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Book Chapters
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**Brown, T.L., *Smith, N.G. Experimentally testing the impact of status threat on heterosexual men’s use of anti-gay slurs: A precarious manhood and coalitional value perspective. Curr Psychol 42, 11891–11901 (2023). https://doi.org/10.1007/s12144-021-02489-7Abstract The current study proposes an extension of theory and research on the effect of status threat specific to heterosexual men’s anti-gay slurs usage. Drawing on both the Precarious Manhood Thesis and the Coalitional Value Theory, the current study investigates whether masculine personality traits moderate the association between status threat and men’s readiness to use anti-gay slurs. A sample of heterosexual male university students (N = 139) was recruited from two English-speaking universities in Montreal, Quebec, and Houston, Texas. Participants completed questionnaires and randomly received either status threatening or status confirming feedback. Next, after reading vignettes describing heterosexual men behaving in ways that might jeopardize their status, participants reported their estimated probability of calling the target character a “fag” or “faggot.” Findings revealed a significant interaction effect. That is, only among participants high in masculine personality traits, those in the threat condition indicated significantly greater readiness to use anti-gay slurs relative to those in the status affirmation group. These findings contribute to a more comprehensive understanding of men’s anti-gay slur usage grounded in a status striving motive paired with distinct personality features. Future research directions are discussed.
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Tami-Maury I, Klaff R, Hussin A, *Smith NG, Chang S, McNeill L, Reitzel LR, Shete S, Abroms LC. (2022). A Text-Based Smoking Cessation Intervention for Sexual and Gender Minority Groups: Protocol for a Feasibility Trial. JMIR Res Protoc. https://doi.org/10.2196/42553Abstract Background:Smoking among sexual and gender minority (SGM) groups, which include lesbian, gay, bisexual, transgender, and queer individuals, has been reported to be highly prevalent. This is attributed to several factors, including minority-specific stress and targeted tobacco marketing. Therefore, this population is at an increased risk for tobacco-related diseases. SMS text messaging programs have been found to be effective for smoking cessation and appeal to traditionally hard-to-reach populations over other interventions. It has also been suggested that targeted and tailored interventions could be more effective among SGM smokers because they can be designed to assure a safe, validating health care environment that enhances receptivity to cessation. Objective:The aim of this study is to develop SmokefreeSGM, a text-based smoking cessation program tailored to and tested among SGM smokers. Methods:The study consists of three phases, culminating in a feasibility trial. In Phase 1, our research team will collaborate with a Community Advisory Board to develop and pretest the design of SmokefreeSGM. In Phase 2, the tailored text messaging program will be beta tested among 16 SGM smokers. Our research team will use a mixed-methods approach to collect and analyze data from participants who will inform the refinement of SmokefreeSGM. In Phase 3, a feasibility trial will be conducted among 80 SGM smokers either enrolled in SmokefreeSGM or SmokefreeTXT, the original text-based program developed by the National Cancer Institute for the general population. Our research team will examine recruitment, retention, and smoking abstinence rates at 1-, 3-, and 6-month follow-up. Additionally, a qualitative interview will be conducted among 32 participants to evaluate the feasibility and acceptability of the programs (SmokefreeSGM and SmokefreeTXT). Results:This study received approval from The University of Texas Health Science Center at Houston Committee for the Protection of Human Subjects to begin research on August 21, 2020. Recruitment for the beta testing of SmokefreeSGM (Phase 2) began in January 2022. We estimate that the feasibility trial (Phase 3) will begin in September 2022 and that results will be available in December 2023. Conclusions:Findings from this research effort will help reduce tobacco-related health disparities among SGM smokers by determining the feasibility and acceptability of SmokefreeSGM, an SGM-tailored smoking cessation intervention. Trial Registration:ClinicalTrials.gov NCT05029362; https://clinicaltrials.gov/ct2/show/NCT05029362 International Registered Report Identifier (IRRID):DERR1-10.2196/42553 JMIR Res Protoc 2022;11(12):e42553 doi:10.2196/42553
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*Smith, N. G. (2022). John D. Robinson (1946–2021). American Psychologist, 77(6), 793. https://doi.org/10.1037/amp0001017Abstract Memorializes John D. Robinson (1946-2021). John was the first African American psychologist to serve in both the United States Air Force (1973–1975) and Navy (1975–1983). He was also the first African American administrator at the University of Texas at Austin (1968–1969). His roles throughout his career included professor of Surgery and Psychiatry and Behavioral Sciences at Howard University until his retirement (1992–2016). At Howard University Hospital, John pioneered the field of transplant psychology, working hand in hand with surgeons and patients to both prepare patients—behaviorally and emotionally—for upcoming surgeries and ensure that patients were able to follow through with aftercare activities to ensure a successful transplant. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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Knutson, D., Matsuno, E., Goldbach, C., Hashtpari, H., & *Smith, N. G. (2022). Advocating for transgender and non-binary affirmative spaces in graduate education. Higher Education, 83, 461-479. https://doi.org/10.1007/s10734-020-00673-5ABSTRACT Nearly 50% of graduate students report experiencing emotional or psychological distress during their enrollment in graduate school. Levels of distress are particularly high for transgender and nonbinary graduate students who experience daily discrimination and marginalization. Universities and colleges have yet to address and accommodate the needs and experiences of transgender and nonbinary graduate students. Given the multitude of challenges these students may face, educational settings should not present additional barriers to educational success and well-being. In an effort to improve graduate education for transgender and nonbinary students, we add to the existing scholarship on affirming work with transgender undergraduate students by addressing the unique concerns of graduate students. We use a social-ecological model to identify sources of discrimination in post-secondary education and to provide transgender- and nonbinary-affirming recommendations at structural, interpersonal, and individual levels. For practitioners who wish to do personal work, we provide guidance for multicultural identity exploration. A table of recommendations and discussion of ways to implement our recommendations are provided.
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*Smith, N. G. (2022). John D. Robinson (1946-2021). American Psychologist. Advance online publication. https://doi.org/10.1037/amp0001017ABSTRACT Memorializes John D. Robinson (1946-2021). John was the first African American psychologist to serve in both the United States Air Force (1973–1975) and Navy (1975–1983). He was also the first African American administrator at the University of Texas at Austin (1968–1969). His roles throughout his career included professor of Surgery and Psychiatry and Behavioral Sciences at Howard University until his retirement (1992–2016). At Howard University Hospital, John pioneered the field of transplant psychology, working hand in hand with surgeons and patients to both prepare patients—behaviorally and emotionally—for upcoming surgeries and ensure that patients were able to follow through with aftercare activities to ensure a successful transplant. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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**Brown, T. L., & *Smith, N. G. (2021). Experimentally testing the impact of status threat on heterosexual men’s use of anti-gay slurs: A precarious manhood and coalitional value perspective. Current Psychology. Advance online publication. https://doi.org/10.1007/s12144-021-02489-7ABSTRACT The current study proposes an extension of theory and research on the effect of status threat specific to heterosexual men’s anti-gay slurs usage. Drawing on both the Precarious Manhood Thesis and the Coalitional Value Theory, the current study investigates whether masculine personality traits moderate the association between status threat and men’s readiness to use anti-gay slurs. A sample of heterosexual male university students (N = 139) was recruited from two English-speaking universities in Montreal, Quebec, and Houston, Texas. Participants completed questionnaires and randomly received either status threatening or status confirming feedback. Next, after reading vignettes describing heterosexual men behaving in ways that might jeopardize their status, participants reported their estimated probability of calling the target character a “fag” or “faggot.” Findings revealed a significant interaction effect. That is, only among participants high in masculine personality traits, those in the threat condition indicated significantly greater readiness to use anti-gay slurs relative to those in the status affirmation group. These findings contribute to a more comprehensive understanding of men’s anti-gay slur usage grounded in a status striving motive paired with distinct personality features. Future research directions are discussed.
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Chen, T., *Smith, N. G., Regan, S, Obasi, E. M., Anderson, K. F., & Reitzel, L. R. (2021). Combining global positioning system (GPS) with saliva collection among sexual minority adults: A feasibility study. PLoS ONE, 16(5), e0250333. https://doi.org/10.1371/journal.pone.0250333ABSTRACT This is the first study, of which we are aware, to evaluate the feasibility and accessibility of simultaneous use of Global Positioning System (GPS) and saliva collection for biomarker assessment as an objective measure of stress physiology among sexual minority (lesbian, gay, bisexual, queer, and other non-heterosexual identities) individuals. The principal motivation for pairing GPS and saliva collection was to investigate how characteristics of the built and social environments along with participants’ daily activity paths affect stress. This can contribute to a better understanding of health and health behaviors in the sexual minority community. A convenience sample of enrolled participants (N = 124) from Houston, Texas was asked to complete questionnaires, carry with them a GPS unit daily, and collect and store 6 samples of saliva at specific times across the span of a day prior to a second visit around one week later. Of 124 participants, 16 participants (12.90%) provided no useable GPS data and 98 (79.03%) provided at least 4 days of data. More than three-fourths (n = 98, 79.03%) also provided complete saliva samples. Our results show that the simultaneous use of GPS and saliva collection to assess sexual minority individuals’ activity paths and stress level is feasible.
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**DeLucia, R., & *Smith, N. G. (2021). The impact of provider biphobia and microaffirmations on bisexual individuals’ treatment-seeking intentions. Journal of Bisexuality, 21(2), 145-166. https://doi.org/10.1080/15299716.2021.1900020ABSTRACT Bisexual individuals experience mental illness at higher rates than monosexual individuals. In addition, previous research has found that bisexual persons face documented discrimination from mental health providers. However, research is lacking in examining how negative experiences with providers impact attitudes toward mental health care utilization among bisexual clients. This study explores the associations between bisexual individuals’ level of outness with providers, experiences of provider biphobia, experiences of microaffirmations from providers, and help-seeking attitudes. We hypothesized that: (a) Anti-bisexual experiences from a mental health provider would mediate the relationship between outness and help-seeking intentions, and (b) Microaffirmations from a provider would mediate the relationship between outness and help-seeking intentions. Results indicated that greater outness with mental health providers predicted greater microaffirmation experiences from mental health providers. As expected, anti-bisexual experiences significantly and negatively impacted intent to seek mental health treatment. There was not evidence of mediation.
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**Flynn, S., & *Smith, N. G. (2021). Interactions between blending and identity concealment: Effects on non-binary people’s distress and experiences of victimization. PLoS ONE, 16(3), e0248970. https://doi.org/10.1371/journal.pone.0248970ABSTRACT Identity concealment (whether or not a person is open with others about their transgender status) and passing/blending (how much a transgender person can, or chooses to, blend into the binary social environment) have been shown to impact transgender people’s experiences in various ways, but few studies examine these constructs in the lives of non-binary individuals (those whose gender identity does not fall exclusively into the categories of man or woman). This study analyzed the non-binary subset of the nationwide sample from the 2015 United States Transgender Survey (9,769 participants) to examine the effects of blending/passing and identity concealment on distress and victimization. When ethnicity and income were controlled for, low concealers reported higher distress and more victimization experiences than high concealers, and blenders reported more distress and fewer victimization experiences than non-blenders. Not concealing may put non-binary people at higher risk for victimization, but blending into the binary-gendered environment may increase distress through identity erasure. Implications are discussed and future research directions are suggested.
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**Guschlbauer, A., *Smith, N. G., De Stefano, J., & Soltis, D. E. (2019). Minority stress and emotional intimacy among individuals in lesbian and gay couples: Implications for relationship satisfaction and health. Journal of Social and Personal Relationships, 36, 855-878. https://doi.org/10.1177/0265407517746787ABSTRACT Lesbian and gay (LG) couples face a particular stress that is unique from their heterosexual counterparts: minority stress, the increased stress experienced as a result of living in an environment that is stigmatizing of their sexual orientation and identity. Research demonstrates that minority stress has far-reaching health implications for LG individuals. However, the literature examining the effects of minority stress on health at the couple level is limited. This study examined the impact of minority stress on emotional intimacy, relationship satisfaction, and psychological and physical health outcomes, as well as the moderating role of gender and marital status. A total of 181 LG-identified adults in same-sex relationships completed an online self-report survey. Results indicated that internalized homonegativity and sexual orientation concealment were negatively related to emotional intimacy and that emotional intimacy was positively related to relationship satisfaction. Emotional intimacy mediated the link between internalized homonegativity and relationship satisfaction for married—but not unmarried—individuals. Sexual orientation concealment mediated the link between sexual orientation concealment and relationship satisfaction for married men but not for any other group. Findings from the current study highlight the importance of emotional intimacy among individuals in LG couples. Areas for future research are explored, and implications for research, clinical practice, and policy are explicated.
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Seal, D. W., *Smith, N. G., Sun, C. J., & Thompson, E. L. (2019). Reflections on a mentoring partnership journey. Health Behavior Research, 2(4). https://doi.org/10.4148/2572-1836.1060ABSTRACT This commentary offers reflection on the mentoring partnership journey between a senior Fellow of the American Academy of Health Behavior (AAHB) and three early- or mid-career AAHB members. Their partnership was supported by the AAHB Research Scholars Mentorship Program. The authors discuss the nature of their working relationship, products they generated, and other lessons learned from the experience. The authors also offer their perspectives on effective mentorship characteristics.
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**Winderman, K., & *Smith, N. G. (2019). Minority stress and LGB-inclusive television viewing frequency among LGB adults: The roles of community connectedness and perceived social support. Mass Communication and Society, 22, 248-269. https://doi.org/10.1080/15205436.2018.1504303ABSTRACT Using a cross-sectional, correlational design, the present study examined the moderating roles of perceived social support and community connectedness in the relationship between minority stress and viewing frequency of lesbian, gay, and bisexual (LGB)–inclusive television shows among LGB adults. Participants identified predominately as White and female, and the largest group identified as bisexual. Participants completed self-report measures of minority stressors, social support, LGB community connectedness, and viewing frequency. A multiple linear regression was conducted to examine the relationships among these variables. Findings revealed that perceived social support moderated the effect of prejudice events on viewing frequency, such that LGB viewers who reported high levels of prejudice events and low perceived social support endorsed the highest levels of viewing frequency. These findings provide further insight into the ways in which LGB individuals consume media content and may be informative for clinicians in understanding coping strategies for minority stress among LGB clients.
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**Fuks, N., *Smith, N. G., Peláez, S., De Stefano, J., & Brown, T. L. (2018). Acculturation experience among lesbian, gay, bisexual, and transgender immigrants in Canada. The Counseling Psychologist, 46, 296-332. https://doi.org/10.1177/0011000018768538ABSTRACT In the current study, we used a grounded theory methodology to understand the acculturation process of LGBT immigrants in Canada. Results revealed two parallel themes: Cultural Identity Development and Sexual and Gender Identity Development. Heterosexism and cissexism in the culture of origin was a central phenomenon in the development of the cultural, sexual, and gender aspects of LGBT immigrant identity. Moreover, LGBT immigrants’ culture of origin and Canadian culture influenced their sexual and gender identity development before and after immigration. Results suggest that many LGBT immigrants assume a Western orientation as a coping response to heterosexism and cissexism in their culture of origin, even before immigration occurs. The current study identified the perceived challenges and advantages that LGBT immigrants experience during the acculturation process as well as various acculturation outcomes. We discuss clinical implications and future research directions in light of the results.
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*Smith, N. G., Mohr, J. J., & Ross, L. E. (2018). The role of bisexual-specific minority stressors in sexual compulsivity among bisexual men. Sexual and Relationship Therapy, 33, 81-96. https://doi.org/10.1080/14681994.2017.1386301ABSTRACT The current study examined the role of bisexual-specific distal stressors (i.e. anti-bisexual discrimination from heterosexuals and from lesbians and gay men) and proximal stressors (i.e. internalized binegativity and anticipated discrimination) in sexual compulsivity among bisexual men. Sexual compulsivity disproportionately affects gay and bisexual men and confers risk of sexually transmitted infections, including HIV. A total of 942 bisexual male adults, recruited primarily from three large cities in the United States and Canada, completed online self-report surveys. Results revealed that discrimination from lesbians and gay men (but not from heterosexuals) was associated with both internalized binegativity and anticipated discrimination. Internalized binegativity and anticipated discrimination, in turn, were associated with increased sexual compulsivity. Moreover, there was a significant indirect effect of discrimination from heterosexuals and from lesbians and gay men on sexual compulsivity through anticipated discrimination. There was also a significant indirect effect of discrimination from lesbians and gay men on sexual compulsivity through internalized binegativity. Results suggest that these bisexual-specific distal and proximal minority stressors are important risk factors for sexual compulsivity. As such, treatment providers are encouraged to address these underlying risk factors in treating sexual compulsivity among bisexual men.
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*Smith, N. G., **Winderman, K., King, B., Obasi, E. M., & Reitzel, L. R. (2018). The association of lesbian, gay, and bisexual identity facets with smoking dependence motives. Nicotine & Tobacco Research, 20, 388-392. https://doi.org/10.1093/ntr/ntx061ABSTRACT Lesbian, gay, and bisexual (LGB) adults have higher rates of smoking than heterosexual adults. LGB individuals face unique stressors, including challenges associated with having a LGB identity. The extent to which these unique stressors are related to dependence motives in LGB adult smokers, however, has not been previously explored. The current study was conducted to redress these gaps. Participants (N = 52; Mage = 42.8; 55.8% Black/African American) were recruited from the local community. Identity facets were measured by the Lesbian, Gay, and Bisexual Identity Scale (LGBIS). Dependence motives were measured by the Brief Wisconsin Inventory of Smoking Dependence Motives. Linear multiple regressions were calculated with the predictors of seven LGBIS subscales for primary and secondary dependence motives, respectively. Primary dependence motives (core nicotine dependence features) were predicted by affirmation of LGB identity (β = 0.44). Secondary dependence motives (eg, taste, cognitive/affective enhancement) were predicted by uncertainty of LGB identity (β = 0.43). LGB identity affirmation was associated with primary dependence motives, suggesting that a positive view of one’s sexual orientation is a risk factor for dependence. It may be that identity affirmation is related to stronger involvement with the LGB community, which has smoking-friendly norms. Identity uncertainty was associated with secondary dependence motives; this unique identity challenge may represent a stressor contributing to smoking dependence. Findings can help explain the higher rate of smoking in LGB populations and offer avenues to better tailor smoking cessation interventions. The current study is the first to examine multidimensional aspects of LGB identity in explaining smoking dependence motives among LGB adults. Results reveal that LGB identity challenges are associated with dependence motives, suggesting that interventions targeting these challenges may be help reduce LGB smoking disparities. Specifically, reducing identity uncertainty may help reduce smoking dependence. Though identity affirmation was a smoking dependence correlate, it is counterproductive to reduce affirmation, given its association with other positive health outcomes. Rather, interventions to change LGB community norms around smoking appear warranted, given the documented high overlap between affirmation and community affiliation.
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**Winderman, K., Martin, C. E., & *Smith, N. G. (2018). Career indecision among LGB college students: The role of minority stress, perceived social support, and community affiliation. Journal of Career Development, 45, 536-550. https://doi.org/10.1177/0894845317722860ABSTRACT Although several studies have examined the ways in which lesbian, gay, and bisexual (LGB) individuals experience difficulties with career decision-making, little is known about the impact of minority stressors on this integral process. The purpose of the current study was to examine the relationship between minority stressors, LGB community connectedness, social support, and four facets of career indecision among LGB college students. Participants (N = 270) were predominately White (53.7%), bisexual (57.8%), single (42.2%), and female (59.6%). Hierarchical linear regression analyses revealed that social support was protective against lack of readiness (β = −.39, p < .001) and interpersonal conflict (IPC; β = −.30, p < .001). Moreover, an interactive effect of internalized homonegativity and community affiliation was protective against IPC (β = −.22, p < .05). Implications for researchers and career counselors are discussed.
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Reitzel, L. R., *Smith, N. G., Obasi. E. M., Forney, M., & Leventhal, A. M. (2017). Perceived distress tolerance accounts for the covariance between discrimination experiences and anxiety symptoms among sexual minority adults. Journal of Anxiety Disorders."https://doi.org/10.1016/j.janxdis.2016.07.006ABSTRACT Sexual orientation-related discrimination experiences have been implicated in elevated rates of anxiety symptoms within sexual minority groups. Theory suggests that chronic discrimination experiences may dampen the ability to tolerate distress, increasing vulnerability for anxiety. This study examined the role of distress tolerance, or the capacity to withstand negative emotions, as a construct underlying associations between discriminatory experiences and anxiety among sexual minority adults. Participants (N = 119; Mage = 36.4 ± 14.8; 50% cisgender male, 31% cisgender female, 19% transgender; 37% non-Latino white) were recruited from Houston, Texas. Measures administered included the Heterosexist Harassment, Rejection, and Discrimination Scale (discrimination experiences), Distress Tolerance Scale (distress tolerance), and the State-Trait Inventory for Cognitive and Somatic Anxiety (anxiety). The association of discrimination experiences and anxiety through distress tolerance was assessed using covariate-adjusted mediation modeling. Results indicated that sexual orientation-related discrimination experiences were significantly and positively associated with anxiety and that this association was mediated through lower distress tolerance. Significant indirect effects were specific to cognitive (versus somatic) anxiety symptoms. Results suggest that distress tolerance may be an explanatory mechanism in the association between discriminatory experiences and cognitive symptoms of anxiety and a potentially relevant target within clinical interventions to address anxiety-related health disparities among sexual minority adults. However, more sophisticated designs are needed to delineate causal associations.
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Juster, R. P., Ouellet, E., Lefebvre-Louis, J.-P., Sindi, S., Johnson, P. J., *Smith, N. G., & Lupien, S. (2016). Retrospective coping strategies during sexual orientation identity formation and current biopsychosocial stress. Anxiety, Stress, & Coping, 29, 119-138."ABSTRACT Background: Lesbian, gay men, and bisexual individuals (LGBs) often experience distress related to the recognition, self-acceptance, and disclosure of their sexual orientation. Objectives and Design: Retrospectively reported coping strategies enacted during sexual identity formation among LGBs were assessed in relation to current stress indices measured using environmental (frequency of perceived daily hassles), psychological (perceived distress), and biological (allostatic load [AL] levels representing physiological dysregulations) perspectives. Methods: Forty-six healthy LGBs between the ages of 18 and 45 (M = 23.91, SE = .80) participated. Questionnaires included the Ways of Coping Checklist adapted to disclosure milestones, Daily Hassles Inventory, and Perceived Stress Scale. AL was calculated using 21 biomarkers of neuroendocrine, immune, cardiovascular, and metabolic functioning. Results: Avoidance coping during sexual identity formation was positively associated with frequency of daily hassles (β = .598, p < .001), perceived stress (β = .361, p = .015), and AL (β = .405, p = .006). By contrast, seeking social support was negatively associated with perceived stress (β = –.598, p = .048). Conclusions: Emotion-focused coping strategies during LGB sexual identity development are associated with current indices of biopsychosocial stress. doi:10.1080/10615806.2015.1004324
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MacKinnon, C. J., Smith, N. G., Henry, M., Milman, E., Berish, M., Farrace, A. J., Körner, A., Chochinov, H. M., & Cohen, S. R. (2016). A pilot study of meaning-based group counseling for bereavement. Omega: Journal of Death and Dying, 72(3), 210-233. doi: 10.1177/0030222815575002"ABSTRACT Scientific studies demonstrating either the efficacy or effectiveness of interventions for uncomplicated bereavement are lacking. This study reports the results of a novel meaning-based group counseling (MBGC) intervention developed for bereaved adults. MBGC was built on previous scholarly critiques using a formative evaluation methodology within a group of bereaved adults (n = 11). The primary research questions were as follows: (a) How do bereft individuals respond to MBGC? and (b) What refinements are needed to MBGC to ensure feasibility? A secondary research question was: (c) Is collection of quantitative outcome measures at baseline and postintervention feasible? Analysis of multiple qualitative data sources resulted in numerous refinements to MBGC. Results indicate that the majority of participants found the meaning-based intervention beneficial. Limitations included concurrent external therapies and a small sample size that was largely homogenous. There were no major counterindications to proceeding with a pilot randomized controlled trial (RCT).
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Juster, R. P., Hatzenbuehler, M. L., Mendrek, A., Pfaus, J. G., *Smith, N. G., Johnson, P. J., Lefebvre-Louis, J.-P., Raymond, C., Marin, M. F., Sindi, S., Lupien, S. J., & Pruessner, J. C. (2015). Sexual orientation modulates endocrine stress reactivity. Biological Psychiatry, 77, 668-676."ABSTRACT Background: Biological sex differences and sociocultural gender diversity influence endocrine stress reactivity. Although numerous studies have shown that men typically activate stronger stress responses than women when exposed to laboratory-based psychosocial stressors, it is unclear whether sexual orientation further modulates stress reactivity. Given that lesbian, gay, and bisexual (LGB) individuals frequently report heightened distress secondary to stigma-related stressors, we investigated whether cortisol stress reactivity differs between LGB individuals and heterosexual individuals in response to a well-validated psychosocial stressor. Methods: The study population comprised 87 healthy adults (mean age, 25 years) who were grouped according to their biological sex and their gendered sexual orientation: lesbian/bisexual women (n = 20), heterosexual women (n = 21), gay/bisexual men (n = 26), and heterosexual men (n = 20). Investigators collected 10 salivary cortisol samples throughout a 2-hour afternoon visit involving exposure to the Trier Social Stress Test modified to maximize between-sex differences. Results: Relative to heterosexual women, lesbian/bisexual women showed higher cortisol stress reactivity 40 min after exposure to the stressor. In contrast, gay/bisexual men displayed lower overall cortisol concentrations throughout testing compared with heterosexual men. Main findings were significant while adjusting for sex hormones (estradiol-to-progesterone ratio in women and testosterone in men), age, self-esteem, and disclosure status (whether LGB participants had completed their “coming out”). Conclusions: Our results provide novel evidence for gender-based modulation of cortisol stress reactivity based on sexual orientation that goes beyond well-established between-sex differences. This study raises several important avenues for future research related to the physiologic functioning of LGB populations and gender diversity more broadly. doi:10.1016/j.biopsych.2014.08.013
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Kleiman, S., Spanierman, L. B., & Smith, N. G. (2015). Translating oppression: Understanding how sexual minority status is associated with White men’s racial attitudes. Psychology of Men & Masculinity, 16, 404-415. doi:10.1037/a0038797"ABSTRACT The present study comprised 3 interrelated purposes. First, the authors examined differences between White heterosexual (n = 97) and sexual minority (e.g., gay, bisexual, and queer; n = 83) men on various racial attitudes and empathy. Second, they examined whether highlighting oppressed identity status with an experimental prime could influence racial empathy. Third, the authors investigated whether sexual orientation disclosure and experiences with heterosexist discrimination among sexual minority men were associated with racial attitudes directly and indirectly through racial empathy. Key findings included: (a) sexual minority participants demonstrated more positive racial attitudes and empathy than heterosexual men; (b) there was no effect of prime on racial empathy; and (c) sexual orientation disclosure and experiences with heterosexism were associated significantly with positive racial attitudes indirectly through racial empathy. Implications for diversity education and future research directions are discussed.
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MacKinnon, C. J., Smith, N. G., Henry, M., Milman, E., Chochinov, H. M., Körner, A., Berish, M., Farrace, A. J., Liarikos, N., & Cohen, S. R. (2015). Reconstructing meaning with others in loss: A feasibility pilot randomized controlled trial of a bereavement group. Death Studies, 39, 411-421. doi:10.1080/07481187.2014.958628"ABSTRACT More effective psychosocial interventions that target uncomplicated bereavement are needed for those actively seeking support. The objective of this study was to assess the feasibility of evaluating a unique meaning-based group counseling (MBGC) intervention with a randomized controlled trial (RCT) design. Twenty-six bereft individuals were randomly assigned to either MBGC or a control bereavement support group. Twenty participants (11 experimental, nine control) completed all aspects of the study including self-report measures at baseline, postintervention, and 3-month follow-up of meaning in life, anxiety, depression, and grief. Results support the feasibility of an RCT with MBGC.
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Moody, C., Fuks, N., Pelaez, S., & Smith, N. G. (2015). “Without this, I would for sure already be dead”: A qualitative inquiry regarding suicide protective factors among trans adults. Psychology of Sexual Orientation and Gender Diversity, 2, 266-280. doi:10.1037/sgd0000130"ABSTRACT Despite an alarmingly high rate of attempted suicide among trans adults, few studies have investigated suicide protective factors among this population. The current study was aimed at identifying suicide protective factors among trans adults using a qualitative methodology. A sample of self-identified trans adults (N = 133) was recruited from LGBT LISTSERVs across Canada. Participant were predominantly White and ranged in age from 18 to 75 years old (M = 37). Qualitative data were collected online via open-ended questions and analyzed using thematic network analysis. A hybrid inductive– deductive coding framework was created by combining published suicide protective factors and participants’ responses. Five organizing themes were identified, namely social support, gender identity-related factors, transition-related factors, individual difference factors, and reasons for living. Results provide important insights for suicide prevention workers and mental/medical health professionals who work to promote the health and well-being of trans clients and their families. Clinical implications are discussed, such as the importance of aiding trans clients who seek transition-related care to gain access to care in a timely manner.
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Smith, N. G., Hart, T. A., Moody, C., Willis, A. C., Andersen, M. A., Blais, M., & Adam, B. (2015). Project PRIDE: A cognitive-behavioral group intervention to reduce HIV risk behaviors among young gay and bisexual men. Cognitive and Behavioral Practice. Advance online publication. doi:10.1016/j.cbpra.2015.08.006"ABSTRACT Young gay and bisexual men are at increased risk for human immunodeficiency virus (HIV) infection. Research suggests that the stress associated with being a stigmatized minority is related to negative mental health outcomes, substance use, and condomless sex. However, interventions aimed at reducing HIV risk behaviors in young gay and bisexual men have failed to address these important variables. The purpose of the present paper is to assist cognitive and behavioral therapists who work with young gay and bisexual men to conduct therapy for stress management and HIV prevention. This paper provides an overview of the research on stress and coping among gay and bisexual men and its relation with condomless sex among young gay and bisexual men. The treatment described here integrates minority stress theory (e.g., Meyer, 2003) and stress and coping theory (e.g., Lazarus, 2000) in a small group counseling framework that uses psychoeducation, cognitive reframing, and role plays to help young gay and bisexual men to manage stress, reduce substance use, and reduce condomless sex. The application of empirically supported theory and a combination of cognitive and behavioral techniques to reduce both psychological distress and HIV risk behavior for young gay and bisexual men is illustrated using three case examples. The present treatment may help therapists working with young HIV-negative gay and bisexual men who engage in condomless sex and who wish to remain HIV-negative by decreasing their HIV risk behavior.
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Benson, F. J., Smith, N. G., & Flanagan, T. (2014). Easing the transition for queer student teachers from program to field: Implications for teacher education. Journal of Homosexuality, 61, 382-398. doi:10.1080/00918369.2013.842429"ABSTRACT Tensions exist between what some queer student teachers experience in the university setting, their lives in schools during field placements, and upon graduation. We describe a series of workshops designed for queer student teachers and their allies that were conducted prior to field placement. Participants revealed high degrees of satisfaction with the program and increased feelings of personal and professional self-efficacy. Participants reported high levels of experienced homophobia in their academic programs; as such, the workshops were a valuable “safe space.” These workshops appear to fill a significant gap for queer students and their allies in teacher preparation programs.
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Carter, L. W., Mollen, D., & Smith, N. G. (2014). Locus of control, minority stress, and psychological distress among lesbian, gay, and bisexual individuals. Journal of Counseling Psychology, 61, 169-175. doi:10.1037/a0034593"ABSTRACT Within the framework of minority stress theory, lesbian, gay, and bisexual (LGB) individuals are conceptualized as members of a minority group defined by sexual orientation. Two of the component processes of minority stress hypothesized by Meyer (2003), internalized heterosexism and the experience of prejudice events, were examined in the current study. Both internalized heterosexism and the experience of prejudice events have been associated with increased psychological distress in LGB populations. Researchers have also observed a relationship between external locus of control and increased psychological distress in general population samples. The current study explored whether locus of control served as a moderator in the relationship between the overall psychological distress of LGB individuals and both internalized heterosexism and the experience of workplace-based prejudice events (n = 165). Results indicated that locus of control served as a moderator in the relationship between experience of workplace-based prejudice events and overall psychological distress but not for the relationship between internalized heterosexism and distress.
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MacKinnon, C. J., Smith, N. G., Henry, M., Milman, E., Berish, M., Körner, A., Copeland, L. S., Chochinov, H. M., & Cohen, S. R. (2014). Meaning-based group counseling for bereavement: Bridging theory with emerging trends in intervention research. Death Studies, 38, 137-144. doi:10.1080/07481187.2012.738768"ABSTRACT A growing body of scholarship has evaluated the usefulness of meaning-based theories in the context of bereavement counseling. Although scholars have discussed the application of meaning-based theories for individual practice, there is a lack of inquiry regarding its implications when conducting bereavement support groups. The objective of this article is to bridge meaning-based theories with bereavement group practice, leading to a novel intervention and laying the foundation for future efficacy studies. Building on recommendations specified in the literature, this article outlines the theoretical paradigms and structure of a short-term meaning-based group counseling intervention for uncomplicated bereavement.
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MacKinnon, C. J., Smith, N. G., Henry, M., Milman, E., Chochinov, H. M., Körner, A., Berish, M., Farrace, A., Liarikos, N., & Cohen, S. R. (2014). New directions in group counselling for bereavement: Results of a meaning-based pilot randomized controlled trial. The Canadian Virtual Hospice Exchange."ABSTRACT What we did: Palliative care does not end at the moment of death, and international guidelines recommend that bereavement support be offered to bereft families and friends (Hudson et al., 2012). Consistent with these guidelines, our clinical research team conducted a literature review, and subsequently developed and conducted a series of feasibility tests of a novel Meaning-Based Group Counselling (MBGC) intervention for adults following an uncomplicated bereavement trajectory. An uncomplicated grief trajectory is defined using the framework of Shear et al. (2011) including common symptoms of bereavement (e.g., yearning, deep sadness, somatic distress, etc.); overall these symptoms do not impair daily functioning. Our research was conducted in three stages: initial design using best available evidence, a feasibility test, and a pilot randomized controlled trial (RCT). Our goal was to lay the ground work for possible future large scale studies that could test the efficacy of Meaning-Based Group Counselling. Why we did this: The clinical profile of individuals with uncomplicated bereavement includes varying levels of physical and psychological distress that do not severely impair social, occupational, and daily functioning (Shear et al., 2011), but nevertheless are distressing enough for some to seek services. Studies of the effectiveness of past psychosocial interventions targeting uncomplicated grief show a negligible effect (Currier, Neimeyer, & Berman, 2008). However, these past studies have been critiqued for design flaws (Larson, & Hoyt, 2007), making any definitive conclusions about effectiveness premature. Our appraisal of the scholarship suggests an important step for future research is a need for theoretically-based uncomplicated bereavement interventions for individuals actively seeking support, underpinned by sound methodology (Schut & Stroebe, 2005). We chose to focus the intervention on the meaning-making paradigm (MacKinnon et al., 2013a), a contemporary theory of bereavement adaptation that is garnering increased empirical attention (Park, 2010). How we did it and what were our results: Our research team developed a novel Meaning-Based Group Counselling (MBGC) intervention for adults in uncomplicated bereavement (reported in MacKinnon et al., 2013b). In constructing MBGC, we carefully attended to the previous scholarly literature on bereavement. We also integrated several recent theories of bereavement and group psychotherapy, as well as aspects of recent meaning-focused psychosocial interventions developed for cancer patients. MBGC took place weekly over 3 months and was comprised of explicit tasks and themes of meaning making. It was facilitated by two licensed mental health professionals (e.g., psychologists). See Table 1 below for a description of tasks and themes of this group counselling intervention.
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Paul, R., Smith, N. G., Mohr, J. J., & Ross, L. E. (2014). Measuring dimensions of bisexual identity: Initial development of the Bisexual Identity Inventory. Psychology of Sexual Orientation and Gender Diversity, 1, 452-460. doi:10.1037/sgd0000069"ABSTRACT The authors describe the initial development of the Bisexual Identity Inventory (BII). A review of the extant bisexuality literature led to the development of 46 preliminary items assessing facets of bisexual identity that were administered to a total of 422 self-identified bisexual participants. Results from exploratory factor analysis of data from a random subsample of participants revealed 4 factors: Illegitimacy of Bisexual Identity, Anticipated Binegativity, Internalized Binegativity, and Identity Affirmation, with internal consistency reliability estimates ranging from .73 to .93. Confirmatory factor analysis of data from a separate subsample suggested the proposed factor structure offered a good fit to the observed data. Illegitimacy, Anticipated Binegativity, and Internalized Binegativity were positively associated with depression and negatively associated with outness, whereas Identity Affirmation was unrelated to depression but positively associated with outness. Overall, the present study provides preliminary evidence supporting the use of the BII as a measure of facets of bisexual identity. (PsycINFO Database Record (c) 2015 APA, all rights reserved)
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Juster, R. P., Smith, N. G., Ouellet, E., Sindi, S., & Lupien, S. J. (2013). Sexual orientation and disclosure in relation to psychiatric symptoms, diurnal cortisol, and allostatic load. Psychosomatic Medicine, 75, 103-116."ABSTRACT Objectives. Lesbian, gay, and bisexual (LGB) individuals—particularly those who have not disclosed their sexual orientation—are believed to experience increased chronic stress in comparison with heterosexuals. This interdisciplinary study assessed whether psychiatric symptoms (self-rated anxiety, depression, and burnout), stress hormone profiles (diurnal cortisol), and physiological dysregulations (allostatic load [AL]) would differ for a) LGBs versus heterosexuals and b) disclosed LGBs versus nondisclosed LGBs. Methods. The study included 87 healthy participants (mean [SD] age = 24.6 [0.6] years; LGB n = 46, 43% women; and heterosexual n = 41, 49% women). Diurnal cortisol sampled at five time points was averaged for 2 days. AL indices were based on an algorithm incorporating 21 biomarkers representing neuroendocrine, immune/inflammatory, metabolic, and cardiovascular functioning. Psychological measures were assessed with well-validated questionnaires. Results. Between-group results revealed no significant differences in symptoms of anxiety and burnout, nor among diurnal cortisol levels between sexual orientations. By contrast, gay/bisexual men unexpectedly had lower depressive symptoms (p = .003) and AL levels (p = .043) compared with heterosexual men. Within-group results revealed that disclosed LGBs had fewer psychiatric symptoms (p values < 0.01) and lower cortisol levels +30 minutes upon awakening (p = .004) compared with nondisclosed LGBs. Disclosure was not significantly related to AL levels. Conclusions. LGBs did not manifest more stress-related problems than did heterosexuals. Life transitions like disclosing to one’s family and friends may be protective against psychopathologies and hyperactive cortisol awakening responses. Our novel findings underline the roles disclosure processes have on positive health and well-being for sexual minorities. doi: 10.1097/PSY.0b013e3182826881
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MacKinnon, C. J., Milman, E., Smith, N. G., Henry, M., Berish, M., Copeland, L. S., Körner, A., Chochinov, H. M., & Cohen, S. R. (2013). Means to meaning in cancer-related bereavement: Identifying clinical implications for counseling psychologists. The Counseling Psychologist, 41, 216-239."ABSTRACT The search for meaning in bereavement is a topic of increasing scholarly interest. Nonetheless, literature has not yet appeared that examines the intersections of diverse theories of meaning, corresponding empirical findings, and clinical implications for counseling psychologists engaged in cancer-related bereavement psychotherapy. Meaning theories drawn from several domains of scholarship including existential, spirituality, stress, and bereavement are surveyed followed by a review of related empirical trends in the scholarship. A hypothetical case vignette is then presented to highlight potential strategies for counseling psychologists to integrate a broadened meaning-based approach to bereavement psychotherapy related to the loss of a loved one from cancer. The article concludes by identifying limitations of a meaning-based approach, as well as directions for further research. doi: 10.1177/0011000012459969
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Moody, C., & Smith, N. G. (2013). Suicide protective factors among trans adults. Archives of Sexual Behavior, 42, 739-752."ABSTRACT A recent study indicated a suicide attempt rate of 41 % among trans (e.g., trans, transgender, transexual/transsexual, genderqueer, two-spirit) individuals. Although this rate is alarming, there is a dearth of literature regarding suicide prevention for trans individuals. A vital step in developing suicide prevention models is the identification of protective factors. It was hypothesized that social support from friends, social support from family, optimism, reasons for living, and suicide resilience, which are known to protect cis (non-trans) individuals, also protect trans individuals. A sample of self-identified trans Canadian adults (N = 133) was recruited from LGBT and trans LISTSERVs. Data were collected online using a secure survey platform. A three block hierarchical multiple regression model was used to predict suicidal behavior from protective factors. Social support from friends, social support from family, and optimism significantly and negatively predicted 33 % of variance in participants’ suicidal behavior after controlling for age. Reasons for living and suicide resilience accounted for an additional 19 % of the variance in participants’ suicidal behavior after controlling for age, social support from friends, social support from family, and optimism. Of the factors mentioned above, perceived social support from family, one of three suicide resilience factors (emotional stability), and one of six reasons for living (child-related concerns) significantly and negatively predicted participants’ suicidal behavior. Overall, these findings can be used to inform the practices of mental health workers, medical doctors, and suicide prevention workers working with trans clients. doi: 10.1007/s10508-013-0099-8
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Sornberger, M. J., Smith, N. G., Toste, J. R., & Heath, N. L. (2013). Nonsuicidal self-injury, coping strategies, and sexual orientation. Journal of Clinical Psychology, 69, 571-583."ABSTRACT Objectives. The current study sought to investigate the relationship between sexual orientation and nonsuicidal self-injury (NSSI). This study also includes an examination of coping styles, both maladaptive and adaptive, based on sexual orientation. Method. Participants included 207 young adults who identified as lesbian/gay, bisexual, or questioning (50.2% female) and a heterosexual comparison group. Results. A hierarchical logistic regression showed that bisexual and questioning individuals were more likely to report having engaged in NSSI in their lifetime. A chi-square yielded no difference between groups on frequency of NSSI. Multivariate analyses of variance examining maladaptive and adaptive coping strategies demonstrated that bisexual and questioning individuals reported greater use of maladaptive strategies than the heterosexual group; however, there was little difference between groups on adaptive coping. Conclusions. The relationship between sexual orientation and coping appears to be a complex one, suggesting that bisexual and questioning individuals attempt to use a wide range of coping mechanisms, possibly due to increased stress. doi: 10.1002/jclp.21947
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Long, S., Mollen, D., & Smith, N. G. (2012). College women’s attitudes toward sex workers. Sex Roles, 66, 117-127."ABSTRACT A growing number of women are entering the sex industry as a means of funding their education (Reilly 2008). Many people view sex workers in stereotyped ways, and may discriminate and oppress women who work in the sex industry (Wolffers and van Beelen 2003). This investigation assessed attitudes toward sex work. Two hundred sixty-six women from a primarily woman’s university located in the Southwestern region of the U.S. completed selected items from the Attitudes Toward Prostitution Scale, Marlowe-Crowne Social Desirability Scale, and Hostility Toward Women Scale. Results indicated that participants who knew a sex worker had less stereotypical attitudes toward sex workers. However, participants with higher levels of social desirability and hostility toward women had more stereotypical attitudes toward sex workers. doi: 10.1007/s11199-011-0088-0
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Mollen, D., Smith, N. G., Levy, J. J., & Magyar-Moe, J. L. (2012). Privilege and belonging: The quest to make the Society of Counseling Psychology more welcoming. The Counseling Psychologist, 40, 856-867."ABSTRACT In this rejoinder, we advance the dialogue stimulated by our major contribution (Smith et al., 2012) in which we present the findings from a survey of early career professionals (ECPs) in Division 17, the Society of Counseling Psychology. We respond to the reactants’ concerns and observations using the lenses of privilege and belonging to guide our response. Building from the premise that the Society needs to continue to create and sustain efforts to attract and retain burgeoning counseling psychologists—including faculty members, practitioners, and those whose careers have combined or unique foci—we offer additional suggestions toward meeting the goal of expanding the richness of membership to include a wide array of those who identify with the premises of the Society and the specialty of counseling psychology. The importance of mentoring for advanced students and ECPs with an array of career trajectories is particularly emphasized. doi: 10.1177/0011000012443857
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Smith, N. G., Keller, B., Mollen, D., Bledsoe, M., Buhin, L., Edwards, L. M., Levy, J. J., Magyar-Moe, J. L., & Yakushko, O. (2012). Voices of early career psychologists in Division 17, the Society of Counseling Psychology. The Counseling Psychologist, 40, 794-825."ABSTRACT This article reports on a survey of early career members of the Society of Counseling Psychology (SCP). Seventy early career psychologists completed a survey assessing the usefulness and climate of SCP, barriers to and facilitative factors for involvement in SCP, inclusiveness of SCP regarding cultural diversity and professional interests, degree of involvement in various aspects of SCP, and their areas of satisfaction and dissatisfaction with SCP membership. In general, participants were split on the degree to which they were satisfied with SCP, with participants in faculty positions reporting significantly more positive views of SCP than their practitioner counterparts did. Faculty members viewed SCP as more useful to their careers and reported more positive social interactions within SCP than did non–faculty members. Open-ended responses suggested that satisfaction with SCP was related to availability of mentorship and opportunities for involvement in SCP. Suggestions for engaging new professionals in SCP are offered. doi: 10.1177/0011000011417145
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MacKinnon, C. J., Bhatia, M., Sunderani, S., Affleck, W., & Smith, N. G. (2011). Opening the dialogue: Implications of feminist supervision theory with male supervisees. Professional Psychology: Research and Practice, 42, 130-136."ABSTRACT There is a lack of scholarship examining the implications of feminist-informed theories of clinical supervision to guide practice with male supervisees. A critical discussion is needed to better understand the intersections of feminist supervision theory and masculine psychology lest ineffective supervisory interventions occur. The present article begins with a critical review of the intersections of male psychological theory and feminist supervision theory. A hypothetical case vignette is then presented to highlight a number of potential implications for supervisors working with male supervisees informed by feminist supervision theory. The article concludes with directions for future training and research, as well as limitations of the arguments presented.doi: 10.1037/a0022232
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Russell, G. M., Bohan, J. S., McCarroll, M. C., & Smith, N. G. (2011). Trauma, recovery, and community: Perspectives on the long-term impact of anti-LGBT politics. Traumatology, 17, 14-23."ABSTRACT Research conducted since the early 1990s has suggested that elections designed to delimit the rights of lesbian, gay, and bisexual (LGB) individuals carry the potential for significant negative psychological consequences. Research has also suggested that some LGB people use these elections as opportunities for positive individual and social change. Virtually all of the research on the psychological impact of anti-LGB elections has focused on the immediate aftermath of these political events. This article reports results from a qualitative study designed to explore community members’ perceptions of the longer term impact of the full cycle of Colorado’s Amendment 2, including the campaign, election, and judicial reversal. The results from interviews with a purposive sample of LGB and heterosexual informants offer commentaries on the enduring impact of Amendment 2 at the levels of individuals, the LGBT community, and the broader community. doi: 10.1177/1534765610362799
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Smith, N. G. (2010). Productivity in lesbian, gay, bisexual, and transgender scholarship in counseling psychology: Institutional and individual ratings for 1990 through 2008. The Counseling Psychologist, 38, 50-68."ABSTRACT This study examined individual and institutional productivity in lesbian, gay, bisexual, and transgender (LGBT) scholarship published in counseling psychology—oriented journals for the years 1990 through 2008. Eight journals were included in the analyses. An author-weighted score was calculated for each scholar, using a formula developed by Howard, Cole, and Maxwell. To determine the impact of authors’ work, h indices were calculated for the most productive scholars. Finally, institutions publishing LGBT scholarship were proportionally ranked, consistent with the work of Tinsley and Tinsley. Twenty-nine authors and 13 institutions emerged as leaders in LGBT scholarship. Data on percentage of articles published in each journal, as well as trends over time, are presented. Implications and directions for future research are discussed. doi: 10.1177/0011000009345533
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Vinson, C., Mollen, D., & Smith, N. G. (2010). Perceptions of childfree women: The role of perceivers’ and targets’ ethnicity. Journal of Community and Applied Social Psychology, 20, 426-432."ABSTRACT The purpose of this study was to examine the impact of ethnicity on perceptions of voluntary childfree women. We were interested in determining whether mothers were viewed as more stereotypically positive than women without children and how the ethnicity of the participant and the target impacted participants' ratings. We utilized vignettes and manipulated motherhood status and ethnicity of the target. Participants (n = 224) were comprised of female university students in the southwestern region of the United States. Results indicated that women view childfree women negatively. Moreover, women view African American mothers more favourably than childfree African American women. Results are discussed in terms of gender roles in communities of colour. doi: 10.1002/casp.1049
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Vosvick, M., Martin, L., Smith, N. G., & Jenkins, S. R. (2010). Gender differences in HIV-related coping and depression. AIDS and Behavior, 14, 390-400."ABSTRACT Our study examined differences in HIV-related coping in relation to depression in men and women. Ethnically diverse participants (n = 247, 46% women) were recruited in Dallas/Fort Worth and completed medical and demographic information, the Coping with HIV Scale (CHIV), and the Center for Epidemiological Studies-Depression scale (CES-D). Multiple regression analyses revealed that in men, depression was associated with symptoms, higher use of distraction, blame, expression and lower use of positive growth. In women, depression was associated with symptoms and higher use of blame. These results shed light on the ways in which each gender copes with HIV and may help researchers develop interventions tailored to the needs of the HIV-positive population. doi: 10.1007/s10461-008-9490-1
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Smith, N. G., Tarakeshwar, N., Hansen, N. B., Kochman, A., & Sikkema, K. J. (2009). Coping mediates outcome following a randomized group intervention for HIV-positive bereaved individuals. Journal of Clinical Psychology, 65, 319-335."ABSTRACT The purpose of this study was to examine the mechanisms responsible for the beneficial psychological effects of a coping-focused group intervention for HIV-positive individuals who had lost loved ones to AIDS. Data from 235 HIV-positive men and women enrolled in a randomized controlled clinical trial testing a coping-focused group intervention were analyzed using a multiple-indicator-multiple-cause (MIMIC) structural equation model. Results revealed that the effects of the intervention on decreases in depression and grief were mediated by decreases in avoidant coping. Specifically, participants in the intervention condition decreased their use of avoidant coping. Decreases in avoidant coping, in turn, were related to decreased depression and grief. The results of this study help to validate the use of coping-focused interventions for HIV-positive bereaved individuals. doi: 10.1002/jclp.20547
*Denotes Dr. Nathan Grant Smith, Ph.D.
**Denotes Ph.D. Student
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