Prospective effects of social support on internalized homonegativity and sexual identity concealment among middle-aged and older gay men: a longitudinal cohort study

Background and objectives: Middle-aged and older gay men experience higher rates of depression and anxiety compared to their heterosexual counterparts, with internalized homonegativity and sexual identity concealment known to be major stress-related contributors. This study examined the prospective effect of different types and sources of social support on internalized homonegativity and sexual identity concealment experienced among middle-aged and older gay men.

Methods: A longitudinal survey involving two waves of data collection separated by 12 months was conducted among a cohort of 186 gay-identified men aged 40 years and older.

Results: Two types of social support were found to be important. Greater baseline tangible or practical support independently predicted lower internalized homonegativity at 12-month follow-up, while greater baseline emotional or psychological support independently predicted a lower tendency toward sexual identity concealment at 12-month follow-up. Greater baseline support from community or government agencies, such as health services and support organizations, predicted higher internalized homonegativity at 12-month follow-up.

Conclusions: These findings suggest that tangible and emotional support may be beneficial in reducing internalized homonegativity and sexual identity concealment among middle-aged and older gay men. Ensuring that services provide environments that do not compound the stressful impact of stigma also appears to be important.     

Gender Symmetry and Asymmetry in Violent Relationships: Patterns of Mutuality Among Racially Diverse Women

Three patterns of mutual intimate partner violence (IPV) are proposed, based on frequency and severity: Male primary perpetrator (MPP), female primary perpetrator (FPP), and symmetrical (SYM). Patterns and effects of ethnicity were examined with 445 African American, Euro-American, and Mexican American low-income women experiencing mutual IPV. More relationships were classified as MPP (54%) than SYM (35%) or FPP (11%). Comparing women's and men's perpetration of several types of IPV (e.g., threats, severe physical) indicated MPP-pattern women experienced all IPV types more often and were more likely to sustain injury than their male partners. Fewer gender differences were found in the FPP pattern. Racial/ethnic groups were more similar than different; previously reported differences may be explained by variation in socioeconomic status. The larger part of the study was funded by grant R49/CCR610508 from the National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention, awarded to the third author. This article was also made possible by grant 2001-WT-BX-0504 from the National Institute of Justice awarded to the first and third authors. These agencies are not responsible for the results. Portions of this paper were presented by the first and third authors at the International Family Violence Conference in Portsmouth, NH, July, 2003.     

Clinical Validation of the Swedish Version of the Quality of Life Inventory in Crime Victims with Posttraumatic Stress Disorder and a Nonclinical Sample

The Swedish version of the Quality of Life Inventory (QOLI) was cross-culturally validated with a crime victim sample (N = 53) with posttraumatic stress disorder (PTSD) and a nonclinical group (N = 100) with no lifetime and current psychiatric disorder from the general population in the Stockholm county of Sweden. The QOLI showed excellent internal consistencies in the clinical and the nonclinical sample. In addition, PTSD participants displayed a significantly lower self-perceived quality of life in 13 out of 16 domains of life than the nonclinical individuals. Furthermore, the QOLI was inversely correlated with interview and self-report measures of PTSD symptoms, depression, and anxiety. Overall, the results support the utility of the Swedish QOLI version as a potentially useful measure of self-perceived quality of life in Swedish clinical and nonclinical samples. The results are discussed in relation to the Swedish cross-cultural validation of the QOLI, methodological limitations and future directions.     

Making sense of male rape: constructions of gender,sexuality and experience of rape victims

This study reports a preliminary investigation into accounting practices for male rape in conversation. Thirty men and women, in dyads, were asked to discuss an incident of male rape presented to them in a vignette. The findings showed that two main issues were discussed: the experience of the rape act and societal responses to male victims. In addition, participants established a ‘hierarchy of suffering’, where rape was judged to be worse for ‘heterosexual’ men than it is for ‘women’ or ‘gay’ men. Hegemonic, phallocentric representations of heterosexuality were mobilized to argue that acts of rape and consensual intercourse are the same for ‘gay’ men and ‘women’ and therefore less traumatic than for ‘heterosexual’ men. This obscures the violence of rape for gay men and women and exonerates perpetrators by minimizing injury sustained. Participants also argued that heterosexual victims are likely to experience ridicule for having departed from hegemonic masculinity. Arguments were constructed to avoid charges of being dismissive towards women and gay men and of victim blaming in relation to heterosexual men. Copyright © 2004 John Wiley & Sons, Ltd.     

Stonewalling through Schizophrenia: An Anti-Gay Rights Culture in Hong Kong?

With its British colonial legacy and Chinese make-up, Hong Kong provides a stimulating stadium and lens through which to examine the validity of the use of “culture” in arguing against homosexuality and the development and protection of the rights of sexual minorities. After a brief account on the legal developments in Hong Kong on homosexuality, this article examines how the argument that Hong Kong has an inherently anti-gay rights culture, which simultaneously emphasizes Confucianism and Christianity, and which the government then uses to stonewall the development and protection of the rights of sexual minorities, merely illuminates an underlying schizophrenia as to what that culture actually is. In the process of my diagnosis, I will also discuss whether Confucianism and Christianity indeed oppose homosexuality and sexual minority rights.

Coming out stories framed as faith narratives, or stories of spiritual growth

The tension between religion and sexuality is particularly pronounced for gay and lesbian people who are often “caught in the middle” between a constitutional sexual orientation and a religious body that rejects it. This paper demonstrates how gay men can be helped in trying to integrate these deeply human and intrinsic parts of themselves, using a developmental approach first articulated by Robert Kegan. It argues that such development is often reflected later in theological language: in this case, in these men's coming out narratives, which are often framed as stories of spiritual growth.     

“One of us”: Outstanding willingness to help save a single identified compatriot

Willingness to help victims unrelated to oneself, in situations where reciprocity is irrelevant, is a common form of altruism. Prior research showed that people are more willing to extend such help when the victims are identified, particularly when the target of help is a single individual. However, in the present research we found that only when the perceivers regard the victims as belonging to their own in-group, willingness to help a single identified individual is greater than willingness to help a group of individuals: identifying tsunami victims by name increased actual contributions only when the specified target was a single compatriot. The role of perceived shared social group in promoting the victim singularity advantage in contributions was mirrored in ratings of emotions, thus supporting an affective account of helping behavior.     

Narcissistic mortification of ageing men

The development of a male gender identity involves the task of relinquishing the identification with the female primary object. If this separation is experienced as loss or expulsion, and responded to by the development and libidinous cathexis of phallic-narcissistic characteristics, a specifically male narcissistic vulnerability emerges, which can, particularly in ageing men, escalate to critical proportions. However, phallic-narcissistic crises in the ageing process also contain opportunities for development, provided the losses of age can be faced with mourning. The author sets out the statements on the subject of old age in the myth of Narcissus and makes use of the concepts of developmental psychology. He outlines clinical examples illustrating this problem. Finally, he brings to mind the narcissistic plight of the aged Oedipus.     

An Integrative Model for Ethnocultural Counseling and Psychotherapy of Victims of Organized Violence

The author researched sociocultural factors related to psychotherapy with victims of organized violence from different perspectives: a refugee counseling center in a metropolis (Frankfurt, 1991–95) and refugee camps in neighboring countries (Uganda, 1994–96). At first the psychopathology of victims of organized violence is described. Then a review of treatment approaches follows and a conceptual model for integrative psychotherapy is developed. On the basis of qualitative analysis of client–therapist interactions, case discussions, supervision, evaluation of treatment, and literature review, an eclectic model for ethnocultural counseling and psychotherapy was developed. This eclectic model can be divided into (1) therapeutic relationship and transference, (2) modeling techniques, (3) extrapsychic techniques, (4) somatic techniques,(5) working through traumatic/grief/repressive experiences, and (6) reeducative and supportive techniques.     

It takes two to tango: Research and practice as an amazing dance

This paper offers an appreciative critique of Kim Etherington's recent book, Narrative Approaches to Working with Adult Male Survivors of Male Child Sexual Abuse. I discuss the issues raised in the book with reference to one of my current clients. Etherington does not produce new substantive theory: the power of this work is in the narrative. Her important contribution lies in the reflexivity with which she encounters her material. The use of critical reflexivity challenges the subject/object dichotomy inherent in much positivistic research, and presents a much‐needed approach to process that is congruent with the lived experience of counselling. I would suggest that research is more likely to succeed in informing practice if the material is open to personal interpretation by the reader/therapist. Further, I would claim that the activity of using research creatively is itself a heuristic process: useful learning is most likely to occur if the dialogic relationship with the client and therapist is mirrored in the relationship between the therapist and the research text.