The role of the social environment in non-suicidal self-injury among LGBTQ youth: A mixed methods study

Non-suicidal self-injury (NSSI), such as cutting and burning, is a widespread social problem among lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth. Extant research indicates that this population is more than twice as likely to engage in NSSI than heterosexual and cisgender (non-transgender) youth. Despite the scope of this social problem, it remains relatively unexamined in the literature. Research on other risk behaviors among LGBTQ youth indicates that experiencing homophobia and transphobia in key social contexts such as families, schools, and peer relationships contributes to health disparities among this group. Consequently, the aims of this study were to examine: (1) the relationship between LGBTQ youth's social environments and their NSSI behavior, and (2) whether/how specific aspects of the social environment contribute to an understanding of NSSI among LGBTQ youth. This study was conducted using an exploratory, sequential mixed methods design with two phases. The first phase of the study involved analysis of transcripts from interviews conducted with 44 LGBTQ youth recruited from a community-based organization. In this phase, five qualitative themes were identified: (1) Violence; (2) Misconceptions, Stigma, and Shame; (3) Negotiating LGBTQ Identity; (4) Invisibility and Isolation; and (5) Peer Relationships. Results from the qualitative phase were used to identify key variables and specify statistical models in the second, quantitative, phase of the study, using secondary data from a survey of 252 LGBTQ youth. The qualitative phase revealed how LGBTQ youth, themselves, described the role of the social environment in their NSSI behavior, while the quantitative phase was used to determine whether the qualitative findings could be used to predict engagement in NSSI among a larger sample of LGBTQ youth. The quantitative analyses found that certain social-environmental factors such as experiencing physical abuse at home, feeling unsafe at school, and greater openness about sexual orientation significantly predicted the likelihood of engaging in NSSI among LGBTQ youth. Furthermore, depression partially mediated the relationships between family physical abuse and NSSI and feeling unsafe at school and NSSI. The qualitative and quantitative results were compared in the interpretation phase to explore areas of convergence and incongruence. Overall, this study's findings indicate that social-environmental factors are salient to understanding NSSI among LGBTQ youth. The particular social contexts in which LGBTQ youth live significantly influence their engagement in this risk behavior. These findings can inform the development of culturally relevant NSSI interventions that address the social realities of LGBTQ youth's lives.

A Qualitative Study of Potential Suicide Risk Factors Among Soldiers Transitioning From Operation Iraqi Freedom/Operation Enduring Freedom

Using qualitative methods, this study explored potential risk factors for suicide, as defined by Joiner's Interpersonal-Psychological Theory of Suicide (IPTS), in a population of Soldiers returning from deployment in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF). Sixty-eight Soldiers participated in semi-structured interviews during the period of transition from deployment to the garrison environment. These Soldiers were asked about changes in perception of pain, experiences of perceived burdensomeness, and lack of belonging. Interviews were transcribed and analyzed. A phenomenological methodology was employed (Creswell, 2006). In response to questions about perception of pain, Soldiers discussed both positive and negative changes in their experience of physical and emotional pain. When asked about experiences of perceived burdensomeness, Soldiers described changes related to deployment, such as injuries and combat related guilt, as well as changes related to transition from combat, including care seeking, reintegration into family and society, and emotional distancing. Regarding the experience of lack of belonging, Soldiers described difficulties related to the deployment, such as combat injuries, leadership roles, and individual differences, as well as difficulties related to reintegration such as symptoms of emotional numbing and distancing. Findings highlight the potential utility of IPTS in exploring both acute and chronic suicide risk factors associated with deployment and transition, as well as potential treatment strategies that may reduce suicide risk in the population of Soldiers during reintegration.

Sexual Sensation Seeking, Alcohol Use, and Risky Sexual Behavior Among Men Who Have Sex With Men

Men who have sex with men (MSM) remain most at risk for developing HIV infection. The best prevention in this population is to identify risk factors associated with unprotected sex. Recent research suggests that sexual sensation seeking (SSS) and level of average drinking moderates the relationship between drinking alcohol in the context of sex and risky sexual behavior in a young MSM population (ages 16-20). Current study is an exploratory analysis using multilevel modeling to examine if these results are consistent across a MSM population with a wider range of ages who are also heavy drinkers. Participants (n = 181) included MSM (ages 18-75 years) from a longitudinal clinical research trial. Results indicate that MSM with higher SSS were more likely to have unprotected anal sex if they drank alcohol 3 hours prior to sex than those who did not, (OR = 1.07; 95% CI: 1.03 – 1.12). There was no significant interaction effect for average levels of drinking.

Development of a Household Pharmaceutical Waste Collection Program for Atlanta, Georgia: An Analysis of Risk Factors and Public Awareness with a Comprehensive Collection Plan

Decades of mixed messages from three federal agencies left many Americans unaware of the hazards associated with the indiscriminate disposal of unwanted or expired medicines. For this Capstone project, a systematic review of state and federal regulations was undertaken to determine how these laws obstruct household pharmaceutical waste collection. In addition, a survey of 654 Atlanta residents was conducted to evaluate unwanted medicine disposal habits, awareness of pharmaceutical compounds being detected in drinking water, surface, and ground waters, and willingness to participate in a household pharmaceutical waste collection program. Survey responses were tabulated to provide overall results and by age group, gender, and race. A household pharmaceutical waste collection plan was developed for the city and included as an appendix.