Division of Health Promotion and Behavioral Science, San Diego State University Graduate School of Public Health, CA, and the Institute for Behavioral and Community Health, San Diego State University Research Foundation, CA.
Feinberg School of Medicine, Northwestern University, Chicago, IL.
J Am Acad Child Adolesc Psychiatry. 2019 Feb;58(2):200-210. doi: 10.1016/j.jaac.2018.09.437. Epub 2018 Oct 30.
To expand knowledge of co-occurring alcohol use and disordered eating behaviors (DEB) among sexual minority (ie, nonheterosexual) youth.
Using pooled 2009 to 2015 US Youth Risk Behavior Surveys (322,687 students; 7.3% lesbian, gay, bisexual), multivariable logistic regression models examined the following: (1) associations of age of onset of drinking and past month binge drinking with past year DEB (fasting, diet pill use, purging, steroid use); and (2) effect modification by sexual orientation.
Alcohol use and sexual minority identity were independently associated with elevated odds for diet pill use and purging among female adolescents, and with fasting and steroid use among male adolescents. Odds of fasting increased with greater frequency of monthly binge drinking among heterosexual adolescent female youth, and odds of diet pill use increased with greater frequency of monthly binge drinking among heterosexual adolescent male youth. DEB prevalence was particularly pronounced among adolescents who binge drank and who were not sure of their sexual orientation identity. Among male adolescents not sure of their sexual orientation identity, those who binge drank more than 1 day in the past month had 8.63 to 23.62 times the odds of using diet pills relative to those who did not binge drink, and 13.37 to 26.42 times the odds of purging relative to those who did not binge drink.
More research is needed on psychosocial factors underlying alcohol use and DEB in youth of all sexual orientations.
扩展对性少数群体（即非异性恋）青年中同时存在的酒精使用和饮食失调行为（DEB）的认识。
利用 2009 年至 2015 年美国青少年风险行为调查（322687 名学生；7.3%为女同性恋、男同性恋、双性恋）的数据，多变量逻辑回归模型检验了以下内容：（1）饮酒和过去一个月 binge 饮酒与过去一年 DEB（禁食、服用减肥药、催吐、使用类固醇）的发病年龄之间的关联；（2）性取向的影响修饰作用。
酒精使用和性少数群体身份与女性青少年中使用减肥药和催吐的几率增加，以及男性青少年中禁食和使用类固醇的几率增加独立相关。异性恋女性青少年中，每月 binge 饮酒频率越高，禁食的几率就越高，而异性恋男性青少年中，每月 binge 饮酒频率越高，使用减肥药的几率就越高。在那些 binge 饮酒且不确定自己性取向身份的青少年中，DEB 的患病率尤其明显。在不确定自己性取向身份的男性青少年中，过去一个月内 binge 饮酒超过 1 天的青少年使用减肥药的几率是不 binge 饮酒者的 8.63 到 23.62 倍，催吐的几率是不 binge 饮酒者的 13.37 到 26.42 倍。
需要对所有性取向的青少年中酒精使用和 DEB 的潜在心理社会因素进行更多研究。
