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The American Psychological Association's (APA's) as well as other professional organizations' (e.g., American Psychiatric Association) removal of homosexuality as a mental disorder represented a paradigmatic shift in thinking about exual orientation. Since then, APA (2000) disseminated guidelines for working with lesbian, gay, and bisexual (LGB) clients, and a variety of scholars and researchers alike have advocated affirmative therapeutic interventions with LGB individuals. Despite these efforts, the controversy over treating individuals with LGB orientations using nonaffirmative techniques continues. In this discussion, the limited evidence regarding the efficacy and effects of conversion therapy is surveyed, particularly in the context of empirically supported treatment criteria summarized by Division 12 (clinical psychology) of the APA. Authors then consider the resulting ethical considerations in performing conversion therapy and propose alternative uses of affirmative therapy on the basis of ethical standards defined by APA. Finally, options for treating LGB individuals who are coming to terms with their sexual orientations are discussed. [ABSTRACT FROM AUTHOR]

Background: Hate-motivated behaviour (HMB) ranges from microaggressions to criminal acts and is a public health concern with wide-ranging consequences., Aims: The current study aimed to examine the mental health correlates of HMB perpetration, victimisation and co-occurring victimisation/perpetration., Methods: Participants ( n  = 447) completed an online cross-sectional survey assessing demographic factors, HMB (perpetration and victimisation), positive mental wellbeing and symptoms of depression and anxiety., Results: HMB victimisation was associated with lower positive mental wellbeing and increased symptoms of anxiety and depression. However, neither HMB perpetration nor co-occurring perpetration/victimisation were associated with any of the three mental health outcome measures., Conclusion: Experiencing HMB as a victim is linked to increased psychological distress. Additional research, which focuses on sampling populations who are known to be at greater risk for involvement in HMB, is needed to fully understand the impact of the victim-offender overlap on mental health outcomes.

Hate-motivated behavior (HMB) ranges from microaggressions to criminal acts and is a public health concern with consequences for the physical and mental well-being of individuals, families, and communities. The Hate-Motivated Behavior Checklist (HMBC) was developed with the goal of advancing the measurement of HMB perpetration. To provide insights into perpetration and victimization across the HMB continuum in Scotland, the present study sought to examine the factor structure of both the original HMBC and our adapted victimization version in a sample of adults currently living in Scotland. It also aimed to test associations between HMB and cognitions, which are related to self-directed violence (defeat and entrapment). Participants ( n  = 447) completed an online cross-sectional survey assessing demographic factors, HMB (perpetration and victimization), and perceptions of defeat and entrapment. Confirmatory factor analysis was used to examine the factor structure of the HMBC and the adapted victimization version of this checklist and path analyses were implemented to provide insights into potential links between HMB, defeat, and entrapment. In line with previous work, results provided support for interpreting the HMB Checklist as a single-factor total score. This was also true for the victimization version of the checklist. Results indicated that HMB victimization (but not perpetration) was associated with increased perceptions of defeat and entrapment. These findings suggest that the HMBC (for assessing both perpetration and victimization) represents potentially useful tools for HMB research and supports their applicability outside of an American context. Furthermore, by examining HMB through the lens of a contemporary model of suicidal behavior, our findings also provide insights into potential psychological mechanisms linking interpersonal and self-directed violence. Future research should implement prospective research designs and integrate measures of self-directed violence outcomes alongside HMB, defeat, and entrapment, to further advance understanding of this association., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Objective: Contemporary approaches to suicide assessment and treatment incorporate reasons for living (RFL) and reasons for dying (RFD). This study qualitatively explored individuals' self-described RFL and RFD in the context of suicidal thinking and behaviors., Method: Within a community United Kingdom (UK) sample, adults ( N  = 331, aged 16+) responded to eight open-ended questions probing their experiences of suicide, defeat, and entrapment. Utilizing these data, which were collected from a larger online survey examining risk and protective factors for suicidal behaviors, this study explored RFL and RFD within these narratives. After the research team established an initial code book, RFL and RFD codes were subsequently analyzed through inductive and deductive thematic analyses., Results: The present study identified five complimentary RFD-RFL themes: (1) Hopelessness-Hopefulness, (2) Stress of Responsibilities-Duty to Responsibilities, (3) Social Disconnection-Social Connection, (4) Death as Sin-Desire for an Afterlife, and (5) Temporary Escapes as Coping-Entrapment (i.e., a lack of escape). Three subthemes within the RFD theme Entrapment were General/Unspecified, By Feelings, and Within Self., Conclusions: Identified themes reflect the existing quantitative RFL and RFD literature. The identified RFL and RFD themes are discussed with reference to their clinical applications in advancing suicide-specific assessments and interventions. We propose a dimensional framework for RFD and RFL which informs future suicidal behaviors research and practice.

Objectives/background: Prior research identified a connection between evening chronotype and suicidality, but the mechanism underlying that connection is not well understood. The Integrated Motivational Volitional (IMV) Model of Suicide may provide a theoretical explanation for this link. The current project includes a three-time point longitudinal survey to examine whether 1) suicide intent likelihood varies across time, 2) chronotype affects suicide intent likelihood prospectively, and 3) defeat and entrapment explain the association between chronotype and suicide intent likelihood., Patients/methods: Participants (n = 187 UK adults) completed a baseline survey (demographics, chronotype (morning-eveningness; MEQ), defeat and entrapment, and perceived intent to make a future suicide attempt), and follow-up surveys (MEQ and suicide intent likelihood) 3 and 6 months later., Results: Results indicated that suicidal intent at 6-month follow-up was lower than baseline or 3-month follow-up. It was also found that strong evening chronotype at baseline is associated with increased suicidal intent 6 months later, and that defeat mediates this relationship., Conclusion: Our theoretically informed findings shed light on the psychological mechanisms linking chronotype (i.e., eveningness) and future suicide intent by highlighting the role of defeat and entrapment. We propose that feelings of defeat might be derived from evening types' experiences of social jetlag (resulting from conflict between biologically driven sleep schedules and externally dictated social schedules), which consequently drives entrapment and greater future suicide intent. Within this context, defeat and entrapment may be good transdiagnostic and modifiable target variables for future intervention development., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Improved understanding of how US service members transition from chronic/baseline to acute suicide risk is warranted. One such model, the Integrated Motivational Volitional Model of Suicide, posits entrapment as central to this process. However, entrapment has not been extensively investigated within military populations., Methods: This study examines the factor structure, reliability, and predictive validity of the Entrapment Scale (E-Scale) within a military population. Exploratory structural equation modeling (SEM) and confirmatory factor analysis compared one- versus two-factor structures of the E-Scale. Autoregressive SEM assessed if E-Scale scores predicted suicidal ideation and suicide attempt likelihood at 6- and 12-month follow-up, and examined whether the impact of entrapment was moderated by social support (i.e., appraisal, tangible, and belonging)., Results: Results favored a two-factor solution (external and internal) of entrapment. The relationship between entrapment and suicide outcomes was moderated by perceived social support but in unexpected directions. Unexpectedly, social support strengthened the relationship between external entrapment and suicide outcomes for most models. Only tangible support moderated the relationship between internal entrapment (IE) and suicide outcomes as predicted., Conclusions: IE is linked with suicidal ideation in the short-term, whereas external entrapments relationship with suicide outcomes may reflect more persistent social challenges for military members., (© 2024 The Author(s). Suicide and Life‐Threatening Behavior published by Wiley Periodicals LLC on behalf of American Association of Suicidology.)

Background: Self-directed violence (SDV) comprises both suicide and self-injury and represents a pressing problem among incarcerated persons. Negative impacts of SDV in correctional settings also extend to behavioral health clinicians (BHCs) (e.g., job turnover). Correctional SDV risk assessment and management standards include staff training as part of the comprehensive approach. The Core Competency Model for Corrections (CCM-C) is a novel, evidence-informed training program for BHCs covering both clinician self-management and clinical care skills., Methods: This pilot trial is a type 3 hybrid implementation-effectiveness approach. It will employ a wait-list control sequential cross-over design. Participants (N = 50-100) will be BHCs employed by the North Carolina Department of Adult Corrections. Following stratification for years of clinical experience, BHCs will be randomly assigned to (1) a training group that receives CCM-C immediately and (2) a wait-list control receiving CCM-C approximately 6 weeks later. Electronically administrated survey evaluation will occur across baseline and two follow-up (i.e., 2 weeks after each training session) time points., Discussion: The primary outcome is feasibility assessed through collaboration with a Corrections Advisory Panel and feedback from BHCs. Secondary effectiveness outcomes that will be evaluated over time include SDV-related knowledge, attitudes, stigma, and intent to use training content. We will examine a tertiary outcome, namely compassion fatigue. Clinical trial limitations and impacts are discussed., Trial Registration: Clinicaltrials.gov, NCT06359574. This study was registered on 04/05/2024., (© 2024. The Author(s).)

Background: Adverse childhood experiences (ACEs) are important factors for population mental and physical health. While considerable public health literature demonstrates the global relevance of ACEs, more recent research shows that benevolent childhood experiences (BCEs) might be important to consider in their direct and mitigating roles for psychological distress and other mental health outcomes. There is little evidence of latent class examinations involving both ACEs and BCEs among adults in western nations. The present study sought to replicate and extend prior literature by: (1) assessing the extent to which past latent class groupings reproduce in present samples, and (2) analyzing the association of latent classes of childhood experiences with psychological distress and suicidal thoughts and behaviours (STBs). We examined psychological distress (i.e., depression, anxiety, post-traumatic stress, general wellbeing) and STBs (i.e., suicidal ideation, self-harm ideation and behaviour, entrapment, and defeat)., Method: Data were drawn from two nationwide cross-sectional online survey studies in the United Kingdom. The first sample (N = 488) was drawn from a study on suicidal behaviour, and the second sample (N = 447) was from a study concerning risk for interpersonal violence., Results: Results largely replicated an existing four class solution of childhood experiences: Class 1 (Moderate ACEs/High BCEs; 17.6%), Class 2 (High ACEs/Moderate BCEs; 15.3%), Class 3 (Low ACEs/High BCEs; 48.3%), and Class 4 (Low ACEs/Moderate BCEs; 18.8%). Class 2 (High ACEs/Moderate BCEs) was associated with consistently worse psychological distress and STBs. Classes containing high BCEs (1 and 3) were characterized by generally lower levels of psychological distress and STBs., Conclusions: Results affirm the potential value for jointly considering ACEs and BCEs to understand psychological distress and STBs. ACEs and BCEs may serve foundational roles in theories of suicide. The protective role of BCEs hypothesized in resiliency theory may be supported. Prevention practice and research implications are discussed., (© 2024. The Author(s).)

Kink practitioners are marginalized and experience adverse health and social outcomes, which are exacerbated by consent violations. This study aims to understand experiences of reporting consent violations within a kink context. Kink practitioners ( N  = 2,888) completed a survey focused on consent violations, reporting, and recommendations, with 767 (25.56%) of them reporting consent violations in the kink context. The type of consent violation (sexual assault or kink-related behaviors), disclosure, and reporting significantly differed based on gender, sexual orientation, and injury status, but not age. Additionally, recommended steps included avoidance of police and others in positions of power and increased accountability., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: Bystander intervention (BI) is a prevention approach commonly used for interpersonal violence, but is less studied for problematic alcohol use (PAU). Domestic graduate and international students' life experiences bring a unique context for the potential application of BI to PAU., Methods and Measures: We conducted a mixed methods study that consisted of a needs assessment and focus groups at a southeastern university in the U.S. The aims of this study were to understand (1) differences in PAU BI opportunities for domestic graduate versus international students, (2) reasons for differences in PAU BI use, and (3) barriers/facilitators in use of PAU BI., Results: Overall, participants had few opportunities to use BI. Domestic graduate students had slightly more opportunities compared to international students. Most prominent reasons for lack of opportunities included not wanting to drive, the cost of drinking, and holding a graduate student identity (e.g. not interested in heavy drinking). Trusting others to be responsible for themselves was a common barrier noted for not using BI for PAU., Conclusion: PAU BI programs should contextualize experiences of domestic graduate and international students to provide appropriate skill development that considers unique barriers and facilitators to intervention use.

Entrapment and defeat are empirically-supported suicide risk factors. Their measurement is the subject of some debate, however. Also, limited work exists examining sexual and gender minority (SGM) differences in these suicide risk factors despite overall elevated rates of suicidal thoughts and behaviors (STBs) for SGM persons. The present study examined (1) entrapment and defeat differences by sexual orientation and gender identity, (2) factor structure and criterion validity of the Entrapment Scale (E-Scale) and the Defeat Scale (D-Scale), and (3) measurement invariance by sexual orientation (subsamples were too small for gender identity). A sample of 1,027 adults living in the United Kingdom completed a cross-sectional online questionnaire assessing mental health. Analysis of Variance and Kruskal-Wallis testing revealed: (1) all sexual minority (i.e., gay/lesbian, bisexual, and other SM) persons reported higher internal and external entrapment, defeat, and suicidal ideation compared to their heterosexual counterparts, and; (2) gender minority (i.e., transgender and gender diverse) persons reported higher internal and external entrapment, defeat, and suicidal ideation compared to cisgender persons. Supported by suicide theory, confirmatory factor analysis showed modest support for a two-factor E-Scale (internal and external), and a one-factor D-Scale. All entrapment and defeat scores displayed significant moderate positive correlations with suicidal ideation. E- and D-scale scores displayed high intercorrelation, tempering confidence in conclusions regarding the facture structure findings. Item threshold-level responding varied by sexual orientation for the D-Scale but not the E-Scale. Results are discussed with respect to suicide theory and measurement, public health, and clinical practice.

Self-directed violence (SDV), including both suicide and non-suicidal self-injury, represents a major challenge for carceral systems. Persistent self-injury (PSI) is an understudied SDV subtype, especially within the carceral context. The present study addressed three research questions: (a) do naturally occurring SDV subgroups occur within a carceral population (e.g., PSI versus other classes); (b) how SDV groups may be differentiated by verbal or behavioral SDV; and (c) whether demographic, mental health, and incarceration-related factors are associated with SDV subgroups. We conducted a secondary analysis of existing data from a statewide carceral electronic medical record (N = 3527). Latent class analysis supports two SDV subtypes: episodic and persistent self-injury. The PSI class was characterized by significantly greater verbal expressions and behavioral acts of SDV compared to the episodic group. Correlates of the PSI subtype included older age, male sex, prior SDV, and lower depressive symptoms. Findings are discussed with respect to the proposed Diagnostic and Statistical Manual self-injury focused disorder, influential factors on SDV in carceral settings, and recommendations for future research and practice., Competing Interests: Declaration of competing interest Authors report no conflicts., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: Suicide remains a public health problem within the United Kingdom (UK) and globally. Impulsivity is a key risk factor within the Integrated Motivational-Volitional Model (IMV) of Suicide warranting further study. The current study applied a multi-dimensional impulsivity framework (UPPS-P) to differentiate suicidality subgroups within an IMV framework (i.e., no suicidal behavior, suicidal ideation only, and suicide attempt). Impulsivity subscales were evaluated as moderators of the suicidal ideation-future suicide attempt link., Method: Adults living in the UK ( N  = 1027) completed an online survey addressing demographics, impulsivity, psychological distress, and lifetime suicidal behavior. We used analysis of variance (ANOVA) and linear regression with simple slopes analyses to investigate study objectives., Results: Data analyses revealed that: (1) four impulsivity subtypes (negative urgency, positive urgency, lack of premeditation, sensation-seeking) differentially distinguished suicidal behavior groups; (b) negative urgency, positive urgency, and lack of premeditation were meaningfully associated with suicide outcomes, and (c) negative urgency served as a moderator of the suicidal ideation-future attempt link., Conclusions: Urgency, regardless of positive or negative valence, is important for understanding differences in lifetime suicidal behavior. Sensation-seeking may play a protective role for direct suicidal behavior. Negative urgency may be the most prominent aspect of impulsivity when considered as an IMV moderator. Findings are contextualized with respect to impulsivity and IMV frameworks. Clinical implications involve accounting for negative urgency in suicide risk assessment and intervention.

The Life Attitudes Schedule-Short Form (LAS-SF) is a measure of suicide proneness featuring various conceptual models. We tested four competing LAS-SF factor structures, as well as construct validity with mental health and suicide metrics. Community dwelling adults ( N  = 488) completed an online cross-sectional survey. Results supported a four factor (i.e., death-related, health-related, injury-related, and self-related subscales) LAS-SF structure with one higher order factor. Death-related, injury-related, and self-related subscales demonstrated moderate positive associations with mental health and suicidal ideation. Death-related and self-related subscales showed links with suicidal ideation, as well as suicide and depression risk (controlling for other factors). This study is important in highlighting suicide proneness theory may need to be refined. LAS-SF uses include possible risk screening in clinical settings and future focus on the psychological death aspects of the LAS-SF in prospective research. Study limitations include lack of sample diversity and cross-sectional design.

Sexual and gender minority (SGM) individuals endure a number of health disparities, such as higher rates of violence, mental health conditions, and medical concerns. These disparities are exacerbated by the fact that SGM individuals face stigmatizing health care provider and system-related experiences. The primary purpose of this study was to quantify health service providers' SGM health competency by developing a measure, namely the Health Care Competency Assessment Form-Sexual and Gender Minority Patients (HCAF-SGM). Further, we examined correlates of SGM health competency based on leading theories of prejudice, primarily the dual process model of prejudice and social identity theory. The study comprised two phases: item development and pilot testing, followed by a primary online survey administration with several health care professionals and training organizations ( N = 155). Study findings supported a one-factor HCAF-SGM score, suggesting that health care providers view their competency regarding SGM individuals in a holistic manner, without differentiating between knowledge, attitude, and skill. The measure was found to be negatively associated with right-wing authoritarianism and positively correlated with specific social identities most salient to the topic of SGM health (i.e., health care professional and SGM). The HCAF-SGM shows promise as a reliable and valid assessment of perceived provider health care competency. Implications for SGM health-related measurement, clinical supervision, and training are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Suicide is a pressing matter for the military. Not only does it pose a health risk, but suicide also compromises operational readiness. Despite provision of suicide prevention clinical best practices, the Department of Defense suffers several challenges (e.g., clinician shortages) limiting the agency's ability to effectively respond to service member suicide. Implementation of evidence-based suicide-specific group therapy is a possible solution to service member well-being needs and system challenges. Service members can also gain coping skills useful beyond managing suicidal thoughts and behaviors., Methods: This 2-arm non-inferiority randomized controlled trial compares a group therapy format of Brief Cognitive Behavioral Therapy (i.e., G-BCBT) with Dialectical Behavior Therapy (DBT) Skills Group. Both therapies are delivered in-person at a United States Naval Medical Center. Participants (N = 136) are active-duty service members with recent suicidal thoughts or suicidal behavior. Evaluation features electronically delivered questionnaires at baseline, after each treatment session, and at 3- and 6-month follow-up., Discussion: The primary outcome concerns G-BCBT impacts on suicidal ideation. Secondary outcomes of interest are suicide attempt, psychological distress (e.g., symptoms of depression, anxiety), and self-regulatory skills (e.g., emotion regulation). We also examine self-regulatory skills as treatment moderators. Clinical trial strengths and limitations are reviewed., Trial Registration: This study was registered at Clinicaltrials.gov (protocol NCT05401838)., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Assessing resilience among alternative sexuality (alt-sex; e.g., kink, polyamory) community members is imperative as alt-sex individuals often face discrimination and possess intersecting marginalized identities. The Brief Resilience Scale (BRS) has extensive psychometric support; however, prior research indicates both a one- and two-factor (i.e., succumbing and resilience) structure. Further, the psychometric properties of the BRS have not been examined among alt-sex community members. As such, the current study examined the BRS factor structure among alt-sex individuals and measurement invariance across demographic groups (i.e., sexual orientation, gender identity, and sexual assault history). Confirmatory factor analyses and multi-groups invariance analyses were conducted. The two-factor BRS model demonstrated better fit to the data. Model fit did not differ by sexual orientation or gender identity. Measurement invariance was observed by lifetime sexual assault history, with higher factor loadings on succumbing items among alt-sex community members with a lifetime history of sexual assault. Our findings support use of the BRS to measure resilience among alt-sex individuals. Succumbing, or weakened resilience, is a salient factor for alt-sex community members who are sexual assault survivors, warranting further attention., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Objectives: The Integrated Motivational-Volitional Model (IMV) of Suicide is growing in empirical support. The present study advances IMV research through two aims: (1) to qualitatively probe the subjective experiences of defeat, internal entrapment, and external entrapment, and (2) conducting a 3-month prospective mediation analysis using quantitative and qualitative metrics of defeat and entrapment., Methods: The study featured an online two-point survey separated by 3 months. Participants were 255 adults living in the United Kingdom., Results: Persons endorsing qualitative defeat and internal entrapment in their narratives also showed higher quantitative scores on corresponding IMV and suicide-related self-report scales. Internal entrapment mediated the effect of baseline defeat on 3-month suicidal ideation, whereas external entrapment mediated the association of baseline defeat on 3-month suicide attempt likelihood. Quantitative assessment of entrapment was more significantly associated with suicide attempts and ideation within mediation tests compared to corresponding qualitative variables., Conclusions: IMV model principles are largely supported by findings. Mediation results support further consideration of entrapment and defeat within clinical practice and public health-focused suicide research. Understanding the complexity of entrapment narratives represents an important next step for conducting qualitative IMV-focused research with minoritized and high-risk suicide populations., (© 2023 American Association of Suicidology.)

Access to effective, replicable services is critical to reduce known mental health disparities for sexual and gender minority or LGBTQ+ veterans (lesbian, gay, bisexual, transgender, queer, questioning, and related identities). This paper examines the impact of a manualized 10-week health education group, called PRIDE in All Who Served on veteran patient experience, protective factors (e.g., identity acceptance), and mental health outcomes (e.g., suicide risk) at 10 Department of Veterans Affairs (VA) facilities. Implementation facilitation strategies (e.g., consultation, staff training) supported adoption at new sites and initial facilitators and barriers are described. Forty-four veterans ( M = 47.21 years old) completed outcome surveys before and after the group. Significant improvement in acceptance concerns, identity uncertainty, community involvement, and likelihood of future suicide attempts were observed; other changes in mental health symptoms were not replicated in this sample (e.g., depression, anxiety). Open-ended veteran feedback reflected improved social support and engagement and increased self-understanding as the most frequent themes. At the facility level, Healthcare Equality Index scores (a Human Rights Campaign measure of affirmative care climate) improved from 30% to 90% achieving top-performer/leader status from pre- to postimplementation. Manualized approaches, like PRIDE in All Who Served, that are based on established minority stress models and can be spread for use with diverse LGBTQ+ veterans (e.g., age, race, gender identity, sexual orientation, rurality, housing) are needed. The PRIDE in All Who Served program is an increasingly available resource to VA clinicians advocating for greater health equity within a national healthcare setting. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: The 988 telephone number was established by the National Suicide Hotline Designation Act of 2020 and implemented in July 2022 as a more accessible way to reach the National Suicide Prevention Lifeline. Current financial and training resources, however, are insufficient to ensure effective implementation., Methods: To better understand the state of the literature on crisis support lines in light of the 988 transition, the authors summarized research on suicidal and nonsuicidal outcomes of callers, research on other types of crisis support services, and the benefits of text- and chat-based crisis lines., Results: Overall, existing evidence for the effectiveness of crisis lines has been weak and has primarily focused on short-term improvements in user distress and on user satisfaction. In addition, research on crisis lines specifically targeted to marginalized populations (e.g., sexual minority groups) and on text- or chat-based crisis lines is lacking., Conclusions: The policy-focused recommendations derived from this review include the need for additional research on crisis lines, design and evaluation of culturally tailored training for volunteers and staff, and ethical oversight of private data collected from crisis services. Scaling up state-level planning and comprehensive crisis systems is necessary to successfully implement 988 and to fill current training and research gaps.

Objective: This paper advances understanding of the kink community by examining mental health and coping-self efficacy (CSE) variation by gender and sexual orientation., Design: Adult members of the National Coalition for Sexual Freedom ( N  = 332) completed an online cross-sectional health assessment., Main Outcome Measures: The assessment included the Coping Self-Efficacy (CSE) Scale; Depression and Anxiety Stress Scale-21; and Alcohol Use Disorders Identification Test., Results: Transgender and non-binary persons reported consistently low coping beliefs and poor mental health. Queer sexual minority persons reported low CSE thought stopping and high anxiety. Several CSE thought stopping moderation effects on mental health were observed., Conclusions: Findings may inform clinical implications, as bolstering coping-related beliefs and skills via cognitive-behavioral therapy may offer mental health benefit to kink practitioners.

Hate-motivated behavior (HMB) comprises a continuum ranging from microaggressions to criminal acts. The measurement of HMB is limited primarily to one or two minoritized groups in any given instrument. Current HMB research also lacks a way to assess the full range of acts and motivations for bias-based behavior. The present study fills gaps in HMB measurement by conducting a psychometric study of the Hate-Motivated Behavior Checklist (HMBC). The HMBC is a self-report instrument of HMB perpetration; the instrument also has sections capturing victim target group (e.g. race, sexual orientation, disability) and perpetrator motivation for HMB commission (e.g., perceived threat, impulsivity). We conducted an online cross-sectional survey of community-dwelling adults and college students ( N  = 463). Measures assessed demographic information, HMB, and social-political characteristics. Confirmatory factor analysis, item response theory analyses, between-groups analyses (e.g., Analysis of Variance), and descriptive statistics were used to examine HMBC properties. Primary findings included (1) poor model fit of the HMBC behaviors score; (2) good model fit with high reliability for an HMBC behaviors score adapted to binary (no/yes) scoring; (3) men reported meaningfully higher HMB scores compared to women; (4) the most common target classification for HMB was based on political affiliation; and (5) perceived intrusion was the most cited reason for committing HMB. Our findings are an important step in refining the HMBC. The instrument represents a potentially useful tool for HMB research, surveillance, and intervention evaluation. Future directions in HMBC research include application to extremist and criminal samples, replication and extension of the binary scoring to include cut-score derivation, and validation against behavioral outcomes.

The coronavirus disease (COVID-19) pandemic has substantially impacted psychological health in the U.S and has disproportionately impacted underresourced individuals. Despite the higher need for mental health services during this time, service availability and access were disrupted due to increased demand, social distancing recommendations, and stay-at-home orders. Thus, it is crucial to understand factors that predict the desire for psychological services for underresourced individuals. The present study examined factors at multiple levels of Bronfenbrenner's socioecological model (Bronfenbrenner, 1994) to determine which factors best predicted the desire for mental health services including individual, group, in-person, and online services. The sample consisted of 155 underresourced adults in North Carolina. Participants completed an online survey of mental health symptoms, coping strategies, COVID-19 related stressors, and provided demographic information including ZIP code, which was used to classify urban-central and urban-outlying dwellers. Results from univariate general linear models demonstrated that depression symptoms, venting as a coping strategy, COVID-related stress, and living in more rural regions were all significant predictors of the desire for psychological services. Venting as a predictor of the desire for services may signify a general misunderstanding regarding the purpose of psychotherapy as well as the need for individuals to gain social support and connectedness during a pandemic. This study helps to clarify individual-level and contextual factors that impact the desire for psychological services during a global pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The rate of college student mental health difficulties has been climbing, leading to overburdened college counseling centers. We propose the Holistic Prevention & Intervention Model (HPIM) as one solution in which campus and community resources work collaboratively to support students experiencing psychological distress and alleviate clinical demands. The HPIM moves from autonomous solutions to organizational-based strategies on a continuum of proactive to reactive interventions. We discuss how this model can be tailored and implemented for college campuses across the United States, including examining the resources available to the campus, the overall campus culture, and college demographics that affect risk and protective factors.

Campus mass shootings have become a pressing policy and public health matter. Twitter is a platform used for processing events among interested community members. Examining the responses of invested community members to a mass shooting on a college campus provides evidence for how this type of violence affects the immediate community and the larger public. These responses may reflect either content (e.g. context-specific) or emotions (e.g. humor). Aims Using Twitter data, we analyzed the emotional responses as well as the nature of non-affective short-term reactions, in response to the April 2019 shooting at UNC Charlotte. Methods Drawn from a pool of tweets between 4/30/19-5/7/19, we analyzed 16,749 tweets using keywords related to the mass shooting (e.g. "shooting," "gun violence," "UNC Charlotte"). A coding team manually coded the tweets using content and sentiment analyses. Results Overall, 7,148 (42.67%) tweets contained negative emotions (e.g. anger, sadness, disgust, anxiety), 5,088 (30.38%) contained positive emotions (e.g. humor, hope, appreciation), 14,892 (88.91%) were communal responses to the shooting (e.g. prayers, healing, victim remembrance), 8,329 (49.73%) were action-oriented (e.g. action taken, policy advocacy), and 15,498 (92.53%) included information (e.g. death/injury, news). All tweets except positive emotions peaked one day following the incident. Conclusions Our findings point to peaks in most emotions in the 24 hours following the event, with the exception of positive emotions which peaked one day later. Social media responses to a campus shooting suggest college preparedness for immediate deployment of supportive responses in the case of campus violence is needed., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Bowling et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: As behaviors, alternative sexual (alt-sex) (i.e., kink, bondage, discipline, dominance, submission, sadism, and masochism , consensual non-monogamy, swinging, leather, and fetish practices) practitioners often emphasize that consent and boundaries are key elements of alt-sex activities. Despite these emphases, individuals experience consent violations and sexual assault both prior to engaging and during their involvement in alt-sex activities., Purpose: This study examines alt-sex practitioners' sexual assault and nonconsensual experiences in order to highlight potential means of intervention and prevention, as well as inform clinical and legal professionals., Methods: In collaboration with the National Coalition for Sexual Freedom, this study uses an international survey of adults in alt-sex communities ( N = 2996) to examine sexual assault and nonconsensual experiences both within and outside of alt-sex contexts., Results: We found a lower rate of consent violations in the alt-sex community (26%) compared to sexual assault as an adult outside of alt-sex contexts (34%) and sexual assault as a minor (40%). We found significant differences by groups in sexual assault as a minor (gender, sexual orientation, age, and live in the US or not), sexual assault outside of alt-sex contexts (gender, sexual orientation, and age), nonconsensual experiences in alt-sex contexts (gender, sexual orientation, age, and race), receiving nonconsensual touch in alt-sex contexts (gender, sexual orientation, and age), giving nonconsensual touch in alt-sex contexts (sexual orientation, age, living in the US or not, and race), and being falsely accused of nonconsensual touching in alt-sex contexts (gender, age, and living in the US or not). Within the most recent consent violation, the most common behaviors were non-kink related, except for lack of aftercare. Nearly 40% of participants reported the reasons for their most recent consent violation in alt-sex contexts were being selfish or caught up in the moment., Implications: Focused interventions are needed to address how different populations are experiencing assault and violations in alt-sex contexts.

The COVID-19 pandemic has raised concerns regarding possible spikes in suicidal behavior in light of heightened risk factors such as social isolation and financial strain; thus, comprehensive suicide prevention training for emerging health service providers is increasingly vital. This article summarizes an interprofessional education (IPE) suicide prevention course delivered in-person in Spring 2020. Pilot data demonstrate that despite the impact of COVID-19 on higher education, this course had long-term impacts on trainee suicide prevention efficacy, IPE attitudes, and use of course content in practice. Discussion serves to address enhancements for interprofessional and suicide prevention education during and after the pandemic. Emphasis is placed on adaptable training strategies, considerations in the delivery format, guidelines for intensive virtual meetings with trainee teams, and future directions in IPE suicide prevention training research.

Suicide rates remain high among military populations. Stigmatizing beliefs about suicide contribute to the problem of heightened suicide risk as a deterrent for help-seeking. Measurement of military suicide stigma is therefore an important gap in the literature as a necessity toward the development of military suicide prevention programming. This paper assessed the factor structure, reliability, and validity of the Military Suicide Attitudes Questionnaire (MSAQ). Study 1 featured secondary analysis of a suicide risk dataset from active duty treatment-seeking military personnel (N = 200). Study 2 was a secondary analysis of a statewide assessment of Army National Guard service members' beliefs about mental health and suicide (N =1116). Factor analyses results collectively supported a four-factor Military Suicide Attitudes Questionnaire (MSAQ) structure: discomfort, unacceptability, support, and empathic views. Subscale reliabilities ranged from 0.77 to 0.83 across samples. Unacceptability and support displayed significant negative correlations with psychological distress. Men displayed more negative suicide-related beliefs compared to women counterparts. Discomfort and unacceptability beliefs displayed significant positive associations with perceived barriers to care. The final short version of the MSAQ is an efficient, multi-dimensional measure of military suicide-related beliefs. The instrument can be used for public health assessment and program evaluation in military settings., Competing Interests: Declaration of Competing Interest Authors declare no conflicts of interest., (Copyright © 2022. Published by Elsevier B.V.)

Self-directed violence (SDV), comprising both suicide and self-injury, presents a continued public health challenge for correctional institutions. In fact, correctional settings are one of four primary targets for the reduction of SDV by leading professional organizations. This article presents a public health solution to SDV in correctional settings, namely the Core Competency Model for Corrections (CCM for Corrections), an educational program for correctional mental health providers. Grounded in the general CCM of Suicide Prevention, we proffer an evidence-based sample curriculum covering 10 SDV prevention competencies in correctional settings. These competencies address both clinical care (e.g., enacting evidence-based treatment plans, using best practice documentation standards) and provider-focused (e.g., managing personal attitudes about SDV and incarcerated persons, engaging in self-care and debriefing) skills. We further espouse the underlying social-cognitive theory of CCM for Corrections toward the goal of identifying mechanisms of action for improved SDV prevention skills. Finally, we highlight considerations in the initial design and testing of CCM for Corrections. These recommendations address (a) utilization of a community-academic partnership approach and corrections SDV advisory panel, (b) selection of an in-person or online training modality, and (c) measurement of sample educational program outcomes. The CCM for Corrections represents a promising approach to SDV reduction and management in correctional settings ripe for collaborative pilot testing. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Psychological theories of suicide posit conceptually similar constructs related to the development of suicidal thinking. These constructs often evince high-magnitude interrelationships across studies. Within these theories, defeat, entrapment and hopelessness standout as conceptually and quantitatively similar. Theoretical improvements may be facilitated through clarifying the subscale and item-level similarities among these constructs. Factor analytic and phenomenological work has demonstrated equivocal evidence for a distinction between defeat and entrapment; hopelessness is not typically analyzed together with defeat and entrapment despite evidence of large-magnitude interrelationships. This study explored the interrelationships among the foregoing constructs within a sample of undergraduate students ( N = 344) from two universities within the Southeastern United States. Participants, oversampled for lifetime history of suicidal ideation and attempts, completed an online cross-sectional survey assessing defeat, entrapment, hopelessness and SI. Exploratory factor and parallel analyses demonstrated support for a one factor solution when analyzed at subscale level of the three measures as well as when all items of the three measures were analyzed together. Ad hoc exploratory structural equation modeling (ESEM) bifactor results evinced support for the existence of a single, general factor at the item level. Item level communalities and bifactor fit indices suggest that hopelessness may be somewhat distinct from defeat and entrapment. Clinical and theoretical implications are discussed in the context of study limitations.

The Hate Crime Beliefs Scale (HCBS) is an assessment of attitudes about hate crime laws, offenders, and victims. The original HCBS includes four subscales (negative beliefs, offender punishment, deterrence, and victim harm), while a shortened and modified version from the United Kingdom (UK; HCBS-UK) consists of three subscales (denial, sentencing, and compassion). We conducted a psychometric test of the HCBS in order to identify a best fitting structure with possible item reduction. A total of 463 participants completed the original HCBS, measures of social dominance orientation (SDO) and right-wing authoritarianism (RWA), and demographic questions. Factor analyses revealed good fit of the data for a Hate Crime Beliefs Scale-Short Form (HCBS-SF), largely modeled after the HCBS-UK. The three subscales were: denial (i.e., downplaying hate crime severity and low support for hate crime laws), sentencing (i.e., support for more punitive offender punishment), and compassion (i.e., understanding and concern for victims). All subscales possessed acceptable internal consistency. The denial subscale was positively associated with RWA subscale and SDO scores. The sentencing and compassion subscales were significantly negatively correlated with SDO and RWA subscale scores. Republicans held the least supportive views of hate crime laws, concern for victims, and punishment of offenders. Data underscore the importance of evaluating hate crime beliefs in public opinion and other contexts. The HCBS-SF better captures hate crime related attitudes than the previously developed longer version of the HCBS., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: The use of distance-based interventions (DBIs) to reduce suicidal ideation and behaviours are an increasingly relevant form of intervention. DBIs are more affordable, scalable and available than traditional face-to-face interventions, helping to narrow the gap between needed and provided care., Aims: To evaluate the overall effectiveness of DBIs against suicidal ideation and behaviours., Method: We systematically searched Web of Science, Scopus and PubMed for all DBIs primarily aimed at reducing suicidal ideation and behaviours. Data were analysed with a robust variance estimation corrected, multi-level meta-analysis., Results: We found 38 studies, reporting 110 outcomes. Effectiveness in reducing suicidal ideation was low (standardised mean difference -0.174, 95% CI -0.238 to -0.110). DBIs were significantly less effective against suicidal behaviours than against suicidal ideation, although still effective (standardised mean difference -0.059, 95% CI -0.087 to -0.032). Human involvement had no significant effect on effectiveness., Conclusions: Despite low effectiveness, DBIs might play a role in large-scale prevention efforts against suicidal ideation within a stepped care approach. Further, DBIs may be helpful in expanding mental health services in low- and middle-income countries with otherwise limited access to mental healthcare. Although the evidence for DBIs efficacy is well grounded, the technical and scientific evaluation of DBIs regarding their set up, functionality and components needs to be addressed in future studies.

Objective: We developed the Self-Injury Risk Assessment Protocol for Corrections (SIRAP-C) to meet legal mandates for self-directed violence (SDV) risk assessment standards in correctional settings. We focused on two empirical aims: (1) factor structure and internal consistency and (2) subscale associations with SDV and intervention recommendation outcomes., Hypotheses: We expected a multifactorial SIRAP-C structure with acceptable internal consistency. We further expected SIRAP-C subscales would distinguish history of SDV events while incarcerated, current SDV event category, and treatment recommendation., Method: We drew electronic health record data for adult incarcerated persons ( N = 3,929) from state Division of Prisons records from 2016 to 2020. Clinical records included demographic and correctional institutional information, as well as SIRAP-C records. Factor analyses assessed Aim 1. Regression models tested Aim 2., Results: Factor analyses supported a seven-factor SIRAP-C structure (27 items) comprising Depressive Symptoms, Reasons for Living, History of Self-Directed Violence, Current Suicidal Thinking, Family History of Self-Directed Violence, Coping Skills, and Social Connectedness. Subscales displayed acceptable internal consistency, with the exception of social connectedness in the confirmatory factor analysis subsample. Lower depressive symptoms and coping skills, as well as higher history of SDV, were associated with increased risk for a prior SDV assessment event while incarcerated. Lower depressive symptoms, current suicidal thinking, and coping skills and higher history of SDV marked worse risk for self-injurious behavior. Higher depressive symptoms and current suicidal thinking, as well as lower reasons for living, demarcated suicidal acts from self-injury. Higher history of SDV and lower coping skills indicated outpatient/residential treatment. Elevated depressive symptoms and history of SDV, as well as lower reasons for living and coping skills, were associated with inpatient hospitalization., Conclusions: The SIRAP-C represents a promising clinical approach advancing correctional SDV risk assessment. We offer future research, policy, and implementation recommendations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: Suicidal behavior remains a pressing problem in the United Kingdom. Continued theory development is a critical step toward designing effective prevention., Aims: The present study tested a novel element to suicide theory, the Desire for Control, for its direct and moderating roles within the Integrated Motivational-Volitional (IMV) Model of Suicidal Behavior., Method: An online-administered cross-sectional suicide risk survey study ( n  = 116) was conducted among adults living in the United Kingdom., Results: Mean suicidal ideation scores were in the non-clinical range. DOC Leadership and Destiny Control were associated with good mental health. DOC Decision Avoidance was associated with poor mental health. DOC Decision Avoidance also acted as a motivational moderator in which the entrapment-suicidal thinking link was worse among those high in decisional avoidance., Conclusion: DOC represents a novel, valuable addition to suicide theory and may inform suicide-specific psychotherapeutic intervention. Additional research is needed to full understand the role of DOC and its factor structures in the IMV.

The COVID-19 pandemic has forced couples to navigate illness-related stressors and unique public health responses, including extended lockdowns. This study focused on under-resourced North Carolina residents ( n = 107) who self-reported changes in relationship conflict (Increased, Decreased, Stayed the Same) and intimate partner violence (IPV) during the pandemic. We expected high rates of increased conflict and IPV since the start of the pandemic. We then sought to determine the associations between dyadic changes in conflict and reports of IPV and pandemic-related experiences and responses. Participants completed a brief online survey assessing their demographics, COVID-19 exposure/stressors, and pandemic responses. As expected, reports of increased couple conflict were related to difficulties getting needed social support, loss of health insurance, more fear and worry, stress, pain, and greater use of alcohol and/or illicit drugs, related to the coronavirus. Participants reporting increased conflict were also more likely to be unemployed. Conversely, reports of decreased conflict were associated with being ill from the virus (48.9%), having health insurance, and working part time. Substantial amounts of IPV were reported (62.2% of the sample); however, increased conflict and IPV were unrelated. Those reporting No IPV were less likely to be receiving public assistance but more likely to have home responsibilities due to the virus. They also reported increased social interactions and less use of alcohol than those reporting IPV perpetration. Findings highlight key associations among pandemic experiences and responses, IPV, and couple functioning in an under-resourced sample. Efforts to facilitate coping, resilience, and tolerating uncertainty may facilitate cooperative and safe couple functioning throughout the pandemic.

Human immunodeficiency virus (HIV) continues to disproportionately affect gay, bisexual, and other men who have sex with men (GBM) and transgender and nonbinary (trans/NB) individuals. This study investigated attitudes toward participation in HIV survey research, guided by Emanuel's framework for ethical clinical research (e.g., risk-benefit ratio, fair participant selection, respect for participants, social value, and collaborative partnership). GBM ( n  = 294) and trans/NB ( n  = 86) persons recruited at a Pride event in Milwaukee completed a survey assessing risks and benefits of participation in, and comfort responding to, sexual health surveys. Participants reported few ethical concerns (e.g., privacy and confidentiality), with notable differences by race, sexual orientation and gender identity, and prior research experiences. Implications for HIV research with GBM and trans/NB individuals are discussed.

Introduction: Suicide and substance use are prevalent problems among persons discharged from facilities. This study (1) articulated rates of substance-related suicide deaths among those discharged correctional, behavioral health, and healthcare facilities, and (2) identified factors associated with substance-related suicide deaths unique to, or generalizing across, facility discharge., Methods: We used data from the National Violent Death Reporting System. Suicide deaths (N = 105,968) were aggregated from 2003 to 2017. Chi-square and independent samples t-tests were used to examine associations between drug/alcohol-related deaths and each correlate. Logistic regression was employed to identify the most robust substance-related suicide death-related factors., Results: Suicide deaths were commonly marked as being substance-related: 69% from correctional institutions, 54% from behavioral health facilities, 45% from those not released from a facility, and 39% from healthcare facilities. Regression models indicated housing interruptions and interpersonal stressors increased odds of the suicide death being marked as substance-related across discharge categories. Each discharge category also had unique predictors, underscoring the need for tailored prevention., Conclusions: Substance-related suicide deaths are particularly common among adults discharged from correctional and behavioral health facilities. Findings are discussed with respect to community-focused, discharge planning, and clinical care suicide prevention strategies., (© 2021 The American Association of Suicidology.)

Objective: The integrated motivational-volitional model of suicide proposes that feelings of entrapment play a key role in the development of suicidal ideation. The model also posits a set of motivational moderators which either facilitate or hinder the development of suicidal thinking when entrapment is present. These motivational moderators include factors such as attitudes, future goals, thwarted belongingness, and social support. Two previously studied protective factors against suicide, reasons for living and life meaning, have received support in suicidology and might serve as motivational moderators in this model., Methods: The current cross-sectional study included college students (N=195) oversampled for recent suicidal ideation who took a series of self-report questionnaires online., Results: Our findings demonstrated that both reasons for living and life meaning are protective against the relation between entrapment and suicidal ideation, especially when presence of life meaning and reasons for living of high. Search for life meaning was found demonstrated a less protective relation with SI severity, particularly when reasons for living were low., Conclusion: Both motivational moderators demonstrated protective relationships with suicidal ideation and may be relevant to suicide prevention strategies. Limitations and future directions are discussed., (© 2021 The American Association of Suicidology.)

This study focuses on identifying COVID-19 related exposure, stress, and mental health concerns in the larger Charlotte, North Carolina region, an area with many low-income and under resourced communities. A community-academic partnership conducted a regional COVID-19 needs assessment. Low-income adults ( N = 156) completed an online-administered survey of demographic information, COVID-19 exposure, stress, coping-related factors, and mental health. Frequency data showed that common COVID-19 related stressors included job exposure, lost job/income, and increased home responsibilities. Frequency data further showed elevated screening risk rates for mental health concerns were observed for post-traumatic stress (83.3%), depression (52.2%), problematic drinking (50.0%), generalized anxiety (43.0%), and suicide (40.4%). Bivariate correlation and multivariate regression models identified robust mental health risk factors including COVID-19 related stress affecting close persons, fear/worry reaction to the pandemic, and use of venting as a coping strategy; protective factors included active coping and problem-focused coping beliefs. Findings are discussed with respect to informing regional public health efforts during the pandemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Kaniuka, Cramer, Wilsey, Langhinrichsen-Rohling, Mennicke, Patton, Zarwell, McLean, Harris, Sullivan and Gray.)

The present study examined Preferences in Information Processing (PIP), an emerging model of understanding suicidal thoughts and behaviors (STBs), in a clinical military sample for the first time. Constructs of need for affect (NFA; i.e., extent to which one engages or avoids emotional content) and need for cognition (NFC; i.e., extent of preference for and enjoyment of cognitive effort) are central individual differences of the PIP model hypothesized to be associated with STBs. Data ( n  = 200 active duty personnel) were drawn from medical records and self-report questionnaires from two outpatient treatment settings in a military hospital. Primary findings include: (1) moderate positive bivariate associations of NFA avoidance with mental health symptoms and lifetime STBs; (2) consistent patterns in which NFA approach buffers the negative associations of depression with life STBs, clinical suicide risk, perceived burdensomeness and thwarted belonging. Recommendations are offered for military suicide prevention, and future suicide theory testing.

Purpose: Suicidal thoughts and behaviors (STBs) remain a pressing public health problem for transgender and gender diverse (TGD) persons. The goal of this study was to apply social-ecological and minority stress frameworks to identify individual and interpersonal-level TGD-specific STB risk and protective factors., Methods: This is a secondary analysis of the 2015 United States Transgender Health Survey, a comprehensive cross-sectional health assessment of a national sample of TGD adults (N = 27,658). Chi-square and Analysis of Variance (ANOVA) were used to identify bivariate correlates of 12-month and lifetime suicidal ideation (SI) and suicide attempt (SA). Logistic regression was employed to identify the strongest STB risk and protective factors across levels., Results: Sexual minority identification, racial minority identification, and having a disability were lifetime STB risk factors. TGD identity, sexual minority identification, racial minority identification (SA only), lower education, lower income, military experience, having a disability, and being uninsured were 12-month STB risk factors. Psychological distress was the most robust STB risk factor. Workplace discrimination, family rejection, healthcare discrimination, and childhood bias-based victimization were lifetime STB risk factors. All forms of discrimination and victimization (with the exception of family rejection for SI) were 12-month STB risk factors. Family and coworker support were protective factors for lifetime SA (but not SI) and all 12-month STBs. Being less out about TGD identity was a protective factor for STBs (except for 12-month SI)., Conclusion: Findings support social-ecological and minority stress STB risk frameworks. Recommendations are provided for a comprehensive approach to TGD suicide prevention., (© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)

Suicide-related behavior (SRB) is a growing mental health concern on college campuses. We argue that causes of this rising trend go beyond student stress, to include outdated campus policies, overburdened counseling center staffing, and untapped targets for prevention efforts. We outline the social-ecological model applied to suicide and related public health problems. Such a viewpoint provides an example road map to redress suicide and related risk factors (e.g., violence, substance abuse) through multiple levels of prevention-focused programing. Using our SAMHSA-funded campus suicide prevention programmatic approach as a case illustration, we proffer lessons and guidelines for the implementation of a social-ecological suicide prevention program (SESPP). Emphasis is placed on review of evidence-informed prevention programs, utilization of interdisciplinary prevention teams, need for rigorous program evaluation, and consideration of the unique demography of each campus.

Sexual and gender minority (SGM) military veterans have endured a history of discriminatory policies and hetero- and cis-sexist-related military culture that can negatively impact identity and mental health. The present pilot evaluation examined measure characteristics of the Lesbian, Gay, and Bisexual Identity Scale (LGBIS) and lesbian, gay, and bisexual positive identity measure (LGB-PIM) in a clinical sample of SGM military veterans in order to assess the potential use of these instruments in understanding identity and mental health in the context of program implementation. A cross-sectional pilot survey of 83 SGM veterans was conducted in 10 veterans affairs sites. Self-report data were collected as part of a quality improvement project across 2018 and 2019. Results showed that the sample was characterized by low internalized prejudice and identity uncertainty, as well as generally high positive aspects of identity (e.g., identity affirmation, authenticity, social justice beliefs). LGB-PIM subscale internal consistency values were acceptable (α range = .89-.92), whereas LGBIS subscale values varied (α range = .51-.87). Acceptance concerns, identity uncertainty, and social justice beliefs distinguished mental health symptom severity levels. Higher identity uncertainty and social justice beliefs were associated with worse symptoms of depression, anxiety, and suicide risk. Preliminary results support further application and study of the LGB-PIM and some LGBIS subscales as possible tools in program development and improvement within military veteran samples. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

US military Veterans are at greater risk for suicide than those who have never served in the US military. Recent federal calls include the need to investigate military-specific suicide risk and protective factors among military-affiliated populations. To date, no study has examined the link between military identity, self-stigma, and suicide risk. The current study used a nationally representative sample of post-Vietnam US military Veterans (N = 1,461) in order to determine relationships between military identity, self-stigma, and suicide risk. Idealism (OR = 0.86) with less odds of elevated suicide risk, whereas individualism (OR = 1.15) and military self-stigma (OR = 1.39) were associated with increased odds of elevated suicide risk. Military self-stigma was found to mediate the relationship between military identity components and suicide risk. Implications for conceptualization of military Veteran identity, suicide prevention, and future research are discussed., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2021 Society for Military Psychology, Division 19 of the American Psychological Association.)

Background: Social capital, the potential for individuals to access resources through group memberships, is linked to a constellation of health outcomes. We modified a previously evaluated Constructed Family Social Capital Scale for gay, bisexual and other men who have sex with men who belong to constructed families to create a new measure of social capital within sexual minority men and gender minority individuals' social networks., Methods: Participants were recruited from a Pride festival in Milwaukee, Wisconsin in 2018 to complete a cross-sectional survey. This analysis is restricted to 383 participants who identified as sexual minority men or gender minority individuals and completed nine items measuring social capital within their social networks. We conducted exploratory and confirmatory factor analyses to assess factor structure. Internal consistency was measured using Cronbach's alpha., Results: Reliability was high, indicating the scale's utility to assess Network Social Capital among sexual minority men and gender minority individuals. A single-factor solution with high factor loadings was found for the nine-item scale., Conclusions: This study extended the psychometric properties of a preliminary social capital instrument modified from a prior study in a different population and context. The modified measure has implications for use among sexual minority men and gender minority individuals to measure social capital within social networks. Previous studies suggest that interventions to enhance social capital among sexual minority men and gender minority individuals may be beneficial for HIV prevention interventions. This tool may be relevant for the evaluation of social capital interventions within networks of sexual minority men and gender minority individuals., (© 2021. The Author(s).)

Objective/background: A clear link between insomnia concerns and suicidal ideation has been shown in a variety of populations. These investigations failed to use a theoretical lens in understanding this relationship. Research within the veteran population has demonstrated that feelings of thwarted belongingness (TB), but not perceived burdensomeness (PB), mediate the insomnia and suicidal ideation relationship. Using two high risk samples, the present investigation replicated and extended this line of inquiry to include interpersonal hopelessness about TB, a key component of the Interpersonal Psychological Theory of Suicide., Methods/results/conclusions: Using medical record review and survey data, study 1 replicated the finding that TB is a stronger explanatory factor of the insomnia to suicidal ideation/suicide risk relationship in a sample of N = 200 treatment-seeking active-duty personnel. Study 2 found that insomnia symptoms had an indirect effect on suicidal ideation through TB and PB but not interpersonal hopelessness in a sample of N = 151 college students with a history of suicidal thoughts and/or behaviors. TB was the only mediator of the insomnia-suicide attempt likelihood link and insomnia to clinically significant suicide risk screening status. Limitations include cross-sectional design of both studies and the lack of formal diagnoses of insomnia. Implications and future research directions are discussed., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Suicide remains a pressing problem among active-duty military personnel. Recent Department of Veterans Affairs and Department of Defense suicide prevention practice guidelines highlight the need for further screening research. The present study assessed the psychometric properties of 2 common self-report suicide screening tools: the Suicidal Behaviors Questionnaire-Revised (SBQ-R) and the Columbia Suicide Severity Rating Scale (C-SSRS) ideation subscale. Data ( n = 200 active-duty personnel) were drawn from medical records and self-report questionnaires from 2 outpatient treatment settings in a military hospital. Primary findings include: (a) confirmatory factor analytic support for the SBQ-R but not the self-report version of the C-SSRS ideation severity subscale; and (b) acceptable reliability for both the SBQ-R and C-SSRS ideation severity subscale. Recommendations are offered for military suicide screening practice and research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).