Jennifer A. Poon

Background: Young adult sexual minority men (SMM) disproportionately experience childhood interpersonal trauma. The Dimensional Model of Adversity and Psychopathology (DMAP) framework proposes that exposure to threat (i.e., emotional, physical, and sexual abuse) and deprivation (e.g., physical and emotional neglect) are differentially linked to adult psychopathology. Studies of predominantly heterosexual samples have revealed emotion regulation and mindfulness as mechanisms linking childhood trauma to mental health and health risk behaviors in adulthood. However, the influence of emotion regulation (ER) or mindfulness as associated with exposure to threat vs. deprivation has not been examined among SMM in adulthood. Objective: This study explored the relationships between childhood threat/deprivation and mental health and health risk behaviors among SMM with ER and mindfulness as mediators. Participants and Setting: The sample consisted of 317 SMM (M_age = 26.70; SD = 3.87; ages 18–35; 59.3% White) recruited from the community. Methods: Childhood experiences of threat and deprivation were assessed via the Childhood Trauma Questionnaire; ER difficulties and dispositional mindfulness were assessed using self-report. Mental health behaviors were assessed using a composite score consisting of self-reported depressive, anxiety, PTSD symptoms, and suicidality. Health risk behavior score included the Sexual Compulsivity Scale, Alcohol Use Disorders Identification Test, and smoking history (Y/N). Results: Threat and deprivation were both positively correlated with mental health and health risk behaviors. Threat was associated with both mental health and health risk behaviors via emotion regulation (ER) difficulties. Deprivation was associated with these outcomes through both ER difficulties and mindfulness. Conclusions: Treatment aimed at bolstering ER and mindfulness skills among those with histories of abuse and deprivation, respectively, may help reduce psychopathology risk among SMM.

Weight stigma is associated with a range of adverse health outcomes (e.g., disordered eating). Women, sexual minorities, and higher-weight individuals are at increased risk of experiencing weight stigma, but little is known about its influence on emotions, cognitions, and behaviors in real-world contexts, particularly among multiply marginalized individuals such as higher-weight sexual minority women (SMW). The current study examined how lifetime and daily weight stigma experiences relate to momentary weight/shape concerns, size-based avoidance, and negative affect in this population. Fifty-five higher-weight (BMI > 25 kg/m2) SMW completed a baseline survey and a five-day Ecological Momentary Assessment protocol (five prompts per day) assessing weight stigma events, weight/shape concerns, size-based avoidance, and negative affect. Greater frequency of lifetime weight stigma experiences was significantly associated with greater odds of engaging in size-based avoidance at least once during the 5-day period. Reporting momentary weight stigma events at any given prompt was significantly associated with greater odds of reporting momentary weight/shape concerns, but not negative affect, at the same prompt. Greater frequency of lifetime weight stigma experiences was also marginally associated with greater odds of reporting momentary weight/shape concerns at any given prompt. Both lifetime and momentary experiences of weight stigma are linked to negative consequences (e.g., weight/shape concerns, size-based avoidance) among higher-weight SMW. Although structural interventions are needed to reduce weight stigma at its source, individual interventions can help higher-weight SMW to cope with weight stigma in ways that may reduce its negative consequences.

Within the Dimensional Model of Adversity and Psychopathology, extant research shows that exposure to threat—including emotional, physical, and sexual abuse—is linked to psychopathology among adolescents; problems with emotion regulation may, at least in part, explain this association. Both theoretical and empirical work also suggests that emotion regulation difficulties—particularly access to emotion regulation strategies—may mediate the relation between threat and self-injurious thoughts and behavior, though no studies to date have explicitly tested this model. The current study tested relations between threat, limited access to emotion regulation strategies, and self-injurious thoughts and behaviors among high-risk youth across an 18-month follow-up. The sample consisted of 180 adolescents (M_age = 14.89; SD = 1.35; ages 12–17; 71.7% female; 78.9% White; 55.0% heterosexual) recruited from an inpatient psychiatric unit. Threat was assessed at baseline using the abuse subscales from Childhood Trauma Questionnaire. Access to emotion regulation strategies was assessed using the Difficulties in Emotion Regulation Scale at baseline, 6-, and 12-months. Presence (versus absence) of non-suicidal self-injury and suicidal ideation severity were assessed at baseline, 12-, and 18-months using the Self-Injurious Thoughts and Behaviors Interview and the Suicidal Ideation Questionnaire-JR, respectively. After accounting for baseline levels of the mediator, outcome, and depressive symptoms, structural equation models supported the role of 12-month access to emotion regulation strategies as a mediator between baseline threat and 18-month suicidal ideation and non-suicidal self-injury. Treatment aimed at bolstering access to emotion regulation strategies may help reduce suicide risk among youth who have experienced childhood abuse.

The alarming rates and pervasiveness of suicidal and self‐destructive behaviors (e.g., non‐suicidal self‐injury) among young sexual minorities represent a major public health concern. We set out to examine whether an empirically driven treatment for suicide and self‐harm, dialectical behavior therapy for adolescents (DBT‐A), provides benefits for adolescents who identify as gay, lesbian, bisexual, or questioning (LGBQ). LGBQ adolescents (n = 16) were compared with non‐LGBQ peers (n = 23). Psychological measures were collected before and after participation in a comprehensive DBT‐A program. LGBQ participants demonstrated significant improvements in emotion regulation, depression, borderline symptoms, and coping strategies; changes were comparable to their heterosexual peers.

Adolescence is a critical developmental period marked by an increase in risk behaviors, including nonsuicidal self‐injury (NSSI). Heightened reward‐related brain activation and relatively limited recruitment of prefrontal regions contribute to the initiation of risky behaviors in adolescence. However, neural reward processing has not been examined among adolescents who are at risk for future engagement for NSSI specifically, but who have yet to actually engage in this behavior. In the current fMRI study (N = 71), we hypothesized that altered reward processing would be associated with adolescents' thoughts of NSSI. Results showed that NSSI youth exhibited heightened activation in the bilateral putamen in response to a monetary reward. This pattern of findings suggests that heightened neural sensitivity to reward is associated with thoughts of NSSI in early adolescence. Implications for prevention are discussed.