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女同性恋、男同性恋、双性恋和异性恋成年人中的自杀意念、自杀未遂及非自杀性自伤行为:一项澳大利亚全国性研究的结果

Suicidal ideation, suicide attempts and non-suicidal self-injury among lesbian, gay, bisexual and heterosexual adults: Findings from an Australian national study.

作者信息

Swannell Sarah, Martin Graham, Page Andrew

机构信息

Discipline of Psychiatry, School of Medicine, The University of Queensland, Herston, QLD, Australia.

Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown, NSW, Australia

出版信息

Aust N Z J Psychiatry. 2016 Feb;50(2):145-53. doi: 10.1177/0004867415615949. Epub 2015 Dec 1.

Abstract

OBJECTIVES

This study investigated associations between sexual orientation and measures of suicidality and non-suicidal self-injury in Australian adults. Previous studies of sexual orientation and suicidality have been limited by unclear conceptualisations of suicidal intent, failure to differentiate between homosexuality and bisexuality, inattention to gender differences and use of convenience-based samples.

METHODS

A large (N = 10,531) representative national sample of Australian adults was used to investigate associations between sexual orientation (heterosexual, homosexual, bisexual) and (1) suicidal ideation, (2) attempted suicide and (3) non-suicidal self-injury, for males and females separately, in a series of sequentially adjusted logistic regression models.

RESULTS

Sexual minority participants were at greater risk of suicidality and self-injury than heterosexuals, after adjusting for age and other covariates, with patterns of risk differing by sexual orientation and gender. Compared with their heterosexual counterparts, gay men, but not bisexual men, were more likely to report suicidal ideation (odds ratio = 3.05, 95% confidence interval = [1.65, 5.60]) and suicide attempts (odds ratio = 4.16, confidence interval = [2.18, 7.93]). Bisexual women, but not lesbian women, were more likely to report suicidal ideation (odds ratio = 4.40, confidence interval = [3.00, 6.37]) and suicide attempts (odds ratio = 4.46, confidence interval = [2.41, 8.24]). Neither bisexual nor gay men were more likely than heterosexual men to report self-injury. However, bisexual women, but not lesbian women, were more likely than heterosexual women to report self-injury (odds ratio = 19.59, confidence interval = [9.05, 42.40]). Overall, bisexual females were at greatest risk of suicidality and self-injury.

CONCLUSION

Clinicians working with sexual minority populations are encouraged to openly discuss suicidal and self-injurious thoughts and behaviours with their clients and may consider using therapeutic strategies to reduce internalised stigma and enhance personal and social resources.

摘要

目的

本研究调查了澳大利亚成年人的性取向与自杀倾向及非自杀性自我伤害指标之间的关联。以往关于性取向与自杀倾向的研究存在局限性,包括自杀意图概念不清晰、未区分同性恋和双性恋、未关注性别差异以及使用基于便利抽样的样本。

方法

采用一个大型(N = 10531)具有代表性的澳大利亚成年人全国样本,在一系列逐步调整的逻辑回归模型中,分别针对男性和女性,研究性取向(异性恋、同性恋、双性恋)与(1)自杀意念、(2)自杀未遂和(3)非自杀性自我伤害之间的关联。

结果

在调整年龄和其他协变量后,性少数群体参与者比异性恋者有更高的自杀倾向和自我伤害风险,风险模式因性取向和性别而异。与异性恋男性相比,男同性恋者(而非双性恋男性)更有可能报告自杀意念(优势比 = 3.05,95%置信区间 = [1.65, 5.60])和自杀未遂(优势比 = 4.16,置信区间 = [2.18, 7.93])。双性恋女性(而非女同性恋者)更有可能报告自杀意念(优势比 = 4.40,置信区间 = [3.00, 6.37])和自杀未遂(优势比 = 4.46,置信区间 = [2.41, 8.24])。双性恋男性和男同性恋者报告自我伤害的可能性均不比异性恋男性更高。然而,双性恋女性(而非女同性恋者)报告自我伤害的可能性比异性恋女性更高(优势比 = 19.59,置信区间 = [9.05, 42.40])。总体而言,双性恋女性自杀倾向和自我伤害的风险最高。

结论

鼓励为性少数群体提供服务的临床医生与他们的客户公开讨论自杀和自我伤害的想法及行为,并可考虑采用治疗策略来减少内化的耻辱感,增强个人和社会资源。

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