Monica A. Landolt

Gender Nonconformity, Childhood Rejection, and Adult Attachment: A Study of Gay Men

Several childhood factors are reported to be associated with a homosexual orientation in men, including gender nonconformity and rejection by parents and peers. The purpose of this study was to explore the associations between these childhood factors and attachment anxiety (the tendency to experience anxiety regarding potential loss and rejection in close relationships) and attachment avoidance (the tendency to avoid versus seek out closeness in relationships) in gay and bisexual men. A community sample of 191 gay and bisexual men completed questionnaires and an attachment interview. Gender nonconformity was significantly associated with paternal, maternal, and peer rejection in childhood. In addition, paternal and peer rejection, but not maternal rejection, independently predicted attachment anxiety. Peer rejection and, to a lesser extent, paternal rejection mediated the association between gender nonconformity and attachment anxiety. Finally, peer rejection mediated the association between paternal rejection and attachment avoidance. Findings highlight the role of gender nonconformity in contributing to childhood rejection and the importance of peer relationships in the socialization of gay men.

The Living Anonymous Kidney Donor: Lunatic or Saint?

Studies indicate that 11% to 54% of individuals surveyed would consider donating a kidney, while alive, to a stranger. The idea of ‘living anonymous donors’ (LADs) as a donor source, however, has not been embraced by the medical community. Reservations focus on the belief that LADs might be psychologically unstable and thus unsuitable donors. Our goal was to inform policy development by exploring the psycho‐social make up and motivations of the LAD. Ninety‐three unsolicited individuals contacted our center expressing interest in living anonymous donation. Of these, 43 participated in our study, completing two extensive inventories of psychopathology and personality disorder and taking part in the Comprehensive Psycho‐Social Interview (CPSI). From the Personality Assessment Inventory (PAI), the revised NEO Personality Inventory (NEO PI‐R), and the CPSI, coders assessed psychological health, psycho‐social suitability, commitment, and motivations. Twenty‐one participants passed the stringent criteria to be considered potential LADs. Content analysis of motivations showed that potential LADs were more likely than non‐LADs (those who did not pass the criteria) to have a spiritual belief system and to be altruistic. Non‐LADs were more likely than potential LADs to use donation to make a statement against their families. The authors conclude with a preliminary outline of eight policy recommendations.

Jealousy, intimate abusiveness, and intrusiveness

An examination of self-report scales of 160 men and 76 of their partners or former partners found significant correlations between jealousy and abusiveness (for coupled dyads) or intrusiveness (for separated dyads). Jealousy was related to borderline personality and to MCMI-II measures of Post Traumatic Stress Disorder. Rejection sensitivity leading to pathological acts, such as abusiveness and intrusiveness, is seen as originating in early insecure attachment and exposure to shaming experiences.

Intimate Violence in Male Same-Sex Relationships

Despite findings suggesting a high prevalence of violence in male same-sex relationships, little is known about the characteristics of this violence. This study explored the general nature of male same-sex intimate violence. The sample consisted of 69 gay and bisexual men, chosen from a randomly selected community sample, who reported at least 1 violent episode in an interview exploring their intimate relationships. Mens descriptions of the most severe incident in the most recent violent relationship were coded from the taped interviews. Patterns of intimate violence varied widely, including a range from mild to severe violence, and situations of unidirectional and bidirectional violence. In the vast majority of cases, violence was an escalation of ongoing conflict, involved bidirectional emotional abuse, and was more expressive than instrumental in nature. Difficulties in conflict resolution and attachment fears appeared to better explain the occurrence of violence than did the intent to control ones partner.

Living anonymous kidney donation: What does the public think?

Background. Health professionals are increasingly turning to living organ donation to augment cadaveric donation. Although living donation is currently performed with donors who are either genetically or emotionally related to the recipient, a 1997 British Columbia Transplant Society survey indicated that 32% of BC residents would be willing to donate a kidney, while alive, to a stranger (unpublished data). The goal of this study is to tap the public pulse about the living anonymous donor (LAD) by replicating and expanding the 1997 findings. Methods. Five hundred BC residents completed a telephone survey including demographic information, questions about their organ donation behaviors and attitudes, and their willingness to donate a kidney, while alive, to particular individuals (child, spouse, parent, relative, friend, and stranger). To improve the methodological rigor of the 1997 study, an informed condition was added in the current study where participants learned about living donation before being asked about their willingness to donate. Results. There were no differences among the 1997 results and the two conditions in the 2000 survey. Twenty-eight percent of participants in the uninformed condition and 29% of participants in the informed condition indicated that they would be willing to be LADs. LADs were more likely than self-reported non-donors to have registered as cadaveric donors and to endorse attitudes that were congruent with wanting to donate to a stranger. Conclusions. This study replicates the 1997 findings and increases confidence that a significant minority of British Columbians support living anonymous donation and that some would consider becoming LADs themselves.

Power and Personality: An Analysis of Gay Male Intimate Abuse

A study was conducted to investigate the issue of gay male intimate abuse in a sample of 52 couples. The objective of the study was to explore the association between relationship power dynamics and the perpetration of psychological abuse, and to investigate the correspondence between intimate abuse and factors associated with the Abusive Personality [D. G. Dutton and A. J. Starzomski (1993) “Borderline Personality in Perpetrators of Psychological and Physical Abuse,” Violence and Victims, Vol. 8, pp. 327–337; D. G. Dutton (1994a) “Behavioral and Affective Correlates of Borderline Personality Organization in Wife Assaulters,” International Journal of Law and Psychiatry, Vol. 17, pp. 265–279.] The majority of participants were middle to upper class and their ethnic/racial breakdown is as follows: White (86%), Native American (7%), Asian (4%), and Other (3%). In terms of power, results indicated that the more frequent form of psychological abuse was significantly higher in relationships characterized by divided power (i.e., partners sharing decision-making authority by the partners each making decisions in different domains). This finding supports the supposition that abuse can occur in relatively egalitarian relationships. An association between intimate abuse and the Abusive Personality was also clearly observed and this personality profile seemed to characterize both members of abusive dyads. Conclusions are drawn regarding the generalizability of intimate abuse across lines of sexual orientation.

They talk the talk: surveying attitudes and judging behavior about living anonymous kidney donation1

Background. Over the past 30 years, numerous studies have reported that some individuals are willing to donate a kidney anonymously to a stranger; however, intentions are poor predictors of behavior. We surveyed individuals interested in being living anonymous donors (LADs), exposed them to an interview paralleling live-donor assessment, and measured their LAD commitment. Personality and donation decision factors were examined to corroborate cases of attitudinal and behavioral congruency. Methods. A telephone survey of 1,002 randomly selected adults living in Vancouver, British Columbia, asked respondents how willing they were to donate a kidney, while alive, to particular individuals including a stranger. A subsample participated in a follow-up, which involved completing a mailed questionnaire and taking part in an in-depth interview. Expert raters judged respondents’ commitment to being a LAD on the basis of the interviews. Results. Two hundred fifty-eight (26%) of those surveyed stated they would probably or definitely be willing to donate a kidney to a stranger. Fifty-two completed the follow-up. Sixteen of the 52 (31%) were judged to be “committed LADs.” No demographic differences were found between the committed LADs and the 33 remaining “noncommitted participants.” The committed LADs differed significantly from the noncommitted participants on personality measures and donation decision factors. These differences underscore the latter group’s anonymous donation commitment. Conclusions. This study brings into focus the potential for a significant number of individuals coming forward as potential LAD candidates if they are informed about the need and given unbiased information about the procedure. We believe there is ethical latitude in allowing the promotion of LAD donation by interested third parties such as patient advocacy groups and professional bodies. We advocate public awareness of LAD programs as a first step followed thereafter by more provocative measures to engage the public in this endeavor.

Measuring Physical Violence in Male Same-Sex Relationships An Item Response Theory Analysis of the Conflict Tactics Scales

Previous research has not established whether standard violence measures are appropriate for assessing violence in same-sex relationships. This study, therefore, evaluated the structure of an expanded version of the physical violence scale of the Conflict Tactics Scales (CTS) in a sample of randomly selected gay and bisexual men. In total, 284 gay and bisexual men reported on perpetration and receipt of 14 violent acts in their same-sex relationships, both at any time in the past and during the past 12 months. Item response theory analyses indicated that the violence items were unidimensional for receipt ever in the past and for perpetration both ever in the past and in the past 12 months. The items were dispersed along the underlying violence continuum, from lower to higher severity of violence, and discriminated well in this range. We discuss implications for scoring the CTS.

Coping with Multiple AIDS-Related Loss Among Gay Men

Abstract This study examined strategies gay men used to cope with multiple AIDS-related loss. One hundred forty-one gay men completed a questionnaire assessing how many losses they had experienced and how they had dealt with their losses. Participants chose from a list of 19 possible response strategies and then rated their choices for degree of helpfulness. Results showed that support from others, especially friends and partners, and personal ways of dealing with loss, such as spirituality and accepting the loss, were most helpful in dealing with AIDS-related loss.

Assessing for Domestic Violence Exposure in Primary Care Settings The Transition from Classroom to Clinical Practice

To evaluate the ability of medical students to apply domestic violence training in an early clinical experience, a cross-sectional survey was undertaken among 2nd-year medical students from the University of British Columbia during their rural family practice practicum. Participants recorded whether they assessed adult patients for exposure to domestic violence during routine office visits. Domestic violence was discussed in 11% of the 341 recorded patient encounters. All discussions involved female patients. Domestic violence was discussed in 27% of the one-on-one encounters with patients versus 3.6% of the encounters in which a preceptor was present. Barriers that prevented medical students from undertaking assessment and counseling included lack of mentoring and role modeling and a perceived lack of privacy and time available. Application of classroom knowledge in this challenging domain requires preceptorship by appropriately trained supervisors in the clinical setting.