Emotional approach coping: Gender differences on psychological adjustment in young to middle-aged cancer survivors

Objective : The effect of emotional approach coping (EAC) varies by gender. However, this gender difference has not yet been investigated in cancer survivors. We investigated whether the effects of two kinds of EAC – emotional processing (EP) and emotional expression (EE) – vary by gender and whether EAC has effects above and beyond the effect of other coping strategies.

Design : EAC and other coping strategies were assessed at baseline in a sample of 248 young to middle-aged adult (between the age of 22 and 55) cancer survivors. One hundred and sixty-six survivors responded to psychological adjustment one year later.

Results : EAC had different relationships with Time 2 adjustment in men and women. Hierarchical regression analyses showed that for men, EE predicted lower intrusive thoughts and, for women, EP was associated with higher positive affect when other coping strategies and EE were controlled.

Conclusion : Gender differences held true in cancer survivors, and EAC was effective when other coping strategies were controlled. Further, EE was effective in reducing negative adjustment in men while EP was helpful in promoting positive adjustment in women.     

Health disparities between binary and non binary trans people: A community-driven survey

Abstract

Background: Genderqueer and nonbinary () people have remained largely invisible in health research. Previous research shows worse outcomes on health indicators for trans people when compared with cisgender controls, but the differences between binary trans and GQNB individuals are inconclusive.

Aims: To compare overall health and well-being of GQNB people with controls of trans men and trans women, taking into account the impact of the additive effect of their socio-economic position, as well as their current need for gender affirming medical interventions.

Methods: A community-driven survey was conducted in 2016 in five countries (Georgia, Poland, Serbia, Spain, and Sweden). Self-reported health and general well-being were analysed for differences between binary trans and GQNB respondents. The effects of multiple control variables (age, economic situation, educational level, belonging to an ethnic, religious, sexual or ability minority group, sex assigned at birth) as well as the current need for gender affirming medical interventions were controlled for.

Results: The sample consisted of 853 respondents aged 16 and older, with 254 trans women (29.8%), 369 trans men (43.2%), and 230 GQNB people (26%). GQNB respondents showed significantly worse self-reported health and worse general well-being in comparison to binary trans respondents. Additional negative impacts of having a lower educational level, having more economic stress, and belonging to a disability minority group were found. Being in need of gender affirming medical interventions contributed significantly to worse self-reported health, whereas being younger contributed to worse general well-being.

Discussion: In understanding health disparities between binary trans and GQNB people, it is necessary to take into account the additive effect of multiple socio-economic positions, and the current need for gender affirming medical interventions. The high proportion of GQNB respondents who report worse health outcomes highlights the need for policy makers and health-care providers in creating nonbinary-inclusive environments.     

Causal explanations for lack of pregnancy applying the common sense model of illness representation to the fertility context

Abstract

Objectives: The current study explored causal explanations for lack of pregnancy and association with help-seeking behaviour. Differences based on gender and country Human Development Index were examined.

Design: A mixed method design was used.

Main outcome measures: Data were drawn from the International Fertility Decision-Making Study, a cross-sectional study of 10,045 individuals (1690 men; 8355 women) from 79 countries. Respondents rated to what extent they believed their lack of pregnancy was due to something they or their partner had done/not done or other factors and described their reasons for making this rating.

Results: Respondents were aged 18–50 (M?=?31.83) years, partnered and had been trying to achieve a pregnancy/father a child for over six months (M?=?2.8 years). Men and women primarily believed their lack of pregnancy was due to medical problems or chance/bad luck. Thematic analysis of textual responses from 29.7% of the sample found that respondents focused on their personal experience or a salient life event when describing the cause of their lack of pregnancy. Women expressed more regret and helplessness about causes than men. Significant country differences were observed.

Conclusions: Individuals may develop inaccurate causal explanations based on their personal experiences. Access to accurate information is necessary to facilitate timely help-seeking.     

Internalized transphobia and mental health among transgender adults: A nationwide cross-sectional survey in South Korea

Abstract

Introduction: Transgender people are stigmatized in South Korea (hereafter Korea), where cultural expectations of a biologically-based, binary sex and gender system present fundamental challenges to those whose gender identity does not align with their birth-assigned sex. A growing international body of literature implicates gender minority stress as a key contributor to transgender mental health disparities, but little research has been conducted on this topic in Korea. As in other cultural settings, depression and suicidality are urgent public health concerns for transgender people in Korea, primarily for those who have not initiated gender affirming medical treatment (GAMT), such as cross-sex hormone therapy. In the current study, an international and interdisciplinary team of authors apply the lens of gender minority stress to elucidate the relationships between a key facet of gender minority stress, internalized transphobia (ITP), and outcomes of depressive symptoms and suicidality.

Methods: Based on a cross-sectional survey of 207 Korean transgender adults, the current study evaluates the relationships between ITP and depressive symptoms, suicidal ideation, and suicide attempts. ITP was measured with an eight-item, Korean-language questionnaire adapted from the Gender Minority Stress and Resilience Measure through a translation and back-translation process.

Results: Korean trans women and trans men mean (mean age?=?26.4) were included in the analysis, most of whom had at least one experience of any GAMT. The findings of this study show that Korean transgender adults face similar public health concerns such as high prevalence of depressive symptoms, suicidal ideation, and suicide attempts. As predicted, ITP was significantly related to depressive symptoms, suicidal ideation, and suicide attempts.

Conclusion: The authors suggest potential clinical, policy, and research applications, including institutional interventions, to address structural and cultural barriers to optimal mental health and GAMT as well as mental health interventions to reduce Korean transgender people’s internalized negative beliefs about their gender identity.     

Frightfully funny: combining threat and humour in health messages for men and women

Objective: It is imperative for public health to investigate what factors may reduce defensive responses and increase the effectiveness of health information. The present research investigated gender differences in responses to threatening health-promoting information communicated with humour.

Design: Male and female participants were exposed to a health message stressing the negative consequences of binge drinking (Experiment 1; N = 209) or caffeine consumption (Experiment 2; N = 242), that did or did not contain a funny visual metaphor (Experiment 1) or a slapstick cartoon (Experiment 2).

Main Outcome Measures: Message evaluation, message attention, and attitudes and intentions towards the behaviour were measured.

Results: Results showed that health messages were more persuasive when communicated with humour, although humour played a different role for men and women. Whereas men responded more in line with message goals when the message combined high threat with humour, women preferred the low threat humour messages.

Conclusion: By uncovering the moderating role of gender as a key audience characteristic, this research contributes to designing effective future health campaigns and provides important insights for future studies investigating the underlying mechanisms responsible for the different effects of threat and humour appeals for men and women.     

Evaluating Psychosocial Factors and Psychological Reactions to Infertility Treatment

Abstract

This study presents preliminary findings evaluating the relationship between marital cohesion, pregnancy outcome, and gender and the level of stress and depression experienced by individuals pursuing infertility treatment. Women exhibited more stress and depression than men prior to treatment did, yet the level of change (pre-post) in depression and stress after treatment did not differ by gender. Pregnancy outcome helped predict post-treatment depression in women and men, and post-treatment stress for women. Clinical suggestions for preand post-cycle consultations are presented.     

Harley and Sandra

SUMMARY

This article describes an initial therapy session with a white, heterosexual married couple in their late thirties. The therapeutic approach illustrated attempts to help men and women use relationships with each other as a resource for mutual healing, for deepening knowledge of self and others, and for cultivating a greater capacity for compassion, intimacy and effective interaction. Conflicts that arise in the context of relationship are viewed as opportunities for the above, and the impact of gender conditioning on both women and men is considered a key force to reckon with. Paradigm shifts inspired by contemporary feminist scholars and therapists are here applied as a foundation for better understanding the impact of oppression on women and men and dynamics between them.     

Dependency and Counter-Dependency in Couples

SUMMARY

There is a tendency on the part of many men in couples to deny their dependency needs, and for the women in these couples to view themselves as excessively needy. These uneven subjective perceptions are examined, as are the ways contemporary gender socialization interferes with the attainment of the ideal of mutual dependency in couples. Some implications for couples therapy are explored.     

Exercise behavior and gender-related differences in posttraumatic stress disorder symptoms

ObjectivesExercise has been proposed as a potential treatment for posttraumatic stress disorder (PTSD). However, the relationship between exercise, gender, and PTSD symptoms is unknown.DesignThis study examined the cross-sectional relationship among these variables in a national sample of 165 men and women who screened positive for PTSD.MethodParticipants completed an online survey consisting of the Godin Leisure-Time Exercise Questionnaire and the PTSD Checklist-Civilian.ResultsActive participants had significantly lower PTSD symptoms than insufficiently active participants. Significant interactions between gender and exercise for PTSD symptoms were found, such that active men had significantly lower PTSD symptoms than active women, and insufficiently active men and women. Additionally, strenuously active men reported significantly lower hyperarousal symptoms than strenuously active women, and insufficiently active men and women.ConclusionFindings suggest that the relationship between PTSD and exercise may differ for specific sub-populations of individuals with PTSD, such as men and women.     

Sources of influence on the professional development of psychologists and psychiatrists in Norway and Germany

Background: There are many professional psychotherapists, but no psychotherapy profession. The psychotherapists’ professions vary between countries, the most frequent being psychiatry and clinical psychology.

Aim: As these professions have different basic training and also may be impacted differently by other factors, we wanted to study potential differences as to perceived influences on their development as psychotherapists across career level, theoretical orientation, and gender.

Methods: More than 2500 Norwegian and German psychiatrists and psychologists reported data on their professional development in the DPCCQ/2000, a lengthy multi-part survey instrument developed within the ‘Collaborative Research Network’ of the Society for Psychotherapy Research. The four groups were compared for differences, and a series of multiple regression analyses were conducted to examine the impact of profession on a variety of aspects of therapist experiences.

Results: Although a few therapist experiences (e.g. teaching, treating patients, institutional conditions) had a significantly different impact between the two professions, as a main effect, they only accounted for less than 1% or the variance.

Conclusion: Profession seems to have little influence on perceived development as a psychotherapist, and it is reasonable to conclude that other therapist qualities, often personal qualities, are more important for therapeutic processes and outcomes.     

Intersecting cultural identities and help-seeking attitudes: the role of religious commitment,gender, and self-stigma of seeking help

ABSTRACT

The current study (N?=?404) used a moderated moderation model to examine how gender, religious commitment, and self-stigma toward seeking psychological help may interact in the prediction of help-seeking attitudes. Bivariate zero-order correlations indicated that help-seeking attitudes was negatively associated with self-stigma of seeking help (r?=??.55) and positively associated with religious commitment (r?=?.14), and self-stigma was not significantly associated with religious commitment. Men reported more negative attitudes than women (ΔM?=??.18). Furthermore, multiple regression results revealed a three-way interaction such that the relationship between gender and help-seeking attitudes was moderated by both self-stigma and religious commitment. Specifically, men with high religious commitment and high self-stigma endorsed the most negative help-seeking attitudes, suggesting that religious men’s help-seeking attitudes may be particularly susceptible to the influence of self-stigma. Implications for research and the development of targeted interventions are discussed.     

Positive Contact with Feminist Women as a Predictor of Feminist Solidarity,Gender Privilege Awareness,and Public and Domestic Support for Gender Equality in Straight Men

Men can play an important role in supporting gender equality. In the present research, we draw on Intergroup Contact Theory to examine positive intergroup contact with feminist women as one factor that can encourage men to support gender equality. In one cross-sectional study (N?=?170) and one half-longitudinal panel study (N?=?240), we found that straight men who reported more positive contact with feminist women also reported greater feminist solidarity. Cross-sectional results indicated that straight men’s solidarity with feminists, in turn, predicted more support for gender equality in public and domestic spheres and greater awareness of their gender privilege. The longitudinal results also supported the association between solidarity with feminists and gender privilege awareness, but not public and domestic support for gender equality. Decades of research has shown that positive intergroup contact can change attitudes. Our research suggests that, when it comes to gender equality, positive contact with feminist women may also encourage men to identify with feminists and raise their gender consciousness.

     

Bullies,blades, and barricades: Practical considerations for working with adolescents expressing concerns regarding gender and identity

ABSTRACT

Background: Adolescents, by their very nature and need for maturity, struggle with issues of the self and identity, while challenging the very systems that are there to support them. However, gender diverse adolescents may become detached and overwhelmed as a trans identity solidifies during this time. Bullies, blades and barricades describes the challenges, hardship and dispossession that some gender diverse adolescents face from interpersonal and intrapersonal conflicts, societal pressure and hostility.

Method: This paper utilizes the current research on safety and risks affecting trans youth, the authors clinical experience of trans and gender diverse adolescents, and recommendations in the literature for professional care and support of gender diverse adolescents to identify the various ways gender diverse adolescents are negatively affected by their experiences.

Results: Bullying is not limited to school or peer environments and may be present in adolescents' homes, in local communities, in professional services or from sources of information such as the media. The physical dangers gender diverse adolescents face may arise from victimization, violence or rejection, or self-harming behaviors due to negative beliefs, fear or frustration. Barriers preventing disclosure and expression of gender and/or identity may stem from negative experiences, rejection, pubertal changes, imposed limitations, dependence upon school, home or legal environments, or other spheres of influence.

Discussion: Affirmative approaches, individual focus, recognition of family dynamics, inclusion of significant others, advocacy in school and local community environments as well as professional training are the most commonly recommended interventions. This paper provides an inclusive review of the myriad of challenges confronting gender diverse adolescents including often unrecognized forms of pressure, oppression and restrictions. This paper aims to support clinicians by contextualizing the adversity that gender diverse adolescents face and offers strategies for engagement and intervention.     

Exploring rates of transgender individuals and mental health concerns in an online sample

Background: Prevalence estimates of adults identifying as transgender are scarce, particularly in the United States. Method: The current study endeavored to estimate the prevalence of individuals identifying as transgender in a large online sample of adult U.S. residents (n = 6,727) and compare the prevalence of common mental health disorders (depression, anxiety, attention-deficit/hyperactivity disorder) and the age of onset for individuals identifying as men or women versus those identifying as transgender. Results: The prevalence estimate of individuals identifying as transgender was 0.8%. Individuals identifying as transgender were significantly more likely than individuals identifying as men or women to report having had a single diagnosis or co-occurring diagnoses for all three disorders examined. Additionally, transgender individuals were more likely than individuals identifying as men or women to receive a diagnosis of anxiety or depression at a younger age. Conclusion: Given the prevalence of transgender individuals and the associations with common mental health conditions, clinicians must be informed and competent to care for their clinical needs. This study introduces online crowdsourcing resources as a potentially fruitful option for reaching and researching gender diversity.     

Endocrine and emotional response to exclusion among women and men; cortisol,salivary alpha amylase,and mood

Background and Objectives: Social exclusion is ubiquitous and painful. Evolutionary models indicate sex differences in coping with social stress. Recent empirical data suggest different sex patterns in hypothalamic–pituitary–adrenal (HPA) and sympathetic–adrenal–medullary (SAM) reactivity. The present study sought to test this hypothesis.

Design: We examined differences in endocrine and emotional response to exclusion by using a virtual ball tossing paradigm (Cyberball). Saliva samples and mood ratings were collected to reflect levels before, and repeatedly following, exclusion.

Methods: The sample included 21 women and 23 men. Cortisol and salivary alpha amylase (sAA), biomarkers of the HPA and SAM systems, respectively, were used as indices of two arms of stress response.

Results: Following exclusion, all participants experienced mood worsening followed by mood improvement, with men reporting less distress than women. Women evinced decline in cortisol following the Cyberball task, whereas men’s cortisol levels showed a non-significant rise, and then decline, following exclusion.

Conclusions: Our results concur with previous findings showing SAM reactivity to be gender-neutral and HPA reactivity to be gender-divergent. Additional studies are needed to examine sex-specific response to social exclusion. Implications for individual differences in recovery from stress are discussed.     

Sexism,rape myths and feminist identification explain gender differences in attitudes toward the #metoo social media campaign in two countries

ABSTRACT

On October 15, 2017, actress Alyssa Milano popularized the #metoo campaign, which sought to expose the prevalence of sexual harassment and assault in public domains by encouraging victims to share their experiences on social media using the hashtag metoo. The online campaign rapidly grew to a global phenomenon, which was generally well supported. However, some criticized the campaign online as a battle of the sexes, which pits men against women. Our cross-cultural research investigated whether gender differences in attitudes and feelings toward #metoo are due to underlying differences in ideologies and experiences that only partly overlap with gender. We surveyed respondents in the United States, where the campaign began, and in Norway, a highly gender-egalitarian country. In both countries, men expressed less positivity toward #metoo than women and perceived it as substantially more harmful and less beneficial. These gender differences were largely accounted for by men being higher than women in hostile sexism, higher in rape myth acceptance, and lower in feminist identification. The results, hence, suggest that gender differences in attitudes to social media campaigns such as #metoo might be best characterized as dimensional ideological differences rather than fundamental group differences.     

The Genderqueer Identity (GQI) Scale: Measurement and validation of four distinct subscales with trans and LGBQ clinical and community samples in two countries

ABSTRACT

Background: Non-binary gender measurement has grown out of a need for accurate representation in scholarship and public health services available to a diverse gender population.

Aims: The Genderqueer Identity Scale (GQI) was developed to allow for a multidimensional assessment of genderqueer identity, including non-binary identity, socially constructed versus essentialist gender, theoretical awareness of gender concepts, and gender fluidity. The GQI was designed to assess gender identity across a full spectrum of gender, at any age after mid-adolescence, and at various stages of gender identity development, including prior to, during, and after a gender transition, where applicable. Two of the GQI subscales focus on intrapersonal processes, while two focus on interpersonal processes.

Methods: The measure was piloted and refined across four distinct samples: a U.S. university based LGBT sample, consecutive clinical referrals at the Center of Expertise on Gender Dysphoria in Amsterdam, the Netherlands, a Dutch LGB community sample, and an online survey forum (LGBTQ).

Results: The first exploratory factor analysis identified minor potential adjustments, which were refined and retested. Researchers evaluated and cross-validated the hypothesized factor structure and determined that the three factor GQI subscales and the unidimensional Gender Fluidity measure yielded internally consistent and valid scores among transgender individuals seeking clinical treatment and LGB individuals within a community setting. The exploratory and confirmatory factor analyses provide evidence of good reliability, construct validity, and internal consistency of all four subscales.

Discussion: The subscales were appropriate across a spectrum of gender identities and can be taken in the same form over time and across gender transition statuses, making them suitable for clinical evaluation and community based longitudinal research with trans-identified or gender nonconforming persons. The development of the GQI fills critical gaps in gender-related measurement including the ability to assess multiple dimensions of gender identity, and to assess gender identity across time.     

Experiences with stigmatization among transgender individuals after transition: A qualitative study in the Netherlands

Abstract

Background: Transgender individuals belong to one of the most stigmatized groups in society. Although the social stigma of transgender individuals has been examined many times, post transition stigma experiences among transgender individuals have received limited research attention. The aim of this study was to examine experiences with stigmatization among Dutch transgender individuals after their transition.

Method: Ten trans women (age: M?=?58.50, SD?=?9.49) and 10 trans men (age: M?=?42.90, SD?=?13.62) participated in face-to-face semistructured interviews. Grounded theory was used to conceptualize and analyze the data. We examined the positive and negative reactions that transgender individuals experienced in the period after their transition. Furthermore, we explored differences between experiences of trans men and trans women. Finally, we examined differences between cisgender men and women regarding their reactions toward transgender individuals.

Results: Participants reported improved psychological well-being since transition. However, they still experienced different forms of stigmatization. Trans women appeared to experience stronger social stigma than trans men. Trans women also experienced lower social status after their transition. They mainly experienced negative responses from cisgender men. Participants emphasized the importance of social and peer support.

Conclusion: The current study findings demonstrate the presence of stigmatization after transition and argue for psychological aftercare. Social and peer support appeared to be important for coping with stigmatization, and improving the social network of transgender individuals is beneficial. Health providers and researchers are recommended to promote the development of constructive coping skills for transgender individuals with interventions especially targeting trans women.     

Religion as Moderator of the Sense of Control–Health Connection: Gender Differences

ABSTRACT

Objectives. Sense of personal control is a key marker of successful aging, yet little is known about its relation to religiousness and personal adversity among older adults. This study investigated the relation between two different religious orientations, a church-centered religiousness and a non-church-based spiritual seeking, sense of control, physical health, and gender in late adulthood.

Methods. The participants consisted of a community sample of men and women (N = 156) in their late sixties and mid-seventies who were born in the San Francisco Bay Area. Three-way ANOVAs were used to test in separate analyses, the effects of religiousness and spiritual seeking on sense of control among men and women who were either in good or poor physical health.

Results. Both religiousness and spiritual seeking buffered women, but not men, against loss of sense of control due to poor physical health. The buffering effect of religiousness and spiritual seeking was associated with different psychological characteristics: high life satisfaction for religiousness and engagement in life review for spiritual seeking. For men, the absence of a buffering effect of either religiousness or spiritual seeking was associated with disengagement from involvement in daily activities.

Discussion. Our findings highlight (1) the importance of employing multidimensional models of religion in studying its effect on psychosocial functioning in late adulthood and (2) the possibility that men and women who are high in religiousness and spiritual seeking regulate their sense of control using different adaptive strategies.     

Jealousy and infidelity: The role of gender identity and culture of honour

Abstract

This research is aimed at examining whether gender and the culture of honour were associated with the type of infidelity (sexual or emotional) that is perceived as most disturbing. A total of 748 Spanish university students (336 men and 412 women), answered to six dilemmas which raised the type of infidelity that had greater impact on them (sexual or emotional), a scale of gender identity and a scale of culture of honour. The results showed that both men and women were more affected by emotional infidelity. In addition it was found that the effect of sex on the type of infidelity that stresses the participants more was moderated by sociocultural variables such as the culture of honour, masculinity and femininity.