Association of recent gay‐related stressful events and emotional distress with suicidal behaviors over 12 months in <scp>C</scp>hinese men who have sex with men

Yu, Liya E.; Li, Yanxia; Liu, Li; Li, Shuang; Na, Jun; An, Xiaoxia; Zhou, Yan; Gu, Ying; Bi, Xuejuan; Mu, Huijuan; Zhang, Rui; Dong, Wen; Pan, Guowei

doi:10.1111/appy.12286

Cited by 16 publications

(20 citation statements)

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“…Thus the result could be partially attributed to the cross-study variations in methodology (e.g., sample characteristics, definition and measurement of IPV). We also found a prevalence of 36.0% of depression in the MSM sample, which is comparable to the prevalence reported in previous studies among MSM in China [40,41]. Younger age and lower income level were associated with increased risk of depression, corroborating with prior studies among Chinese MSM [42,43].…”

Section: Discussionsupporting

confidence: 90%

The mediating role of self-stigma and self-efficacy between intimate partner violence (IPV) victimization and depression among men who have sex with men in China

Peng

She

et al. 2020

BMC Public Health

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Background: Previous studies have shown that intimate partner violence (IPV) is prevalent in men who have sex with men (MSM). Mental health problems among MSM with IPV victimization have become a growing concern. The present study examined homosexual self-stigma and self-efficacy as potential mediators of the association between IPV victimization and depression. Methods: We recruited 578 MSM from 15 cities across China. Participants completed sociodemographic measures, the IPV-GBM (IPV among gay and bisexual men) scale, the Self-Stigma Scale-Short Form (SSS-S), the General Self-Efficacy (GSE) Scale and the Center for Epidemiologic Studies Depression 10 (CES-D-10). We calculated biascorrected 95% confidence interval (CI) for total, direct and indirect effects using bootstrapping to conduct mediation analyses. Results: Findings showed that the prevalence of IPV victimization and depression were 32.7% (189/578) and 36.0% (208/578), respectively. Result from mediation analysis using structural equation modeling indicated that the association between level of IPV victimization and depression among MSM was fully mediated by higher homosexual self-stigma and lower self-efficacy. Homosexual self-stigma had a direct effect and an indirect effect via self-efficacy on depression. Conclusion: The results provided evidence that integrated interventions that reduce self-stigma and foster selfefficacy could be promising approaches to decrease depression among MSM with IPV victimization.

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Section: Discussionsupporting

confidence: 90%

The mediating role of self-stigma and self-efficacy between intimate partner violence (IPV) victimization and depression among men who have sex with men in China

Peng

She

et al. 2020

BMC Public Health

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“…Specifically, depression was most strongly linked to workplace-based gay-related stressful events (e.g., "trouble with boss or supervisor about same-sex behavior") [53]. In addition, "Getting in trouble with the police because of same-sex behavior" as a stressful event was associated with highest elevated risks of suicidal ideation, plan, and attempt, though the overall prevalence of this event was low [73].…”

Section: Distal Sexual Minority Stress and Mental Healthmentioning

confidence: 99%

“…A longitudinal study in Beijing and a cross-sectional survey of a national sample of MSM in China reported no associations between experiences of discrimination (or enacted sexual identity stigma) and psychological distress, although both studies found discrimination to be associated with sexual risk behaviors [31,102]. However, a study with MSM in Liaoning Province revealed that gay-related stressful life events in the past 3 months were associated with elevated risks of depression and suicidal behaviors [53,73]. Specifically, depression was most strongly linked to workplace-based gay-related stressful events (e.g., "trouble with boss or supervisor about same-sex behavior") [53].…”

Section: Distal Sexual Minority Stress and Mental Healthmentioning

confidence: 99%

Addressing Minority Stress and Mental Health among Men Who Have Sex with Men (MSM) in China

et al. 2020

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Purpose of Review Men who have sex with men (MSM) in China experience elevated risks of mental health issues in comparison to the general population in China, which contribute to vulnerability to HIV/STI risks and can comprise the effectiveness of HIV prevention efforts. A conceptual framework for understanding this mental health disparity is minority stress theory, which posits that experiences of external prejudice events (i.e., distal stressors) and internal stress processes such as internalized homophobia and concealment (i.e., proximal stressors) contribute to sexual minorities' elevated risk of psychological distress. To deepen the understanding of mental health among Chinese MSM and explore the potential utility of minority stress theory in this population, this paper synthesizes research evidence regarding prevalent mental health issues as well as how minority stress may be linked to psychological health in Chinese MSM. Recent Findings Results indicate that Chinese MSM experience a high prevalence of several mental health issues including depression, anxiety, suicidal behaviors, and alcohol dependence. Summary This review further reveals minority stress to be an important determinant of psychological distress among Chinese MSM, though evidence is mixed regarding the relationship between proximal minority stress and psychological health. Nonetheless, there is a lack of mental health services and interventions focusing on MSM in China. Culturally relevant, competent, and LGBT-affirmative mental health interventions are needed for Chinese MSM. To guide future intervention research, we provide considerations for reducing minority stress and promoting psychological health among Chinese MSM.

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“…Anxiety was mainly measured with the Self-rating Anxiety Scale (SAS) (Zung, 1971) and the Generalised Anxiety Disorder Scale-7 (GAD-7) (Spitzer et al, 2006), used in 17 and 4 studies, respectively. The measurement Epidemiology and Psychiatric Sciences of suicide (suicide ideation, suicide plans or suicide attempts) based on a single item, except for two studies (Yu and Xiao, 2017;Yu et al, 2018), used standardised scales [a section of the World Mental Health Composite International Diagnostic Interview (WMH-CIDI)] (Kessler and Ustün, 2004) and a shortened 6-item version of the suicide questionnaire designed by Kessler et al (2005). The recall time to measure suicide included 'over the past week', 'over the past six months', 'over the past year', 'since HIV diagnosis' and 'lifetime'.…”

Section: Study Characteristicsmentioning

confidence: 99%

Prevalence of depression, anxiety and suicide among men who have sex with men in China: a systematic review and meta-analysis

Dong

Wang

You

et al. 2020

Epidemiol Psychiatr Sci

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Aims Chinese men who have sex with men (MSM) are at high risk for depression, anxiety and suicide. The estimated prevalence of these problems is essential to guide public health policy, but published results vary. This meta-analysis aimed to estimate the prevalence of depressive symptoms, anxiety symptoms and suicide among Chinese MSM. Methods Systematic searches of EMBASE, MEDLINE, PsycINFO, PubMed, CNKI and Wanfang databases with languages restricted to Chinese and English for studies published before 10 September 2019 on the prevalence of depressive symptoms, anxiety symptoms, suicidal ideation, suicide plans and suicide attempts among Chinese MSM. Studies that were published in the peer-reviewed journals and used validated instruments to assess depression and anxiety were included. The characteristics of studies and the prevalence of depression and anxiety symptoms, suicidal ideation, suicide plans and suicide attempts were independently extracted by authors. Random-effects modelling was used to estimate the pooled rates. Subgroup analysis and univariate meta-regression were conducted to explore potential sources of heterogeneity. This study followed the PRISMA and MOOSE. Results Sixty-seven studies were included. Fifty-two studies reported the prevalence of depressive symptoms, with a combined sample of 37 376 people, of whom 12 887 [43.2%; 95% confidence interval (CI), 38.9–47.5] reported depressive symptoms. Twenty-seven studies reported the prevalence of anxiety symptoms, with a combined sample of 10 531 people, of whom 3187 (32.2%; 95% CI, 28.3–36.6) reported anxiety symptoms. Twenty-three studies reported the prevalence of suicidal ideation, with a combined sample of 15 034 people, of whom 3416 (21.2%; 95% CI, 18.3–24.5) had suicidal ideation. Nine studies reported the prevalence of suicide plans, with a combined sample of 5271 people, of whom 401 (6.2%; 95% CI, 3.9–8.6) had suicide plans. Finally, 19 studies reported the prevalence of suicide attempts, with a combined sample of 27 936 people, of whom 1829 (7.3%; 95% CI, 5.6–9.0) had attempted suicide. Conclusions The mental health of Chinese MSM is poor compared with the general population. Efforts are warranted to develop interventions to prevent and alleviate mental health problems among this vulnerable population.

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Association of recent gay‐related stressful events and emotional distress with suicidal behaviors over 12 months in Chinese men who have sex with men

Abstract: More efforts to reduce GRSE are worth investigating as a strategy to reduce suicidal thoughts and behaviors in Chinese MSM.

Cited by 16 publications

References 30 publications

The mediating role of self-stigma and self-efficacy between intimate partner violence (IPV) victimization and depression among men who have sex with men in China

The mediating role of self-stigma and self-efficacy between intimate partner violence (IPV) victimization and depression among men who have sex with men in China

Addressing Minority Stress and Mental Health among Men Who Have Sex with Men (MSM) in China

Prevalence of depression, anxiety and suicide among men who have sex with men in China: a systematic review and meta-analysis

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