Evidence suggests that sexual minorities (e.g., those identifying as lesbian, gay, or bisexual) experience increased rates of depression compared to heterosexual individuals. Minority stress theory suggests that this disparity is due to stigma experienced by sexual minorities. Stigma processes are proposed to contribute to reduced coping/support resources and increased vulnerability processes for mental health problems. This review provided a systematic examination of research assessing the evidence for mediating factors that help explain such disparities. A literature search was conducted using the databases PubMed, PsycINFO, and Web of Science. The review included 40 identified studies that examined mediators of sexual minority status and depressive outcomes using a between-group design (i.e., heterosexual versus sexual minority participants). Studies of adolescents and adult samples were both included. The most common findings were consistent with the suggestion that stressors such as victimization, harassment, abuse, and increased stress, as well as lower social and family support, may contribute to differing depression rates in sexual minority compared to heterosexual individuals. Differences in psychological processes such as self-esteem and rumination may also play a role but have had insufficient research attention so far. However, caution is needed because many papers had important methodological shortcomings such as the use of cross-sectional designs, inferior statistical analyses for mediation, or measures that had not been properly validated. Although firm conclusions cannot be drawn, the current evidence base highlights many factors potentially suitable for further exploration in high-quality longitudinal research or randomized studies intervening with the potential mediators.

Asylum-seekers experience high levels of traumatic events pre-, post- and during migration. Poly-traumatisation is associated with complex post-traumatic stress disorder (CPTSD), which has not yet been extensively explored in this population. CPTSD is a prevalent and highly disabling disorder in the present population requiring culturally sensitive diagnostic and treatment approaches. In this service evaluation, we evidence the high prevalence of CPTSD in an asylum-seeking sample and its association with greater distress compared with PTSD. We outline the treatment needs of asylum seekers with CPTSD.

OBJECTIVE: This longitudinal study investigated psychosocial mediators in the association between minority sexual orientation (e.g., identifying as lesbian, gay, or bisexual) and depressive symptoms in young people. METHOD: Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) UK birth cohort were analyzed. Sexual orientation was assessed at 15 years and depressive symptoms were assessed at 18 years. Mediators were assessed at 17 years: unhelpful assumptions (i.e., dysfunctional attitudes about the self and others), hypothesized to be vulnerability factors in cognitive theories of depression; selfesteem; and family relationships measured with four items. Multiple mediation analysis of 14,814 individuals utilized structural equation models estimated via full information maximum likelihood, with family relationships entered as a latent variable. Sex at birth was examined as a moderator. RESULTS: Sexual minority youth had higher risk for depressive symptoms at 18 years than heterosexual youth. They also had poorer relationships with their family and more unhelpful assumptions, with weaker evidence for lower self-esteem, especially those who were male sex at birth. Poorer family relationships and unhelpful assumptions mediated the relation between sexual minority status and depressive symptoms, with weaker evidence for self-esteem as a mediator. There was no evidence to suggest that sex at birth moderated these relations. CONCLUSIONS: Poorer family relationships, more unhelpful self-beliefs, and possibly lower self-esteem may contribute to sexual orientation disparities in depressive symptoms, indicating possible areas for prevention and intervention.

Survivors of human rights abuses often present with significant mental health difficulties as well as social and integration problems. We present a community-based approach that helps address social isolation and integration difficulties, and can complement evidence-based psychological therapies.