K. Bryant Smalley

Initial Validation of the Male Role Norms Inventory-Revised (MRNI-R)

This article reports the results of the initial evaluation of the revised version of the Male Role Norms Inventory (MRNI-R). The MRNI-R assesses only traditional male role norms (thus dropping the Non-Traditional Attitudes subscale of the original MRNI), revises the labeling and content of the Self-Reliance subscale, drops the Achievement/Status subscale and substitutes the Dominance subscale, and updates the language throughout the instrument. The MRNI-R was administered to 170 undergraduate and graduate students (38 men and 132 women). One hundred and seven initial items were reduced to fifty-three items following iterative analyses of item-to-subscale correlations. Improved reliabilities were found for the MRNI-R and its subscales, with Cronbach alphas ranging from .73 to .96. Significant sex and racial/ethnic differences were found with respect to the endorsement of traditional masculinity ideology, providing support for its construct validity.

Rural mental health and psychological treatment: a review for practitioners

Practitioners in rural areas face particular challenges in providing psychological services, ranging from disparate rates of mental disorders to unique circumstances in treating special populations. In this article, we discuss the burden of mental disorders in rural areas, current trends in integration of mental health care and primary care, and unique concerns practitioners face in treating two special populations in rural areas (children and families, and older adults and their caregivers). Implications for practice are also discussed.

The normative Male Alexithymia Scale: Measurement of a gender-linked syndrome.

This series of studies assessed the psychometric properties of the Normative Male Alexithymia Scale (NMAS), a brief scale designed to assess normative male alexithymia. Exploratory and confirmatory factor analyses using separate samples (n = 248 and 467, respectively) indicated that the NMAS consist

Psychological well-being among transgender and genderqueer individuals

ABSTRACT The purpose of this study was to compare psychological well-being among transgender women, transgender men, genderqueer/nonbinary individuals, and their cisgender sexual minority counterparts. A total of 2,932 gender and sexual minority individuals participated in the online study. While controlling for age, race/ethnicity, employment status, education, and relationship status, there was significant variation between gender minority subgroups in depression (p < 0.001); anxiety (p = 0.003); stress (p = 0.004); perceived social support (p < 0.001); self-esteem (p = 0.031); self-perceived need for mental health care (p < 0.001); family history of mental illness (p = 0.003); personal history of mental health concerns (p = 0.003); and being in recovery (p = 0.004). Overall, transgender women had the poorest psychological well-being across the majority of variables. In contrast to their transgender peers, genderqueer/nonbinary–identified individuals did not significantly differ from their cisgender sexual minority counterparts on outcomes; however, they did differ on stressors. Transgender men appeared to fall between transgender women and genderqueer/nonbinary individuals in terms of risk factors and outcomes. The current findings highlight the importance of considering the psychosocial experiences of the various gender minority subgroups, separate from not only their cisgender sexual minority counterparts but also each other.

Barriers to Care and Psychological Distress Differences between Bisexual and Gay Men and Women

The bisexual community may face unique barriers to health care that affect mental health outcomes; however, previous research has not specifically compared bisexual and gay men and women on these factors. This study explored differences between bisexual and gay men and women in barriers to care and psychological distress among a sample of 2,500 bisexual and gay men and women recruited online. Bisexual men and women were more likely to report barriers to care ranging from limited availability of providers to less comfort discussing their sexual orientation with their provider. Differences in specific mental health outcomes centered on sexual orientation, but not gender. Bisexual women reported the highest levels of depression, stress, and anxiety, and bisexual men reported higher levels of anxiety than gay men and gay women. Findings suggest that the sociocultural pressures affecting barriers to care and psychological distress may be disproportionately affecting bisexual individuals, even more so than previously documented sociocultural pressures related to gender.

Psychosocial Impact of Fracking: a Review of the Literature on the Mental Health Consequences of Hydraulic Fracturing

The process of natural gas extraction known as hydraulic fracturing, or fracking, is a controversial energy acquisition technique often viewed with disdain by the public, due to its potential for environmental harm. However, the mental health and psychological well-being of fracking communities, including potential benefits and detriments, are often overlooked. We reviewed the literature on the association between fracking and psychological functioning, finding that although persons living in fracking communities may experience some minimal, initial benefits such as land lease income or infrastructure development, they may also experience worry, anxiety, and depression about lifestyle, health, safety, and financial security, as well as exposure to neurotoxins and changes to the physical landscape. Indeed, entire communities can experience collective trauma as a result of the “boom/bust” cycle that often occurs when industries impinge on community life. Impacted communities are often already vulnerable, including poor, rural, or indigenous persons, who may continue to experience the deleterious effects of fracking for generations. An influx of workers to fracking communities often stokes fears about outsiders and crime; yet, it must be recognized that this population of mobile workers is also vulnerable, often ostracized, and without social support. Practitioners, researchers, and policy makers alike should continue to investigate the potential psychological ramifications of fracking, so that effective and targeted intervention strategies can be developed, disseminated, and implemented to improve mental health in fracking communities.

Variations in psychological distress between gender and sexual minority groups

ABSTRACT The purpose of this study was to compare rates of elevated levels of depression, anxiety, and stress among six different lesbian, gay, bisexual, and transgender (LGBT) subgroups (cisgender lesbians, cisgender gay males, cisgender bisexual females, cisgender bisexual males, transgender females, and transgender males). A total of 2,702 LGBT-identified individuals participated in the online study. While controlling for other demographic factors, rates of elevated levels of depression (p < 0.001), anxiety (p = 0.015), and stress (p < 0.001) all varied significantly between LGBT subgroups. Post-hoc examinations of pairwise differences revealed substantial and unexpected variations, highlighting the importance of separately examining LGBT subgroups when considering mental health outcomes.

Recent Alcohol, Tobacco, and Substance Use Variations Between Rural and Urban Middle and High School Students

ABSTRACT The use of addictive substances by adolescents is a major public health concern; however, rural versus urban variations are poorly understood. The purpose of the current study was to examine rural-urban differences in the prevalence of recent use of 11 substances in grades 6 through 12 in a statewide sample of students from the Georgia Student Health Survey II (N = 513,909). We found that rural-urban differences in substance use depend largely upon grade level, with rural middle school students demonstrating higher rates of alcohol, smoking tobacco, and chewing tobacco use, and urban high school students demonstrating higher rates of illicit drugs.

Psychological Distress and Perceived Barriers to Care for Rural Lesbians

The purpose of the current study was to examine rural lesbians’ experiences of psychological distress and barriers to mental healthcare compared with their nonrural counterparts. A geographically diverse sample of 716 lesbians from across the United States participated in an online study. Results revealed that compared with their nonrural counterparts, rural lesbians experience higher levels of psychological distress. In addition, after controlling for age, race, and education level, rural lesbians were also more likely to report the following barriers to needed mental healthcare: (1) a lack of coverage/financial limitations, (2) a limited availability of providers in their area, and (3) avoidance of care due to fears of discrimination/unfair treatment by a provider. Rural lesbians appear to face greater mental health related vulnerabilities. Implications for research and clinical practice are discussed.

Rural-Urban Differences in Perceptions of Child Overweight Among Children and Adolescents, Their Guardians and Health Care Professionals in the United States

RESEARCH OBJECTIVE Children and adolescents residing in rural environments with higher prevalence of an overweight population may develop inaccurate perceptions of a healthy weight. This study examines rural-urban differences in perceptions of child overweight among overweight (85 ≤ BMI percentile < 95) and obese children (BMI percentile ≥ 95), their guardians and health care providers (HCPs), and childrens concomitant weight control. METHODS The cross-sectional study was based on the 2005-2010 NHANES data (1,844 overweight and obese children and adolescents, aged 8-15 years). Rurality was defined using the 2003 RUCC. The weight status was based on the standardized measures of childrens height and weight. Children reported whether they considered themselves overweight and whether they were trying to lose weight. Proxy respondents (ie, guardians) reported whether they considered their child to be overweight and whether an HCP had ever told them their child was overweight. Weighted percentages and predicted probabilities from multivariable logistic regressions were calculated, accounting for the complex, multistage, probability sampling design and nonresponse. FINDINGS Rural residents comprised 18.8% of the study population; 41.8% of them were overweight and 58.2% were obese compared to 46.7% and 53.3% of urban peers, respectively. Misperceptions of childrens weight status were 11.3 and 6.0 percentage points higher in rural children and their guardians, respectively. Recall of an HCP identification of child overweight was 6.3 percentage points lower among rural versus urban guardians. CONCLUSION Obesity prevention efforts may be fostered by improving accuracy of child overweight perceptions. This may be particularly impactful in rural settings, where weight misperceptions are high.