Marshal Michael P, Friedman Mark S, Stall Ron, King Kevin M, Miles Jonathan, Gold Melanie A, Bukstein Oscar G, Morse Jennifer Q
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Addiction. 2008 Apr;103(4):546-56. doi: 10.1111/j.1360-0443.2008.02149.x.
Several decades of research have shown that lesbian, gay and bisexual (LGB) adults are at high risk for substance use and substance use disorders (SUDs). These problems may often start prior to young adulthood; however, relatively little is known about risk for substance use in LGB adolescents. The primary aims of this paper were to conduct a meta-analysis of the relationship between sexual orientation and adolescent substance use and a systematic review and critique of the methodological characteristics of this literature.
Medical and social science journals were searched using Medline and PsychInfo. Studies were included if they tested the relationship between sexual orientation and adolescent substance use. Eighteen published studies were identified. Data analysis procedures followed expert guidelines, and used National Institutes of Health (NIH)-sponsored meta-analysis software.
LGB adolescents reported higher rates of substance use compared to heterosexual youth (overall odds ratio = 2.89, Cohen's d = 0.59). Effect sizes varied by gender, bisexuality status, sexual orientation definition and recruitment source. None of the studies tested mediation and only one tested moderation. One employed a matched comparison group design, one used a longitudinal design, and very few controlled for possible confounding variables.
The odds of substance use for LGB youth were, on average, 190% higher than for heterosexual youth and substantially higher within some subpopulations of LGB youth (340% higher for bisexual youth, 400% higher for females). Causal mechanisms, protective factors and alternative explanations for this effect, as well as long-term substance use outcomes in LGB youth, remain largely unknown.
数十年的研究表明，女同性恋、男同性恋和双性恋（LGB）成年人存在物质使用及物质使用障碍（SUDs）的高风险。这些问题往往在成年早期之前就开始出现；然而，对于LGB青少年物质使用的风险了解相对较少。本文的主要目的是对性取向与青少年物质使用之间的关系进行荟萃分析，并对该文献的方法学特征进行系统综述和批判。
使用Medline和PsychInfo检索医学和社会科学期刊。如果研究测试了性取向与青少年物质使用之间的关系，则纳入研究。共识别出18项已发表的研究。数据分析程序遵循专家指南，并使用美国国立卫生研究院（NIH）资助的荟萃分析软件。
与异性恋青少年相比，LGB青少年报告的物质使用率更高（总体优势比 = 2.89，科恩d值 = 0.59）。效应大小因性别、双性恋状态、性取向定义和招募来源而异。没有一项研究测试中介作用，只有一项测试调节作用。一项采用匹配比较组设计，一项采用纵向设计，很少有研究控制可能的混杂变量。
LGB青少年物质使用的几率平均比异性恋青少年高190%，在LGB青少年的一些亚群体中更高（双性恋青少年高340%，女性高400%）。这种效应的因果机制、保护因素和替代解释，以及LGB青少年的长期物质使用结果，在很大程度上仍然未知。
