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Many individuals with anxiety disorders use alcohol or cannabis for temporary relief of worry, sleeplessness, tension, and other typical anxiety symptoms. For some, this coping response can lead to worsening [...]

Our nation is facing a mental health crisis. This crisis is magnified for perinatal individuals who are pregnant or up to 1 year postpartum. Perinatal mood and anxiety disorders (PMADs) [...]

An important concept in managing clozapine's clinical issues and adverse effects is that not all approaches possess the highest levels of evidence from randomized clinical trials (RCTs), leaving clinicians to [...]

I began my career when the major treatments for schizophrenia were haloperidol and chlorpromazine. Since then, treatments for schizophrenia have improved slowly and incrementally, especially when looking back in the [...]

Physician-assisted suicide (PAS)-commonly but misleadingly called 'medical aid in dying' (1)--is now legal in 11 jurisdictions in the US. PAS remains an area of great controversy among physicians, medical ethicists, [...]

In Canada, cannabis was legalized for medical purposes in 2001 and for nonmedical use in 2018, with edibles, concentrates, and topicals following in 2019 under the Canadian Cannabis Act (Bill [...]

Background: Critical adolescent neural refinement is controlled by the DCC (deleted in colorectal cancer) protein, a receptor for the netrin-1 guidance cue. We sought to describe the effects of reduced DCC on neuroanatomy in the adolescent and adult mouse brain. Methods: We examined neuronal connectivity, structural covariance, and molecular processes in a DCC-haploinsufficient mouse model, compared with wild-type mice, using new, custom analytical tools designed to leverage publicly available databases from the Allen Institute. Results: We included 11 DCC-haploinsufficient mice and 16 wild-type littermates. Neuroanatomical effects of DCC haploinsufficiency were more severe in adolescence than adulthood and were largely restricted to the mesocorticolimbic dopamine system. The latter finding was consistent whether we identified the regions of the mesocorticolimbic dopamine system a priori or used connectivity data from the Allen Brain Atlas to determine de novo where these dopamine axons terminated. Covariance analyses found that DCC haploinsufficiency disrupted the coordinated development of the brain regions that make up the mesocorticolimbic dopamine system. Gene expression maps pointed to molecular processes involving the expression of DCC, UNC5C (encoding DCC's co- receptor), and NTN1 (encoding its ligand, netrin-1) as underlying our structural findings. Limitations: Our study involved a single sex (males) at only 2 ages. Conclusion: The neuroanatomical phenotype of DCC haploinsufficiency described in mice parallels that observed in DCC- haploinsufficient humans. It is critical to understand the DCChaploinsufficient mouse as a clinically relevant model system., Background Adolescence is a critical period for the maturation of complex cognitive functions like reward, motivation, and behavioural control. (1) This period is also characterized by the maturation of the [...]

Background: Esketamine is a version of ketamine that has been approved for treatment-resistant depression, but our previous studies showed a link between non-medical use of ketamine and brain structural and functional alterations, including dorsal prefrontal grey matter reduction among chronic ketamine users. In this study, we sought to determine cortical thickness abnormalities following long-term, non-medical use of ketamine. Methods: We acquired structural brain images for patients with ketamine use disorder and drug-free healthy controls. We used FreeSurfer software to measure cortical thickness for 68 brain regions. We compared cortical thickness between the 2 groups using analysis of covariance with covariates of age, gender, educational level, smoking, drinking, and whole-brain mean cortical thickness. Results: We included images from 95 patients with ketamine use disorder and 169 controls. Compared with healthy controls, patients with ketamine use disorder had widespread decreased cortical thickness, with the most extensive reductions in the frontal (including the dorsolateral prefrontal cortex) and parietal (including the precuneus) lobes. Increased cortical thickness was not observed among ketamine users relative to comparison participants. Estimated total lifetime ketamine consumption was correlated with reductions in the right inferior parietal and the right rostral middle frontal cortical thickness. Limitations: We conducted a retrospective cross-sectional study, but longitudinal studies are needed to further validate decreased cortical thickness after nonmedical use of ketamine. Conclusion: This study provided evidence that, compared with healthy controls, chronic ketamine users have widespread reductions in cortical thickness. Our study underscores the importance of the long-term effects of ketamine on brain structure and serves as a reference for the antidepressant use of ketamine., Introduction Although ketamine--a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist--is valued for its clinical applications in anesthesia and pain management, and esketamine (the S-enantiomer of ketamine) has begun to be used for [...]

Background: Recent studies have identified empathy deficit as a core impairment and diagnostic criterion for people with autism spectrum disorders; however, the improvement of empathy focuses primarily on behavioural interventions without the target regulation. We sought to compare brain regions associated with empathy-like behaviours of fear and pain, and to explore the role of the oxytocinoxytocin receptor system in fear empathy. Methods: We used C57BL mice to establish 2 models of fear empathy and pain empathy. We employed immunofluorescence histochemical techniques to observe the expression of c-Fos throughout the entire brain and subsequently quantified the number of c-Fos-positive cells in different brain regions. Furthermore, we employed chemogenetic technology to selectively manipulate these neurons in Oxt-[Cre.sup.-/+] mice to identify the role of oxytocin in this process. Results: The regions activated by fear empathy were the anterior cingulate cortex, basolateral amygdala, nucleus accumbens, paraventricular nucleus (PVN), lateral habenula, and ventral and dorsal hippocampus. The regions activated by pain empathy were the anterior cingulate cortex, basolateral amygdala, nucleus accumbens, and lateral habenula. We found that increasing the activity of oxytocin neurons in the PVN region enhanced the response to fear empathy. This enhancement may be mediated through oxytocin receptors. Limitations: This study included only male animals, which restricts the broader interpretation of the findings. Further investigations on circuit function need to be conducted. Conclusion: The brain regions implicated in the regulation of fear and pain empathy exhibit distinctions; the activity of PVN neurons was positively correlated with empathic behaviour in mice. These findings highlight the role of the PVN oxytocin pathway in regulating fear empathy and suggest the importance of oxytocin signalling in mediating empathetic responses., Introduction Empathy refers to an individual's perception and recognition of the internal emotions and feelings of others, including the ability to identify and respond to their voices, expressions, and physical [...]

A recent meta-analysis of functional neuroimaging contrasts between emotional and neutral face processing has shown that the processing of facial emotions can be better classified according to threat detection than emotional valence, with the authors suggesting that their data are inconsistent with both the right-hemisphere and valence models of emotional laterality. I report empirical and theoretical data indicating that facial expressions are better classified according to threat detection than to the distinction between positive and negative emotions. I challenge, however, the claim that laterality effects provide little support to the right-hemisphere model of emotional laterality. This claim contrasts with neuropsychological and psychophysiological investigations that have shown that the right hemisphere has a graded prevalence for emotions provoked by threatening events. A reanalysis of data obtained in the target study suggests that the reported data are not necessarily inconsistent with a model assuming a graded, right-hemisphere dominance for emotions. I present a model of hemispheric asymmetries that could be consistent with the assumption that the right hemisphere's dominance for emotions may mainly be concerned with threatening events., Introduction In a recent article, Lukito and collleagues (1) published an updated meta-analysis of functional neuroimaging contrasts between emotional (e.g., angry, happy) and neutral face processing, taking into account the [...]

Background: Neuroimaging studies have revealed abnormal functional interaction during the processing of emotional faces in patients with major depressive disorder (MDD), thereby enhancing our comprehension of the pathophysiology of MDD. However, it is unclear whether there is abnormal directional interaction among face-processing systems in patients with MDD. Methods: A group of patients with MDD and a healthy control group underwent a face-matching task during functional magnetic resonance imaging. Dynamic causal modelling (DCM) analysis was used to investigate effective connectivity between 7 regions in the face- processing systems. We used a Parametric Empirical Bayes model to compare effective connectivity between patients with MDD and controls. Results: We included 48 patients and 44 healthy controls in our analyses. Both groups showed higher accuracy and faster reaction time in the shape-matching condition than in the face-matching condition. However, no significant behavioural or brain activation differences were found between the groups. Using DCM, we found that, compared with controls, patients with MDD showed decreased selfconnection in the right dorsolateral prefrontal cortex (DLPFC), amygdala, and fusiform face area (FFA) across task conditions; increased intrinsic connectivity from the right amygdala to the bilateral DLPFC, right FFA, and left amygdala, suggesting an increased intrinsic connectivity centred in the amygdala in the right side of the face-processing systems; both increased and decreased positive intrinsic connectivity in the left side of the face-processing systems; and comparable task modulation effect on connectivity. Limitations: Our study did not include longitudinal neuroimaging data, and there was limited region of interest selection in the DCM analysis. Conclusion: Our findings provide evidence for a complex pattern of alterations in the face-processing systems in patients with MDD, potentially involving the right amygdala to a greater extent. The results confirm some previous findings and highlight the crucial role of the regions on both sides of face-processing systems in the pathophysiology of MDD., Introduction Major depressive disorder (MDD) is one of the most severe and prevalent mental illnesses, with significantly impaired social functioning. (1-3) The processing of emotional human faces plays a vital [...]

Background: Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD), but substantial heterogeneity in outcomes remains. We examined a potential mechanism of action of rTMS to normalize individual variability in resting-state functional connectivity (rs-fc) before and after a course of treatment. Methods: Variability in rs-fc was examined in healthy controls (baseline) and individuals with MDD (baseline and after 4-6 weeks of rTMS). Seed-based connectivity was calculated to 4 regions associated with MDD: left dorsolateral prefrontal cortex (DLPFC), right subgenual anterior cingulate cortex (sgACC), bilateral insula, and bilateral precuneus. Individual variability was quantified for each region by calculating the mean correlational distance of connectivity maps relative to the healthy controls; a higher variability score indicated a more atypical/idiosyncratic connectivity pattern. Results: We included data from 66 healthy controls and 252 individuals with MDD in our analyses. Patients with MDD did not show significant differences in baseline variability of rs-fc compared with controls. Treatment with rTMS increased rs-fc variability from the right sgACC and precuneus, but the increased variability was not associated with clinical outcomes. Interestingly, higher baseline variability of the right sgACC was significantly associated with less clinical improvement (p = 0.037, uncorrected; did not survive false discovery rate correction). Limitations: The linear model was constructed separately for each region of interest. Conclusion: This was, to our knowledge, the first study to examine individual variability of rs-fc related to rTMS in individuals with MDD. In contrast to our hypotheses, we found that rTMS increased the individual variability of rs-fc. Our results suggest that individual variability of the right sgACC and bilateral precuneus connectivity may be a potential mechanism of rTMS., Introduction Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) is an effective treatment for major depressive disorder (MDD). (1,2) It can alter connectivity of networks, including the [...]

In the modern history of medicine, some of the most lifesaving advances have come from the field of critical care medicine. Current medical knowledge and technology have transformed it into [...]

Despite advances in psychotropic agents, treatment-resistant psychotic symptoms remain surprisingly prevalent in schizophrenia spectrum disorders. Deep brain stimulation (DBS) could be an attractive option in terms of effectiveness, although more [...]

Previous research suggests that experiencing disgust in sexual contexts may negatively impact sexual satisfaction and functioning. However, little is known about the mechanisms (e.g., sexual anxiety) that influence or underlie sex-related disgust. Additionally, immersive tendencies may play a role in shaping emotional experiences when presented with sexual cues. Recent technological advancements, especially in virtual reality (VR), offer a promising avenue to explore emotions in simulated intimate and sexual interactions. This study aimed to examine the influence of sexual anxiety and immersive tendencies on reported levels of disgust when exposed to virtual erotica. A sample of 59 participants (>18 years) completed self-report questionnaires of sexual anxiety and immersive tendencies. Levels of disgust were assessed during exposure to synthetic virtual characters engaging in erotic behaviours of increasing intensity across six scenarios, ranging from flirting to nudity, masturbation, and orgasm. Linear mixed models were performed on observed data. Higher levels of sexual anxiety were significantly associated with increased disgust throughout the immersive experience (P = 0.48), while greater immersive tendencies were significantly linked to lower disgust ratings (P = -0.66). Additionally, disgust ratings significantly increased with the intensity of the virtual sexual stimuli (P = 0.48). Virtual erotica shows promise as a tool to investigate sex-related disgust and its related mechanisms, such as sexual anxiety and immersive tendencies. KEYWORDS: Immersive tendencies, linear mixed model, sex-related disgust, sexual anxiety, virtual reality, Disgust is a basic and culturally universal emotion, defined as a feeling of revulsion triggered by anticipated contact with an offensive or contaminating substance, object, or person, and is accompanied [...]

Comprehensive sex education (CSE) is evidence-based, addresses a wide variety of topics, and is inclusive of sexual and gender minority (SGM) experiences. However, teachers are often not trained to deliver CSE and are uncomfortable teaching it. This can lead to the omission of important topics and leave youth dissatisfied with their sex education. Thus, more research is needed to understand educator needs/approaches when delivering sex education and how educators incorporate SGM-affirming content. We conducted fifteen interviews with sex educators in Metro Vancouver, British Columbia (BC), Canada, in autumn 2021, to understand current approaches to and gaps in the provision of CSE. We used an interpretive descriptive methodology. Personal and structural factors constrain the delivery of CSE in BC. Personal factors include motivation, teacher comfort/knowledge, personal trauma, and fear of pushback. Structural factors include inequitable access to parent advisory council funding, Learning Standards design, and the peripheral nature of sex education. Participant recommendations for the future of sex education include increased mandatory pre-service and in-service training, the implementation of 'sex education mentors' in each district, an online hub of resources, and government funding for community-based educators. We recommend (1) that government funding be allocated for at least one trained sex educator in every school district who can coach and mentor teachers; (2) the creation and promotion of an online information hub which includes lesson plans, videos, and resources for teachers; (3) and that teachers' colleges create mandatory courses on teaching CSE. KEYWORDS: Sexual and gender minorities, sexual health education, teacher training, Comprehensive sex education (CSE) is a sex-positive (e.g., recognizes that sex is normal, can be pleasurable and joyful, is inclusive of all identities) and evidenced-based approach (Smart Sex Resource, 2023). [...]

Current research suggests that women students may increasingly turn to sex work to help finance their education due to increased economic demands and its glamourization in the media. To date, no research has empirically examined the influence of societal factors, such as the proliferation of digital technology, as factors increasing positive attitudes toward sex work. Addressing this gap, this exploratory study investigated whether women's attitudes varied based on the context and venue of sex work. Additionally, the authors sought to enhance the understanding of established factors linked to attitudes toward sex work. One hundred fifty women-identified students completed an online survey with a within-subjects design to measure their attitudes toward five different types of sex work varying in level and type of contact from street level (in person/full contact) to webcamming (internet- mediated/no contact). In general, women students had negative attitudes toward sex work but held mildly positive attitudes regarding the activity/potency of sex work and, potentially, the women who engage in it. More positive attitudes were held toward sex work when women could maintain a 'distance' between themselves and the client, either through a lack of direct genital contact or through digital technology. This research offers a detailed examination of university women's attitudes toward various forms of sex work, uncovering valuable insights into societal perceptions and how these attitudes vary depending on the context and location of sex work. KEYWORDS: Attitudes, Canada, feminism, sex work, stigma, students, women, Over the past few decades, there has been an increase in economic pressure on the university student population. The cost of university tuition has increased beyond standard inflation rates, and [...]

Sexual satisfaction is at the heart of a thriving romantic relationship and is intertwined with both partners romantic attachment orientations. Prior research has found that insecure romantic attachment orientations (anxiety and avoidance) are associated with lower sexual satisfaction in oneself and one's partner. Stress is known to exacerbate insecure attachment tendencies, and couples with children are often exposed to parenting stress, which has been associated with lower sexual satisfaction. It is therefore possible that parenting stress moderates the association between the attachment and sexual systems, such that among those who are high in parenting stress, the negative link between attachment insecurity and sexual satisfaction is stronger. The objective of this study was to examine the link between romantic attachment and sexual satisfaction, and the impact of parenting stress on this association. One hundred three mixed-sex couples completed self-report questionnaires and were included in actor and partner analyses. Both parents' attachment avoidance was associated with their own reduced sexual satisfaction. Fathers' attachment avoidance was associated with mothers' reduced sexual satisfaction. Additionally, fathers' parenting stress moderated the association between their own romantic attachment avoidance and their partner's sexual satisfaction. Contrary to prediction, as fathers' parenting stress increased, the association between their higher attachment avoidance and mothers' lower sexual satisfaction became weaker. Findings are discussed in light of research and theory on the role of attachment and parenting stress for sexual satisfaction in couples with children. KEYWORDS: Anxious attachment, avoidant attachment, couples with children, insecure attachment, mothers and fathers, parenting stress, romantic attachment, sexual satisfaction, In couples, insecure romantic attachment (i.e., non-optimal support seeking during a time of need) is related to having an unfulfilling sex life and, more specifically, with lower sexual satisfaction (Stefanou [...]

There has been an increasing focus on the development of perpetration prevention programs designed to prevent the onset of sexual offending against children (online and offline). The present study involved a thematic analysis of 20 professional stakeholders in Nova Scotia who participated in a semi-structured interview that occurred prior to the development and implementation of a perpetration prevention program. Results highlighted that stakeholders saw value in a perpetration prevention program aimed at preventing the onset of sexual offending against children. Stakeholders noted that program content should address sexual-based concerns, focus on improving mental health and well-being, and consider the role of trauma. Stakeholders also emphasized the importance of creating a safe therapeutic environment. Several barriers were identified that focused on recruitment challenges, the role of fear and stigma, and the inclusion of diverse clients and facilitators. The importance of leveraging community organizations and supports was also highlighted. Implications of the findings are discussed in relation to perpetration prevention programming. KEYWORDS: Assessment, hebephilia, paraphilia, pedophilia, phallometry, sexual offending, INTRODUCTION Child sexual abuse (CSA) is estimated to impact 18% of girls and 8% of boys worldwide (Stoltenborgh et al., 2011). Although rates of CSA have been declining over the [...]

While predictors of attitudes toward lesbians and gay men, as well as bisexuals and trans individuals, have been investigated relatively thoroughly, attitudes toward asexuality are a recently emerging field. The current study investigates predictors of attitudes toward asexuality, operationally defined using the Attitudes Towards Asexuality (ATA) scale created by Hoffarth and colleagues in 2016. Predictors included authoritarianism, social dominance orientation, intergroup disgust sensitivity, sexism, erotophobia-erotophilia, sociosexuality, motivation to respond without prejudice, singlism, and demographic characteristics of the perceiver. Response to the ATA indicated positivity toward asexuality, with the majority of participants expressing disagreement with the negative statements about asexuality. Many of the individual difference variables correlated moderately with the ATA. Multiple regression analyses indicated that significant predictors of the ATA included right-wing authoritarianism, internal motivation to respond without prejudice, intergroup disgust sensitivity, benevolent sexism, participant sexual orientation, and religiosity. Together, these six predictors accounted for half of the variance in the ATA. The findings of this study suggest that attitudes toward asexuality are similarly predicted by those individual difference variables that predict attitudes toward gays, lesbians, bisexuals, and transpersons. KEYWORDS: Anti-asexual bias, asexual attitudes, asexuality, Attitudes Towards Asexuals scale, authoritarianism, benevolent sexism, intergroup disgust sensitivity, LGBTQ2SIA+, motivation to respond without prejudice, sexual orientation, Consistently across recent literature, studies have shown that individual difference factors such as demographic characteristics and conservative belief orientations predict heterosexual attitudes toward LGBTQ people (e.g., Lopez-Saez et al, 2020; [...]

Addiction is a term recently extended to problem sexual behaviours. Proponents of pornography addiction (PA) argue that pornography is comparable to drugs in its impact on brain processes and behaviour, producing effects similar to substance abuse disorders. Critics, however, assert that PA lacks diagnostic validity, that supporting research is methodologically unsound, and that diagnosis obscures the social contexts and discursive practices in which sexual behaviours are embedded. This study investigates how self-identified pornography addicts describe their experiences and explores the implicit motives and meanings at play in this identity construction. Using a psychoanalytically informed discursive methodology, the authors analyzed interviews with 10 self-identified pornography addicts, focusing on the meaning of self-diagnosis, the process of self-labelling, and participants' psychological investment in diagnosis. Participants perceived an enslavement to desire as central to their addiction identities. Underlying this identity work were defences and conflicts about power, gender, sexuality, and perversion, as well as histories of disturbed attachment and deprivation by parental figures. The PA diagnosis counteracted feelings of shame and allowed participants to speak more freely about their difficulties. However, it also precluded more nuanced self-understandings and identity possibilities. The article concludes with a discussion of the mental health and psychotherapeutic implications of those presenting with self- diagnosed PA. KEYWORDS: Discursive methodology, pornography addiction, psychoanalysis, self-diagnosis, Addiction, most often associated with substance use disorders, has recently been applied to problem behaviours by both mental health professionals and laypeople alike. Since the inclusion of Gambling Addiction Disorder [...]

Many studies focusing on childhood sexual abuse (CSA) may have neglected the consequences related to experiencing other types of childhood maltreatment, such as psychological maltreatment. Moreover, the literature has focused more on negative consequences related to CSA, hence potentially leaving out more adaptive and resilient trajectories. This qualitative study aimed to explore childhood psychological maltreatment and CSA, mindfulness, sexuality, and intimate relationships in adult survivors. The interview data from 19 individuals who experienced CSA and psychological maltreatment were analyzed using conventional content analysis. Four conceptual categories developed: (a) an unsafe family environment that hindered the development of positive experiences and relationships; (b) impaired mindfulness dispositions: the reliving of trauma, the avoidance of suffering, and feeling engulfed; (c) impaired intimacy: instability, codependence, emotional distance, and self-silencing; and (d) mindfulness dispositions and posttraumatic growth (PTG) in participants' intimate lives. These findings highlight that mindfulness, sexuality, and intimate relationships are often poor among survivors of psychological maltreatment and CSA. Yet opportunities to develop mindfulness dispositions appear to enhance PTG in survivors' intimate relationships, significantly contributing to survivors' healing processes. KEYWORDS: Childhood maltreatment, intimate relationships, mindfulness, posttraumatic growth, sexuality, Research on childhood maltreatment, defined as the exposure to negative interpersonal events occurring during childhood by parental or other significant adult figures (e.g., childhood sexual abuse [CSA], psychological abuse, and [...]

Numerous studies have examined associations between sociodemographic characteristics and attitudes toward premarital sex and, more recently, toward casual sex. However, no recent study has examined these associations in Canada's general population. The present exploratory study consists of a secondary analysis of the World Values Survey's seventh wave of data collected in 2020 from a sample of 4,018 Canadian adults. Results indicate moderately positive attitudes toward premarital sex and lower levels of approval for casual sex, on average. Religion-related variables yielded moderate to strong effect sizes, with identifying as religious, higher frequencies of religious service attendance, and greater attributed importance to religion being associated with lower levels of approval for premarital and casual sex. Small to moderate effects were found for politics-related, family-related, and ethnocultural variables. On average, participants who considered premarital and casual sex as justifiable tended to be more left-leaning, have fewer children, live together as married, have been born in Canada, identify as White, report French as the language they normally speak at home, and live in Quebec. While age and generation were weakly associated with premarital sex attitudes, they were more strongly associated with casual sex attitudes, with younger participants being somewhat more accepting of casual sex than older participants. Small gender differences were found for casual but not premarital sex attitudes. Attitudinal differences based on socioeconomic variables were overall statistically insignificant or negligible. The findings are consistent with and expand on the existing literature. They also shed light on Canada's ethnocultural and provincial particularities. KEYWORDS: Canada, casual sex, premarital sex, sexual attitudes, sociodemographic, World Values Survey, Institutional and attitudinal trends related to the 'sexual revolution,' which took place during the late 1960s and early 1970s in the West (Hekma & Giami, 2014; Liu, 2021), have been [...]

Intimate partners' sexual desire for each other can fluctuate throughout the course of their relationship, and greater difference between partners' habitual level of sexual desire (i.e., sexual desire discrepancy [SDD]) is linked to lower sexual and relationship satisfaction (Mark, 2015). Although some couples view SDD as a natural and normal part of a sexual relationship, others experience significant distress and may seek therapy. Based on a prominent literature on attachment among couples (Birnbaum & Reis, 2019; Mark et al., 2018; Mikulincer & Shaver, 2007), the current study incorporated an actor-partner interdependence model to examine the dyadic associations between insecure attachment style (i.e., anxious, avoidant) and sexual desire among couples experiencing distressing or non-distressing levels of SDD. Couples (N = 202; 51% female, 48% male, 1% different gender; M = 28 years old, SD = 5.05) were recruited through social media (e.g., Instagram, Twitter) and completed a survey assessing sexual distress, adult attachment style, and sexual desire. Although anxious and avoidant attachment did not moderate an association between SDD and sexual distress, higher levels of avoidant attachment were associated with sexual distress for the individual, but not with their partner's distress. Findings suggest attachment may be essential for understanding individuals' experience of sexual distress when coping with discrepant levels of sexual desire in romantic relationships. KEYWORDS: Attachment, couples, intimate relationships, sexual desire, sexual distress, Sexual desire, which encompasses sexual thoughts, fantasies, and urges for sexual activity, is integral to sexual wellbeing among couples (Basson, 2002; Laumann et al., 2006; Stephenson & Meston, 2015). It [...]

There is a growing body of research on the disparities, barriers, and inequities experienced by sexual- and gender- minority communities in Canada, particularly in comparison with heterosexual cisgender counterparts. This article examines data from the community-based Canada-wide Sex Now 2018 (in person) and Sex Now 2019 (online) surveys to gauge the mental health, social and community connection, and service needs of young gay, bisexual, transgender, Two-Spirit, and queer (GBT2Q) men and non-binary people. Differences across people of colour, Indigenous, trans, and non-binary sub-populations provide insight for future interventions and targeted programs to support the mental health of GBT2Q young people across Canada. KEYWORDS: GBT2Q men, mental health, non-binary, sexual and gender minority (SGM), transgender, young people, This article examines data from the Sex Now 2018 and 2019 surveys to highlight the mental health of young sexual- and gender-minority people (SGM) in Canada. Descriptive statistics were used [...]

Gay, bisexual, and other men who have sex with men (GBMSM) have been identified as a population at higher risk of experiencing non-consensual sexual experiences (NSEs). However, previous research studies examining the prevalence of NSEs in this population have been limited by inconsistent terminology and a lack of research on the topic. The main focus of this study was to compare the effectiveness of using self-labels versus behavioural indicators to measure the prevalence of NSEs experienced in adulthood in GBMSM and contribute to more accurate prevalence rates in the Canadian context. A total of 346 participants were recruited from various social media platforms in Canada. The study used a two-part question that asked participants if they had ever been sexually assaulted or raped, followed by a question about other nonconsensual sexual experiences. The study also used a formal behavioural measure, the Sexual Experiences Survey, to assess the prevalence of NSEs. The results indicated that a two-part question and the formal measure reported similar prevalence rates of NSEs--64.5% and 66.8% respectively. Overall prevalence of NSEs was very high in this sample, and people of colour and trans men reported even higher rates. Depending on the context, the parsimonious choice of questioning persons on the NSE history may be valid, however, only if applied in the context of asking for rape and assault as well as other NSEs that may not be captured by these definitions. The study highlights the importance of using consistent terminology and effective measurement methods when studying the prevalence of NSEs in GBMSM. These findings may have important implications for developing interventions and for obtaining more accurate prevalence rates in a variety of settings without having to use a longer, more formalized measure. KEYWORDS: GBMSM, nonconsensual sexual experiences, prevalence rates of sexual violence, sexual consent, The last decade has seen a noticeable increase in the attention given to the topics of sexual consent, sexual assault, and rape in both academic literature and public discussions. The [...]

Lesbian, gay, bisexual, and diverse sexual orientation minorities are disproportionately represented in the prevalence of adverse health conditions, even in Canada, suggested as one of the more progressive countries when it comes to social acceptance and human rights protections. This highlights the inclusion of sexual orientation identity as a point of consideration when providers interact with patients and to consider facilitating sexual orientation identity disclosure when accessing health care. This study explored factors associated with different facets of sexual orientation disclosure to primary care providers. A cross- sectional survey of sexual orientation minority participants, 16 years or older, living, working, or residing in Waterloo Region was distributed (n = 437). Modified Poisson regression methods modelled (a) comfort sharing sexual orientation with their regular primary care provider (RPCP), (b) disclosure of sexual orientation to their RPCP, and (c) talking to their RPCP about health issues related to their sexual orientation. Increasing outness within one's social network was consistently significant across all three outcomes of comfort, disclosure, and talking about health issues related to sexual orientation. Self-esteem was also identified as salient in comfort and when talking to providers. The authors also observed significant associations between sexual orientation identity and relationship status variables. Findings highlight important factors to consider in discussing and disclosing sexual orientation identity and associated health issues with health care providers. Implications for practice include training new health care providers and providing opportunities for continued education for established providers to ensure appropriate care is provided based on sexual orientation. KEYWORDS: LGBTQ+, primary care, self-esteem, sexual orientation disclosure, Lesbian, gay, bisexual (LGB), and diverse sexual orientation-minority individuals are disproportionately represented in the prevalence of adverse health conditions (Chakraborty et al., 2011; Cochran et al., 2016; Conron et al., [...]

In humans, sleep is divided into nonrapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. (1) The non-REM sleep consists of 3 stages (N1-N3), with N1 and N2 [...]

Suicidal thoughts and behaviors (STBs) are among the most dreaded complications of treatment-resistant depression (TRD), which is associated with elevated risk of death from suicide as well as from other [...]

In February 2023, I gave my presidential address for the Association for Academic Surgery. (1) I did something scary. I told the truth. I began my speech like this: 'Yes, [...]

According to new data from the US Centers for Disease Control and Prevention, the suicide rate in the United States recently reached its highest peak since 1941. The Provisional number [...]

Outpatient civil commitment is one of those polarizing topics where many individuals are adamantly for or against legislation and where emotions are high on both sides. Advocates are often the [...]

At the 2024 American Psychiatric Association (APA) Annual Meeting, the American Association for Social Psychiatry (AASP) bestowed H. Steven Moffi c, MD, with the Abraham L. Halpern Humanitarian Award for [...]