Original Research Parental Attitude, Internalized .
Suicidology Online 2019;10:8ISSN 2078-5488Original researchParental Attitude, Internalized Homophobia, and Suicidal IdeationAmong Selected Self-Identified Filipino Gay Men in the PhilippinesAngeli Charmaine C. Tan1, , Marc Eric S. Reyes 1, Roger D. Davis21University of Santo TomasInstitute for the Study of Personality2Submitted to SOL: June 6th, 2018; accepted: January 31th, 2019; published: June 10th, 2019Abstract: Gay men often experience prejudice and discrimination due to their sexual minority identity. Althoughthe Philippines is one of the more Lesbian, Gay, Bisexual and Transgender (LGBT) -friendly countries in Asia,stigma and homonegativity remain pervasive. Due to this, Filipino gay men have been found to have an elevatedrisk for negative mental health outcomes, including suicidal ideation and attempts. This study investigated twofactors that may be related to suicidal ideation, namely perceived parental attitude and internalized homophobia(the inward direction of society’s homophobic attitudes). Through snowball sampling in a span of one year, 121self-identified Filipino gay men completed self-report measures, including the Parental Acceptance-RejectionQuestionnaire, the Internalized Homophobia Scale, and the Adult Suicidal Ideation Questionnaire. Resultssuggest that generally, the participants felt accepted by their parents and reported low levels of internalizedhomophobia and suicidal ideation. Nevertheless, perceived parental attitude and internalized homophobia weresignificantly correlated with suicidal ideation. Perceived parental attitude was also associated with internalizedhomophobia. Regression analyses showed that perceived parental attitude and internalized homophobia bothpredicted suicidal ideation.Keywords: parental attitude, internalized homophobia/homonegativity, suicidal ideation, LGBTCopyrights belong to the Author(s). Suicidology Online (SOL) is a peer-reviewed open-access journal publishing under the Creative Commons Licence 3.0.The Philippines can be considered as one of themore LGBT-friendly countries in Southeast Asia(Manalastas & Torre, 2016). In recent years,Filipinos have become more open-minded andtolerant of sexual minorities in the country.Nevertheless, LGBT Filipinos still struggle withstigma, prejudice, and discrimination (PsychologicalAssociation of the Philippines, 2011).As a highly collectivistic society, Filipino familiesserve as the foundation for the development ofindividual values.Parents play central roles in supporting ordiscouraging sexual minority feelings and behaviorsbecause they are the main socializing agents forchildren (Docena, 2013). However, most parents donot encourage their gay children to accept theirsexual orientation. Gay Filipinos sometimesexperience ridicule, discrimination (Tubeza, 2013;Cuneta, 2014; Cannon, 2014), physical abuse (Tan,2014, as cited in Agence France-Presse, 2014), andthey may even be disowned by their families(Martin, 2013; Pascual, 2014). These and otherfactors set the norms for social conduct and selfexpression in society, stigmatizing LGBT Filipinosand causing undue, debilitating stress. Angeli Charmaine C. Tan, RPm, RPsy; University of SantoTomas; Email address: angelicharmaine@yahoo.com1
Suicidology Online 2019;10:8ISSN nment, confining norms, and persistentstressors LGBT people encounter almost every day,it is no surprise that gay and bisexual men havebeen found to be more vulnerable to depressionand suicidal ideation relative to heterosexual men(King et al., 2008; Manalastas, 2013). In fact,researchers have consistently documented thatLGBTs are generally more susceptible to mentalhealth concerns compared to their heterosexualpeers due mainly to certain factors that are uniqueto them (Meyer, 2003). Researchers have sincereferred to these unique factors as minority stressprocesses.Meyer (2003) described minority stress processesalong a continuum from distal stressors to proximalprocesses. Parents’ rejecting attitude may beregarded as one of the most significant problemsfaced by sexual minority youth (Bregman et al.,2013) This distal stressor produces expectations ofrejection stemming from parental stigmatization.Such expectations may be regarded as proximalstressors, because they exist in the moment andinfluence behavior. In contrast, parental acceptanceis associated with positive health outcomes andsocial adjustment. Acceptance also protects againstnegative outcomes such as depression, substanceabuse, and suicide (Rothman et al., 2012; Ryan,Russell, Huebner, Diaz, & Sanchez, 2010; Costa,Pereira, & Leal, 2013). Thus, the role of parents inpromoting well-being is crucial (Ryan et al., 2010).Another proximal stressor is internalizedhomophobia. Internalized homophobia is definedas the incorporation of societal anti-LGBT attitudesagainst the self (Meyer, 2003). Rejection leads toself-rejection. This internalization leads to loweredself-regard, self-deprecating attitudes and conflictswithin the individual (Meyer and Dean, 1998). Asidefrom societal prejudice, parents’ homophobicattitudes can also influence their children’shomophobia (O’Bryan, Fishbein, & Ritchey, 2004).Research has shown that higher perceived parentalrejection results in higher levels of internalizedhomophobia, suggesting an association betweeninternalized homophobia and acceptance/rejectionof sexual orientation (Costa, Pereira, & Leal, 2013).Since parents’ rejecting attitude and internalizedhomophobia may independently result in suicidalthoughts and attempts as well as commission ofsuicide, these problems require attention. Suicidalideation is especially noteworthy as a precursor ofsuicide attempts; approximately 29% of all thosewith thoughts of suicide eventually attempt suicide(Liu & Mustanski, 2012). Despite increasedprevention efforts in the past 2 decades, rates ofsuicidal ideation have not declined, and suicide hasbecome the second-leading cause of death amongpeople aged 15-29 worldwide (World HealthOrganization, 2014).In the Philippines, the Department of Health (2003)has identified intentional self-harm as the 9thleading cause of death among 20-24-year-oldFilipinos (Philippine Health Statistics, 2003, as citedby the DOH, 2003). Further, rates of suicide byhanging, strangulation, and poisoning have beenrising steadily in the last 20 years (Dacanay, 2012),especially for males (Redaniel et al., 2011). Gay menwere found to be more susceptible to suicide(Remafedi et al., 1998; Haas et al., 2011) whichprompted the present study to investigate ion)andinternalizedhomophobia might account for this trend, usingsuicidal ideation in Filipino gay men as thedependent variable. Since only a few studies havebeenconductedregardinginternalizedhomophobia among Filipino LGBTs (Reyes et al.,2015; Reyes et al., 2017), we intend to highlight thesignificance of an accepting parental attitude as aprotective factor that can aid in buffering Filipinogay men’s suicidal thoughts. With these goals inmind, our study’s objectives are: (1) to assess jection), internalized homophobia,and suicidal ideation among Filipino gay men; (2) toinfer whether relationships exist between thesevariables, and; (3) to determine whether perceivedparental attitude (acceptance/rejection) andinternalizedhomophobiaconjointlyorindependently predict suicidal ideation.MethodResearch DesignA cross-sectional predictive research design wasused to investigate the predictive mophobia, and suicidal ideation among selectedself-identified Filipino gay men. This type ofresearch design entails the collection of data fromthe participants at a single time period for thepurpose of forecasting or predicting an event in thefuture (Johnson, 2001).ParticipantsA total of 121 self-identified Filipino gay men, withages 18 to 41 (M 25.26, SD 5.11) participated inthe current study. This sample is 71.18% of the 170participants contacted and gathered; 49participants were not included in the final sample ofthe current study due to their invalid data (e.g.incomplete responses). They were gatheredthrough nonprobability sampling (snowballsampling) from different universities, workplaces,organizations, cities, provinces, and other places in2
Suicidology Online 2019;10:8ISSN 2078-5488the Philippines. Participants were included if theyself-identified as gay, were age 18 or older, were“out” to at least one parent, and resided in thePhilippines. Approval by the university ethicscommittee was sought prior to data gathering andinformed consent was secured from all Filipino gaymen prior to voluntarily participation.higher levels. Internal consistency has beenreported at alpha .83 for gay men (Herek et al.,1997). Construct validity studies have shown thathigh scores are associated with negative feelingssuch as guilt and distress, psychological and sexualproblems, and even suicide (Meyer, 1995). On theother hand, low scores are associated with selfesteem, “outness” to peers, and generalsatisfaction with the sexual minority community(Herek & Glunt, 1995). A reliability measure of α .86 was obtained in the current study.Adult Suicidal Ideation Questionnaire. The AdultSuicidal Ideation Questionnaire (ASIQ; Reynolds,1991) is a 25-item self-report questionnaire thatestimates current level of suicidal ideation(Reynolds, 1991). Subjects rate each item on a 7point Likert scale based on the frequency of suicidalbehaviors or thoughts. The scale ranges from (0) “Inever had this thought” to (6) “Almost every day”.Example items include “I thought about killingmyself” and “I wished that I had never been born”.The internal consistency reliability coefficient of theASIQ has been measured as high as .97 (Reynolds,1991). Test-retest reliability has been measured at.86 (Reynolds, 1991). The ASIQ is significantlycorrelated with measures of anxiety, hopelessness,low self-esteem, depression, and prior suicideattempts (Reynolds, 1991). A reliability coefficientof .96 was found in the present study.MeasuresParental Acceptance-Rejection Questionnaire. TheParental Acceptance-Rejection Questionnaire(PARQ) is a 60-item self-report instrument thatmeasures an individual’s perceived parentalacceptance or rejection (Rohner, 2005). Participantsrespond to a 4-point Likert-type format thatindicates their agreement or disagreement tostatements that describe the behavior of theirparents. Sample items include “My father ridiculedand made fun of me” and “My mother wasinterested in the things I did”. A response of 4indicates that the behavior is “almost always true”,while 1 means it is “almost never true”. Of the 60total items, 7 are reverse scored prior to scoring.The PARQ has four scales: (1) warmth and affection;(2) hostility and aggression; (3) indifference andneglect, and; (4) undifferentiated rejection.Together, these scales constitute a Total Score thatrepresents the degree to which a personexperienced parental acceptance or rejection. A lowtotal score is indicative of perceived parentalacceptance, while higher scores suggest perceivedrejection from the parents. The PARQ has beenfound to be internally consistent with an alphareliability coefficient of .96 (Rohner, 2004).Construct validity studies have shown the PARQwarmth/affection to be significantly correlated (r .90) with measures of the acceptance scale in theChildren's Reports of Parental Behavior eglect was significantly correlated (r .86) with hostile detachment scale in the CRPBI(Rohner, 2005). In the present study, the PARQTotal Score was utilized which has a Cronbach’salpha of .90.Internalized Homophobia Scale. The InternalizedHomophobia Scale (IHP; Martin & Dean, 1987) is a9-item self-report instrument designed to assessself-stigma due to sexual minority status.Respondents report their agreement ordisagreement using a 5-point Likert scale rangingfrom (1) “strongly disagree” to (5) “strongly agree.”Sample items include: “I feel that being gay is apersonal shortcoming for me” and “I have tried tobecome more sexually attracted to women.” Theratings for each item are summed to obtain thetotal score. Lower scores indicate lower levels ofinternalized homophobia. Higher scores indicateProcedureThe study was reviewed by the Graduate SchoolEthical Review Board of the University of SantoTomas in order to secure the safety, rights and wellbeing of participants. Filipino gay men were soughtsimultaneously through a referral system and byenlisting the assistance of various LGBTorganizations to set up a meeting with theirmembers who were willing to participate. Possibleparticipants were contacted via text message or email to ascertain their interest in participating.Referrals were then sought from each participantthereafter and subsequently contacted throughvarious means (e.g. Facebook Messenger). Datagathering was accomplished in person with a testbattery consisting of a brief description of theobjectives of the study, an informed consent form,and the research instruments. Measures were thenscored and the data were statistically analyzedusing IBM SPSS Statistics 25.ResultsThe socio-demographic profile of our participantsare presented in Table 1. As you may glean from thetable, most participants had college degrees (78%),while 16% obtained high school diplomas and 6%pursued postgraduate studies. 64% of the3
Suicidology Online 2019;10:8ISSN 2078-5488Table 1. Socio-demographic profile of participants.VariablesEducational AttainmentCategoriesPercentageHigh School DiplomaBachelor's DegreeMaster's Degree or one21%With Parents79%BothFather OnlyMother Only70%3%27%OccupationLiving SituationLevel of DisclosureNota: N 121respondents worked as professionals, while theothers were either non-professionals or stillstudying. A significant portion (70%) reported being“out” to both parents. Among those out only to oneparent, 27% were “out” only to their mothers and3% were “out” only to their fathers. Finally, most ofthe participants (79%) still lived with their parents,while 21% of the respondents reported living alone.Table 2 presents both descriptive and inferentialstatistics for perceived parental rejection,internalized homophobia, and suicidal ideation. Asnoted, low PARQ scores indicate perceived parentalacceptance, while higher scores suggest perceivedparental rejection. As such, we can surmise thatboth mothers (x̅ 94.46) and fathers (x̅ 116.41)were accepting of their children’s sexualorientation. Mothers, however, were found to besignificantly more accepting (p 3.49E-07) thanfathers. Additionally, the level of their internalizedhomophobia (x̅ 20.85) as measured in the IHP wasfound to be moderate based on the theoreticalrange for scores (Herek et al., 1997). Theparticipants also reported a low level of suicidalideation (x̅ 14.32) according to the norms in theASIQ (Reynolds, 1991).All dependent variables were found to besignificantly correlated. The highest correlation weobtained was that between Father Attitude andSuicidal Ideation (r .53), followed by a Pearsoncoefficient of .40 between Mother Attitude andTable 2. Means, Standard Deviations, and Pearson Correlations of the research variables.MeanSDFAFather Attitude (FA)116.4136.551Mother Attitude (MA)94.4628.04.38*1Internalized Homophobia (IH)20.857.73.28*.20*1Suicidal Ideation (SI)14.3222.36.53*.40*.29*Note: N 121; *p .054MAIHSI1
Suicidology Online 2019;10:8ISSN 2078-5488Suicidal Ideation. Internalized Homophobia had thelowest correlation with Suicidal Ideation at r .29.According to Cohen (1988), correlations larger than.50 are considered to have a large effect size. Thosebetween .30 and .49 are considered moderateeffects, and those between .10 and .29 areconsidered small effects. Using these guidelines,most of the correlations found in the current studyare considered to be moderate effects.We also wanted to know whether our independentvariables (Father Attitude, Mother Attitude,Internalized Homophobia) predicted SuicidalIdeation among our participants. Table 3 shows theforward stepwise regression we performed in orderto systematically distinguish which variable had themost predictive power, and whether or not thesevariables add up to conjointly better predict SuicidalIdeation. Results show that an accepting orrejecting attitude from the father was the bestpredictor (R .534) of suicidal thoughts, accountingfor 28.5% of the variance in the suicidal ideation.When combined, Mother Attitude and FatherAttitude strongly predict suicidal ideation (R .577),thus accounting for 33.3 percent of the variance insuicidal ideation. On the other hand, InternalizedHomophobia was excluded from the model as it wasnot significant enough to contribute to the otherpredictors when taken altogether. Clearly, theeffect size of parental attitude on suicidal ideationis quite large, with each parent making anindependent contribution to suicidal ideation.Table 3. Forward stepwise regression analysis of the research variables with Suicidal Ideation asthe dependent variable.Dependent VariableSuicidal IdeationModel 1Model 2Father AttitudeFather Mother 24DiscussionOur findings converge with previous researchresults and support our hypotheses regarding therelationship between parental attitude, internalizedhomophobia, and suicidal ideation. Overall,participants reported feeling accepted by theirparents. Nevertheless, there was enough variationin the scores to support moderate- to large-sizedcorrelations between parental attitude and suicidalideation.The participants also reported moderate levels ofinternalized homophobia, which may beinterpreted as self-criticism on behalf of themajority culture. This means that although gayindividuals generally accept their sexual orientationand identify themselves as gay, they still feeldiscomfort due to their environment and negativepast experiences related to their sexual minoritystatus. This coincides with Herek et al.’s (2009)study which found evidence that internalizedhomophobia is present in virtually all LGBTindividuals in varying degrees of intensity. Gay mencontinue to experience a homophobic andheteronormative culture. As such, it is unlikely thatinternalized homophobia in gay men willcompletely abate (Meyer, 2003).Overall, however, the gay men in our studygenerally disclosed a low level of suicidal ideation.Most of the respondents claimed they would neverhurt themselves due to their sexual orientation.Participants who had thoughts of suicide reportedmore passive suicidal ideation, with only oneadmitting having attempted suicide. This isconsistent with Manalastas’ (2013) findings thatdespite having relatively higher levels of suicidalthoughts when compared with heterosexual men,gay men are not “essentially suicidal” (SavinWilliams, 2008, as cited by Manalastas, 2013). As amatter of fact, around 84% of gay Filipino menreported they have never considered taking theirown lives (Manalastas, 2013). As such, we canconclude that the recent spike in intentional selfharm in the country may be due to other factorsthat are unrelated to one’s sexual orientation.Wefound that perceived parental attitude is associatedwith and predictive of suicidal ideation, whichsupports Ryan et al.’s (2009) findings that LGBTs5
Suicidology Online 2019;10:8ISSN 2078-5488who disclosed having been rejected by their familiesduring adolescence were 8.4 times more likely toreport having tried to kill themselves. In the currentstudy, PARQ scores show that receiving supportfrom their parents significantly helped subjectsaccept themselves and cope with societalhomophobia. Several other studies (Rothman et al.,2012; Padilla et al., 2010) have likewise shown thatparental rejection is associated with mental healthconcerns such as
Adult Suicidal Ideation Questionnaire. The Adult Suicidal Ideation Questionnaire (ASIQ; Reynolds, 1991) is a 25-item self-report questionnaire that estimates current level of suicidal ideation (Reynolds, 1991). Sub
Cognitive attitude also exerts a positive impact on affective attitude. The empirical test of Hee-Dong et al. (2004)’s found support for a positive influence of cognitive attitude on affective attitude. Hence: H 9: Cognitive attitude positively influences affective attitude. Attitude may
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χ2 shows there is highly significant association between knowledge and attitude of student towards tobacco use. Regarding attitude towards tobacco use the 77% had healthy positive attitude and only 16.5% had negative attitude towards it. The χ2 test showed that there was statistically significant relationship (p .001) between knowledge and .
Attitude concerning . STIs. patients was assessed using a 9 item questionnaire where, attitude scores between 0-7.5 were considered as unfavorable attitude, and scores 7.5-9 were considered as positive attitude. If students answer more than the mean score out of prepared practice questions where as poor preventive practice: If students answer
Annual leave continues to build up while on parental leave and should be granted by the employer in accordance with Section 20 of the Organisation of Working Time Acts,1997. 8 Your Parental Leave Rights Explained 4.2 protection against Dismissal If an employee is dismissed because he or she takes parental leave or force majeure leave, this is seen as an unfair dismissal under the Unfair .
Parental alienation is frequently confused with the parental alienation syndrome (PAS). Dr. Richard Gardner, an American psychiatrist who died in 2003, coined the phrase “parental alienation syndrome” in 1985 and wrote extensively about it. He defined
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