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      Daily Heterosexist Experiences in LGBTQ+ Adults from Spain: Measurement, Prevalence, and Clinical Implications Translated title: Las experiencias diarias heterosexistas en adultos LGBTQ+ de España: medición, prevalencia e implicaciones clínicas

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          ABSTRACT

          Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals face unique stressors related to their sexual and gender identities that have a detrimental impact on their mental health. Nonetheless, studies have not yet investigated these minority stressors among LGBTQ+ individuals from Spain. The limited availability of standardized tools/instruments to measure minority stressors in Spanish makes it challenging to explore these experiences among Spanish speaking individuals. The present study aimed to examine the factor structure of the Daily Heterosexist Experiences Questionnaire (DHEQ) among LGBTQ+ adults from Spain, compare rates of minority stressors across diverse gender and sexual orientations, and examine the impact of daily heterosexist experiences (henceforth referred to as heterosexist experiences) on symptoms of depression and suicidal behavior. The sample was composed of 509 LGBTQ+ identifying adults in the age range of 18 to 60 years old. Confirmatory factor analysis indicated a good fit for the six dimensions of the DHEQ scale. Individuals identified as transgender or reporting a minority sexual orientation (i.e., asexual, pansexual) indicated higher levels of exposure to heterosexist experiences. Moreover, those with higher levels of heterosexist experiences had higher symptoms of depression and suicide behavior. The present study provides a tool for examining minority stressors in Spanish speaking LGBTQ+ adults. Assessing for minority stressors may aid in the identification of risk and protective factors when working with LGBTQ+ treatment seeking adults.

          RESUMEN

          Las personas lesbianas, gais, bisexuales, transexuales y queer (LGBTQ+) enfrentan en su día a día estresores únicos relacionados con sus identidades sexuales y de género que pueden perjudicar a su salud mental. Sin embargo, no hay investigación que explore estos estresores minoritarios en población LGBTQ+ de España. La limitada disponibilidad de instrumentos estandarizados para medir los estresores minoritarios/experiencias heterosexistas en español dificulta hoy en día explorar estas experiencias en las personas de habla hispana. El presente estudio tiene como objetivo examinar la estructura factorial del Cuestionario de Experiencias Heterosexistas Diarias (DHEQ, según sus siglas en inglés) en adultos LGBTQ+ de España, comparar las tasas de experiencias heterosexistas en diversas identidades de género y orientaciones sexuales y examinar el impacto de las experiencias heterosexistas en los síntomas de depresión y comportamiento suicida. La muestra constaba de 509 adultos LGBTQ+ en el rango de edad de 18 a 60 años. El análisis factorial confirmatorio indica un buen ajuste para las seis dimensiones de la escala DHEQ. Las personas que se identificaron como trans o con una orientación sexual minoritaria (por ejemplo, asexual, pansexual) indicaban mayores niveles de exposición a experiencias heterosexistas. Además, niveles más altos de experiencias heterosexistas se asocian a mayores síntomas de depresión y comportamiento suicida. El presente estudio proporciona una herramienta para examinar experiencias heterosexistas en población adulta LGBTQ+ de habla hispana. La evaluación de experiencias heterosexistas puede ayudar en la identificación de factores de riesgo y de protección cuando se trabaja con adultos LGBTQ+ en el ámbito clínico.

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          Most cited references78

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          Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.

          Ilan Meyer (2003)
          In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
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            Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire.

            The Primary Care Evaluation of Mental Disorders (PRIME-MD) was developed as a screening instrument but its administration time has limited its clinical usefulness. To determine if the self-administered PRIME-MD Patient Health Questionnaire (PHQ) has validity and utility for diagnosing mental disorders in primary care comparable to the original clinician-administered PRIME-MD. Criterion standard study undertaken between May 1997 and November 1998. Eight primary care clinics in the United States. Of a total of 3000 adult patients (selected by site-specific methods to avoid sampling bias) assessed by 62 primary care physicians (21 general internal medicine, 41 family practice), 585 patients had an interview with a mental health professional within 48 hours of completing the PHQ. Patient Health Questionnaire diagnoses compared with independent diagnoses made by mental health professionals; functional status measures; disability days; health care use; and treatment/referral decisions. A total of 825 (28%) of the 3000 individuals and 170 (29%) of the 585 had a PHQ diagnosis. There was good agreement between PHQ diagnoses and those of independent mental health professionals (for the diagnosis of any 1 or more PHQ disorder, kappa = 0.65; overall accuracy, 85%; sensitivity, 75%; specificity, 90%), similar to the original PRIME-MD. Patients with PHQ diagnoses had more functional impairment, disability days, and health care use than did patients without PHQ diagnoses (for all group main effects, P<.001). The average time required of the physician to review the PHQ was far less than to administer the original PRIME-MD (<3 minutes for 85% vs 16% of the cases). Although 80% of the physicians reported that routine use of the PHQ would be useful, new management actions were initiated or planned for only 117 (32%) of the 363 patients with 1 or more PHQ diagnoses not previously recognized. Our study suggests that the PHQ has diagnostic validity comparable to the original clinician-administered PRIME-MD, and is more efficient to use.
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              The Suicidal Behaviors Questionnaire-Revised (SBQ-R): validation with clinical and nonclinical samples.

              Past suicidal behaviors including ideation and attempts have been identified as significant risk factors for subsequent suicidal behavior. However, inadequate attention has been given to the development or validation of measures of past suicidal behavior. The present study examined the reliability and validity of a brief self-report measure of past suicidal behavior, the Suicidal Behaviors Questionnaire-Revised (SBQ-R). Participants included psychiatric inpatient adolescents, high school students, psychiatric inpatient adults, and undergraduates. Logistic regression analyses provided empirical support for the usefulness of the SBQ-R as a risk measure of suicide to differentiate between suicide-risk and nonsuicidal study participants. Receiver operating characteristic (ROC) analyses indicated that the most useful cutoff scores on the SBQ-R were 7 for nonsuicidal samples, and 8 for clinical samples. Both the single SBQ-R Item 1 and SBQ-R total scores are recommended for use in clinical and nonclinical settings.
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                Author and article information

                Journal
                Interv Psicosoc
                Interv Psicosoc
                inter
                Psychosocial Intervention
                Colegio Oficial de la Psicología de Madrid
                1132-0559
                2173-4712
                2 January 2023
                January 2023
                : 32
                : 1
                : 1-10
                Affiliations
                [a ] orgnameAutonomous University of Madrid Madrid Spain originalAutonomous University of Madrid, Spain
                [b ] orgnameUniversity of Texas Rio Grande Valley Edinburg Texas USA originalUniversity of Texas Rio Grande Valley, Edinburg, Texas, USA
                Author notes
                Correspondence: rc.ronzon@ 123456uam.es (R. Ronzón-Tirado).

                Conflict of Interest: The authors of this article declare no conflict of interest.

                Article
                00001
                10.5093/pi2022a15
                10268542
                5b1bbd55-a230-44ee-bdf7-1f35b10b1dcc
                Copyright © 2023, Colegio Oficial de la Psicología de Madrid

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial No Derivative License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited and the work is not changed in any way.

                History
                : 12 May 2022
                : 12 August 2022
                : 26 September 2022
                Page count
                Figures: 0, Tables: 7, Equations: 0, References: 62
                Funding
                Funded by: FEDER
                Funded by: Spanish Ministry of Science, Innovation, and Universities
                Award ID: PSI2017-84764-P
                Funded by: Autonomous Community of Madrid
                Award ID: SI3/PJI/2021-00195
                Funding: This study has been supported by FEDER/Spanish Ministry of Science, Innovation, and Universities – State Research Agency (PSI2017-84764-P) and by the program of stimuli for young researchers of the Autonomous Community of Madrid (SI3/PJI/2021-00195)
                Categories
                Research-Article

                daily heterosexist experiences,lgtbq+,validation,mental health,spanish,experiencias heterosexistas diarias,validación,salud mental,español

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