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Members of sexual minority groups, especially bisexual women, are more likely to encounter barriers to care than their straight counterparts.

Within a larger intervention study, attachment was assessed with the Strange Situation Procedure for 30 infants who co-resided with their mothers in a prison nursery. Sixty percent of infants were classified secure, 75% who co-resided a year or more and 43% who co-resided less than a year, all within the range of normative community samples. The year-long co-residing group had significantly more secure and fewer disorganized infants than predicted by their mothers' attachment status, measured by the Adult Attachment Interview, and a significantly greater proportion of secure infants than meta-analyzed community samples of mothers with low income, depression, or drug/alcohol abuse. Using intergenerational data collected with rigorous methods, this study provides the first evidence that mothers in a prison nursery setting can raise infants who are securely attached to them at rates comparable to healthy community children, even when the mother's own internal attachment representation has been categorized as insecure. Keywords infant attachment; prison nursery; incarceration; interventionResearch in two areas of inquiry, early development of the human brain and the process of infant attachment, support the proposition that every child needs a consistent and responsive primary caregiver, and that such a caregiver is especially critical during infancy and early childhood (Bowlby, 1982;Dawson, Ashman & Carver, 2000;Schore, 2001;Spitz, 1945Spitz, , 1956. Ainsworth, Blehar, Waters, and Wall (1978) extensively described infant attachments in a community, nonclinical sample, and from this foundation the focus of other researchers expanded to include higher-risk community and clinical groups. Insecure attachment is more prevalent in stressed than in non-stressed populations (Belsky & Fearon, 2008), and this observation has led to the development of interventions to improve the rate of secure attachment in at-risk populations (e.g., Bakermans-Kranenburg, van IJzendoorn, & Juffer, 2003;Cicchetti, Rogosch, & Toth, 2006;Hoffman, Marvin, Cooper, & Powell, 2006).A previously ignored group of children, many of whom are deprived of normal attachment experiences, has begun to attract research and policy attention: the children of incarcerated parents. Although much of the research has methodological limitations, findings of adverse effects on development generally converge and raise a significant public health concern (Hagen, Myers, & Mackintosh, 2005;Hanlon et al., 2007;Huebner & Gustafson, 2007 & Farrington, 2006;Poehlmann, 2005aPoehlmann, , 2005b. A small minority of children has been offered an alternative to early and abrupt separation from their imprisoned mothers. These are the infants of women sentenced in correctional jurisdictions that provide a co-residence nursery program. Prison nurseries remove separation created by maternal incarceration as a threat to a child's development, at least during early infancy, and are increasing in number in the U.S. (Goshin & Byrne, 2009; Women's Prison Association, 2009). Charac...

Objective People with serious mental illness (SMI) die at least 11 years earlier than the general U.S. population, on average, due largely to cardiovascular disease (CVD). Disparities in CVD morbidity and mortality also occur among some U.S. racial and ethnic minorities. The combined effect of race/ethnicity and SMI on CVD-related risk factors, however, remains unclear. To address this gap, we conducted a critical literature review of studies assessing the prevalence of CVD risk factors (overweight/obesity, diabetes mellitus, metabolic syndrome, hypercholesterolemia, hypertension, cigarette smoking, and physical inactivity) among U.S. racial/ethnic groups with schizophrenia-spectrum and bipolar disorders. Methods and Results We searched MEDLINE and PsycINFO for articles published between 1986 and 2013. The search ultimately yielded 40 articles. There was great variation in sampling, methodology, and study populations. Results were mixed, though there was some evidence for increased risk for obesity and diabetes mellitus among African Americans, and to a lesser degree for Hispanics, compared to non-Hispanic Whites. Sex emerged as an important possible effect modifier of risk, as women had higher CVD risk among all racial/ethnic subgroups where stratified analyses were reported. Conclusions Compared to general population estimates, there was some evidence for an additive risk for CVD risk factors among racial/ethnic minorities with SMI. Future studies should include longitudinal assessment, stratification by sex, subgroup analyses to clarify the mechanisms leading to potentially elevated risk, and the evaluation of culturally appropriate interventions to eliminate the extra burden of disease in this population.

We report attachment classifications in a sample of pregnant women incarcerated in a state prison with a nursery program. Analyses were based on 69 women serving sentences for felony crimes who were followed from the birth of their child to completion of the prison nursery co-residence. They completed the Adult Attachment Interview shortly after entering the program and scales measuring depression, perceived parenting competency, and social support at study entry (Time 1) and program completion (Time 2). Incarcerated mothers had higher rates of insecure attachment than previous low-risk community samples. Compared with dismissing and secure mothers, preoccupied mothers reported higher levels of depressive symptoms, lower parenting competency, and lower satisfaction with social support at the conclusion of the nursery program. Higher scores on unresolved loss and derogation were associated with a history of substance abuse; higher scores on unresolved trauma were associated with depressive symptoms at program completion. Keywords attachment; prison nursery; high-risk; depressive symptoms; parenting Establishment of a prison nursery is predicated on the fact that children benefit from sustained contact with their mothers throughout their early months of life (Goshin & Byrne, 2009). Attachment research suggests that a child's psychosocial outcomes are associated with the mother's internal working model of attachment (IWM) or attachment classification (e.g., van IJzendoorn, 1995). Therefore, the effectiveness of a prison nursery program may depend in part on the quality of the mother's IWM. As yet, however, nothing is known about the nature of attachment classifications of women participating in a prison nursery program. Further, although there is a substantial body of research linking adult attachment in the general population with various psychosocial correlates, links between attachment and other constructs have not been examined in samples of incarcerated women.Correspondence regarding this manuscript should be addressed to Mary W. Byrne, Ph.D., Stone Foundation and Elise Fish Professor of Clinical Health Care for the Underserved, Columbia University School of Nursing, 617 West 168 Street, New York, NY 10032; phone: (+212-305-3976); mwb4@columbia.edu. NIH Public Access Author ManuscriptAttach Hum Dev. Author manuscript; available in PMC 2011 July 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptThe present study had three aims. The first aim was to describe the distribution of maternal attachment representations within a sample of incarcerated mothers who co-resided with their infants in a prison nursery. The second aim was to evaluate the association between maternal attachment classification and history of substance abuse in this sample. The third aim was to examine the longitudinal connection between maternal attachment organization and three psychosocial constructs related to adjustment and parenting: depressive symptoms, perceptions of parenting competency, and perceived ...

Sexual minority women and gay men report poorer sleep quality compared with their straight counterparts.

IntroductionResearch is needed on chronic health conditions among lesbian, gay, and bisexual populations. The objective of this study was to examine 10 diagnosed chronic conditions, and multiple (≥2) chronic conditions (MCC), by sexual orientation among US adults.MethodsThe 2013 National Health Interview Survey was used to generate age-adjusted prevalence rates and adjusted odds ratios of diagnosed chronic conditions and MCC for civilian, noninstitutionalized US adults who identified as gay/lesbian, straight, or bisexual, and separately for men and women. Chronic conditions were selected for this study on the basis of previous research.ResultsHypertension and arthritis were the most prevalent conditions for all groups. Gay/lesbian adults had a 4.7 percentage-point higher prevalence of cancer than bisexual adults, and a 5.6 percentage-point higher prevalence of arthritis and a 2.9 percentage point higher prevalence of hepatitis than straight adults. The prevalence of chronic obstructive pulmonary disease was 8.1 percentage points higher among bisexual adults than among gay/lesbian adults and 7.0 percentage points higher than among straight adults. These differences remained in the multivariate analyses. Additional differences were found in the sex-stratified analyses. No significant differences were found in MCC by sexual orientation.ConclusionAfter age adjustment and controlling for sociodemographic characteristics, only a few significant health disparities for diagnosed chronic conditions were found by sexual orientation, and none for MCC. However, for conditions where differences were found, magnitudes were relatively large. Further examination of these differences among gay/lesbian and bisexual adults could yield a better understanding of why these disparities exist.

Gay and bisexual men make greater use of HIT than their straight counterparts. Additional research is needed to determine the causal factors behind these group differences in the use of online healthcare, as well as the health implications for each group.