Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, Fla.
Psychology Department, University of Wisconsin-Eau Claire, Eau Claire, Wis.
Acad Pediatr. 2017 Sep-Oct;17(7):715-722. doi: 10.1016/j.acap.2016.11.002.
We investigated differences in prevalence of repetitive nonsuicidal self-injury (NSSI), suicidal ideation, and a suicide attempt among youth who identified as bisexual, gay/lesbian, and questioning. In addition, we examined which types of social connections were associated with reduced risk of repetitive NSSI and suicidality among youth who identified with a specific sexual minority group.
Data came from the 2013 Minnesota Student Survey. The analytic sample included 77,758 students in grades 9 and 11. Connectedness factors included parent connectedness, teacher caring, connectedness to other nonparental adults, school safety, and friend caring. Logistic regression analyses, stratified according to sexual minority group, determined social connectedness factors associated with repetitive NSSI, suicidal ideation, and a suicide attempt, as well as moderating effects of significant connectedness factors on different risk factors (depression, anxiety, bullying, and violence victimization).
Approximately 3% identified as bisexual or questioning their sexual orientation, and <1% identified as gay/lesbian. Sexual minority youth, particularly bisexual youth, were significantly more likely than heterosexual youth to report repetitive NSSI and suicidality. Effects of connectedness varied across sexual minority groups and outcomes on the basis of types of connections. Parent connectedness emerged as a robust protective factor for all self-harm behaviors among bisexual and questioning youth. Feeling connected to nonparental adults and safe at school represented additional factors that reduced risk of repetitive NSSI and suicidality among certain groups.
In addition to facilitating connections between youth and parents, clinicians might consider encouraging sexual minority youth to remain connected to trusted nonparental adults who could offer support and care. Schools might consider implementing sociocultural norms of acceptance, tolerance, and positive identity development to reduce risk of self-harm.
我们调查了自认为是双性恋、同性恋/女同性恋和有疑问的年轻人在重复非自杀性自我伤害(NSSI)、自杀意念和自杀企图方面的发生率差异。此外,我们还研究了哪些类型的社会联系与特定性少数群体认同的年轻人重复 NSSI 和自杀风险降低有关。
数据来自 2013 年明尼苏达州学生调查。分析样本包括 9 年级和 11 年级的 77758 名学生。关联因素包括父母关联、教师关怀、与其他非父母成年人的关联、学校安全和朋友关怀。根据性少数群体进行分层的逻辑回归分析,确定与重复 NSSI、自杀意念和自杀企图相关的社会关联因素,以及显著关联因素对不同风险因素(抑郁、焦虑、欺凌和暴力受害)的调节作用。
约 3%的人自认为是双性恋或对自己的性取向有疑问,<1%的人自认为是同性恋/女同性恋。性少数群体青年,特别是双性恋青年,报告重复 NSSI 和自杀的可能性明显高于异性恋青年。关联因素的影响因性少数群体和基于不同关联类型的结果而有所不同。父母关联是所有双性恋和有疑问的年轻人重复 NSSI 和自杀行为的强有力保护因素。与非父母成年人有联系并感到在学校安全是减少某些群体重复 NSSI 和自杀风险的其他因素。
除了促进年轻人与父母之间的联系外,临床医生可能还会考虑鼓励性少数群体青年与可提供支持和关怀的可信赖的非父母成年人保持联系。学校可能会考虑实施社会文化接受、宽容和积极身份发展的规范,以降低自我伤害的风险。