Stressful childhood experiences and health outcomes in sexual minority populations: a systematic review

Purpose: Stressful childhood experiences (SCE) are associated with many different health outcomes, such as psychiatric symptoms, physical illnesses, alcohol and drug abuse, and victimization experiences. Lesbian, gay, bisexual, and transgender (LGBT) people are at risk to be victims of SCE and show higher prevalence of SCE when compared with heterosexual controls. Methods: This review analyzed systematically 73 articles that addressed different types of SCE in sexual minority populations and included items of household dysfunction. The samples included adults who identified either their sexual orientation as non-heterosexual or their gender identity as transgender. Results: The studies reported childhood sexual abuse (CSA), childhood physical abuse (CPA), childhood emotional abuse (CEA), childhood physical neglect, and childhood emotional neglect. Items of household dysfunction were substance abuse of caregiver, parental separation, family history of mental illness, incarceration of caregiver, and witnessing violence. Prevalence of CSA showed a median of 33.5% for studies using non-probability sampling and 20.7% for those with probability sampling, the rates for CPA were 23.5% (non-probability sampling) and 28.7% (probability sampling). For CEA, the rates were 48.5%, non-probability sampling, and 47.5%, probability sampling. Outcomes related to SCE in LGBT populations included psychiatric symptoms, substance abuse, revictimization, dysfunctional behavioral adjustments, and others. Conclusions: LGBT populations showed high prevalence of SCE. Outcomes related to SCE ranged from psychiatric symptoms and disorders to physical ailments. Most studies were based in the USA. Future research should aim to target culturally different LGBT population in the rest of the world

Weaving Words and Music: Healing from Trauma for People With Serious Mental Illness

This article presents the development of music-verbal therapy trauma groups for people with serious mental illness. The work grew out the collaboration of an interdisciplinary trauma committee in an urban mental health center. Recognizing the high rates of childhood trauma in this population, members of the committee developed interventions targeting their specific needs. The collaboration of music and verbal therapies was found to be very valuable in the treatment of complex trauma. The article outlines the interdisciplinary collaboration and the structure of the groups. Elements of music as tools in trauma treatment are described along with using words to identify specific problems and solutions. Examples of the authors’ clinical work are shared from this interweaving of words and music. Brief vignettes demonstrate survivors’ journeys as they begin to identify and create safety, build healthy relationships, and maintain equilibrium while facing the challenges of their past traumatic experiences. (PsycInfo Database Record (c) 2020 APA, all rights reserved

Effects of assisted outpatient treatment and health care services on psychotic symptoms

An ongoing debate concerns acceptability, benefits, and shortcomings of coercive treatment such as assisted outpatient treatment (AOT). The hypothesis that involuntary commitment to outpatient treatment may lead to a better clinical outcome for a subgroup of persons with severe mental illness (SMI) is controversial. Nonetheless, positive effects of AOT may be mediated by an increased availability of healthcare resources or increased service use.; The purpose of the present study is to evaluate the course of delusions, hallucinations, and negative symptoms among patients with SMI receiving AOT compared to patients receiving non-compulsory treatment (NCT). Moreover, we assessed if the effects of AOT on psychotic symptoms were mediated by increased healthcare service use.; This study used a quasi-experimental design to examine the effect of AOT and the use of healthcare services on psychotic symptoms. In total, 76 (41.3%) participants with SMI received AOT, and 108 (58.7%) received NCT. The participants were interviewed at baseline every 3 months up to 1 year. Propensity score matching was used to control for group differences.; In the basic model, AOT was associated with lower severity of psychotic symptoms over all follow-up points. In the model including healthcare service use, the frequency of case manager visits predicted a reduction in severity of all psychotic symptoms. The frequency of visits to the outpatient clinics, frequency of emergency room, and psychiatrist visits were independently associated with lower levels of delusional symptoms. Psychiatrist visits were related to a decrease in negative symptoms.; Results indicate that the treatment benefits of AOT are enhanced with the increased use of mental healthcare services, suggesting that the positive effect of AOT on psychotic symptoms is related to the availability of mental healthcare service use. Coercive outpatient treatment might be more effective through greater use of intensive services