DO COPING STYLES MODERATE OR MEDIATE THE RELATIONSHIP BETWEEN INTERNALIZED HETEROSEXISM AND SEXUAL MINORITY WOMEN'S PSYCHOLOGICAL DISTRESS?

The purpose of this study was to test tenets of both minority stress and lesbian feminist/sexual identity development theories by examining the potential moderating and mediating roles of individual coping styles (i.e., problem-solving and avoidant coping) in the relationship between internalized heterosexism and lesbian and bisexual (sexual minority) women's psychological distress. Participants included 323 sexual minority women who completed an Internet survey. Results revealed that avoidant coping partially mediated the relationship between internalized heterosexism and psychological distress. No support was found for the mediating role of problem-solving coping or for the moderating roles of problem-solving and avoidant coping in the link between internalized heterosexism and psychological distress. Feminist strategies that may be useful for clinicians working with clients to reduce internalized heterosexism are provided.     

Psychosocial and pharmacological treatment of patients following deliberate self-harm: the methodological issues involved in evaluating effectiveness.

Development of effective treatments for patients following deliberate self-harm (self-poisoning or self-injury) is a very important element in suicide prevention. The randomized controlled trial (RCT) is the mainstay of evaluation of treatments. In a systematic review of the literature, the effectiveness of treatments based on RCTs was examined and the quality of the RCTs was assessed. Twenty trials were identified, and where possible, these were grouped on the basis of similarities among the types of treatment. In this paper, we examine the methodological aspects of the trials and consider what may be learned that will assist in the design of future studies in this field. The methodological quality of the trials was reasonable, but most trials included too few participants to detect clinically important differences in rates of repeated self-harm. In planning future trials, the following major issues should be addressed: investigators should perform power calculations to determine the number of subjects necessary to detect clinically important effects, provide information on method of randomization and interventions, use standard measures of outcome, and focus on homogeneous subgroups of patients. Improving the methodology of future studies in this field will be essential if sound evidence is to be obtained which can inform effective service provision for deliberate self-harm patients.