An integrative model of narrative identity builds on a dual memory system that draws on episodic ... more An integrative model of narrative identity builds on a dual memory system that draws on episodic memory and a long-term self to generate autobiographical memories.Autobiographical memories related to critical goals in a lifetime period lead to life-story memories, which in turn become self-defining memories when linked to an individual's enduring concerns. Self-defining memories that share repetitive emotion-outcome sequences yield narrative scripts, abstracted templates that filter cognitive-affective processing.The life story is the individual's overarching narrative that provides unity and purpose over the life course. Healthy narrative identity combines memory specificity with adaptive meaning-making to achieve insight and well-being, as demonstrated through a literature review of personality and clinical research, as well as new findings from our own research program. A clinical case study drawing on this narrative identity model is also presented with implications for treatment and research.
The authors review research on the risk factors for, and prevalence of, psychological disorders a... more The authors review research on the risk factors for, and prevalence of, psychological disorders as they relate to gender nonconformity in adolescence and adulthood. Findings from existing literature suggest gender nonconforming individuals are more likely to experience a variety of risk factors associated with psychopathology when compared with general and sexual minority populations. Associated with these risk factors, gender nonconforming individuals also report higher rates of psychopathology as well. The authors propose more research that examines gender nonconformity as an independent line of inquiry that transcends sexual orientation and gender identity.
ABSTRACT OBJECTIVES: Increasingly, researchers and practitioners are recognizing transgender indi... more ABSTRACT OBJECTIVES: Increasingly, researchers and practitioners are recognizing transgender individuals’ mental health needs beyond the Gender Dysphoria diagnosis. Nonetheless, most existing research focuses on anxiety, depression, and substance use in localized transgender samples, yielding disparate results. This review aims to synthesize prevalence rates of mental illness, identify gaps in the literature, and recommend further exploration regarding mental health in the transgender community. METHODS: A systematic review of the transgender mental health literature was conducted in PsychInfo and PubMed databases for empirical research articles published during or after 2000. Thematic analysis was employed to organize and interpret results. RESULTS: A total of 24 articles concerning prevalence of mental illness symptoms were found. Studies reporting on depression, anxiety, substance use, and suicidality all supported increased prevalence in comparison to the cisgender population; however, prevalence estimates ranged widely. Few studies reported on post-traumatic stress disorder (N = 2), eating disorders (N = 2), somatic symptom and related disorders (N = 2), dissociative disorders (N = 1), and autism (N = 1); there were no studies found examining other mental health diagnoses. Psychological distress was frequently mediated by experiences of transphobia and victimization. CONCLUSION: Researchers repeatedly suggest that mounting stigmatizing experiences may exacerbate psychological distress for transgender individuals. Nonetheless, more research is needed to fully understand these mental health disparities in light of a rapidly changing sociopolitical climate. Future research directions and implications for public health will be discussed.
We conducted a systematic review to assess evidence for disparities for lesbian and bisexual wome... more We conducted a systematic review to assess evidence for disparities for lesbian and bisexual women (i.e., sexual minority women [SMW]) in comparison with heterosexual women across a range of nine physical health conditions. Among the k = 11 studies meeting eligibility criteria, almost every comparison (i.e., heterosexual vs. (a) lesbian, (b) bisexual, or (c) both lesbian and bisexual women) was in a direction indicating SMW disparities. Despite limited power due to small samples of SMW, we found evidence of disparities as indicated by a statistically significant adjusted odds ratios for asthma (5 of 7 comparisons), obesity (8 of 12), arthritis (2 of 3), global ratings of physical health (4 of 7), and cardiovascular disease (1 of 1). Evidence was lacking for cancer (1 of 4), diabetes and hypertension (both 1 of 5), and high cholesterol (0 of 3). Future work should confirm findings in more diverse, larger samples and examine potential explanatory factors.
ABSTRACT Objectives: Sexual minorities experience elevated rates of victimization and suicidality... more ABSTRACT Objectives: Sexual minorities experience elevated rates of victimization and suicidality (Shields, 2011). In some cases, identity disclosure may protect against suicidality (Morris, 2001). However, less is known about the effects of outness to one’s family. We analyzed family outness as a moderator in the association between victimization and reported number of lifetime suicide attempts. Methods: 730 sexual minority adults (M age = 29.99, SD = 13.84) were recruited nationally from university-affiliated LGBTQ groups, community organizations, and Facebook. Hypotheses were tested using negative binomial regression. Covariates included age, gender, ethnicity, sexual identity, depression, anxiety, and general (i.e., non-family specific) outness. Results: 28% reported one or more suicide attempts (Range = 0 - 50, M = .73, SD = 2.46). The interaction model was significant, omnibus X2 = 205.53, df = 14, p < .001, AIC = 1364.07. As hypothesized, family outness moderated the positive association between victimization and number of lifetime suicide attempts, b = -.20, Wald X2 = 12.86, df = 1, p < .001. A simple effect for victimization remained beyond the interaction, b = .60, Wald X2 = 49.61, df = 1, p < .001. Conclusions: Family outness weakened the association between victimization and suicide risk, suggesting that the extent to which sexual identity is known and openly talked about within the family serves as a protective factor. These findings have important clinical and public health implications regarding family involvement and future suicide prevention and intervention efforts. Future directions, limitations, and implications will be discussed.
Psychology of Sexual Orientation and Gender Diversity, 2015
Sexual minority-based victimization, which includes threats or enacted interpersonal violence, pr... more Sexual minority-based victimization, which includes threats or enacted interpersonal violence, predicts elevated suicide risk among sexual minority individuals. However, research on personality factors that contribute to resilience among sexual minority populations is lacking. Using the Five-Factor Model, we hypothesized that individuals classified as adaptive (versus at-risk) would be at decreased risk for a suicide attempt in the context of reported lifetime victimization. Sexual minority-identified young adults between the ages of 18 and 25 (N=412) were recruited nationally and asked to complete an online survey containing measures of personality, sexual minority stress, and lifetime suicide attempts. A two-stage cluster analytic method was used to empirically derive latent personality profiles and to classify respondents as adaptive (lower neuroticism and higher extroversion, agreeableness, conscientiousness, and openness) or at-risk (higher neuroticism, lower extroversion, agreeableness, conscientiousness, and openness) on the basis of their Five Factor Personality trait scores. Adaptive individuals were slightly older and less likely to conceal their sexual orientation, but reported similar rates of victimization, discrimination, and internalized heterosexism as their at-risk counterparts. Logistic regression results indicate that despite reporting similar rates of victimization, which was a significant predictor of lifetime suicide attempt, adaptive individuals evidenced decreased risk for attempted suicide in the context of victimization, relative to at-risk individuals. These findings suggest that an adaptive personality profile may confer resilience in the face of sexual minority-based victimization. This study adds to our knowledge of sexual minority mental health and highlights new directions for future research.
OBJECTIVES: Transgender individuals face compounding stressors that increase their vulnerability ... more OBJECTIVES: Transgender individuals face compounding stressors that increase their vulnerability to mental illness and suicidality (Bockting, Knudson, & Goldberg, 2006). Whereas these poor mental health outcomes have been associated with events of discrimination and victimization (Rotondi, 2012), less is known regarding the effects of institutionalized stigma. This study explores the relationships between statewide transgender protections, perceived community stigma, and mental health correlates among 120 transgender individuals. METHODS: 32 transwomen, 37 transmen, and 51 gender-variant participants were extracted from a larger study on LGBT mental health. Covarying for age, we performed an ANCOVA to determine the effect of state legal protections on perceived community stigma. Follow up bivariate analyses were performed to examine the relationships between stigma and depression, anxiety, suicidality, victimization, and discrimination. RESULTS: Statewide legal protections had a sig...
OBJECTIVES: Increasingly, researchers and practitioners are recognizing transgender individuals’ ... more OBJECTIVES: Increasingly, researchers and practitioners are recognizing transgender individuals’ mental health needs beyond the Gender Dysphoria diagnosis. Nonetheless, most existing research focuses on anxiety, depression, and substance use in localized transgender samples, yielding disparate results. This review aims to synthesize prevalence rates of mental illness, identify gaps in the literature, and recommend further exploration regarding mental health in the transgender community. METHODS: A systematic review of the transgender mental health literature was conducted in PsychInfo and PubMed databases for empirical research articles published during or after 2000. Thematic analysis was employed to organize and interpret results. RESULTS: A total of 24 articles concerning prevalence of mental illness symptoms were found. Studies reporting on depression, anxiety, substance use, and suicidality all supported increased prevalence in comparison to the cisgender population; however, p...
Objectives: Sexual minorities experience elevated rates of victimization and suicidality (Shields... more Objectives: Sexual minorities experience elevated rates of victimization and suicidality (Shields, 2011). In some cases, identity disclosure may protect against suicidality (Morris, 2001). However, less is known about the effects of outness to one’s family. We analyzed family outness as a moderator in the association between victimization and reported number of lifetime suicide attempts. Methods: 730 sexual minority adults (M age = 29.99, SD = 13.84) were recruited nationally from university-affiliated LGBTQ groups, community organizations, and Facebook. Hypotheses were tested using negative binomial regression. Covariates included age, gender, ethnicity, sexual identity, depression, anxiety, and general (i.e., non-family specific) outness. Results: 28% reported one or more suicide attempts (Range = 0 - 50, M = .73, SD = 2.46). The interaction model was significant, omnibus X2 = 205.53, df = 14, p < .001, AIC = 1364.07. As hypothesized, family outness moderated the positive assoc...
An integrative model of narrative identity builds on a dual memory system that draws on episodic ... more An integrative model of narrative identity builds on a dual memory system that draws on episodic memory and a long-term self to generate autobiographical memories.Autobiographical memories related to critical goals in a lifetime period lead to life-story memories, which in turn become self-defining memories when linked to an individual's enduring concerns. Self-defining memories that share repetitive emotion-outcome sequences yield narrative scripts, abstracted templates that filter cognitive-affective processing.The life story is the individual's overarching narrative that provides unity and purpose over the life course. Healthy narrative identity combines memory specificity with adaptive meaning-making to achieve insight and well-being, as demonstrated through a literature review of personality and clinical research, as well as new findings from our own research program. A clinical case study drawing on this narrative identity model is also presented with implications for treatment and research.
The authors review research on the risk factors for, and prevalence of, psychological disorders a... more The authors review research on the risk factors for, and prevalence of, psychological disorders as they relate to gender nonconformity in adolescence and adulthood. Findings from existing literature suggest gender nonconforming individuals are more likely to experience a variety of risk factors associated with psychopathology when compared with general and sexual minority populations. Associated with these risk factors, gender nonconforming individuals also report higher rates of psychopathology as well. The authors propose more research that examines gender nonconformity as an independent line of inquiry that transcends sexual orientation and gender identity.
ABSTRACT OBJECTIVES: Increasingly, researchers and practitioners are recognizing transgender indi... more ABSTRACT OBJECTIVES: Increasingly, researchers and practitioners are recognizing transgender individuals’ mental health needs beyond the Gender Dysphoria diagnosis. Nonetheless, most existing research focuses on anxiety, depression, and substance use in localized transgender samples, yielding disparate results. This review aims to synthesize prevalence rates of mental illness, identify gaps in the literature, and recommend further exploration regarding mental health in the transgender community. METHODS: A systematic review of the transgender mental health literature was conducted in PsychInfo and PubMed databases for empirical research articles published during or after 2000. Thematic analysis was employed to organize and interpret results. RESULTS: A total of 24 articles concerning prevalence of mental illness symptoms were found. Studies reporting on depression, anxiety, substance use, and suicidality all supported increased prevalence in comparison to the cisgender population; however, prevalence estimates ranged widely. Few studies reported on post-traumatic stress disorder (N = 2), eating disorders (N = 2), somatic symptom and related disorders (N = 2), dissociative disorders (N = 1), and autism (N = 1); there were no studies found examining other mental health diagnoses. Psychological distress was frequently mediated by experiences of transphobia and victimization. CONCLUSION: Researchers repeatedly suggest that mounting stigmatizing experiences may exacerbate psychological distress for transgender individuals. Nonetheless, more research is needed to fully understand these mental health disparities in light of a rapidly changing sociopolitical climate. Future research directions and implications for public health will be discussed.
We conducted a systematic review to assess evidence for disparities for lesbian and bisexual wome... more We conducted a systematic review to assess evidence for disparities for lesbian and bisexual women (i.e., sexual minority women [SMW]) in comparison with heterosexual women across a range of nine physical health conditions. Among the k = 11 studies meeting eligibility criteria, almost every comparison (i.e., heterosexual vs. (a) lesbian, (b) bisexual, or (c) both lesbian and bisexual women) was in a direction indicating SMW disparities. Despite limited power due to small samples of SMW, we found evidence of disparities as indicated by a statistically significant adjusted odds ratios for asthma (5 of 7 comparisons), obesity (8 of 12), arthritis (2 of 3), global ratings of physical health (4 of 7), and cardiovascular disease (1 of 1). Evidence was lacking for cancer (1 of 4), diabetes and hypertension (both 1 of 5), and high cholesterol (0 of 3). Future work should confirm findings in more diverse, larger samples and examine potential explanatory factors.
ABSTRACT Objectives: Sexual minorities experience elevated rates of victimization and suicidality... more ABSTRACT Objectives: Sexual minorities experience elevated rates of victimization and suicidality (Shields, 2011). In some cases, identity disclosure may protect against suicidality (Morris, 2001). However, less is known about the effects of outness to one’s family. We analyzed family outness as a moderator in the association between victimization and reported number of lifetime suicide attempts. Methods: 730 sexual minority adults (M age = 29.99, SD = 13.84) were recruited nationally from university-affiliated LGBTQ groups, community organizations, and Facebook. Hypotheses were tested using negative binomial regression. Covariates included age, gender, ethnicity, sexual identity, depression, anxiety, and general (i.e., non-family specific) outness. Results: 28% reported one or more suicide attempts (Range = 0 - 50, M = .73, SD = 2.46). The interaction model was significant, omnibus X2 = 205.53, df = 14, p &lt; .001, AIC = 1364.07. As hypothesized, family outness moderated the positive association between victimization and number of lifetime suicide attempts, b = -.20, Wald X2 = 12.86, df = 1, p &lt; .001. A simple effect for victimization remained beyond the interaction, b = .60, Wald X2 = 49.61, df = 1, p &lt; .001. Conclusions: Family outness weakened the association between victimization and suicide risk, suggesting that the extent to which sexual identity is known and openly talked about within the family serves as a protective factor. These findings have important clinical and public health implications regarding family involvement and future suicide prevention and intervention efforts. Future directions, limitations, and implications will be discussed.
Psychology of Sexual Orientation and Gender Diversity, 2015
Sexual minority-based victimization, which includes threats or enacted interpersonal violence, pr... more Sexual minority-based victimization, which includes threats or enacted interpersonal violence, predicts elevated suicide risk among sexual minority individuals. However, research on personality factors that contribute to resilience among sexual minority populations is lacking. Using the Five-Factor Model, we hypothesized that individuals classified as adaptive (versus at-risk) would be at decreased risk for a suicide attempt in the context of reported lifetime victimization. Sexual minority-identified young adults between the ages of 18 and 25 (N=412) were recruited nationally and asked to complete an online survey containing measures of personality, sexual minority stress, and lifetime suicide attempts. A two-stage cluster analytic method was used to empirically derive latent personality profiles and to classify respondents as adaptive (lower neuroticism and higher extroversion, agreeableness, conscientiousness, and openness) or at-risk (higher neuroticism, lower extroversion, agreeableness, conscientiousness, and openness) on the basis of their Five Factor Personality trait scores. Adaptive individuals were slightly older and less likely to conceal their sexual orientation, but reported similar rates of victimization, discrimination, and internalized heterosexism as their at-risk counterparts. Logistic regression results indicate that despite reporting similar rates of victimization, which was a significant predictor of lifetime suicide attempt, adaptive individuals evidenced decreased risk for attempted suicide in the context of victimization, relative to at-risk individuals. These findings suggest that an adaptive personality profile may confer resilience in the face of sexual minority-based victimization. This study adds to our knowledge of sexual minority mental health and highlights new directions for future research.
OBJECTIVES: Transgender individuals face compounding stressors that increase their vulnerability ... more OBJECTIVES: Transgender individuals face compounding stressors that increase their vulnerability to mental illness and suicidality (Bockting, Knudson, & Goldberg, 2006). Whereas these poor mental health outcomes have been associated with events of discrimination and victimization (Rotondi, 2012), less is known regarding the effects of institutionalized stigma. This study explores the relationships between statewide transgender protections, perceived community stigma, and mental health correlates among 120 transgender individuals. METHODS: 32 transwomen, 37 transmen, and 51 gender-variant participants were extracted from a larger study on LGBT mental health. Covarying for age, we performed an ANCOVA to determine the effect of state legal protections on perceived community stigma. Follow up bivariate analyses were performed to examine the relationships between stigma and depression, anxiety, suicidality, victimization, and discrimination. RESULTS: Statewide legal protections had a sig...
OBJECTIVES: Increasingly, researchers and practitioners are recognizing transgender individuals’ ... more OBJECTIVES: Increasingly, researchers and practitioners are recognizing transgender individuals’ mental health needs beyond the Gender Dysphoria diagnosis. Nonetheless, most existing research focuses on anxiety, depression, and substance use in localized transgender samples, yielding disparate results. This review aims to synthesize prevalence rates of mental illness, identify gaps in the literature, and recommend further exploration regarding mental health in the transgender community. METHODS: A systematic review of the transgender mental health literature was conducted in PsychInfo and PubMed databases for empirical research articles published during or after 2000. Thematic analysis was employed to organize and interpret results. RESULTS: A total of 24 articles concerning prevalence of mental illness symptoms were found. Studies reporting on depression, anxiety, substance use, and suicidality all supported increased prevalence in comparison to the cisgender population; however, p...
Objectives: Sexual minorities experience elevated rates of victimization and suicidality (Shields... more Objectives: Sexual minorities experience elevated rates of victimization and suicidality (Shields, 2011). In some cases, identity disclosure may protect against suicidality (Morris, 2001). However, less is known about the effects of outness to one’s family. We analyzed family outness as a moderator in the association between victimization and reported number of lifetime suicide attempts. Methods: 730 sexual minority adults (M age = 29.99, SD = 13.84) were recruited nationally from university-affiliated LGBTQ groups, community organizations, and Facebook. Hypotheses were tested using negative binomial regression. Covariates included age, gender, ethnicity, sexual identity, depression, anxiety, and general (i.e., non-family specific) outness. Results: 28% reported one or more suicide attempts (Range = 0 - 50, M = .73, SD = 2.46). The interaction model was significant, omnibus X2 = 205.53, df = 14, p < .001, AIC = 1364.07. As hypothesized, family outness moderated the positive assoc...
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Papers by Kathryn Oost