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跨诊断精神病理学因素与性少数群体心理健康:差异及与少数群体压力源关联的证据

Trans-diagnostic Psychopathology Factors and Sexual Minority Mental Health: Evidence of Disparities and Associations with Minority Stressors.

作者信息

Eaton Nicholas R

机构信息

Stony Brook University.

出版信息

Psychol Sex Orientat Gend Divers. 2014 Sep 1;1(3):244-254. doi: 10.1037/sgd0000048.

Abstract

Research on mental health disparities between sexual minority individuals and heterosexuals has traditionally taken a disorder-by-disorder approach. Recently developed trans-diagnostic approaches provide a new method to frame such investigations; however, trans-diagnostic factors have yet to be applied to sexual minority mental health disparities research. The current study applied this methodology to investigate mental health disparities between lesbian, gay, bisexual, and heterosexual individuals in a large national probability sample ( = 34,653). Twelve-month diagnoses of 13 common mood, anxiety, substance use, and personality disorders were modeled, and multi-group analysis indicated a sexual orientation-invariant trans-diagnostic latent structure. Significant disparities at the latent trans-diagnostic factor level were observed; these factor-level disparities are manifested as observed mental disorder disparities. Gender differences typically seen in trans-diagnostic research were not present between sexual minority women and men. Trans-diagnostic internalizing and externalizing factors were then used as outcomes in a minority stress framework and were positively predicted by lifetime history of sexual orientation-related minority stressors (i.e., discrimination and victimization). Implications for using trans-diagnostic approaches to frame intervention efforts, supplement disorder-by-disorder disparities methodologies, and synthesize piecemeal disparities literatures are discussed.

摘要

关于性少数群体与异性恋者心理健康差异的研究传统上采用逐个障碍的方法。最近发展起来的跨诊断方法为开展此类调查提供了一种新方法;然而,跨诊断因素尚未应用于性少数群体心理健康差异研究。本研究运用该方法,在一个大型全国概率样本(N = 34,653)中调查女同性恋、男同性恋、双性恋和异性恋个体之间的心理健康差异。对13种常见的情绪、焦虑、物质使用和人格障碍进行了为期12个月的诊断建模,多组分析表明存在一个性取向不变的跨诊断潜在结构。在潜在跨诊断因素水平上观察到显著差异;这些因素水平的差异表现为观察到的精神障碍差异。性少数群体女性和男性之间不存在跨诊断研究中常见的性别差异。然后,在少数群体压力框架中,将跨诊断内化和外化因素用作结果,并由与性取向相关的少数群体压力源(即歧视和受害)的终身经历进行正向预测。讨论了使用跨诊断方法来构建干预措施、补充逐个障碍差异方法以及整合零散的差异文献的意义。

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