute of Medicine Sciences (AIIMS), New Delhi, India

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Microaggressions, Feelings of Difference & Resilience among Adopted Children with Sexual Minority Parents

Limited research exists about the unique experiences and possible marginalization of children with sexual minority parents. From a larger longitudinal project of diverse adoptive families, we examined cross-sectional data using mixed methods from interviews with 49 adopted children (M age = 8 years; 47 % female) in 27 two-father and 22 two-mother families. Using thematic analysis, we coded themes of awareness of difference, microaggressions, and resilience (i.e., coping and positive family conceptualizations). 

Children experienced "feeling different" and microaggressions from peers, but generally at a low to medium intensity and with neutral (not negative) emotion. More instances of resilience and positive family conceptualizations were reported than microaggressions or feelings of difference, suggesting that children develop positive perceptions of their family and navigate experiences of difference with resilience. 

Filling important gaps in the literature, we discuss implications of our results for practice and policy.

Via: http://ht.ly/SpG0t 

By: Farr RH1, Crain EE2, Oakley MK2, Cashen KK2, Garber KJ2.

• 1Department of Psychology, University of Kentucky, 012-B Kastle Hall, 171 Funkhouser Drive, Lexington, KY, 40506-0044, USA.
• 2University of Massachusetts Amherst, Amherst, MA, USA.

Negative Life Events and Depression in Adolescents with HIV: A Stress and Coping Analysis

The prevalence of negative life events (NLE) and daily hassles, and their direct and moderated associations with depression, were examined among HIV-infected adolescents. Specifically, we examined whether the negative association with depression of NLE, daily hassles, and/or passive coping were moderated by social support or active coping strategies. 

Demographic characteristics, depression, coping, social support, NLE, and daily hassles were collected at baseline as part of the Adolescent Impact intervention via face-to-face and computer-assisted interviews. Of 166 HIV-infected adolescents, 53% were female, 72.9% black, 59.6% with perinatally acquired HIV (PIY), the most commonly reported NLE were death in family (81%), violence exposure (68%), school relocation (67%), and hospitalization (61%); and for daily hassles "not having enough money (65%)". 

Behaviorally infected youth (BIY - acquired HIV later in life) were significantly more likely to experience extensive (14-21) lifetime NLE (38.8% vs. 16.3%) than PIY. In multiple stepwise regression analysis, the model accounting for the greatest variability in depression scores (32%) included (in order of entry): daily hassles, low social support, behaviorally acquired HIV, minority sexual orientation, and passive coping. A significant passive coping-by-social support interaction revealed that the association between passive coping and depression was exacerbated when social support was low. Social support moderated the effect of NLE, such that NLE were associated with greater depression when social support was low, although the effect did not remain statistically significant when main effects of other variables were accounted for. 

Daily hassles, poor coping, and limited social support can adversely affect the psychological well-being of HIV-infected adolescents, particularly sexual minority youth with behaviorally acquired HIV. Multimodal interventions that enhance social support and teach adaptive coping skills may help youth cope with environmental stresses and improve mental health outcomes.

Via: http://ht.ly/Sa4dh 

By: V Lewis J1, Abramowitz S, J Koenig L, Chandwani S, Orban L.
1a Department of Pediatric Infectious Diseases , NYU Langone Medical Center , New York , NY , USA

Religious Coping Strategies & Mental Health among Religious Jewish Gay & Bisexual Men

The present study examined the effects of positive and negative religious coping strategies on the mental health of 113 Israeli gay and bisexual Jewish males with high levels of religiosity, and how sexual identity formation (internalized homophobia and coming out) and societal variables (family and friends' acceptance of sexual orientation and social connections within the LGBT community) mitigated the effects of religious coping strategies on mental health. 

Findings showed that when dealing with the stress arising from the conflict between religious and sexual identities, individuals used both positive and negative religious coping strategies, but only negative religious coping was associated with poorer mental health. In addition, only in the presence of social resources (social connections with the LGBT community and the acceptance of sexual orientation by friends), did the use of positive religious coping result in better mental health outcomes. 

These findings underlined the importance of these resilience social factors in the lives of religious Jewish gay and bisexual men.

Via: http://ht.ly/RXsvk

By: Shilo G1, Yossef I, Savaya R.

• 1Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, 69978, Israel, shiloguy@post.tau.ac.il.