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Critical scholarship has illustrated how COVID-19 public health policies can enact racism, classism, and cis-heteronormativity, perpetuating harms among vulnerable communities. We sought to examine the accounts of gay, bisexual, and queer men (GBQM) in Canada on how normative ideologies played out in COVID-19 directives and what impacts these orders had on their lives. Two rounds of semi-structured interviews with GBQM in Montreal (n = 30), Toronto (n = 33), and Vancouver (n = 30) were conducted between November 2020-February 2021 and June-October 2021 (N = 93). Our reflexive thematic analysis drew on the frameworks of cis-heteronormativity and intersectionality to examine how normative assumptions about kinship, sociality, and privilege in COVID-19 public health directives were understood and experienced by GBQM. Our participants explicated how cis-heteronormativity was pervasive in COVID-19 public health messaging, noting that stay-at-home orders and limits on social gatherings reinforced heterosexual forms of kinship. The privileging of cis-heteronormative sociality had detrimental effects on the sense of belonging and identity formation of many participants due to restricted access to queer spaces during the pandemic. Others indicated that stay-at-home orders failed to account for the heterogeneity of queer people's experiences of homelessness and structural racism. These findings provide valuable insights into how public health efforts to control COVID-19 infections have overlooked the complex forms of kinship among GBQM, the importance of queer spaces and community organizations, and the varying vulnerabilities of diverse lesbian, gay, bisexual, trans, and queer (LGBTQ+) groups. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop an expertise-based prognostic model for the treatment of complex posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). We developed a survey in 2 rounds: In the first round we surveyed 42 experienced therapists (22 DID and 20 complex PTSD therapists), and in the second round we surveyed a subset of 22 of the 42 therapists (13 DID and 9 complex PTSD therapists). First, we drew on therapists' knowledge of prognostic factors for stabilization-oriented treatment of complex PTSD and DID. Second, therapists prioritized a list of prognostic factors by estimating the size of each variable's prognostic effect; we clustered these factors according to content and named the clusters. Next, concept mapping methodology and statistical analyses (including principal components analyses) were used to transform individual judgments into weighted group judgments for clusters of items. A prognostic model, based on consensually determined estimates of effect sizes, of 8 clusters containing 51 factors for both complex PTSD and DID was formed. It includes the clusters lack of motivation, lack of healthy relationships, lack of healthy therapeutic relationships, lack of other internal and external resources, serious Axis I comorbidity, serious Axis II comorbidity, poor attachment, and self-destruction. In addition, a set of 5 DID-specific items was constructed. The model is supportive of the current phase-oriented treatment model, emphasizing the strengthening of the therapeutic relationship and the patient's resources in the initial stabilization phase. Further research is needed to test the model's statistical and clinical validity. [ABSTRACT FROM AUTHOR]