Feminism and Health in the Decade of Behavior

National health data are presented to demonstrate that important issues of women's health are linked to inequality and to the generalized oppression of women. Health issues of violence, reproductive health, coronary health, and mental health are reviewed as they relate to women of color and diverse ethnicity as well as to women in general. Feminist principles are applied to these issues, pointing out inequalities in assessment, treatment and access to care, bias in research and lack of research on topics particularly relevant to women and minorities, and limitations in the education and training of health care providers. It is imperative that these problems, which are not solely biological, be addressed in light of systems-level analysis that includes a feminist lens. Guided by feminist principles and sensibilities, the relevance of behavioral and social science is outlined for research, training, assessment, intervention, evaluation, and overall social change.     

Perceived discrimination and mental health symptoms among Black men with HIV

People living with HIV (PLWH) exhibit more severe mental health symptoms, including depression and posttraumatic stress disorder (PTSD) symptoms, than do members of the general public. We examined whether perceived discrimination, which has been associated with poor mental health in prior research, contributes to greater depression and PTSD symptoms among HIV-positive Black men who have sex with men (MSM), who are at high risk for discrimination from multiple stigmatized characteristics (HIV-serostatus, race/ethnicity, sexual orientation). A total of 181 Black MSM living with HIV completed audio computer-assisted self-interviews (ACASI) that included measures of mental health symptoms (depression, PTSD) and scales assessing perceived discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation. In bivariate tests, all three perceived discrimination scales were significantly associated with greater symptoms of depression and PTSD (i.e., reexperiencing, avoidance, and arousal subscales; all p values < .05). The multivariate model for depression yielded a three-way interaction among all three discrimination types (p < .01), indicating that perceived racial discrimination was negatively associated with depression symptoms when considered in isolation from other forms of discrimination, but positively associated when all three types of discrimination were present. In multivariate tests, only perceived HIV-related discrimination was associated with PTSD symptoms (p < .05). Findings suggest that some types of perceived discrimination contribute to poor mental health among PLWH. Researchers need to take into account intersecting stigmata when developing interventions to improve mental health among PLWH.     

Does Global Inequality Matter?

Global economic and political inequalities are in most respects greater today than they have been for decades. From one point of view inequality is a bad thing simply because it involves a deviation from equality, which is thought to have value for its own sake. But it is controversial whether this position can be defended, and if it can, whether the egalitarian ideal on which the defense may depend applies at the global level as in individual societies. Setting aside directly egalitarian reasons for concern about global inequality, this paper explores several reasons for concern that derive from nonegalitarian values – primarily those associated with poverty and material deprivation, humiliation, the impact of inequality on the capacity for self-control and self-government, and the unfairness of political decision-making procedures with large economic inequalities in the background.     

The Association between Religious Discrimination and Health: Disaggregating by Types of Discrimination Experiences,Religious Tradition,and Forms of Health

Research finds that experiences of religious discrimination are often associated with poorer health outcomes. However, there remain important questions to consider gaps, including whether religious discrimination has similar health impacts on religious minority groups and religious majority groups, whether religious discrimination is equally harmful for both mental and physical health, and whether specific types of discrimination have different impacts on health. Using survey data from a probability sample of U.S. adults and measures representing a variety of discrimination experience types, our analyses suggest that religious discrimination is indeed harmful for health, but that experiences of religious discrimination do not universally affect mental and physical health in the same ways. Rather than significant differences in the health impacts of religious discrimination across different religious groups, we find more variation in the health impacts of different types of experiences with discrimination. Further, we find that mental health is negatively impacted by a wider range of experiences with religious discrimination than physical health. These findings are in line with social psychological research on the differential health impacts of discrimination, and they highlight the importance of context in studies of the health effects of religious discrimination.     

The buffering role of social support on the associations among discrimination,mental health,and suicidality in a transgender sample

Introduction: Per the minority stress framework, trans individuals often experience psychological distress given the unique stress engendered by gender identity–related discrimination. Prior research has identified social support as particularly important for psychological distress and has suggested that social support may moderate this relationship. The purpose of the current study was to explore the patterns of connections among discrimination, mental health, and suicidal ideation in trans individuals and whether social support moderates these relationships. Methods: Participants (N = 78) completed measures of these constructs as part of a national online survey. Results: A series of simultaneous multiple regressions found that harassment/rejection discrimination was a unique positive predictor of mental health symptoms and suicidal ideation, with depression positively predicting suicidal ideation. A mediational model indicated that the association between harassment/rejection discrimination and suicidal ideation was fully mediated by depression. Three moderated meditational models were run, and one yielded a significant interaction, such that discrimination predicted suicidal ideation most strongly when participants had low social support from a significant other in comparison to participants who had moderate or high support. Further, conditional direct effects identified that discrimination led to ideation only for individuals with low support from friends or a significant other but not for those with moderate or high support. Conclusions: Helping trans individuals cope with harassment and rejection, particularly by drawing on social support, may promote better mental health, which could help reduce suicidality in this population.     

Mental health measurement among women veterans receiving co-located,collaborative care services

Routine use of measurement to identify patient concerns and track treatment progress is critical to high quality patient care. This is particularly relevant to the Primary Care Behavioral Health model, where rapid symptom assessment and effective referral management are critical to sustaining population-based care. However, research suggests that women who receive treatment in co-located collaborative care settings utilizing the PCBH model are less likely to be assessed with standard measures than men in these settings. The current study utilized regional retrospective data obtained from the Veterans Health Administration’s electronic medical record system to: (1) explore rates of mental health measurement for women receiving co-located collaborative care services (N = 1008); and (2) to identify predictors of mental health measurement in women veterans in these settings. Overall, only 8% of women had documentation of standard mental health measures. Measurement was predicted by diagnosis, facility size, length of care episode and care setting. Specifically, women diagnosed with depression were less likely than those with anxiety disorders to have standard mental health measurement documented. Several suggestions are offered to increase the quality of mental health care for women through regular use of measurement in integrated care settings.     

Mental Health Inequalities During COVID-19 Outbreak: The Role of Financial Insecurity and Attentional Control

The COVID-19 pandemic and subsequent lockdowns negatively impacted the mental health of populations. This impact is not equally distributed and increases existing mental health inequalities. Indeed, government restrictions and the economic consequences of the pandemic affect more the less educated and less wealthy people. However, psychological processes implicated in this increase of mental health inequalities during the COVID-19 pandemic remain unexplored. The present study (N=591) tested the role of financial insecurity and attentional control in the relation between socioeconomic status and mental health, along with the influence of trait anxiety. Based on Structural Equation Modelling, findings showed a mediation effect of financial insecurity, but not of attentional control, in the relationship between socioeconomic status and mental health. In addition, exploratory analyses suggested that financial insecurity also mediated the effect of attentional control on mental health. Results of the present research point at the importance of understanding psychological processes implicated in the effect of economic crises on mental health inequalities.     

Mapping Men's Mental Health

The central theme of this paper is that men are at one and the same time both damaged and damage-doing. The process of being damaged through the agency of masculinity predisposes men to exploit, dominate and abuse—not only as boys, as partners and fathers, but as priests, teachers, therapists, lawyers, nurses, psychologists and psychiatrists. Mental health services need to see both aspects of this male equation: a focus on male abuse alone leads to punishment, containment and, very likely, the continuation of abuse; a focus on male damagedness alone preserves the ideology of male unaccountability. However, evidence reviewed here suggests that most traditional psychiatric services fail to acknowledge the impact of inequalities on men's mental health as comprehensively as they fail to acknowledge the impact of these inequalities on the mental health of women. This is a significant problem, and we suggest ways that a gendered analysis of masculinity can be used to help address this deficit. This analysis is used to develop a map of men's mental health that not only accommodates traditional categories of mental health difficulty, but other important consequences of the close association between masculinity and sexuality inequality, especially the use of violence and the capacity to do harm. This analytical framework also invites consideration of the invisibility of male distress, the disallowing and desensitizing of ‘vulnerability, and their submersion in a kind of psychology of entitlement. Finally, we consider the implications of this mapping exercise for mental health services and for working with men.     

Creating Nurturing Environments: A Science-Based Framework for Promoting Child Health and Development Within High-Poverty Neighborhoods

Living in poverty and living in areas of concentrated poverty pose multiple risks for child development and for overall health and wellbeing. Poverty is a major risk factor for several mental, emotional, and behavioral disorders, as well as for other developmental challenges and physical health problems. In this paper, the Promise Neighborhoods Research Consortium describes a science-based framework for the promotion of child health and development within distressed high-poverty neighborhoods. We lay out a model of child and adolescent developmental outcomes and integrate knowledge of potent and malleable influences to define a comprehensive intervention framework to bring about a significant increase in the proportion of young people in high-poverty neighborhoods who will develop successfully. Based on a synthesis of research from diverse fields, we designed the Creating Nurturing Environments framework to guide community-wide efforts to improve child outcomes and reduce health and educational inequalities.     

不孕症女性污名现象产生原因、影响及对策思考

不孕症女性患者的污名或歧视现象是一个值得关注的话题。在我国,不孕污名的产生具有传统文化背景。不孕污名影响患者的身心健康,造成患者社会隔离,提出相关对策对改善不孕症女性患者及其家属认知与态度、提高不孕女性心理保健水平是有积极意义的。     

Gender typing,importance of multiple roles,and mental health consequences for women

The present study examined the interactive influence of gender role typing and multiple role involvement with regard to specific mental health concerns among middle-class Caucasian women. As with previous research, depression and anxiety proved to be a function of gender role typing (feminine-typed and undifferentiated women displayed greater depression and anxiety relative to masculine-typed or androgynous women) with no differences attributable to multiple role involvement. For substance abuse, however, an interaction effect was obtained. Gender-typed (both masculine and feminine) women striving to excel across multiple roles engaged in greater substance abuse than women not gender typed (androgynous and undifferentiated); indeed, the latter displayed low risk comparable to women not similarly striving at multiple roles regardless of gender typing. A similar interaction previously has been reported with regard to disordered eating. These findings suggest that the lack of gender typing for women may enable them to cope more effectively with the conflicting demands of multiple roles and thereby reduce certain health risk behaviors (e.g., disordered eating and substance abuse), but that other mental health concerns (e.g., depression and anxiety) may not be similarly affected.     

Performance Involvement,Identity, and Emotion Among Cisgender Male Drag Queens

Quantitative research on levels of depression and gender dysphoria in drag populations is lacking. It is possible that this lack occurs because researchers tend to include drag queens within transgender samples. Such sampling practices may result in inaccurate assumptions about drag queen populations. This study established rates of depression and gender dysphoria in a sample of self-identified cisgender drag queens. Participants reported low levels of gender dysphoria and significantly lower levels of depression than have been found among trans women, however, these participants presented with higher rates of depression than have been found among gay men who do not perform drag. Higher rates of involvement in drag performance were positively correlated with depression and negatively correlated with gender dysphoria. Results indicate that self-identified cisgender drag queens are unlikely to experience gender dysphoria and are less depressed than samples of trans women. The researchers discuss implications and future directions for mental health practitioners.     

Gender inequality and gender differences in authoritarianism

Authoritarianism may be endorsed in part as a means of managing and buffering psychological threats (e.g., Duckitt & Fisher, 2003; Henry, 2011). Building on this research, the authors postulated that authoritarianism should be especially prevalent among women in societies with high levels of gender inequality because they especially face more psychological threats associated with stigma compared with men. After establishing that authoritarianism is, in part, a response to rejection, a psychological threat associated with stigma (Study 1), the authors used multilevel modeling to analyze data from 54 societies to find that women endorsed authoritarian values more than men, especially in individualistic societies with high levels of gender inequality (Study 2). Results show that the threats of stigma for women are not uniform across different cultures and that the degree of stigma is related to the degree of endorsement of psychologically protective attitudes such as authoritarianism.     

Unemployment Needs Context: How Societal Differences between Countries Moderate the Loss in Life-Satisfaction for the Unemployed

The notion of voluntary unemployment held by orthodox economic theory could be refuted by happiness research, showing that those unemployed experience a persistent loss in life-satisfaction. However, most current research addressing this question is conducted at the individual level or takes into account only simple economic aggregate indicators, such as unemployment rates or inflation. The effects of unemployment on life-satisfaction however are likely to vary between societies depending on factors beyond the economic realm. This paper demonstrates the need to consider a wider set of country-level characteristics, including economic, demographic and attitudinal indicators, if the relationship between unemployment and life-satisfaction is to be understood adequately. Using data from the World Values Survey multi-level models are computed for up to 40 European and Anglo-Saxon societies. While economic indicators such as GDP per capita and income inequality appear to be relevant, unemployment rates seem to not affect the relationship greatly, contrary to results from several previous studies. Other factors however do, either mitigating the loss in life-satisfaction when becoming unemployed (such as the mean level of the perception of autonomy in a society), or further depressing life-satisfaction (such as the mean emphasis of work in a society, the age-dependency ratio or the proportion of women in the labour force). Possible explanations are discussed and suggestions for improved further research made.     

A daily diary investigation of Latino ethnic identity, discrimination, and depression

The objectives of the current study were to document the effects of discrimination on Latino mental health and to identify the circumstances by which ethnic identity serves a protective function. Instances of discrimination and depressive symptoms were measured every day for 13 days in a sample of Latino adults (N = 91). Multilevel random coefficient modeling showed a 1-day lagged effect in which increases in depression were observed the day following a discriminatory event. The findings also revealed differential effects of ethnic identity exploration and commitment. Whereas ethnic identity exploration was found to exacerbate the influence of daily discrimination on next-day depression, ethnic identity commitment operated as a stress buffer, influencing the intensity of and recovery from daily discrimination. The findings are discussed within a stress and coping perspective that identifies appropriate cultural resources for decreasing the psychological consequences associated with daily discrimination.     

Factor analysis of the heterosexist harassment,rejection, and discrimination scale in lesbian,gay, bisexual,transgender, and queer people of colour

The factor structure of the Heterosexist Harassment, Rejection, and Discrimination Scale (HHRDS) was examined in lesbian, gay, bisexual, transgender, and queer (LGBTQ) people of colour. Two hundred participants completed a survey with the HHRDS and several mental health scales. A confirmatory factor analysis suggested the original HHRDS structure fit the data poorly. Exploratory factor analyses found a different 2-factor structure, consisting of harassment/rejection and family discrimination. Convergent validity analyses demonstrated that family discrimination had the largest association with depression and anxiety, indicating that family discrimination may be particularly salient among LGBTQ people of colour. This study supports the use of the HHRDS in racially/ethnically diverse samples, but with a slightly different factor structure. Examining discriminatory experiences from family members is an important direction for future research in LGBTQ people of colour.     

Depression, Disability, And Rehabilitation Services For Women

The purpose of this paper is to review scientific evidence for the co-occurrence of major depressive illness and disability, and to examine this phenomenon specifically for women in the United States today. Following a discussion of different ways of operationalizing the concept of disability, the analysis addresses gender biases in disability measurement as well as in recent research on depression and functional impairment. Next, the results of research regarding co-occurrence of disability and depression are reviewed, highlighting those studies focused specifically on women. Turning to research on rehabilitation services for those with psychiatric disabilities, studies suggest that service delivery models fail to address needs specific to women with mental illness in general, as well as those women experiencing severe depression. Thus, the analysis concludes with a series of suggestions and future directions for investigators seeking to better understand the linkages between depression, disability, and rehabilitation services for women.     

Gender Differences in Mental Health: The Mediating Role of Perceived Personal Discrimination

Why is women's mental health inferior to that of men? This study hypothesized that women's mental health is not as good as men's because women perceive more personal discrimination. It was confirmed that women obtained higher scores than did men on a subjective scale of psychological distress. Additionally, women perceived greater personal and group discrimination than did men. Perceived personal discrimination proved to be the more robust predictor of psychological distress. This was evident when results of a mediation analysis revealed that gender differences in subjective distress were mediated by the measure of perceived personal discrimination, but not by the measure of group discrimination.     

Working with Low-income Families: Lessons Learned from Basic and Applied Research on Coping with Poverty-related Stress

Poverty and low socioeconomic status create tremendous amounts of physical and psychosocial stress that compromise health and well-being. This paper explores how the stressors created, exacerbated, and maintained by living in poverty lead to compromised mental health, and at the same time present significant challenges to participating in and benefitting from traditional psychotherapy. This paper summarizes the strong research evidence supporting the causal role of poverty-related stress in contributing to mental (and physical) health problems, discusses the physiology that underlies this process and how it affects clients’ ability to make use of psychotherapy, and presents recommendations for incorporating a multi-faceted approach to coping in clinical work with low-income clients and families. Addressing the pernicious effects of economic stress with a multi-step approach to effective coping can serve to prepare low-income clients to better engage in and get the most out of psychotherapy.