Miles Q. Ott

Stability and change in self-reported sexual orientation identity in young people: application of mobility metrics.

This study investigated stability and change in self-reported sexual orientation identity over time in youth. We describe gender- and age-related changes in sexual orientation identity from early adolescence through emerging adulthood in 13,840 youth ages 12–25 employing mobility measure M, a measure we modified from its original application for econometrics. Using prospective data from a large, ongoing cohort of U.S. adolescents, we examined mobility in sexual orientation identity in youth with up to four waves of data. Ten percent of males and 20% of females at some point described themselves as a sexual minority, while 2% of both males and females reported ever being “unsure” of their orientation. Two novel findings emerged regarding gender and mobility: (1) Although mobility scores were quite low for the full cohort, females reported significantly higher mobility than did males. (2) As expected, for sexual minorities, mobility scores were appreciably higher than for the full cohort; however, the gender difference appeared to be eliminated, indicating that changing reported sexual orientation identity throughout adolescence occurred at a similar rate in female and male sexual minorities. In addition, we found that, of those who described themselves as “unsure” of their orientation identity at any point, 66% identified as completely heterosexual at other reports and never went on to describe themselves as a sexual minority. Age was positively associated with endorsing a sexual-minority orientation identity. We discuss substantive and methodological implications of our findings for understanding development of sexual orientation identity in young people.

Repeated Changes in Reported Sexual Orientation Identity Linked to Substance Use Behaviors in Youth

PURPOSE Previous studies have found that sexual minority (e.g., lesbian, gay, bisexual) adolescents are at higher risk of substance use than heterosexuals, but few have examined how changes in sexual orientation over time may relate to substance use. We examined the associations between change in sexual orientation identity and marijuana use, tobacco use, and binge drinking in U.S. youth. METHODS Prospective data from 10,515 U.S. youth ages 12-27 years in a longitudinal cohort study were analyzed using sexual orientation identity mobility measure M (frequency of change from 0 [no change] to 1 [change at every wave]) in up to five waves of data. Generalized estimating equations were used to estimate substance use risk ratios and 95% confidence intervals; interactions by sex and age group were assessed. RESULTS All substance use behaviors varied significantly by sexual orientation. Sexual minorities were at higher risk for all outcomes, excluding binge drinking in males, and mobility score was positively associated with substance use in most cases (p < .05). The association between mobility and substance use remained significant after adjusting for current sexual orientation and varied by sex and age for selected substance use behaviors. This association had a higher positive magnitude in females than males and in adolescents than young adults. CONCLUSIONS In both clinical and research settings it is important to assess history of sexual orientation changes. Changes in reported sexual orientation over time may be as important as current sexual orientation for understanding adolescent substance use risk.

Peer associations for substance use and exercise in a college student social network.

UNLABELLED Substance use and exercise have opposite trajectories in young adulthood, and research indicates that peers are influential for both of these health behaviors, but simultaneous investigations of peer associations with substance use and exercise have not been conducted. OBJECTIVE Use a college residence hall peer network to examine associations between peer behaviors and alcohol use, marijuana use, and exercise behavior. METHOD 129 undergraduates (51.9% female, 48.1% non-Hispanic White; 84.5% first-year students) in one residence hall completed a Web-based survey of substance use and exercise and identified up to 10 students in the residence hall who were important to them. Two social network analytic methods, community detection cluster analysis and network autocorrelation modeling, were used to identify peer groupings and to examine the associations between peer and participant behaviors, respectively. RESULTS Participants nominated an average of 4.1 residence hall members, and 53.9% of the ties were reciprocal. 6 clusters were identified that differed significantly on demographics, college activities, substance use, and exercise. Weekly volume of alcohol consumed among nominated peers was significantly associated with that of participants, and all other covariates, including gender and athlete status, were not significant. Peer marijuana use also was associated with participant use after controlling for covariates. Exercise levels of nominated peers were not associated with exercise levels of participants. CONCLUSIONS College student networks may be good targets for health-related prevention programs. Programs that use close-proximity peers to influence the behavior of others might be more effective with substance use as the target behavior than exercise.

Advance care planning as a shared endeavor: completion of ACP documents in a multidisciplinary cancer program

We examined the roles of oncology providers in advance care planning (ACP) delivery in the context of a multidisciplinary cancer program.

The relevance of network prominence and reciprocity of relationships for alcohol use and alcohol-related problems in a college residence hall network

Peer associations are influential for substance use among college students, but relatively few investigations have been conducted on the social network characteristics that are associated with problematic alcohol use in college. This study investigated the association between network characteristics of prestige, expansiveness, and reciprocity and alcohol use variables in a college residence hall network. Undergraduate students in 1 residence hall (N = 129; 51.9% female; 48.1% non-Hispanic White; 84.5% first-year) reported on their alcohol use and alcohol-related problems in the past semester and nominated up to 10 residence hall peers who were important to them. Network autocorrelation modeling evaluated the association between 5 network variables reflecting prestige (indegree and betweenness centrality), expansiveness (outdegree), and relationship agreement (indegree reciprocity and outdegree reciprocity) and 3 indicators of alcohol use (drinks per week, number of heavy drinking days, number of alcohol problems). Moderation by gender of the associations between network characteristics and alcohol variables was also investigated. Models controlled for demographics and network autocorrelation. A higher outdegree and higher betweenness centrality within the residence hall network were significantly related to the number of heavy drinking days and number of alcohol problems, respectively. Higher indegree and higher betweenness centrality were associated with more alcohol problems for women when alcohol use was controlled. Having higher prestige and indicating oneself as having more friends in a college residential network may convey alcohol-related risks, with some risks higher for women.

Unequal edge inclusion probabilities in link-tracing network sampling with implications for Respondent-Driven Sampling

Respondent-Driven Sampling (RDS) is a widely adopted linktracing sampling design used to draw valid statistical inference from samples of populations for which there is no available sampling frame. RDS estimators rely upon the assumption that each edge (representing a relationship between two individuals) in the underlying network has an equal probability of being sampled. We show that this assumption is violated in even the simplest cases, and that RDS estimators are sensitive to the violation of this assumption.

Relationships between social network characteristics, alcohol use, and alcohol-related consequences in a large network of first-year college students: How do peer drinking norms fit in?

A burgeoning area of research is using social network analysis to investigate college students’ substance use behaviors. However, little research has incorporated students’ perceived peer drinking norms into these analyses. The present study investigated the association between social network characteristics, alcohol use, and alcohol-related consequences among first-year college students (N = 1,342; 81% of the first-year class) at one university. The moderating role of descriptive norms was also examined. Network characteristics and descriptive norms were derived from participants’ nominations of up to 10 other students who were important to them; individual network characteristics included popularity (indegree), network expansiveness (outdegree), relationship reciprocity, and network density. Descriptive norms were defined as participants’ average perceived binge drinking frequency among their nominated peers. Network autocorrelation models revealed that indegree and descriptive norms were positively associated with participants’ average number of drinks per week, binge drinking frequency, and alcohol-related consequences. Indegree and outdegree interacted with descriptive norms, such that when participants perceived less frequent binge drinking among their peers, outdegree was associated with less alcohol consumption but not consequences. When participants perceived more frequent binge drinking among their peers, indegree and outdegree were associated with more alcohol consumption but not consequences. The present results suggest that being popular and believing that heavy episodic drinking is normative among one’s peers are associated with greater alcohol risk. Further, alcohol risks associated with nominating more peers may be enhanced or lessened depending on students’ peer drinking norms. Implications for future research and interventions are discussed.

Distinct Coping Profiles Are Associated With Mental Health Differences in Transgender and Gender Nonconforming Adults

OBJECTIVE This study assessed the unique coping strategies of transgender and gender nonconforming (TGNC) individuals in the United States used to manage gender-related stress, and examined associations between specific coping profiles and mental health. METHODS Data were from 316 participants in the 2014-2015 Transgender Stress and Health Study, an online study of TGNC mental and sexual health. A factor analysis of the coping measure (Brief COPE) was followed by a k-means cluster analysis to evaluate distinct profiles of coping with gender-related stress. Proportional odds models and logistic regression models indicated how coping profiles related to levels of self-reported depressive symptoms and suicidality. RESULTS A 4-factor structure was identified with three distinct profiles of coping with gender-related stress, each representative of the frequency (high or low) in which participants used functional and dysfunctional coping strategies: (a) high-functional/low-dysfunctional, (b) high-functional/high-dysfunctional, and (c) low-functional/low-dysfunctional. There were significant differences in depressive symptoms and suicidality based on distinct gender-related coping profiles. The high-functional/high-dysfunctional group reported significantly poorer mental health compared with the high-functional/low-dysfunctional group. CONCLUSION To improve mental health outcomes in TGNC individuals, health providers and researchers should strive to not only promote functional coping strategies for managing gender-related stress but also decrease dysfunctional coping strategies.

Minority Stressors Associated with Sexual Risk Behaviors and HIV Testing in a U.S. Sample of Transgender Individuals

The majority of published research on transgender health focuses on associations between external minority stressors (e.g., discrimination) and health. Little is known about how internal minority stressors (e.g., identity concealment and expecting rejection) might predict HIV disparities. The current study addresses this gap by examining the association between external and internal minority stressors and sexual risk behaviors and HIV testing history in a sample of 300 transgender adults across the U.S. Transgender-related discrimination and expecting rejection were associated with sexual risk behaviors. When controlling for covariates, none of the minority stressors were associated with HIV testing. Results illustrate how minority stress, both external and internal, may operate uniquely for transgender individuals.

Resistance to peer influence moderates the relationship between perceived (but not actual) peer norms and binge drinking in a college student social network

INTRODUCTION Adolescent and young adult binge drinking is strongly associated with perceived social norms and the drinking behavior that occurs within peer networks. The extent to which an individual is influenced by the behavior of others may depend upon that individuals resistance to peer influence (RPI). METHODS Students in their first semester of college (N=1323; 54.7% female, 57% White, 15.1% Hispanic) reported on their own binge drinking, and the perceived binge drinking of up to 10 important peers in the first-year class. Using network autocorrelation models, we investigated cross-sectional relationships between participants binge drinking frequency and the perceived and actual binge drinking frequency of important peers. We then tested the moderating role of RPI, expecting that greater RPI would weaken the relationship between perceived and actual peer binge drinking on participant binge drinking. RESULTS Perceived and actual peer binge drinking were statistically significant predictors of participant binge drinking frequency in the past month, after controlling for covariates. RPI significantly moderated the association between perceptions of peer binge drinking and participants own binge drinking; this association was weaker among participants with higher RPI compared to those with lower RPI. RPI did not interact with the actual binge drinking behavior of network peers. CONCLUSIONS RPI may function to protect individuals from the effect of their perceptions about the binge drinking of peers, but not from the effect of the actual binge drinking of peers.