Men's Mental Health Research Articles

“We're opening 20 doors!“: Exploring the collective dimensions of Shared Reading as mental health promotion among newly retired men in Denmark

Retirement is a significant life transition, bringing with it structural and social alterations in everyday life. For older men, work life is an important source of identity and meaning, and retirement may therefore lead to diminished well-being due to loss of occupational attachments. This calls for a need to address men's life transitions in health-promoting interventions and to explore how to introduce positive changes in retired men's mental health. Studies have investigated mental health effects of Shared Reading (SR) with promising results, but the impact of a collective reading experience on the positive mental health of male retirees has not been investigated. This study explores the mental health-promoting potential of SR among newly retired men in Denmark through an investigation of collective dimensions of the SR experience. The study identified three central collective dimensions of the SR experience: awareness and presence, sense-making, and social connectivity. Through these dimensions, SR provides a space for 1) affective, existential, and social stimulation; 2) shared reflection on both real and imagined past, present, and future lives; and 3) the (re)establishment or maintenance of senses of engagement, meaning, and community. On this basis, it is concluded that SR holds a potential to promote different aspects of positive mental health, i.e., affective well-being, meaning-making, and a sense of community for newly retired men.

Men's mental health and interventions tailored to masculinity: a scoping review

Masculinity norms, characterized by specific behaviors, thoughts and emotions that are considered socially appropriate for both Eastern and Western men, have been perceived as obstacles to seeking professional help, especially in situations where men are mentally distressed. This scoping review aimed to gain insight into the different factors that affect men’s mental health and explore the different types of interventions tailored to masculinity conventions. Research published between January 2018 and June 2023 was examined using keywords to extract relevant studies from PubMed, CINAHL, SCOPUS and Web of Science, with discussion and cross-checking by both authors. Twelve studies consisting of six randomized-controlled trials, four qualitative studies and two mixed method studies were identified. A variety of interventions were identified in this review, including soccer-related physical activity-based interventions, online interventions, therapeutic counseling interventions that integrate interviews and cognitive-behavioral group therapy, and interventions using expert networks. The need for online interventions that consider traditional masculinity norms in encouraging help-seeking behavior, and the effectiveness of support groups in providing a safe space for men to discuss their mental health, are key findings. As a public health issue, men’s mental well-being is substantially significant, and tailored interventions are needed to support men’s mental health. Therefore, the implementation of effective interventions and the active role of policy makers in promoting mental health awareness for men is also required. Based on these findings, strategies to engage men in mental health services, strengthen social support networks, and challenge harmful male stereotypes within healthcare settings and communities should be considered.

Existential isolation and psychological distress during COVID-19: The role of loneliness and resilient coping in Canadian help-seeking men

BackgroundThe COVID-19 pandemic has had a significant impact on men's lives. Investigating specific constructs and pathways related to men's mental health outcomes may help to more fully understand the short and long-term impact of the pandemic and illuminate opportunities to better promote men's mental health. In this study, we assessed the mediating effect of loneliness on the relationship between existential isolation and psychological distress, and the moderating effect of resilient coping on that relationship. MethodsThis cross-sectional study included a sample of help-seeking Canadian men in the first year of the COVID-19 pandemic (N = 434). Participants completed measures of existential isolation, loneliness, resilient coping, and psychological distress. A moderated mediation analysis was conducted. ResultsOver half (54 %) of the participants reported psychological distress in a clinical range. Findings indicated that loneliness was a significant mediator in the association between existential isolation and psychological distress. Furthermore, findings revealed that resilient coping moderated the relationship between loneliness and psychological distress, such that men who were low on resilient coping experienced the greatest effect on psychological distress. LimitationsThe employed mediation analyses were cross-sectional in nature, limiting any firm conclusions regarding causality. ConclusionsEfforts to reduce psychological distress may be targeted at decreasing men's experiences of existential isolation or improving resilient coping. Consideration should be given to contextual factors related to COVID-19 as well as men's preferences for help-seeking and mental health support.

Regulatory emotional self-efficacy and anxiety in times of pandemic: a gender perspective

ABSTRACT Objectives: The COVID-19 pandemic and resultant lockdown and containment measures have instigated substantial changes in our daily lives and have affected many people’s mental health. This paper reports two studies exploring gender-based differences with regard to the impact of COVID-related confinement on individuals’ self-efficacy to regulate negative emotions (RESE-NE) and anxiety. Methods: Study 1 (cross-sectional; 269 participants; 52% women) explored the evolution of RESE-NE and anxiety. To this end, participants assessed their status at two time points: a retrospective assessment of the period before confinement in Spain, and a current assessment during confinement. Study 2 (longitudinal; 114 participants; 72.2% women) explored the evolution of the variables by adding a post-confinement time point and analyzed the mediating role of RESE-NE in the positivity–anxiety and resilience–anxiety relationships. Results: The results confirmed that: (a) RESE-NE decreased and anxiety increased more among women than among men during confinement (Study 1); (b) women recovered their pre-pandemic levels of mental health more slowly than did men following confinement; and (c) the mediating role of RESE-NE could be observed in the two relationships under analysis. Conclusion: In practical terms, the research highlights the need to pay special attention to women undergoing mental health interventions related to the COVID-19 pandemic, as well as to the differential burden that the pandemic may entail for men and women and to the contrasting social roles traditionally attributed to them. From the gender differences identified, it is possible to infer how stereotypes and social roles influence the behavior and mental health of men and women, leading them to cope differently with stressful situations such as confinement.

Mindfulness and psychological distress in men during the COVID-19 pandemic: The mediating role of environmental mastery and purpose in life.

Men's mental health has been severely affected during the COVID-19 pandemic, with many studies focussing on the determinants of men's psychological distress. This study aimed at examining the relationships between mindfulness, environmental mastery (EM), purpose in life (PL) and indicators of psychological distress (i.e., common mental disorders and perceived stress). This was a cross-sectional online study in which participants were 1,006 men aged between 29 and 39 years (45.1%), residing in Brazil during the first wave of the COVID-19 pandemic. A parallel multiple mediator model was used to test the study variables' relationships, using mindfulness as the independent variable and indicators of psychological distress as the dependent variables. Results indicated that EM and PL significantly mediated the effects of mindfulness on men's psychological distress, lowering its levels and accounting for 31% of common mental disorders and 51% of perceived stress. Implications for public health policies and clinical practice are discussed.

“There’s No Sewing Classes, There’s No Bedazzling Seminars”: The Impact of Masculinity on Social Connectedness and Mental Health for Men Living in Inner-Regional Australia

Regional Australian masculinities are typified by 'traditional' values (e.g., stoicism, self-reliance) known to restrict social connectedness. Thus, these masculinities have been implicated in worsening men's mental health. What remains unclear, however, is how men living in inner-regional communities (i.e., townships on the fringes of major cities) might uniquely experience masculinity, social connectedness, and mental health. We interviewed 29 boys/men and one non-binary participant (M age = 43.77 years) living in the Macedon Ranges (an inner-regional Australian community). Using reflexive thematic analysis, we generated three themes. Participants described inner-regional masculinities as traditional and rigid, and attributed the Macedon Ranges' comparatively high suicide rate to these masculinities. Conversely, migration from the neighbouring city of Melbourne was implicated in introducing more inclusive masculinities to the area that conflicted with existing masculine norms. Thus, Macedon Ranges men were framed as ultimately lacking a cohesive community identity. Proximity to Melbourne was described as encouraging local men to commute daily for work instead of working locally, thereby further weakening community identity. Overall, these phenomena were implicated in damaging the psychosocial wellbeing of local men via reducing social connectedness. Because men's mental illness is so pervasive within regional Australian communities, these findings have direct implications for policymakers. Namely, policies need to acknowledge that masculinities directly influence mental health and that inner-regional masculinities are impacted by unique place-based considerations distinct from men living in other regional communities.

Agriculture, COVID-19 and mental health: Does gender matter?

Agriculture is one of the most precarious professions, being vulnerable to weather extremes and animal disease. As crises hit the agricultural sector, a growing awareness and concern for the mental wellbeing of farmers developed. Economic decline, climate change and culling animals all have a profound impact on affected farmers. To date, research has tended to focus on the farmer, typically a man, and not the farm family. This article considers the impact of Coronavirus (COVID-19)on men and women on farms. Using qualitative interviews and focus groups, the impact of the pandemic on men's and women's work and social life within the family is explored. We found a differential impact. For farmers, usually men, COVID-19 was generally a positive experience both in terms of work and social life. For women, on the other hand, COVID-19 was found to have a negative impact on their work and social life. While gender equality in agriculture persists, women's equality in the workplace has advanced. However, with the pandemic, women worked from home on the farm. They experienced a regression in gender equality with traditional expectations of responsibility for childcare and housework returning. In addition, their emotional and 'mental' labour increased. We conclude that in the future, the mental health of men and women on farms needs to be considered when crises occur. Crises impact the farm family and different members of the family in dissimilar ways.

Shoulder-to-Shoulder: How Pinball Supports Men's Wellbeing

When facing mental health concerns, men seek help less, confront greater stigma in accessing treatment, and experience more severe consequences. Interventions targeted at men are often grounded in activity and situated in appealing contexts, such as sporting or gaming spaces. In this paper, we question how pinball---a social tangible and digital leisure activity---can support men's mental health and wellbeing, through thematic analysis of in-depth semi-structured interviews (n=15) with male pinball enthusiasts. Our contribution is threefold: first, we evidence pinball as a context that provides incidental benefits to mental health directly, and indirectly through social connectedness; second, that enthusiasts actively enhance their social lives and resulting wellbeing via pinball; and third, that pinball contexts are suited for designing interventions that provide mental health supports within subcultures that appeal to men. We situate our findings in theories of wellbeing, activity-based communication, shoulder-to shoulder self-disclosure, and the importance of third-spaces for social wellness.

Designing the model of men's violence against women based on religious orientation and mental health, considering the mediating role of gendered educational style and cognitive emotion regulation styles

Background and objectives: Family is a center for affection and an environment for friendship and kindness among family members. However, the occurrence of violence in the family by one of the members towards others disrupts this function. This study investigated the relationship between religious orientation, cognitive styles of emotion regulation, gendered educational style and men's mental health is affected by violence against women. Materials and methods: The statistical population included the married men who referred to medical centers in Qazvin city; among whom, 300 people were selected through convenience sampling method. Data collection tools were Alport's Religious Beliefs Questionnaire, Keys' Mental Health Questionnaire, Mohseni Tabrizi's Domestic Violence Questionnaire, and Garnevsky's cognitive regulation of emotion. For descriptive analysis of data, central tendency and dispersion were used. The obtained data were analyzed in two descriptive and inferential statistics parts, using SPSS20 and Lisrel 8.80 software. The structural equations technique was used to implement the conceptual model of the research and hypothesis testing. Ethical considerations: Because the questions related to marital relations are private, it was attempted to use Iranian-Islamic questionnaires. Findings: Religious orientation, mental health, gendered educational style, and men’s cognitive emotion regulation styles have a positive relationship with violence against women.

Association of adolescent and young adult depression and anxiety with perinatal mental health in fathers: Findings from an Australian longitudinal study

The current study examined associations between preconception diagnoses of major depressive disorder (MDD) and anxiety disorders in adolescence and young adulthood and perinatal depression and anxiety symptoms in early fatherhood. In an Australian community cohort study of health and development, earlier history of MDD and anxiety disorders (extending back to adolescence) were assessed retrospectively in the third trimester of pregnancy via the Composite International Diagnostic Interview. Paternal perinatal depression and anxiety were then assessed prospectively over three timepoints (third trimester of pregnancy, 8 weeks and 12 months postpartum), using established cut-points on the Edinburgh Postnatal Depression Scale and the Depression Anxiety Stress Scales (anxiety subscale). Mixed-effects regression models examined risk associations between preconception diagnoses of MDD and anxiety disorders, and perinatal depression and anxiety symptoms at each timepoint, adjusting for socio-demographic factors and concurrent maternal mental health difficulties. The odds of clinically concerning levels of paternal perinatal depression and anxiety were 6-fold and 4-fold higher, respectively, in men with a preconception history of MDD. The odds of perinatal depression were 3-fold higher in men with a preconception history of an anxiety disorder. Less evidence was found for an association between preconception diagnoses of an anxiety disorder and perinatal anxiety in fathers. Interventions aimed at improving mental health in men during adolescence and young adulthood may promote continued psychological health in men during early fatherhood.

Psychological inflexibility mediates the relationship between conformity to masculine norms and depression: Preliminary support for a transdiagnostic approach to working therapeutically with men

BackgroundResearch suggests that rigid adherence to masculine norms is associated with negative mental health outcomes in men. However, contributing pathways between masculine norms and men's mental health are not yet well understood. It has been proposed that psychological inflexibility may function as a mediator in the relationship between masculine norms and depression in men. AimsThis study investigated whether psychological inflexibility mediated the relationship between conformity to masculine norms and depression. MethodA community-based sample of 326 men (M age = 62.33, SD age = 15.33 years) completed an online questionnaire using a range of validated scales, including the Conformity to Masculine Norms Inventory (CMNI-22), the Acceptance and Action Questionnaire (AAQ-II), the Cognitive Fusion Questionnaire (CFQ-7), the Patient Health Questionnaire (PHQ-9), and the Male Depression Risk Scale (MDRS-22). Mediation analyses and two-way ANOVAs were used to explore relationships between variables. ResultsResults indicated that psychological inflexibility significantly mediated the relationship between conformity to masculine norms and depression (both prototypic and externalising symptomology). Findings also revealed that psychological inflexibility is more strongly linked with poor mental health than conformity to masculine norms. ConclusionsThe results suggest that psychological inflexibility may be a possible pathway through which conformity to masculine norms is associated with depressive symptoms in men, providing important insights into possible therapeutic targets for psychological intervention.

Human umbilical cord mesenchymal stem cells ameliorate erectile dysfunction in rats with diabetes mellitus through the attenuation of ferroptosis

BackgroundErectile dysfunction (ED), as one of the most prevalent consequences in male diabetic patients, has a serious impact on men's physical and mental health, and the treatment effect of diabetic mellitus erectile dysfunction (DMED) is often worse. Therefore, the development of a novel therapeutic approach is urgent. As stem cells with high differentiation potential, human umbilical cord mesenchymal stem cells (HUCMSCs) have been widely used in the treatment of diseases in other systems, and are expected to be a promising strategy for the treatment of DMED. In this study, we investigated the role of HUCMSCs in managing erectile function in rat models of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) and compared the effects of two different injection methods.MethodsT1DM and T2DM ED rats were given labelled HUCMSCs by corpus cavernosum injection and tail vein injection, respectively. ICP and MAP were monitored simultaneously by electrical stimulation four weeks after injection to indicate the erectile function of rats. To track the development and colonisation capabilities of stem cells, we performed EdU assay with penile tissue. The histological changes of the penis were observed by hematoxylin–eosin staining, and Masson’s trichrome staining was conducted to evaluate the smooth muscle content and the degree of fibrosis in the rat penis. Then, we employed specific kits to measure the level of NO, cGMP, MDA, SOD and Fe in penis. Electron transmission microscopy was implemented to observe morphology of mitochondria. Besides, western blot and immunofluorescence staining were performed to demonstrate the expression of ferroptosis-related genes.ResultsWe found that HUCMSCs improved erectile function in T1DM and T2DM ED rats, with no difference in efficacy between corpus cavernosum injection and tail vein injection. The EdU assay revealed that only a tiny percentage of HUCMSCs colonised the corpus cavernosum, while smooth muscle in the penis expanded and collagen decreased following HUCMSC injection. Moreover, the levels of oxidative stress in the penis of the rats given HUCMSCs were dramatically reduced, as was the tissue iron content. HUCMSCs normalised mitochondrial morphology within corpus cavernosum smooth muscle cells (CCSMCs), which were characteristically altered by high glucose. Furthermore, the expression of ferroptosis inhibitory genes SLC7A11 and GPX4 was obviously elevated in CCSMCs after stem cell management, but the abundances of ACSL4, LPCAT3 and ALOX15 showed the polar opposite tendency.ConclusionsHUCMSCs can effectively and safely alleviate erectile dysfunction in T1DM and T2DM ED rats, while restoring erectile function by attenuating diabetes-induced ferroptosis in CCSMCs. Additionally, this study provides significant evidence for the development of HUCMSCs as a viable therapeutic strategy for DMED.

Effect of High Testosterone Levels on Endothelial Function in Aorta and Erectile Function in Rats.

BackgroundTestosterone is an important hormone for the physical and mental health of men; however testosterone administration has also been suggested to adversely affect the cardiovascular system.AimTo investigate the effects of excessive testosterone administration on vascular endothelial and erectile function in rats.MethodsA total of seventy-five 12-week-old rats were divided into the following groups: Sham, castrated (Cast), castrated with subcutaneous administration of 100 mg/kg/month testosterone (Cast + T1), and castrated with subcutaneous administration of 100 mg/kg/week testosterone (Cast + T4). To observe the changes in testosterone level after the administration, rats were further divided into the following groups: control; T(6.25), wherein the rats were subcutaneously injected with 6.25 mg/kg testosterone; T(25) per week, wherein the rats were subcutaneously injected with 25 mg/kg testosterone per week; and T(100), wherein the rats were subcutaneously injected with 100 mg/kg testosterone per week. The relaxation responses of aorta were measured in these rats using standardized methods, and their erectile function was also evaluated. Statistical analysis of the obtained data was performed using two-way analysis of variance (ANOVA), Tukey-Kramer's multiple comparison test, or Student's t-test.OutcomesAt the end of the study period, endothelial function was evaluated through measurement of isometric tension, while erectile function was assessed using intracavernosal pressure (ICP), mean arterial pressure (MAP), and the expression of endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), sirtuin 1 (Sirt1) and vascular endothelial growth factor A.ResultsThe ICP/MAP ratio in the Cast group (0.42 ± 0.04) was significantly lower than that in the Sham group (0.79 ± 0.07). The ICP/MAP ratio in the Cast + T1 group (0.73 ± 0.06) was significantly higher than that in the Cast group (P < .01) and that of the Cast + T4 (0.38 ± 0.01) group was unchanged (P > .05). The T(25) and T(100) groups exhibited significantly lower responses to ACh than the control group at 4 weeks (P < .01). Meanwhile, the ICP/MAP ratios in the T(25) group (0.44 ± 0.07) and T(100) group (0.47 ± 0.03) were significantly lower than that in the control group (0.67 ± 0.05) at stimulation frequencies of 16 Hz (P < .05). The expression of androgen receptor, Sirt1, and eNOS were significantly lower while that of iNOS was higher in the T(25) group compared with the control group (P < .05).Clinical TranslationThe results based on this animal model indicate that extremely high testosterone levels may affect endothelial and erectile function.Strengths and LimitationsWe found that high-dose testosterone administration decreased endothelial function in aorta and erectile function in rats. A major limitation of this study is that the blood concentration may not be representative of that in humans, and further research is needed.ConclusionThe findings suggest that high doses of testosterone may cause endothelial dysfunction in the aorta and erectile dysfunction in rats and that the blood concentration should be monitored after testosterone administration.Kataoka T, Fukamoto A, Hotta Y, et al. Effect of High Testosterone Levels on Endothelial Function in Aorta and Erectile Function in Rats. Sex Med 2022;10:100550.

Impact of infertility duration on male sexual function and mental health.

This study aimed to explore whether infertility duration has an impact on the sexual function and mental health of men from infertile couples. We conducted a case-control study of 558 men from infertile couples, and the participants were divided into four groups based on their infertility duration: group I: ≤ 2years; group II: 2-5years; group III: 5-8years; and group IV: > 8years. Sexual function and mental disorders were measured using the International Index of Erectile Function-15 (IIEF-15), Premature Ejaculation Diagnostic Tool (PEDT), Generalized Anxiety Disorder scale (GAD-7), and Patient Health Questionnaire (PHQ-9) separately. As the years of infertility duration increase, the total IIEF-15 score and four domains (sexual desire, orgasmic function, erectile function, and intercourse satisfaction) significantly decrease (p < 0.05). The PEDT score gradually increases significantly (p < 0.05). Increased infertility duration is an independent risk factor for erectile dysfunction and premature ejaculation (p < 0.05). However, increased infertility duration is not a risk factor for depression and anxiety (p > 0.05). Our study is the first time to use the infertility duration as an independent variable and group this variable to analyze its impact on the sexual function and mental health of men from infertile couples comprehensively and systematically. The increased infertility duration is an independent risk factor for the occurrence of sexual dysfunction but not for mental disorders. In the process of infertility treatment, sexual health and mental health cannot be ignored, especially for patients with prolonged infertility.

The benefits of psychosocial interventions for mental health in men who have sex with men living with HIV: a systematic review and meta-analysis

ObjectiveMen who have sex with men (MSM) living with HIV are more likely to suffer from mental health problems. They should be given adequate attention to treat and improve their mental health disorders. This meta-analysis aimed to assess whether psychosocial interventions reliably improve psychological well-being among MSM living with HIV.MethodCochrane Library, EMBASE, PsycINFO, and PubMed were searched for psychosocial intervention randomized controlled trials evaluating mental health (e.g., depression, anxiety, self-efficacy). The effect size was pooled using the random-effects model, and continuous outcomes were reported using standardized mean difference (SMD) values .ResultsA total of 12 studies including 1782 participants were included in the meta-analysis. Psychosocial interventions in contrast to control groups significantly reduced depression (SMD, − 0.28; 95% CI − 0.52 – − 0.03) at the follow-up assessment and improved quality of life (SMD 0.43, 95% CI 0.23–0.63) after treatment. Psychosocial interventions also had a significant effect on measures of self-efficacy (SMD 2.22, 95% CI 0.24–4.20), and this effect was sustained until long-term follow-up (SMD 0.55, 95% CI 0.02–1.08). Subgroup analyses revealed that improvements in depression were more significant when participants possessed higher education and treatment providers used cognitive behavioral therapy (CBT).ConclusionsThe findings of this study indicate that psychosocial interventions benefit the mental health of MSM living with HIV. It is necessary to conduct more research to explore characteristics that may affect treatment outcomes in the future.Trial registrationThis research was prospectively registered in PROSPERO (CRD42021262567).

Barbershops as a setting for supporting men's mental health during the COVID-19 pandemic: a qualitative study from the UK.

Previous research has highlighted the need to promote help-seeking by men with mental health problems. To investigate barbers' views about offering mental health support for men in barbershops, with a specific focus on the psychosocial impacts of the COVID-19 pandemic. We used a sequential mixed-methods qualitative design with online data collection. In Phase 1, 30 barbers in Southern England completed surveys exploring perceptions of their clients' mental health during the COVID-19 pandemic, experiences of informal supportive roles and scope for providing formal mental health support in barbershops. Phase 2 involved member validation interviews and explored practice implications with three Phase 1 respondents. Thematic analysis identified three overarching themes: 'more than a haircut' (describing how the physical and relational contexts of barbershops can offer a supportive environment for clients); 'impacts of COVID-19' (describing stressors related to the pandemic and implications for clients' mental health and barber-client relationships); and 'formal mental health strategies' (describing opportunities for, and potential barriers to, formalising mental health support in barbershops). Barbers were aware of their clients' worsening mental health during the COVID-19 pandemic. Barbershops were generally considered to be a suitable setting in which to promote good mental health, monitor for signs of mental ill health and provide information about local mental health services. Future work is needed to co-produce and evaluate formal mental health promotion and prevention strategies in barbershops. Particular attention should be given to service innovations that preserve the credibility and trust that are fundamental to the barbershop experience for many males.

Otherfathering and Black men's mental health: A primer for counselors

AbstractNo counseling research exists about how otherfathering affects Black men's wellness. Black otherfathering has been primarily studied in schools as one of many expectations for Black male teachers. A review of research about the relationship between fathering, otherfathering, and mental health in Black men is presented and concludes with a rationale for more research about Black otherfathering as a potential protective factor for Black men's mental health.

The effects of recent minimum wage increases on self-reported health in the United States

Minimum wage policy continues to receive considerable popular and legislative attention in the United States. Despite a fast-growing empirical literature on the relationship between the minimum wage and health, previous studies generally use data from the 1990s to 2014. In this study, we estimate the impact of recent changes in state-level minimum wages on the self-reported health of adults in the post-Great Recession era. Using data from the Behavioral Risk Factor Surveillance System and a difference-in-differences design, we exploit more than 150 state-level increases in the minimum wage between 2011 and 2019. Our results indicate that a higher minimum wage increases men's physical and mental health burdens but has an ambiguous effect on a more general measure of health. Among women, the minimum wage improves general health and reduces their physical and mental health burdens. Compared to past studies, our work indicates that the relationship between the minimum wage and health has changed over time. It also illustrates the need for policymakers to consider the broader consequences of minimum wage policy, including health effects and gender differences therein.

Emotion Regulation in Context: Expressive Flexibility as a Stigma Coping Resource for Sexual Minority Men.

Although expressive flexibility (i.e., the ability to engage in expressive enhancement and suppression in accordance with situational demands) has been increasingly recognized as an important source of resilience, its role in the context of stigma coping remains under-investigated. The present research examined the role of expressive flexibility as a potential buffer in the association between perceptions of sexual orientation-related discrimination and psychological distress among sexual minority men, a population facing significant mental health problems driven by stigma-related stress. A U.S. sample of sexual minority men (N = 377) completed self-report measures of perceived sexual orientation-related discrimination, expressive flexibility, and psychological distress. Cross-sectional analyses revealed that perceived sexual orientation-related discrimination was positively associated with psychological distress, but the relationship was attenuated for participants with high levels of expressive flexibility. Longitudinal analyses further showed that the association between discrimination and psychological distress measured one year later was significant for sexual minority men with very low levels of expressive flexibility. These findings highlight the role of expressive flexibility as an important resource for coping with sexual orientation-related discrimination and underscore the potential utility of enhancing expressive flexibility in stigma coping interventions that seek to improve sexual minority men's mental health.

LGBQ-affirmative cognitive-behavioral therapy for young gay and bisexual men's mental and sexual health: A three-arm randomized controlled trial.

Effective Skills to Empower Effective Men (ESTEEM) represents the first intervention to address the psychological pathways through which minority stress undermines young sexual minority men's (SMM's) mental and sexual health using transdiagnostic cognitive-behavioral therapy. This study compared the efficacy of ESTEEM against two existing interventions. Participants were young HIV-negative SMM (N = 254; ages = 18-35; 67.2% racial/ethnic minority) experiencing a depression, anxiety, and/or stress-/trauma-related disorder and past-90-day HIV transmission risk behavior. After completing HIV testing and counseling, participants were randomized to receive 10-session ESTEEM (n = 100); 10-session community-based LGBQ-affirmative counseling (n = 102); or only HIV testing and counseling (n = 52). For the primary outcome of any HIV transmission risk behavior at 8 months, ESTEEM was not significantly associated with greater reduction compared to HIV testing and counseling (risk ratio [RR] = 0.89, p = .52). Supportive analyses of the frequency of HIV transmission risk behavior at 8 months showed a nonsignificant difference between ESTEEM compared to HIV testing and counseling (RR = 0.69) and LGBQ-affirmative counseling (RR = 0.62). For secondary outcomes (e.g., depression, anxiety, substance use, suicidality, number of mental health diagnoses) at 8 months, ESTEEM had a larger effect size than the two comparison conditions, but these comparisons did not reach statistical significance when adjusting for the false discovery rate. Observed effect sizes for condition comparisons were smaller than the effect sizes used to power the study. In exploratory analyses, ESTEEM showed promise for reducing comorbidity. Because the control conditions were associated with stronger effects than anticipated, and given the heterogeneous nature of transdiagnostic outcomes, the study possessed insufficient power to statistically detect the consistently small-to-moderate benefit of ESTEEM compared to the two control conditions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).