John Vincke

Suicidal acts and ideation in homosexual and bisexual young people: a study of prevalence and risk factors.

Abstract  Background: Suicide attempts are the most robust clinical predictor of suicide, which is now the second cause of death among young people in many countries. Previous research has shown an increased risk of attempted suicide associated with a homosexual orientation. However, the mechanisms underlying this increased risk are not yet clear. This study therefore aimed to determine the risk of attempted suicide and the effect of potential risk factors on the occurrence of suicidal ideation and behaviour among homosexual youngsters. Methods: The association between suicidal ideation and behaviour and potential risk factors was assessed by means of a questionnaire in a general population sample of homosexual or bisexual young people and a control sample consisting of school pupils. Results: A twofold increased risk of suicidal ideation was found associated with a homosexual or bisexual orientation. A significantly increased risk of attempted suicide associated with homosexuality or bisexuality was found in females. Independent of sexual orientation, depression was identified as a significant risk factor for suicidal ideation, while suicidal behaviour was associated with low self-esteem, higher levels of hopelessness and suicidal behaviour in someone close. Among homosexual or bisexual young people, less satisfying homosexual friendships were an additional risk factor for suicidal behaviour. Conclusions: The identified increased risk of suicidal ideation among homosexual or bisexual young people is associated with depression and may lead to suicidal behaviour, independent of sexual orientation, especially in the presence of a role model of suicidal behaviour, and among those with unsatisfying friendships.

Alcohol and risky sex: In search of an elusive connection

Since the publication of the 1986 article by Stall, McKusick, Wiley, Coates and Ostrow, the conclusion that drinking alcohol prior to or during erotic encounters increases the probability of engaging in high-risk sexual behavior has been widely accepted, despite some contradictory findings from research on this hypothesis. This paper presents the results of tests of the alcohol/risky-sex hypothesis in a cohort of gay men in Flanders, Belgium. Failing to find evidence to support the hypothesis of a general effect of alcohol on sexual risk taking, we argue that previous conclusions on this matter must be viewed with extreme caution, especially in light of the implications that this failure to replicate has for AIDS prevention programs. Cultural, social, and methodological factors that could account for this failure to replicate are discussed in the context of a review of the literature on this hypothesis.

The role of testosterone in aggressive and non-aggressive risk-taking in adolescent boys

While there exists increasing evidence of a relationship between testosterone (T) and risk-taking (RT), many issues remain unsolved. This paper tries to address two main-questions: (i) does T influence aggressive risk-taking (ART) and/or non-aggressive risk-taking (NART) behavior and (ii) is this relationship stable throughout age and pubertal development and how is the relationship affected by affiliations with peers that are highly involved in RT, referred to as differential association (DA)? For a sample of 301 third-grade adolescent boys (mean age 14.4 years), we assessed the relationship between serum levels of T and estradiol (E2), DA and ART/NART. Significant effects of SHBG (Beta=-0.15; p<0.029) and free testosterone (FT) (Beta=0.23; p<0.003) on NART were shown. No significant effects were found with respect to ART. Further analyses showed that the FT-NART and the FT-ART relations differed as to age but not as to pubertal development (PD) and that the relationship between FT and RT is mediated by DA as such that individuals with higher levels of FT have friends that are more involved in RT and their influence contributes to increased levels of RT. Our results indicate that hormone-related interests and predispositions may influence the development of affiliations with risk-taking peers, a factor which is crucial in understanding adolescent RT.

Testosterone, androgen receptor gene CAG repeat length, mood and behaviour in adolescent males

OBJECTIVES Androgen activity has been implicated in a range of traits and behaviours that have well-documented sex differences. However, the results of the studies on the relationship between testosterone and these traits and behaviours are inconsistent. This study has analyzed i) whether CAG repeat length, a presumed modulator of androgen receptor sensitivity, is associated with sex-dimorphic traits and behaviours (aggressive and non-aggressive risk-taking (ART and NART), dominance, depressive symptoms and self-esteem), and ii) whether CAG repeat length interacts with free testosterone (FT) with respect to these traits and behaviours. DESIGN AND METHODS Data obtained from a group of adolescent boys (n=301; mean age: 14.4 years) were analyzed using multivariate general linear modelling (SPSS, Chicago, IL, USA 15.0). RESULTS We found no direct correlation between CAG repeat length and dependent variables. We found significant interactions between CAG repeat length and testosterone, indicating that FT was more positively related to ART and NART with a shorter repeat length, and that an inverse association of FT with depressive symptoms and a positive association with self-esteem were stronger in boys with a longer CAG repeat length. CONCLUSION Our findings indicate the importance of studying FT and CAG repeat length simultaneously with respect to sex-dimorphic traits, taking into account the possible interactions between the two.

Social Support, Depression, and Self-Acceptance Among Gay Men

This study analyzes how low social support of gay men when coming out affects the reported levels of depression and self-acceptance in a non-clinical sample of Flemish (Belgium) gay men. The model used is nonrecursive. It incorporates the mutual causation between depression and self-acceptance. The manipulation of social support is considered as part of the general process of social control. After delineating the methodological problems associated with studying the relationship between the perception of support and depression, it is shown that low social support because one is gay leads first to depression and then to low levels of gay self-acceptance. Findings are discussed within the framework of social stress research and the characteristics of the social context of the setting where the data was collected.

Estradiol, testosterone, differential association and aggressive and non-aggressive risk-taking in adolescent girls

Although the relation between androgens and adolescent risk-taking has been relatively well documented in boys, little is known as to how sex steroid hormones relate to aggressive (ART) and/or non-aggressive adolescent risk-taking (NART) behavior in girls. On the basis of a sample of 298 adolescent girls (mean age: 14.3 years), we examined: (i) the relationship between serum levels of testosterone (T) and estradiol (E2) in relation to ART and NART and (ii) if differential association--having friends who are highly involved in risk-taking--moderates the relationship between relationships between hormones and risk-taking. The sample provided evidence of an association between free estradiol (FE2) and both NART (Beta=0.19; p<0.01) and ART (Beta=0.19; p<0.01), controlling for age and pubertal development. No relationship between T and ART or NART was found. The importance of the relationship between E2 and ART and NART differed between girls at different phases of their menstrual cycle and was significant only for girls in the mid-phase of the menstrual cycle. In addition, significant interactions between differential association and FE2 were found indicating that the relationship between FE2 and NART and ART was particularly strong in girls with high levels of differential association.

Coming out and AIDS-related high-risk sexual behavior.

How the withdrawal of social support associated with the coming out of gay men influences AIDS-related sexual risk-taking among Flemish (Belgian) gay men is analyzed. Recruited via key persons, the 379 gay men in this nonclinical cohort completed a lengthy, computerized questionnaire dealing with diverse aspects of gay life and culture. Independent variables include demographic characteristics, AIDS knowledge, coming-out histories, six social support dimensions, and personal resources. The dependent variables were insertive and receptive anal intercourse with and without a condom. Stepwise regression explained, respectively, 41.2, 38.4, 18.4, and 14.2% of the variance. Absence of appraisal (the view that others approve of the way one does things or feels about things) led to higher frequencies of insertive anal sex (both with and without a condom). The experience of emotional conflict lowered the use of condoms by the insertive partner in anal intercourse. Disapproval by significant others of being gay also led to higher levels of receptive anal intercourse without a condom. Subjects with a high belief in mastery had higher frequencies of risk-taking, suggesting that the combination of the experience of negative reactions and high mastery lead to greater involvement in risky sexual behavior. Findings are interpreted within the theoretical framework of the coming-out process and gay identity formation.

Summer holiday camps for gay and lesbian young adults: An evaluation of their impact on social support and mental well-being

ABSTRACT This study evaluates the effects of participating in a summer holiday camp for Flemish (Belgium) gay and lesbian young adults (N 197). Analysis showed to what extent participation affects the constitution and quality of friendships, the availability of confidant and appraisal support and reported levels of hopelessness, self-esteem, and depression. The study is based on panel data with a six-months interval. At follow-up, respondents reported a higher proportion of gays and lesbians in their friendship network, more satisfaction with these friendships, higher levels of confidant and appraisal support, less hopelessness, higher self-esteem, and lower levels of depression.

Therapy Adherence and Highly Active Antiretroviral Therapy: Comparison of Three Sources of Information

With the advent of the highly active antiretroviral therapy (HAART), adherence became one of the key issues within the behavioral management of the treatment of human immunodeficiency virus (HIV) infection. One of the central limitations in studying adherence to HAART is that usually one has to rely on self-reported measures of adherence. In this study, we combine information on adherence from several sources. We rely not only on the self-report of patients but also on the perception of adherence reported by the patients designated most significant other. As a third measure, we use the evaluation of adherence by the physician in charge of the treatment of the patient, and finally, we also use human immunodeficiency type 1 (HIV-1) RNA levels. In order to explain variations in adherence among patients, we used the health belief model, adherence-specific social support, and the satisfaction of patients with the health care provider-patient relation. The sample consists of 86 persons (78.6% males). The mean age was 41.2 years (standard deviation, 9.1 years). Correlations between the measures are moderate to weak. These results indicate that a substantial amount of error is present when evaluating patient adherence. However, it is not known which measure is the best indicator of adherence. If we use a theoretical framework such as the health belief model as standard to evaluate variations in adherence, then our findings point in the direction of using adherence as perceived by the medical staff.