Reisner Sari L, Biello Katie, Perry Nicholas S, Gamarel Kristi E, Mimiaga Matthew J
Department of Epidemiology, Harvard School of Public Health.
The Fenway Institute, Fenway Health.
Am J Orthopsychiatry. 2014 Sep;84(5):545-56. doi: 10.1037/ort0000008. Epub 2014 Aug 4.
This study investigated and applied a compensatory model of risk and resilience to differences in past-year nonsuicidal self-injury (NSSI) and suicide attempts by sexual orientation using representative data from the 2007 Massachusetts Youth Risk Behavior Survey (n = 3,131). Self-identified lesbian, gay, bisexual, and questioning (LGBQ) adolescents comprised 7% of the sample, but accounted for 67% of NSSI and 80% of suicide attempts. Compared with heterosexuals, LGBQ adolescents had an increased odds of NSSI (adjusted Odds Ratio (aOR) = 2.76; 95% Confidence Interval (CI) [2.00, 3.81] and suicide attempts (aOR = 2.73; 95% CI [1.47, 5.08]. NSSI was highly associated with suicidality (aOR = 10.87; 95% CI [6.17, 19.18]. Family support was independently associated with a decreased odds of both NSSI (aOR = 0.56; 95% CI [0.35, 0.89] and suicidality (aOR = 0.48; 95% CI [0.29, 0.79] supporting a compensatory model of resilience. Screening and preventive interventions for LGBQ adolescents are warranted, including at the family level. Sexual orientation should be included as a standard demographic to monitor health disparities.
本研究利用2007年马萨诸塞州青少年风险行为调查的代表性数据（n = 3,131），对一种风险与复原力的补偿模型进行了调查，并将其应用于按性取向划分的过去一年非自杀性自伤（NSSI）和自杀未遂差异的研究。自我认同为女同性恋、男同性恋、双性恋和性取向存疑（LGBQ）的青少年占样本的7%，但却占NSSI的67%和自杀未遂的80%。与异性恋者相比，LGBQ青少年发生NSSI的几率增加（调整后的优势比（aOR）= 2.76；95%置信区间（CI）[2.00, 3.81]）以及自杀未遂的几率增加（aOR = 2.73；95% CI [1.47, 5.08]）。NSSI与自杀倾向高度相关（aOR = 10.87；95% CI [6.17, 19.18]）。家庭支持与NSSI几率降低（aOR = 0.56；95% CI [0.35, 0.89]）和自杀倾向几率降低（aOR = 0.48；95% CI [0.29, 0.79]）均独立相关，这支持了一种复原力的补偿模型。对LGBQ青少年进行筛查和预防性干预是有必要的，包括在家庭层面。性取向应作为一个标准人口统计学特征纳入监测健康差异的范畴。
