1 Department of Mental Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
2 Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
LGBT Health. 2016 Oct;3(5):357-65. doi: 10.1089/lgbt.2015.0017. Epub 2016 May 24.
Research linking family rejection and health outcomes in sexual minority people is mostly limited to North America. We assessed the associations between negative treatment by family members and depressive symptoms, life satisfaction, suicidality, and tobacco/alcohol use in sexual minority women (SMW) in Viet Nam.
Data were from an anonymous internet survey (n = 1936). Latent class analysis characterized patterns of negative treatment by family members experienced by respondents. Latent class with distal outcome modeling was used to regress depressive symptoms, life satisfaction, suicidality, and tobacco/alcohol use on family treatment class, controlling for predictors of family treatment and for two other types of sexual prejudice.
Five latent family treatment classes were extracted, including four negative classes representing varying patterns of negative family treatment. Overall, more than one negative class predicted lower life satisfaction, more depressive symptoms, and higher odds of attempted suicide (relative to the non-negative class), supporting the minority stress hypothesis that negative family treatment is predictive of poorer outcomes. Only the most negative class had elevated alcohol use. The association between family treatment and smoking status was not statistically significant. The most negative class, unexpectedly, did not have the highest odds of having attempted suicide, raising a question about survivor bias.
This population requires public health attention, with emphasis placed on interventions targeting the family to promote acceptance and to prevent negative treatment, and interventions supporting those SMW who encounter the worst types of negative family treatment.
将家庭排斥与性少数群体健康结果联系起来的研究大多局限于北美。我们评估了家庭成员的负面对待与性少数群体女性(SMW)的抑郁症状、生活满意度、自杀意念和烟草/酒精使用之间的关联。
数据来自一项匿名的互联网调查(n=1936)。潜在类别分析描述了受访者经历的家庭成员负面对待的模式。使用潜在类别与远端结果建模来回归抑郁症状、生活满意度、自杀意念和烟草/酒精使用与家庭治疗类别之间的关系,同时控制家庭治疗的预测因素和其他两种类型的性偏见。
提取了五个潜在的家庭治疗类别,包括四个负面类别,代表不同模式的负面家庭治疗。总体而言,超过一个负面类别预测了较低的生活满意度、更多的抑郁症状和更高的自杀未遂几率(相对于非负面类别),支持了少数群体应激假说,即负面家庭治疗是预测较差结果的因素。只有最负面的类别与更高的酒精使用有关。家庭治疗与吸烟状况之间的关联没有统计学意义。最负面的类别,出乎意料的是,自杀未遂的几率并不最高,这引发了关于幸存者偏差的问题。
该人群需要公共卫生关注,重点放在针对家庭的干预措施上,以促进接受和预防负面对待,并为那些遭遇最严重类型负面家庭对待的 SMW 提供支持。