Center for Rural Health, Oklahoma State University-Center for Health Sciences, Tulsa, OK, USA.
J Affect Disord. 2019 Dec 1;259:362-369. doi: 10.1016/j.jad.2019.08.044. Epub 2019 Aug 19.
Research shows individuals experiencing adverse childhood experiences (ACEs) as well as identifying as a man who has sex with other men (MSM) are at an increased risk for mental health issues. Less has been studied, however, on ACEs in MSM; with even fewer studies investigating non-urban (e.g., rural/small town/suburban) MSM, as most research features urban samples. This is problematic due to studies showing that rurality can influence the behavior of MSM. The current study comparatively investigates the impact of ACEs on the mental health of rural/small town/suburban and urban MSM.
Participants included 156 MSM residing in Oklahoma. Linear regression was used to test the association between ACEs' and mental health (anxiety, depressive symptoms, and loneliness). Split-sample regressions were conducted on rural/small town/suburban and urban MSM.
ACEs were associated with all three mental health outcomes in the full sample. However, ACEs were significantly linked to anxiety and depressive symptoms only in urban MSM.
Limitations include a smaller sample size with limited racial/ethnic variations.
Results suggest that living in an urban environment may amplify the risks of ACEs, rural/small town/suburban MSM may acquire outside, unique support networks which work to limit the effect of ACEs, or that rural/small town/suburban MSM may manifest the effects of ACEs differently (or a combination of the three). Trauma-informed programming has been shown to effectively reduce mental health issues, yet consideration is generally not given with regards to rurality. Future programming and research should consider rurality/urbanity as influential factor.
研究表明，经历过不良童年经历（ACEs）的个体以及被认定为男男性行为者（MSM）的人，心理健康问题的风险增加。然而，对 MSM 中的 ACEs 研究较少；对于非城市（如农村/小镇/郊区）的 MSM 研究甚至更少，因为大多数研究都是针对城市样本的。这是有问题的，因为研究表明农村地区会影响 MSM 的行为。本研究比较性地调查了 ACEs 对农村/小镇/郊区和城市 MSM 心理健康的影响。
参与者包括 156 名居住在俄克拉荷马州的 MSM。线性回归用于测试 ACEs 与心理健康（焦虑、抑郁症状和孤独感）之间的关联。对农村/小镇/郊区和城市 MSM 进行了分样本回归。
ACEs 与全样本的所有三种心理健康结果都相关。然而，ACEs 仅与城市 MSM 的焦虑和抑郁症状显著相关。
限制包括样本量较小，种族/族裔变化有限。
结果表明，生活在城市环境中可能会放大 ACEs 的风险，农村/小镇/郊区 MSM 可能会获得外部独特的支持网络，这些网络有助于限制 ACEs 的影响，或者农村/小镇/郊区 MSM 可能会以不同的方式表现出 ACEs 的影响（或三者的结合）。创伤知情方案已被证明可以有效地减少心理健康问题，但通常不会考虑到农村地区。未来的规划和研究应该考虑到农村/城市的影响因素。
