Complexity of childhood sexual abuse: predictors of current post-traumatic stress disorder, mood disorders, substance use, and sexual risk behavior among adult men who have sex with men

Men who have sex with men (MSM) are the group most at risk for HIV and represent the majority of new infections in the United States. Rates of childhood sexual abuse (CSA) among MSM have been estimated as high as 46 %. CSA is associated with increased risk of HIV and greater likelihood of HIV sexual risk behavior. The purpose of this study was to identify the relationships between CSA complexity indicators and mental health, substance use, sexually transmitted infections, and HIV sexual risk among MSM. MSM with CSA histories (n = 162) who were screened for an HIV prevention efficacy trial completed comprehensive psychosocial assessments. Five indicators of complex CSA experiences were created: CSA by family member, CSA with penetration, CSA with physical injury, CSA with intense fear, and first CSA in adolescence. Adjusted regression models were used to identify relationships between CSA complexity and outcomes. Participants reporting CSA by family member were at 2.6 odds of current alcohol use disorder (OR 2.64: CI 1.24–5.63), two times higher odds of substance use disorder (OR 2.1: CI 1.02–2.36), and 2.7 times higher odds of reporting an STI in the past year (OR 2.7: CI 1.04–7.1). CSA with penetration was associated with increased likelihood of current PTSD (OR 3.17: CI 1.56–6.43), recent HIV sexual risk behavior (OR 2.7: CI 1.16–6.36), and a greater number of casual sexual partners (p = 0.02). Both CSA with Physical Injury (OR 4.05: CI 1.9–8.7) and CSA with Intense Fear (OR 5.16: CI 2.5–10.7) were related to increased odds for current PTSD. First CSA in adolescence was related to increased odds of major depressive disorder. These findings suggest that CSA, with one or more complexities, creates patterns of vulnerabilities for MSM, including post-traumatic stress disorder, substance use, and sexual risk taking, and suggests the need for detailed assessment of CSA and the development of integrated HIV prevention programs that address mental health and substance use comorbidities.This study was supported by a Grant from the NIMH (R01 MH095624) PI: O'Cleirigh; Author time (Safren) was supported, in part, by Grant 5K24MH094214. (R01 MH095624 - NIMH; 5K24MH094214)Accepted manuscrip

Religion and HIV in Tanzania: Influence of Religious Beliefs on HIV stigma, Disclosure, and Treatment Attitudes.

Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV) treatment. A self-administered survey was distributed to a convenience sample of parishioners (n = 438) attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and people living with HIV/AIDS. Results indicate that shame-related HIV stigma is strongly associated with religious beliefs such as the belief that HIV is a punishment from God (p < 0.01) or that people living with HIV/AIDS (PLWHA) have not followed the Word of God (p < 0.001). Most participants (84.2%) said that they would disclose their HIV status to their pastor or congregation if they became infected. Although the majority of respondents (80.8%) believed that prayer could cure HIV, almost all (93.7%) said that they would begin ARV treatment if they became HIV-infected. The multivariate analysis found that respondents' hypothetical willingness to begin ARV treatme was not significantly associated with the belief that prayer could cure HIV or with other religious factors. Refusal of ARV treatment was instead correlated with lack of secondary schooling and lack of knowledge about ARVs. The decision to start ARVs hinged primarily on education-level and knowledge about ARVs rather than on religious factors. Research results highlight the influence of religious beliefs on HIV-related stigma and willingness to disclose, and should help to inform HIV-education outreach for religious groups

Employee Attributions of the Why of HR Practices: Their Effects on Employee Attitudes and Behaviors, and Customer Satisfaction

The construct of Human Resource (HR) Attributions is introduced. We argue that the attributions that employees make about the reasons why management adopts the HR practices that it does have consequences for their attitudes and behaviors, and ultimately, unit performance. Drawing on the strategic HR literature, we propose a typology of five HR-Attribution dimensions. Utilizing data collected from a service firm, we show that employees make varying attributions for the same HR practices, and that these attributions are differentially associated with commitment and satisfaction. In turn, we show that these attitudes become shared within units and that they are related to unit-level organizational citizenship behaviors and customer satisfaction. Findings and implications are discussed

Stress, Religious Involvement, and Cholesterol: Is It Better to Give than to Receive?

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138202/1/jabr12064_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138202/2/jabr12064.pd

Forgiveness by God, religious commitment, and waist/hip ratios

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141367/1/jabr12104_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141367/2/jabr12104.pd

Workplace Contextual Supports for LGBT Employees: A Review, Meta‐Analysis, and Agenda for future Research

The past decade has witnessed a rise in the visibility of the lesbian, gay, bisexual, and transgender (LGBT) community. This has resulted in some organizational researchers focusing their attention on workplace issues facing LGBT employees. While empirical research has been appropriately focused on examining the impact of workplace factors on the work lives of LGBT individuals, no research has examined these empirical relationships cumulatively. The purpose of this study was to conduct a comprehensive review and meta‐analysis of the outcomes associated with three workplace contextual supports (formal LGBT policies and practices, LGBT‐supportive climate, and supportive workplace relationships) and to compare the relative influence of these workplace supports on outcomes. Outcomes were grouped into four categories: (a) work attitudes, (b) psychological strain, (c) disclosure, and (d) perceived discrimination. Results show that supportive workplace relationships were more strongly related to work attitudes and strain, whereas LGBT supportive climate was more strongly related to disclosure and perceived discrimination compared to the other supports. Our findings also revealed a number of insights concerning the measurement, research design, and sample characteristics of the studies in the present review. Based on these results, we offer an agenda for future research

Religious attendance after elevated depressive symptoms: is selection bias at work?

In an attempt to determine if selection bias could be a reason that religious attendance and depression are related, the predictive value of elevated depressive symptoms for a decrease in future attendance at religious services was examined in a longitudinal panel of 1,673 Dutch adults. Religious attendance was assessed yearly over five years using the single question, “how often do you attend religious gatherings nowadays?” Depressive symptoms were assessed four times within the first year using the Depression subscale of the Brief Symptom Inventory. Logistic regression models of change in attendance were created, stratifying by baseline attendance status. Attenders who developed elevated symptoms were less likely to subsequently decrease their attendance (relative risk ratio: 0.55, 95% CI [0.38–0.79]) relative to baseline as compared to those without elevated symptoms. This inverse association remained significant after controlling for health and demographic covariates, and when using multiply imputed data to account for attrition. Non-attenders were unlikely to start attending after elevated depressive symptoms. This study provides counter evidence against previous findings that church attenders are a self-selected healthier group

EMDR as a treatment for long term depression: a feasibility study

Objective. Current treatments for long-term depression – medication and psy-chotherapy – are effective for some but not all clients. New approaches need to bedeveloped to complement the ones already available. This study was designed to test thefeasibility of using an effective post-traumatic stress disorder treatment for people withlong-term depression. Design. A single-case experimental design with replications was undertaken as afeasibility study of eye movement desensitization and reprocessing (EMDR) in treatinglong-term depression. Methods. Thirteen people with recurrent and/or long-term depression were recruitedfrom primary care mental health services and given standard protocol EMDR for amaximum of 20 sessions. Levels of depression were measured before and after treatmentand at follow-up, clients also rated their mood each day. Results. Eight people engaged with the treatment; seven of these had clinically significantand statistically reliable improvement on the Hamilton Rating Scale for Depression. Dailymood ratings were highly variable both during baseline and intervention. Conclusions. EMDR is a feasible treatment for recurrent and/or long-term depression.Research on treatment efficacy and effectiveness is now required

Spiritual Struggles and Health: Assessing the Influence of Socioeconomic Status

Growing evidence suggests that spiritual struggles may play a major role in explaining the relationship between religion and health. Even so, there are significant gaps in the literature. More specifically, researchers do not know enough about how spiritual struggles arise in the first place. This study has two major goals. The first is to see whether socioeconomic status is associated with spiritual struggles. The second is to see whether spiritual struggles are associated with physical health. A conceptual model is tested that contains the following core hypotheses: (1) individuals with lower levels of educational attainment are more likely to encounter chronic economic difficulties; (2) people who experience ongoing financial strain are more likely to live in rundown neighborhoods; (3) people who live in dilapidated neighborhoods will be more angry than their well‐to‐do counterparts; (4) people who are more angry will, in turn, be more likely to experience spiritual struggles; and (5) greater spiritual struggles will be associated with more symptoms of physical illness. Data from a recent nationwide survey (N = 2,146) provide empirical support for each hypothesis.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143659/1/jssr12364_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143659/2/jssr12364.pd

Sociocultural considerations in aging men's health: implications and recommendations for the clinician

http://dx.doi.org/10.1016/j.jomh.2009.07.00