Mental health of the bisexual Veteran

Despite evidence showing that bisexual individuals may be at greater risk for mental health issues than lesbian and gay individuals, they are often combined into a single group, with lesbian and gay individuals the actual focus of the research. This study aims to address this gap in the literature among US Veterans. Using data collected from a multicity purposive sample (N = 4,493), logistic regression was used to analyze whether the following groups differ in current posttraumatic stress disorder (PTSD) and depression: (a) bisexual (n = 101) vs. heterosexual Veterans (n = 4,271); (b) bisexual vs. lesbian/gay Veterans (n = 121); (c) lesbian/gay vs. heterosexual Veterans; and (d) combined group of lesbian, gay, and bisexual (LGB; n = 222) vs. heterosexual Veterans. Controlling for significant covariates, bisexual Veterans had 2.5 times the risk of severe depression (95% confidence interval [CI] = 1.34–4.67; p = 0.004) and 2.3 times the odds of PTSD (95% CI = 1.40–3.77; p = 0.001) relative to heterosexual Veterans. Bisexual Veterans had 3 times the risk of severe depression (95% CI = 1.22–7.44; p = 0.017) and 1.9 times the risk of PTSD (95% CI = 1.02–3.70; p = 0.045) compared to lesbian/gay Veterans. Lesbian/gay Veterans had no significant difference in risk for depression compared to heterosexual Veterans. However, the combined group of LGB Veterans had 1.6 times the odds of PTSD (95% CI = 1.12–2.15; p = 0.008) compared to heterosexual Veterans. These findings suggest that past research showing mental health disparities between LGB and heterosexual individuals may be driven by the inclusion of bisexual individuals. Research should assess bisexual individuals as a distinct group, and future studies should explore factors leading to depression and PTSD among bisexual Veterans.     

The authorship of Uri Zohar: the ethics and aesthetics of the Archimedean lever

This article discusses Zohar’s subversive reflexive aesthetics, termed the “Archimedean-lever ethics,” comprised of three stages: the world rendered from one perspective; the same world rendered from a different perspective, challenging or destroying the first; and awareness of the shift of perspectives. It argues that Zohar’s creative energy, imbued with male sexuality, derives from this collision, and examines its ethical aspect in relation to Zionist values during the 1950s and 1960s. Zionism and Israel should always consider more than one perspective, being able not only to build but also to destroy (convictions, territories) in order to bring change, with destruction thus becoming a particular form of creation. However, in Zohar’s films made during the 1970s, the male sexual energy becomes an endless sexual appetite, expressed mostly through coveting gazes, which is no more than a cover up for male impotency, tantamount to Israel’s endless appetite for land.     

Varying Levels and Types of Engagement in an Online Relationship Enhancement Program for Couples Following Breast Cancer

Engagement in online interventions, defined as the extent to which participants are involved in and attentive to the contents of the intervention, has been shown to predict treatment outcome. However, participant engagement and program completion are often quite low. Aiming to provide insights that could help improve engagement, this study explores engagement in an online intervention for young couples with breast cancer, Couplelinks, by describing the development of a method to assess engagement, presenting a framework for understanding varying engagement levels, and discussing strategies used by Couplelinks facilitators to work with participants of differing engagement levels. The measure of engagement developed for this study was a composite consisting of indices of average completion time, accountability, and attitude. Utilizing this composite measure, the following distinct “couple types,” with varying levels of engagement, were discerned: (a) “keen” couples, (b) “compliant” couples, (c) “apologetic” couples, and (d) “straggling” couples. Facilitators’ approaches to working with each type of couple and suggestions for potential therapeutic applications are discussed. The finding that couples vary in terms of engagement level, and not solely based on facilitator skill and/or involvement, supports the need to better understand the concept of engagement in order to make online interventions more effective.     

In Search of Meaning: A Preliminary Typology of Gay Male Spiritual Identity Development

Reconciliation of the conflict between religious identity and sexual orientation has been related to a number of psychological challenges (Lease, Horne, & Noffsinger‐Frazier, 2005; Schuck & Liddle, 2001), and little is known about the convergence of spiritual identity, distinctly defined as separate from religious identity, and sexual orientation identity. This qualitative inquiry investigated the process by which 7 Caucasian gay men from a variety of religious backgrounds constructed spiritual identities outside the realm of institutionalized religion. From the findings, the authors hypothesize a typology of spiritual development influenced by religions of origin. Limitations of the study, implications, and future directions in research are also addressed.     

Do You Know What I Feel? Partners' Predictions and Judgments of Each Other's Emotional Reactions to Emotion-Eliciting Situations

The goal of the present study was to investigate empathic accuracy in couples, specifically the partners' ability to predict each other's emotional reactions to social situations. For this, 36 French Canadian couples aged from 18 to 34 years predicted their own reactions as well as their partner's reactions to a series of emotional situations. They then role-played these emotional situations while being videotaped. At a later time, the taped role-play segments were rated by the role-play actors themselves, by their partners, and by 5 individuals who did not know the actors. Results revealed high levels of empathic accuracy when we compared the partners' predictions of each other's reactions. However, when these predictions were compared with the participants' self-evaluations of their role-plays or with evaluations by individuals who did not know the actors, partners showed a positive bias in that they predicted more appropriate and fewer inappropriate reactions to the social situations for their partners than were self-rated by the partners themselves or rated by individuals who did not know the actors. Finally, the existence of couple-specific private meaning systems could not be confirmed in the present context as the evaluations of emotional expressions by unknown others, the actors' partners, and the actors themselves were largely congruent.     

Couples, Existential Psychotherapy, and Myocardial Infarction: A Ten Year Evaluation Study

Existential psychotherapy with couples after the occurrence of a myocardial infarction can be a useful, effective, and productive service approach in combination with medical services and cardiac rehabilitation services. In this article the existential treatment dynamics of holding, telling, mastering, and honoring with couples after a heart attack are described and illustrated. In addition, data from a 10-year before-after field evaluation study is reported, which supports the usefulness of the treatment approach.     

Accessing the multitude within: A psychoanalytic perspective on the transformation of masculinity at mid‐life1

This paper reflects upon the essential components of male identity that commonly are reworked in middle age. The author argues that healthy masculine gender identity involves an ongoing, plastic process of destabilization and reconstruction at various pivotal developmental stages, particularly during middle adulthood. In essence, a man's mature transformation of his sense of masculinity results when finite concepts of gender identity are superseded by an awareness of the complexity of one's multiple, early and diverse gender identifications. A clinical case provides insight into how psychoanalytic treatment can contribute to a new experience of masculinity. The case illustrates how a maturing man, meeting an altered sense of identity in mid‐life, relies less on gender splitting and more on reuniting previously antithetical intrapsychic elements. Why this more pluralistic, polythreaded masculinity frequently must wait until mid‐life is further clarified. Specific importance is attached to the early development of male gender identity as it is founded on the boy's unique struggles in separating from his mother. The foundation for male gender identity formation is reconsidered as the author questions the ‘dis‐identification’ model while explicating how the boy's striving for narcissistic completion shapes the gendered masculine ego ideal. Classically termed ‘phallicism’ is understood both to facilitate and obstruct a man's adult development, while the concept of ‘genitality’ is augmented by the postclassical notion of ‘interiority’. At mid‐life, ‘phallic’ ego ideals (resting on omnipotence, desires for narcissistic completion and gender splitting) are transformed into more realistic, ‘genital’ ego ideals (synthesizing autonomy and connection). The achievement of a mature, less sharply gendered ‘masculine’ ego ideal (revitalizing the foreclosed dimensions of both the early maternal and paternal imagos) occurs as the balance of forces shifts in the direction of true genitality rather than defensive phallicism.     

Does contact with lesbians and gays lead to friendlier attitudes? a two year longitudinal study

Attitudes toward and contact with lesbian women and gay men were assessed through questionnaires in a 2‐year follow‐up study in a cohort of 511 Norwegian participants, 19 years of age at first data collection. A substantial proportion reported negative attitudes at baseline (between 39 and 63%) and two years later (between 32 and 59%), females being more positive than males. A majority reported having no contact with lesbian women or gay men either at 19 years of age (66–79%) or 2 years later (51–62%). Longitudinally, the measures were moderately stable (Pearson's r 0.43–0.73), and contact change was positively related to attitude change. Also, attitude change positively predicted contact change. The findings imply that efforts to reduce stigma associated with homosexuality are still needed among young people in Norway. Copyright © 2002 John Wiley & Sons, Ltd.     

Rational Emotive and Cognitive Behavior Therapy with Adult Male Offenders

Criminal behaviour has devastating effects upon society. Cognitive therapy, broadly defined, has been shown to be effective with offenders. REBT philosophy, in particular, appears ideally suited to treating this heterogeneous population. Although this chapter focuses on adult male offenders, the presented principles apply to most offender groups. Fundamentals and research support of empirically supported treatment are presented. Common clinical challenges are discussed, and case examples illustrate general principles.