性取向不一致与美国高中生的非致命性自杀行为。
Sexual Orientation Discordance and Nonfatal Suicidal Behaviors in U.S. High School Students.
机构信息
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
出版信息
Am J Prev Med. 2018 Apr;54(4):530-538. doi: 10.1016/j.amepre.2018.01.013. Epub 2018 Feb 21.
INTRODUCTION
Studies among adults have documented association between sexual orientation discordance and some suicide risk factors. However, studies examining sexual orientation discordance and nonfatal suicidal behaviors in youth are rare. This study examines the association between sexual orientation discordance and suicidal ideation/suicide attempts among a nationally representative sample of U.S. high school students.
METHODS
Using sexual identity and sex of sexual contact measures from the 2015 national Youth Risk Behavior Survey (n=6,790), a sexual orientation discordance variable was constructed describing concordance and discordance (agreement and disagreement, respectively, between sexual identity and sex of sexual contacts). Three suicide-related questions (seriously considered attempting suicide, making a plan about how they would attempt suicide, and attempting suicide) were combined to create a two-level nonfatal suicide risk variable. Analyses were restricted to students who identified as heterosexual or gay/lesbian, who had sexual contact, and who had no missing data for sex or suicide variables. The association between sexual orientation discordance and nonfatal suicide risk was assessed using logistic regression. Analyses were performed in 2017.
RESULTS
Approximately 4.0% of students experienced sexual orientation discordance. High suicide risk was significantly more common among discordant students compared with concordant students (46.3% vs 22.4%, p<0.0001). In adjusted models, discordant students were 70% more likely to have had suicidal ideation/suicide attempts compared with concordant students (adjusted prevalence ratio=1.7, 95% CI=1.4, 2.0).
CONCLUSIONS
Sexual orientation discordance was associated with increased likelihood of nonfatal suicidal behaviors. Discordant adolescents may experience unique stressors that should be considered when developing and implementing suicide prevention programs.
引言
成人研究已记录了性取向不一致与某些自杀风险因素之间的关联。然而，研究青少年性取向不一致与非致命性自杀行为的研究很少。本研究调查了美国全国代表性高中生样本中性取向不一致与自杀意念/自杀企图之间的关联。
方法
使用 2015 年全国青少年风险行为调查中的性身份和性接触性别测量值（n=6790），构建了性取向不一致变量，描述了一致性和不一致性（分别表示性身份和性接触性别之间的一致和不一致）。将三个与自杀相关的问题（认真考虑自杀、制定自杀计划和自杀企图）合并为一个两级非致命性自杀风险变量。分析仅限于自我认同为异性恋或同性恋、有过性接触且性别的数据无缺失的学生。使用逻辑回归评估性取向不一致与非致命性自杀风险之间的关联。分析于 2017 年进行。
结果
约有 4.0%的学生经历了性取向不一致。与一致性学生相比，高自杀风险在不一致学生中明显更为常见（46.3%比 22.4%，p<0.0001）。在调整模型中，与一致性学生相比，不一致学生有自杀意念/自杀企图的可能性高 70%（调整后的患病率比=1.7，95%CI=1.4，2.0）。
结论
性取向不一致与非致命性自杀行为的可能性增加相关。不一致的青少年可能经历独特的压力源，在制定和实施自杀预防计划时应考虑这些压力源。
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