Sexual orientation and suicide attempt: a longitudinal study of the general Norwegian adolescent population

Past and future suicide attempt rates among gay, lesbian, and bisexual (GLB) young people were compared with those of heterosexual young people. A sample of Norwegian students (N = 2.924; grades 7-12) was followed in 3 data collection waves. Risk factors included previous suicide attempt,depressed mood, eating problems, conduct problems, early sexual debut, number of sexual partners, pubertal timing, self-concept, alcohol and drug use, atypical gender roles, loneliness, peer relations, social support, parental attachment, parental monitoring, and suicidal behavior among family and friends. When homosexual attraction, homosexual identity, and same-sex sexual behavior were entered to predict suicide attempt, only same-sex sexual behavior was significantly predictive. The increased odds could not be attributed to GLB students' greater exposure to risk factors for suicide attempt.     

Friends' sexual orientation,relational quality,and mental health among gay,lesbian, and bisexual youth

Abstract The existing literature on gay, lesbian, and bisexual (GLB) youth emphasizes unique benefits of having GLB friends, but empirical studies have shown no or only small mental health advantages of having them. To unravel this contradiction, this study tested a common assumption that GLB youth develop better relational quality with their GLB friends than with straight friends. Statistical analysis used interview data from community organization participants in Indianapolis, Indiana, USA (n = 84) and employed analysis of variance and ordinary least squares regression models. GLB youth's friendships with GLB and straight peers did not differ in contact frequency, emotional closeness, and hassles. Further, GLB and straight friends were similar in the degree to which each relational quality dimension was associated with mental health.     

Developmental and Adjustment Issues of Gay, Lesbian, and Bisexual Adolescents: A Review of the Empirical Literature

Various studies have reported adjustment problems experienced by gay, lesbian, and bisexual (GLB) adolescents. A primary purpose of this paper is to critically review this literature. Difficulties that have been studied include past suicide attempts, substance use and abuse, conduct problems, and academic concerns. For example, a considerable number of GLB youth report a history of suicide attempts, with prevalence rates ranging from 11 to 42%. However, among other methodological concerns, studies in this area have not used a comparison sample of heterosexual youths. Characteristics of development particular to GLB adolescents are described, the empirical research on adjustment issues is reviewed, and potential risk and protective factors for GLB youths are discussed.     

Integrating gay, lesbian, and bisexual issues into mainstream psychology.

Despite the growing clinical and research literature dealing with gay, lesbian, and bisexual (GLB) issues, mainstream psychology has tended to ignore much of the work that has been done in this area. This article illustrates how clinical and research writings on GLB issues continue to remain invisible to mainstream psychology in such areas as life span development and aging, teenage suicide, substance abuse, victimization and abuse, and family and couple relationships. It also deals with some of the determinants of well-being among GLB individuals, such as family support, and notes the benefits accruing to mainstream psychology from studying GLB issues. A network of family members within psychology having GLB relatives has been formed--AFFIRM: Psychologist Affirming Their Gay, Lesbian, and Bisexual Family--and is dedicated to supporting its own family members, encouraging other family members to do likewise, supporting research and clinical work on GLB issues, and closing the gap between GLB clinical and research work and mainstream psychology.     

Counseling dropout relative to client attractiveness,disturbance, and expected number of sessions

Participants were 12 counseling center psychologist and thir 257 college-student clients. Immediately after intake, clients indicated whether or not they would make an additional appointment, their reasons for not making another appointment, and the estimated number of sessions they would attend. Counselors rated clients' attractiveness and disturbance and estimated the number of sessions they would have with each client. Clients who did not make a second appointment were generally satisfied with the help they received in one session. Client estimates were more predictive than counselor estimates of actual number of sessions. Relative to less attractive and disturbed clients, more attractive and disturbed clients made and kept post-intake appointments.     

Retrospective recall of sexual orientation identity development among gay, lesbian, and bisexual adults

Although recent attention has focused on the likelihood that contemporary sexual minority youth (i.e., gay, lesbian, bisexual [GLB]) are "coming out" at younger ages, few studies have examined whether early sexual orientation identity development is also present in older GLB cohorts. We analyzed retrospective data on the timing of sexual orientation milestones in a sample of sexual minorities drawn from the California Quality of Life Surveys. Latent profile analysis of 1,260 GLB adults, ages 18-84 years, identified 3 trajectories of development: early (n = 951; milestones spanning ages 12-20), middle (n = 239; milestones spanning ages 18-31), and late (n = 70; milestones spanning ages 32-43). Motivated by previous research on variability in adolescent developmental trajectories, we identified 2 subgroups in post hoc analyses of the early profile group: child onset (n = 284; milestones spanning ages 8-18) and teen onset (n = 667; milestones spanning ages 14-22). Nearly all patterns of development were identity centered, with average age of self-identification as GLB preceding average age of first same-sex sexual activity. Overall, younger participants and the majority of older participants were classified to the early profile, suggesting that early development is common regardless of age cohort. The additional gender differences observed in the onset and pace of sexual orientation identity development warrant future research.     

Prediction of university students' academic achievement by linear and logistic models

University students' academic achievement measured by means of academic progress is modeled through linear and logistic regression, employing prior achievement and demographic factors as predictors. The main aim of the present paper is to compare results yielded by both statistical procedures, in order to identify the most suitable approach in terms of goodness of fit and predictive power. Grades awarded in basic scientific courses and demographic variables were entered into the models at the first step. Two hypotheses are proposed: (a) Grades in basic courses as well as demographic factors are directly related to academic progress, and (b) Logistic regression is more appropriate than linear regression due to its higher predictive power. Results partially confirm the first prediction, as grades are positively related to progress. However, not all demographic factors considered proved to be good predictors. With regard to the second hypothesis, logistic regression was shown to be a better approach than linear regression, yielding more stable estimates with regard to the presence of ill-fitting patterns.     

Training direct service staff in congregate settings to interact with people with severe disabilities: A quick,effective and acceptable program

An area of traditional as well as recent concern in congregate settings for people with severe disabilities is ensuring frequent social interactions between direct service staff and individuals who live in the residences. This study evaluated a program for training staff to interact frequently and positively across clients while in group situations in living units. The program involved a short classroom instructional session encompassing less than 1 h, followed by a maximum of 4 brief on-the-job observations and feedback sessions. Results indicated interaction rates of all 9 participating direct service staff increased above a normative criterion rate while participating in the training program. All staff also increased the proportion of their social interactions with clients that were positive in nature, and 6 of the 9 staff increased their distribution of interactions across clients. The improved interaction performances occurred when staff were provided with immediate on-the-job feedback regarding their performances as well as when provided with delayed feedback. Acceptability measures indicated the training program was well received by staff, although program components also were noted that may have affected staff acceptance differentially. Directions for future research are suggested in regard to further evaluating and increasing staff acceptance of effective training procedures.     

The predictive moment: reverie,connection and predictive processing

ABSTRACT

According to the theory of predictive processing, understanding in the present involves non-consciously representing the immediate future, based on probabilistic inference shaped by learning from the past. This paper suggests links between this neuroscientific theory and the psychoanalytic concept of reverie – an empathic, containing attentional state – and considers implications for the ways therapists intuit implicit material in their clients. Using findings from a study about therapists’ experiences of this state, we propose that reverie can offer practitioners from diverse theoretical backgrounds a means to enter the predictive moment deeply, making use of its subtle contents to connect with clients.     

Therapist empathy,homework compliance,and outcome in cognitive behavioral therapy for generalized anxiety disorder: partitioning within- and between-therapist effects

Although client-perceived therapist empathy relates to positive therapy outcomes, including in cognitive behavioral therapy (CBT), little is known about how empathy exerts its ameliorative effect. One possible way is by promoting clients’ subsequent homework compliance, a variable that also predicts positive outcomes in CBT. The present study sought to investigate simultaneously, in the context of 43 therapist–client dyads receiving 15 sessions of CBT for generalized anxiety disorder, (1) the association of early client-perceived therapist empathy (averaged over sessions 1, 3, 5) with mid-treatment client homework compliance (averaged over sessions 6, 8, 10); (2) the association of mid-treatment homework compliance on client posttreatment worry severity; and (3) the indirect effect of early perceived therapist empathy on posttreatment worry through mid-treatment homework compliance. Given that clients were nested within therapists, we examined both within- and between-therapist differences in clients’ ratings of therapist empathy and homework compliance, and tested both of these indices as predictors of the relevant dependent variables in a multilevel model. At the within-therapist level (i.e., differences between clients within a given therapist’s caseload), greater early empathy was associated with greater mid-treatment homework compliance. At the between-therapist level (i.e., differences between therapists across all of their cases), greater between-therapist homework compliance was related to lower posttreatment worry. Finally, homework compliance was not found to mediate the relationship between empathy and posttreatment outcome. The results underscore the importance of parsing client and therapist effects, and are discussed with regard to their training and research implications.     

Sexual Attraction and Religious Therapists: Survey Findings and Implications

Five hundred Christian therapists returned surveys describing their beliefs and behaviors regarding sexual attraction and sexual expression toward their clients. Four groups of Christian therapists responded: psychologists, licensed therapists, nonlicensed therapists, and lay counselors. Christian therapists' responses are compared with those from a similar survey of 456 psychologists selected without regard to religious values. Most groups of Christian therapists are less likely than previously surveyed psychologists to report sexual attraction and fantasy toward clients, but the differences between Christian psychologists and other psychologists are minimal. Religious factors that may increase the stigma of admitting sexual attraction are considered.     

Examination of racial differences on the MMPI-2 clinical and restructured clinical scales in an outpatient sample

The current study examined the possibility of differential predictive accuracy of selected Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2) clinical and Restructured Clinical (RC) scales in a group of Black and White mental health center clients. Results indicate that Black clients scored higher than White clients on one non-K-corrected clinical scale and 4 RC scales. All these differences produced medium effect sizes and were clinically significant according to Greene's (1987) criterion. These differences, however, were not accompanied by differential predictive accuracy of the scales in Black versus White clients. Although additional research is needed, especially on the RC scales, this study indicates that the MMPI-2 is not a biased predictor of symptomatology for Black versus White test takers.     

Experiences of Countertransference: Reports of Clinical Psychology Students

While historically linked with psychoanalysis, countertransference is recognised as an important component of the experience of therapists, regardless of the therapeutic modality. This study considers the implications of this for the training of psychologists. Fifty‐five clinical psychology trainees from four university training programmes completed an anonymous questionnaire that collected written reports of countertransference experiences, ratings of confidence in managing these responses, and supervision in this regard. The reports were analysed using a process of thematic analysis. Several themes emerged including a desire to protect or rescue clients, feeling criticised or controlled by clients, feeling helpless, and feeling disengaged. Trainees varied in their reports of awareness of countertransference and the regularity of supervision in this regard. The majority reported a lack of confidence in managing their responses, and all reported interest in learning about countertransference. The implications for reflective practice in postgraduate psychology training are discussed.     

Client Gender and Sex Role: Predictors of Counselors' Impressions and Expectations

Researchers of this study questioned: Are clients (male or female) with self-reported “masculine” versus “feminine” role orientations viewed more favorably by counselors? Which is more predictive of the counselor's impressions: the client's gender or his or her sex role orientation? Results suggested that highly masculine and highly feminine clients (regardless of gender) are perceived as more socially skilled and likely to experience a positive therapeutic outcome. Gender did not uniquely predict counselors' impressions. Highly feminine women clients, however, were viewed as more socially skilled than were highly feminine men. On average, clients were viewed as friendly and submissive.     

A Phenomenological Study of Identifying as Lesbian,Gay and Bisexual in an Islamic Country

Ten adult Kuwaitis (four women and six men) who self-identified as being gay, lesbian, or bisexual (GLB) participated in in-depth semi-structured interviews examining their experience of being a sexual minority and living in a socially conservative Islamic country. The data were analyzed using interpretive phenomenology and yielded four primary themes including the role of religion and culture, risks, coping, and influential political factors. These themes help understand the ways in which LGB individuals in Kuwait integrate their sexual identity with religious and cultural factors and navigate a socially conservative society. The results of the study have implications for political and social policies in Kuwait, and for more culturally-sensitive models of sexual identity development among Arab populations.     

Independent and interdependent self-construals as predictors of multicultural case conceptualization ability in counsellor trainees

This study examined the extent to which independent and interdependent self-construals were related to counsellor trainees' multicultural case conceptualization ability (i.e., ability to conceptualize clients from a multicultural perspective). Results revealed that, after accounting for race or ethnicity and prior multicultural training, counsellor trainees' self-construal scores were significantly predictive of their ability to conceptualize clients from a multicultural perspective. Specifically, independent self-construal scores were negatively related to trainees' ability to conceptualize clients from a multicultural perspective, whereas interdependent selfconstrual scores were positively associated with multicultural case conceptualization ability. Future research directions are offered.     

Lesbian,gay, and bisexual suicidal behavior: testing a constructivist model

The present investigation surveyed 162 self-identified lesbian, gay, and bisexual individuals recruited from LGB-related social organizations or contacted through networking procedures with regard to suicidal behaviors, suicide risk factors, and reasons for living. Approximately 41% of the respondents indicated a serious consideration of suicide including the identification of a specific suicide plan (23%) or a past suicide attempt (36%) with significant intent to die (13%). Forty-six percent of the sample indicated at least some degree of chance of attempting suicide in the future. Grounded in the existential-constructivist theory of suicide (Rogers, 2001), empirically and theoretically identified suicide risk factors were found as a group to predict suicidal ideation (R2 = .16) and attempts (R2 = .17), with abuse-related items independently predicting both suicidal ideation (R2 = .03) and attempts (R2 = .08). Items related to self-identity issues and social acceptance were predictive of suicidal ideation (R2 = .04), while substance abuse was predictive of suicidal ideation (R2 = .05) and attempts (R2 = .13) for males only. The established factor structure of the Reasons for Living Inventory (Linehan et al., 1983) was not supported in the current data, suggesting that it may not be an appropriate measure of reasons for living with LGB individuals.     

The Intersection of Mutual Partner Violence and Substance Use Among Urban Gays,Lesbians, and Bisexuals

Intimate partner violence among gays and lesbians has gained increased attention in recent years. The present study assessed mutual partner violence within a gay, lesbian, bisexual (GLB) community sample to explore how mutual partner violence relates to the use of psychoactive substances. The results suggest that individuals engaging in mutual partner violence are more likely to report the use of numerous drugs than other subjects. However, this finding holds more consistently among men. The results also indicate that the exchange of violence is more significant for substance use than the particular type of violence involved. The authors suggest that minority stress may be an underlying mechanism of both substance use and partner violence and may contribute to the intersection of these deviant phenomena in the GLB community.     

Gay, Lesbian, and Bisexual Patients’ Recommendations for Genetic Counselors: A Qualitative Investigation

Gay, lesbian, and bisexual (GLB) individuals comprise a growing patient population in genetic counseling. However, only one article from a genetic counseling journal provides empirical data on GLB patients' genetic counseling experiences and genetic counselor attitudes and practices regarding GLB patients. The present study, an extension of the aforementioned article, gathered further information about patients' genetic counseling experiences through semi-structured telephone interviews. Twelve of the previous study's 29 patient respondents (n?=?10 lesbian women, n?=?1 gay man, n?=?1 bisexual woman) participated. Interview questions concerned the use of medically inclusive forms, factors influencing patient disclosure, counselors' ability to relate to them, and their expectations of genetic counselors. Inductive analysis of the interviews yielded seven themes: 1) Medically inclusive forms with gender neutral terms are important; 2) Genetic counselor ability to relate to a GLB person depends more on the relationship established during the session and less on external symbols; 3) The presence of GLB-friendly symbols increases comfort when disclosing one's orientation; 4) Inclusion of the patient's partner is important and best done by encouraging their active participation in sessions; 5) When GLB patients disclose their orientation, they expect to be treated like any other patient; 6) Providers should ask about orientation if medically pertinent and the remaining discussion should take orientation into consideration; and 7) When a provider inquires about orientation it should be done in a safe and appropriate way. Illustrative quotations, genetic counseling practice implications, and research recommendations are presented.     

Predictors and impact of psychotherapy side effects in young adults

What should we tell our younger clients—who may or may not have chosen to come to therapy—about possible risks of engaging in psychotherapy? To explore this question, we examined psychotherapy side effects in 366 young adults with a history of psychotherapy or counselling. Psychotherapy side effects were common, with 41% of participants reporting at least one. Perceived lack of control over the decision of when and how to engage in therapy was the strongest predictor of experiencing therapy side effects. Of the different kinds of side effects, feeling that therapy had gone on too long and experiencing worsening of existing symptoms were the most strongly predictive of poor therapy outcomes such as dissatisfaction with care and lower perceived improvements. Finally, there was a significant association between reporting side effects of psychiatric medications and side effects of psychotherapy, suggesting common factors that contribute to side effect experience across treatment modalities. These findings highlight the need to monitor possible side effects during psychotherapy and counselling, and to have an open dialogue with our youngest clients and their families about the likelihood for negative outcomes when they are compelled to engage in therapy.