Avoidant Personality Disorder and the Generalized Subtype of Social Phobia

Social phobia and avoidant personality disorder (APD) may be given as comorbid diagnoses. However, it is not known if the labels provide independent, useful diagnostic information. We classified social phobics by social phobia subtype and presence of APD. Generalized social phobics with and without APD (ns = 10 and 10) and nongeneralized social phobics without APD (n = 10) were distinguished on measures of phobic severity. The generalized groups also showed earlier age at onset and higher scores on measures of depression, fear of negative evaluation, and social anxiety and avoidance than did the nongeneralized group. APD criteria of general timidity and risk aversion were more frequently endorsed by social phobics with APD. The data suggest that both the generalized subtype of social phobia and the presence of APD do provide useful diagnostic information but the additional diagnosis of APD may simply identify a severe subgroup of social phobics

First impressions online: The inclusion of transgender and gender nonconforming identities and services in mental healthcare providers’ online materials in the USA

Background: When accessing mental healthcare services, transgender and gender nonconforming (TGNC) individuals face systemic barriers to gender-affirmative care. Initial points of contact, like intake forms, may show limited consideration for the heterogeneity of TGNC identities and can lead to negative consequences prior to face-to-face interaction with providers. Aims: The first aim was to mimic a likely pathway a TGNC individual may follow to seek mental healthcare services in the USA and to describe the extent to which they may encounter enacted stigma or affirmative messages that may impede or facilitate access to care. The second aim was to determine if a positive State legal climate for TGNC people was associated with more affirmative provider materials. Methods: Content analysis was used to examine a national sample of websites and intake forms of mental healthcare providers who advertise online as working with TGNC clients. Intake forms were coded for usage of affirmative language in gender/sex questions and including questions for a client’s pronouns and preferred name. Websites were coded for mentioning a variety of services or resources for TGNC clients. Results: While provider websites were found through Google searches for a “gender therapist,” only 56.6% of websites stated a provider specialty to work with TGNC clients and 32.1% of websites had no mention of services or resources for TGNC people. Additionally, a significantly larger proportion of intake forms from States with legal protections for TGNC people used affirmative language in gender/sex questions and asked for a client’s pronouns than intake forms from States without legal protections. Discussion: Barriers to affirmative healthcare for TGNC people within patient and provider interactions have been identified in previous research and these data show TGNC individuals may face enacted stigma even in their search for a provider, particularly those TGNC people living in States without legal protections

Behavior, Color Change and Time for Sexual Inversion in the Protogynous Grouper (Epinephelus adscensionis)

Hermaphroditism, associated with territoriality and dominance behavior, is common in the marine environment. While male sex-specific coloration patterns have been documented in groupers, particularly during the spawning season, few data regarding social structure and the context for these color displays are available. In the present study, we define the social structure and male typical behavior of rock hind (Epinephelus adscensionis) in the wild. In addition, we detail the captive conditions and time period necessary to induce the onset of the sex-specific coloration and sexual change. At six oil production platform locations in the Gulf of Mexico, rock hind social group size and typical male rock hind social behavior were documented. We observed a rapid temporary color display in rock hind that could be turned on and off within three seconds and was used for confronting territory intruders and displays of aggression towards females. The male-specific “tuxedo” pattern consists of a bright yellow tail, a body with alternating dark brown and white patches and a dark bar extending from the upper mandible to the operculum. Identification and size ranges of male, female and intersex fish collected from oil platforms were determined in conjunction with gonadal histology. Rock hind social order is haremic with one dominant male defending a territory and a linear dominance hierarchy among individuals. In five captive experiments, the largest remaining female rock hind displayed the male specific color pattern within 32d after dominant male removal from the social group. To our knowledge, this is the first evidence in a grouper species of color patterning used to display territoriality and dominance outside of spawning aggregations. The behavioral paradigm described here is a key advance that will enable mechanistic studies of this complex sex change process

A Systematic Review of Recommendations for Behavioral Health Services for Transgender and Gender Diverse Adults: The Three-Legged Stool of Evidence-Based Practice is Unbalanced

There is a growing literature of clinical recommendations for transgender and gender diverse (TGD) affirming behavioral health care, yet it is unknown to what extent these recommendations are rooted in evidence-based practice (EBP). This systematic review included 65 articles published between 2009 and 2018 with recommendations for behavioral health services with TGD adults, emphasizing general clinical care. Coded variables included type of article, participant demographics, aspects of EBP, and whether care was informed by objective assessment. Most articles did not equally draw from all components of EBP. Recommendations for specific clinical problems are increasingly available and address diversity within TGD communities. More research, including clinical trials adapting established interventions, is needed to inform state-of-the-art TGD-affirmative behavioral health care

Situational Domains of Social Phobia

Although social phobia is defined as severe anxiety in social situations, little is known about the range or prevalence of social situations that elicit anxiety in social phobic individuals. The present study developed the concept of situational domains, groups of similar situations that may provoke anxiety in subsets of social anxious persons. Four conceptually derived situational domains were examined: formal speaking/interaction, informal speaking/interaction, observation by others, and assertion. Ninety-one social phobic patients were classified as anxiety-positive or anxiety-negative within each situational domain, varying inclusion criteria of anxiety experienced in each situation and the number of anxiety-producing situations within a domain. Patients were highly likely to be classified to the formal speaking/interaction domain, regardless of inclusion criteria employed or presence of anxiety within other domains. Support was also found for previous findings that most social phobics experience anxiety in more than one social situation, even under conservative classification criteria. Implications for the current diagnostic nosology and directions for future research are discussed

Specialists in Name or Practice? The Inclusion of Transgender and Gender Diverse Identities in Online Materials of Gender Specialists

Recommendations for health care providers working with transgender and gender diverse (TGD) individuals emphasize affirming clients’ identities, such as using correct pronouns and name, however it is unknown how often gender specialists adhere to such recommendations. Websites and intake forms of gender specialists were coded for use of affirming language, asking for pronouns and chosen name, and mention of TGD specialties and resources. Most websites identified the provider’s specialty to work with TGD individuals, though much fewer provided additional resources concerning TGD issues and only half of intake forms included affirming language. Given previous research that has demonstrated providers working in states with legal protections for TGD individuals use affirming language more often than providers in locales without protections, association with state legal climate is also examined

Situational Domains of Social Phobia

Although social phobia is defined as severe anxiety in social situations, little is known about the range or prevalence of social situations that elicit anxiety in social phobic individuals. The present study developed the concept of situational domains, groups of similar situations that may provoke anxiety in subsets of social anxious persons. Four conceptually derived situational domains were examined: formal speaking/interaction, informal speaking/interaction, observation by others, and assertion. Ninety-one social phobic patients were classified as anxiety-positive or anxiety-negative within each situational domain, varying inclusion criteria of anxiety experienced in each situation and the number of anxiety-producing situations within a domain. Patients were highly likely to be classified to the formal speaking/interaction domain, regardless of inclusion criteria employed or presence of anxiety within other domains. Support was also found for previous findings that most social phobics experience anxiety in more than one social situation, even under conservative classification criteria. Implications for the current diagnostic nosology and directions for future research are discussed

The X-ray Remnant of SN1987A

We present high resolution Chandra observations of the remnant of SN1987A in the Large Magellanic Cloud. The high angular resolution of the Chandra X-ray Observatory (CXO) permits us to resolve the X-ray remnant. We find that the remnant is shell-like in morphology, with X-ray peaks associated with some of the optical hot spots seen in HST images. The X-ray light curve has departed from the linear flux increase observed by ROSAT, with a 0.5-2.0 keV luminosity of 1.5 x 10^35 erg/s in January 2000. We set an upper limit of 2.3 x 10^34 ergs/s on the luminosity of any embedded central source (0.5 - 2 keV). We also present a high resolution spectrum, showing that the X-ray emission is thermal in origin and is dominated by highly ionized species of O, Ne, Mg, and Si.Comment: 16 pages, 3 figures, Accepted for publication in ApJ Letter