Intersecting minority identities may confer unique risks for stress and trauma. In this article, we reviewed extant research on the processes and outcomes of racial and sexual/gender identity-related (i.e., "intersectional") stress and trauma among the understudied population of lesbian, gay, bisexual, transgender, and queer (LGBTQ) Asian Americans. Specifically, we proposed a model of intersectional stress and trauma in LGBTQ Asian Americans that builds upon elements of minority stress theory for sexual minorities. Method: We used PsycINFO and other online databases and search engines to search for information in developing and describing our model. We included 84 peer-reviewed empirical, qualitative, and review/theoretical articles, as well as books, book chapters, unpublished data, and organization reports from 1970 to 2016. Results: In the model, we detail how structural oppression, cultural norms and stigma, interpersonal discrimination, internalized minority stress cognitions, and maladaptive coping and poor social support interact in contributing to negative mental and sexual health outcomes in LGBTQ Asian Americans, as a function of their intersecting racial and sexual/gender identities. Conclusions: LGBTQ Asian Americans face unique stressors that can lead to traumatization. Future research should empirically validate our model of intersectional stress and trauma, increase scientific representation of all LGBTQ Asian American subgroups, and emphasize the LGBTQ Asian American identity as multifaceted and intersectional. Finally, components of our model appear to be promising areas for intervention. However, we urge clinicians to consider the utility of treatments from the perspective of indigenous practices and healing, compared with adaptation from Western, heteronormative treatment approaches.

Prior research has demonstrated a clear relationship between experiences of racial microaggressions and various indicators of psychological unwellness. One concern with these findings is that the role of negative affectivity, considered a marker of neuroticism, has not been considered. Negative affectivity has previously been correlated to experiences of racial discrimination and psychological unwellness and has been suggested as a cause of the observed relationship between microaggressions and psychopathology. We examined the relationships between self-reported frequency of experiences of microaggressions and several mental health outcomes (i.e., anxiety [Beck Anxiety Inventory], stress [General Ethnic and Discrimination Scale], and trauma symptoms [Trauma Symptoms of Discrimination Scale]) in 177 African American and European American college students, controlling for negative affectivity (the Positive and Negative Affect Schedule) and gender. Results indicated that African Americans experience more racial discrimination than European Americans. Negative affectivity in African Americans appears to be significantly related to some but not all perceptions of the experience of discrimination. A strong relationship between racial mistreatment and symptoms of psychopathology was evident, even after controlling for negative affectivity. In summary, African Americans experience clinically measurable anxiety, stress, and trauma symptoms as a result of racial mistreatment, which cannot be wholly explained by individual differences in negative affectivity. Future work should examine additional factors in these relationships, and targeted interventions should be developed to help those suffering as a result of racial mistreatment and to reduce microaggressions.

Fears of sexually harming children are fairly common among clients suffering from obsessive-compulsive disorder (OCD), yet these symptoms are largely unrecognized and frequently misdiagnosed by mental health professionals. Specifically, clients with pedophilia-themed OCD (P-OCD) experience excessive worries and distressing intrusive thoughts about being sexually attracted to, and sexually violating, children. Expressing these concerns may provoke misjudgments from uninformed mental health professionals that a client is presenting instead with pedophilic disorder. This misdiagnosis and subsequent improper interventions can then contribute to increased fear, anxiety, and in many cases, depression, in affected clients. Therefore, it is imperative that mental health professionals first possess a good understanding of this common manifestation of OCD. As such, in this article, we described obsessions and compulsions typical of P-OCD, in order to inform the reader of the distinctive differences between P-OCD and pedophilic disorder. Information about how to assess for P-OCD symptoms is then provided, followed by suggestions on how to tailor aspects of exposure and response prevention to treat this specific form of OCD.

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In racialized societies, race divides people, prioritizes some groups over others, and directly impacts opportunities and outcomes in life. These missed opportunities and altered outcomes can be rectified only through the deliberate dismantling of explicit, implicit, and systemic patterns of injustice. Racial problems cannot be corrected merely by the good wishes of individuals-purposeful actions and interventions are required. To create equitable systems, civil courage is vital. Civil courage differs from other forms of courage, as it is directed at social change. People who demonstrate civil courage are aware of the negative consequences and social costs but choose to persist based on a moral imperative. After defining allyship and providing contemporary and historical examples of civil courage, this paper explains the difficulties and impediments inherent in implementing racial justice. To enable growth and change, we introduce ten practical exercises based on cognitive-behavioral approaches to help individuals increase their awareness and ability to demonstrate racial justice allyship in alignment with valued behaviors. We explain how these exercises can be utilized to change thinking patterns, why the exercises can be difficult, and how psychologists and others might make use of them to expand the capacity for civil courage in the service of racial justice. Public Significance StatementRacial justice is an important goal for the well-being of racialized people globally. However, most Americans, psychologists included, find it difficult to align their values and intentions with actions. This paper offers a frank discussion of the issues of shame and discomfort that often surround issues of racial injustice and describes cognitive-behavioral approaches for cultivating civil courage.