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Sexual minorities experience higher levels of stress than heterosexuals, which in turn affects coping and psychological quality of life (PQOL). Although many sexual minorities remain mentally healthy, a higher prevalence of mental disorders among members of the lesbian, gay and bisexual (LGB) communities exists; thus, LGB PQOL becomes an important area to examine. Several key factors are related to PQOL: shame due to heterosexism, self-esteem and perceived stress. Using minority stress model, I hypothesized that shame due to heterosexism and perceived stress are negatively correlated with PQOL, while self-esteem is positively correlated with PQOL. I hypothesized that collectively shame due to heterosexism, self-esteem and perceived stress account for a significant proportion of the variance in PQOL, that self-esteem moderates the relationship between perceived stress and PQOL and that age moderates the relationship between shame due to heterosexism and PQOL. I calculated Pearson product-moment correlation coefficient and found shame due to heterosexism was negatively correlated with PQOL (r(146) = -.21, p = .009), perceived stress was negatively correlated with PQOL (r (146) = -.69, p < .001) and self-esteem was positively correlated with PQOL (r(146) = .72, p < .001). I conducted a regression analysis and found our model accounted for 59% of the variance in PQOL (adj. R2 = .59, F(3, 144) = 68.88, p < .001). Self-esteem did moderate the relationship between perceived stress and PQOL (p = .029), but age did not moderate the relationship between shame due to heterosexism and PQOL. Results suggest perceived stress and self-esteem play key roles in sexual minorities’ PQOL. Implications are discussed.

Despite legal and policy advancements in South Africa, prejudice, discrimination and victimisation are still a reality for many lesbian, gay and bisexual (LGB) people in the country. The Psychological Society of South Africa (PsySSA) has embarked on a process to develop lesbian, gay, bisexual, transgender and intersex (LGBTI) affirmative practice guidelines for psychology professionals, when working with these client populations. As a part of the larger objective, this research study highlights LGB people’s experiences of psychotherapy and counselling in South Africa as possible inputs for the mentioned practice guidelines. Qualitative in-depth interviews were conducted with selected participants. The results indicate that some aspects of LGB people’s experiences are similar to those of anyone in psychotherapy or counselling, but also that there are distinct differences. Negative experiences were almost exclusively due to the counsellor being disaffirming of the client's sexual orientation. Self-acceptance and the development of alternative perspectives of sexuality were more prominent outcomes of counselling compared to studies among broader populations. The participants’ feedback on a list of affirmative statements provides a potential basis for future affirmative practice guidelines. / Psychology / M. A. (Clinical Psychology)

Despite growing evidence of their prevalence, clinical and subclinical disordered eating behaviors among men continue to be understudied phenomena. When compared to females, predictors of male disordered eating vary across ethnic groups, suggesting cultural influences on disordered eating. Moreover, gay and bisexual men experience pronounced levels of body dissatisfaction, sensitivity to societal body image standards, and subsequent disordered eating when compared to straight men and gay women. This study investigated possible differences in prediction of disordered eating among intersections of male ethnicity and sexuality. We approached this question through a transtheoretical lens that integrated intersectionality and minority stress theories. Archival data from a sample of African American, Latino, and White college men were analyzed using hierarchical multiple regression. Predictors of emotional and binge eating behaviors differed across ethnicity, in that body dissatisfaction and media internalization for African American and Latino males exhibit the strongest unique associations with emotional and binge eating behaviors, while the strongest unique predictors of emotional and binge eating behaviors among White males are depressive symptoms and low self-esteem. Moreover, African American sexual identity and depressive symptoms interact, as gay or bisexual men report stronger unique associations between depression symptoms and emotional and binge eating. All predictors (i.e., body dissatisfaction, depression symptoms, low self-esteem, media internalization, and sexual minority identity) were unable to explain sufficient variance in over exercise behaviors in African American men. Results suggest ethnicity and sexual orientation are meaningful to the experience of disordered eating in men, and that underlying mechanisms may exhibit differing associative patterns across ethnic identity. Clinicians working with ethnically and sexually diverse male disordered eating populations may use the results to better inform treatment interventions and conceptualization. These findings also support the value of intersectional quantitative methodology and the limits of relying on single-axis identity as a predictive element.

Despite legal and policy advancements in South Africa, prejudice, discrimination and victimisation are still a reality for many lesbian, gay and bisexual (LGB) people in the country. The Psychological Society of South Africa (PsySSA) has embarked on a process to develop lesbian, gay, bisexual, transgender and intersex (LGBTI) affirmative practice guidelines for psychology professionals, when working with these client populations. As a part of the larger objective, this research study highlights LGB people’s experiences of psychotherapy and counselling in South Africa as possible inputs for the mentioned practice guidelines. Qualitative in-depth interviews were conducted with selected participants. The results indicate that some aspects of LGB people’s experiences are similar to those of anyone in psychotherapy or counselling, but also that there are distinct differences. Negative experiences were almost exclusively due to the counsellor being disaffirming of the client's sexual orientation. Self-acceptance and the development of alternative perspectives of sexuality were more prominent outcomes of counselling compared to studies among broader populations. The participants’ feedback on a list of affirmative statements provides a potential basis for future affirmative practice guidelines. / Psychology / M. A. (Clinical Psychology)

Elevated social anxiety (SA) is linked to issues with emotional distress, substance use, and social anxiety disorder (SAD). Notwithstanding concerns of how sexuality has been defined in the extant literature, emerging evidence suggests that the prevalence of SA and related challenges may be disproportionately present among sexual minorities, including lesbians, gay men, and bisexuals (LGBs). This trend may be especially relevant within the developmental context of emerging adulthood, an important period for development of sexual identity, and a time when individuals are already predisposed to heightened feelings of SA. The present study examined the relationship between sexual orientation (measured using sexual identity, sexual attraction, and past romantic and sexual behavior) and social anxiety (related to social interaction and social performance) among emerging adults. minority sexual identities [Welch's F(5,48.08) = 5.56, p = .002, ηp2 = .02.], same-sex attraction [Welch's F(4,108.06) = 11.27, p < .001, ηp2 = .04], and same-sex romantic [Welch's F(5,85.91) = 6.88, p < .001, ηp2 = .03] and sexual experiences[F(5,61.95) = 8.88, p < .001, ηp2 = .04], particularly among those who indicated attraction to multiple sexes. Findings support research that indicates that sexual minority adults experience higher levels of SA than majority (i.e., heterosexual, opposite-sex oriented) adults, and that assessment of sexuality may reflect number of sexual minorities identified. Future directions including intersections of race/ethnicity and gender are discussed.

Introduction. HIV positive men who have sex with men (HIVMSM), facing severe stigma and many stressors, have high prevalence of mental health problems, such as depression. However, there is a lack of mental health promotion and treatment services targeting HIVMSM in China. The Three Good Things (TGT) exercise is one of the commonly used positive psychology interventions; its benefits in reducing depression have been scientifically proven in many disease groups. Yet, TGT has not been applied among HIVMSM. In addition, social support has shown to be protective of depression. The emergence of electronic social media allows for integration of social networking and TGT exercise among HIVMSM. / Objectives. This study aimed to evaluate the efficacy of a one-month online intervention combining TGT with social networking (TGT-SN) versus a control of dissemination of information in reducing depressive symptoms among HIVMSM in Chengdu, China. / Methods. A randomized controlled trial design was applied. A total of 205 HIVMSM were recruited and randomly assigned to the TGT-SN (N=100) or control group (N=105) by four well-trained peer fieldworkers. Self-administered surveys were given to all participants at baseline, at the end of the 1-month intervention (T1), and at the 3-month (T2) and 6-month (T3) post-intervention follow-ups. The intervention was delivered via “QQ”, the most widely used Chinese social networking service. Participants in TGT-SN group were divided into four “QQ” groups, each the size of 20-30 persons. Participants in TGT-SN were asked to post three things they experienced that they feel grateful about daily onto the QQ platform and share them with members of their group. They were also asked to read others’ messages and give positive and encouraging feedbacks to those messages. Members of the control group received information about mental health promotion from research assistants via QQ once a week during the one-month intervention period. The primary mental health outcome was probable case of mild to severe depression measured by Center for Epidemiologic Studies Depression Scale (CES-D). Secondary psychological outcomes include depressive symptoms, anxiety, positive and negative affect, life satisfaction, subjective happiness, gratitude level, and perceived social support. Generalized Estimating Equation models were fit. Structural equation modeling was applied for mediation analysis. / Results. Among all participants, the prevalence of probable mild, moderate, and severe depression were, respectively, 14.6%, 9.3%, and 35.6% at baseline. All baseline background characteristics and outcome measures were balanced (statistically non-significant) between the two groups. Based on data obtained at T1, T2 and T3 that were analyzed by GEE model, there was a significant main effect of TGT-SN on reducing depression (B=-2.35, 95% CI=-4.53, -0.16, p=0.035), indicating significantly lower depression score in the intervention group as compared with that of control group. Nonetheless, such significant effect became non-significant (B=-1.67, 95% CI=-3.79, 0.46, p=0.124) when controlled for baseline depression score. Significant differences were also found between the TGT-SN and the control group in anxiety symptoms (B=-1.14, 95% CI=-2.06, -0.22, p=0.016) and negative affect (B=-2.08, 95% CI=-3.62, -0.55, p=0.008). The effect of TGT-SN on reducing depression was most evident at T3. Structural equation modeling indicated that gratitude and negative affect fully mediated the effect of TGT-SN in reduction of depression and anxiety (mediation effect=-0.17, 95% CI=-0.30, -0.04, p<0.05) at T3. / Conclusions. TGT-SN is a feasible, acceptable, sustainable, and scalable intervention to improve mental health among HIVMSM. It is warranted to increase awareness and policy support for mental health services for people living with HIV (PLWH). Mental health services should be integrated into the HIV/AIDS care system as a key component. Future translational studies are needed to further investigate the efficacy and effectiveness of the intervention in other groups of PLWH and in other cultures and countries. / 研究背景：艾滋病在男男性接觸（men who have sex with men, MSM）人群中的感染率正在以前所未有的速度在我國蔓延。艾滋病陽性的男男性接觸（HIV positive men who have sex with men, HIVMSM）人群面臨極大的壓力，心理疾病（例如抑鬱症）的患病率很高。但是，目前我國對HIVMSM人群的心理健康服務比較缺乏。“三件好事情”是最被廣泛使用的能有效降低抑鬱症的積極心理學干預。這項練習要求參與者每天寫下三件令他們感到高興或者感激的事情。“三件好事情”這兩練習還沒有在HIVMSM 人群中應用。此外，社會支持對抑鬱症有保護作用。電子社交網絡是一種潛在的有效的平台，可以將調查對象（HIVMSM）的“好事情”相互傳遞，加強“三件好事情”的效果。 / 研究目的：本研究的目的是在中國成都市使用隨機對照研究評估積極心理學結合社會網絡干預對減少HIVMSM人群抑鬱症的效果。 / 研究方法：本研究採用隨機對照試驗。四名同伴調查員共招募205位HIVMSM，其中100人被隨機分配到“三件好事情結合電子社交網絡組（TGT-SN）”，105人被分配到對照組。所有參與本研究的調查對象將在隨機分組之前完成基線調查（T0），並在一個月的干預結束時（T1）、干預結束后三個月（T2）、十二個月（T3）時完成隨訪調查。 / TGT-SN干預通過騰訊QQ實施。騰訊QQ是在中國最被普遍使用的社交網絡。TGT-SN組的調查對象將被分配到4個QQ組，每組20-30人。TGT-SN干預要求調查對象在一個月的干預期，每天需要完成以下三個任務：i）每天回想當天發生的三件或以上令自己開心、感激的事情，并將這三件好事情發佈到各自的QQ群留言板；ii）每天閱讀本QQ群其他組員發佈的三件好事情；iii）每天對組員發佈的三件好事情進行正面的積極的評論。被隨機分配到對照組的調查對象在一個月的干預期內，每週收到一條有關心理健康促進的信息。 / 本研究的主要結果為抑鬱症狀，採用美國國立衛生研究院流行病學研究中心抑鬱量表。次級結果包括焦慮症狀、正性和負性情緒、生活滿意度、主觀幸福感、感恩心理、以及社會支持。分析採用廣義估計方程模型（GEE）。中介效應分析採用結構方程模型。 / 研究結果：所有調查對象中，59.5%有輕度到重度抑鬱症（CESD≥16）。TGT-SN和對照組基線所有的背景變量及結果變量均無顯著性差異。基於對T1、T2和T3數據的GEE模型分析，相比于對照組，TGT-SN對降低抑鬱症有顯著主效應（B=-2.35, 95% CI=-4.53, -0.16; p=0.035）。但是此顯著主效應在控制基線抑鬱症狀后變為不顯著（B=-1.67, 95% CI=-3.79, 0.46, p=0.124）。相比于對照組，TGT-SN對降低焦慮症狀（B=-1.29, 95% CI=-2.22, -0.36; p=0.007）和負性情緒（B=-2.24, 95% CI=-3.73, -0.74; p=0.003）也有顯著效果。TGT-SN對降低抑鬱症的效果在T3最為顯著。結構方程模型表明，負性情緒和感恩心理對TGT-SN干預降低T3時抑鬱症和焦慮症的效果中發揮完全中介效應（中介效應=-0.17, 95%置信區間=-0.30, -0.04; p<0.05）。 / 研究結論：TGT-SN能有效減少HIVMSM人群的心理健康問題（例如抑鬱症和焦慮症），並且是可行的和被HIVMSM所接受的干預措施。TGT-SN練習的實施成本較低並且不需要心理學專家的參與，因此可以在資源有限的國家和地區（例如中國）推廣實施。未來需要更多的研究來評估TGT-SN干預在其他艾滋病病毒感染者人群中以及其它國家的效力和效果。" / Li, Jinghua. / Thesis Ph.D. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 136-149). / Abstracts also in Chinese; some appendixes in Chinese. / Title from PDF title page (viewed on 06, October, 2016). / Li, Jinghua. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.