Boyas Javier F, Villarreal-Otálora Tatiana, Alvarez-Hernandez Luis R, Fatehi Mariam
University of Georgia, School of Social Work, 279 Williams St., Athens, GA, 30602, USA.
Health Promot Perspect. 2019 Aug 6;9(3):198-206. doi: 10.15171/hpp.2019.28. eCollection 2019.
Guided by an ecological systems theory (EST) framework, the purpose of the present study was to investigate how multiple micro, mezzo, and macro factors influence the suicidality continuum from suicidal ideation to suicide attempt among Latinx LGB (lesbian, gay, and bisexual) youth living in the United States. Data for this cross sectional-study included 451 participants who self-identified as Latinx LGB on the 2017-National Youth Risk Behavioral Survey. The analysis explored micro, mezzo, and macro-level factors' association with three suicidality outcomes (ideation, planning, and attempt) at the bivariate and multivariate level. Since the outcome variables were dichotomized, univariate logistic regressions and backward elimination logistic regressions were used. The most commonly reported suicidal behavior was ideation (n = 173; 40%), followed by planning (n = 150; 34%), and then attempt (n = 64; 21%). Findings from the backward elimination logistic regression on suicidal ideation suggest the best set of independent variables are being bullied at school (odds ratio [OR] = 2.81; CI: 1.61-4.89), experiencing sexual assault(OR = 2.32; CI: 1.32-4.07), experiencing depressive symptoms (OR = 1.99; CI: 1.07- 3.69),being cannabis use (OR = 1.76; CI: 1.08-2.89), and being female (OR = 1.72; CI: 1.01-2.93).For suicide planning the model suggested, experiencing depressive symptoms (OR = 3.21; CI:1.74-5.91), cannabis use (OR = 2.46; CI: 1.49-4.07), being bullied at school (OR = 2.04; CI:1.17-3.58), and experiencing sexual assault (OR = 1.88; CI: 1.07-3.31) exhibited the strongest relationships. Suicide attempt was significantly associated with cannabis use (OR = 3.12; CI:1.60-6.08), experiencing depression (OR= 2.89; CI: 1.30-6.43), experiencing sexual assault (OR = 2.77; CI: 1.34-5.71), and being bullied at school (OR = 2.34; CI: 1.12-4.91). Given the findings of this study, it is essential that tailored suicide prevention efforts be established that uniquely address the intersections of race/ethnicity and sexual orientation and how this intersection influences micro, mezzo, and macro factors associated with suicide ideation, planning, and attempt among Latinx LGB adolescents.
在生态系统理论(EST)框架的指导下,本研究旨在探讨多种微观、中观和宏观因素如何影响居住在美国的拉丁裔女同性恋、男同性恋和双性恋(LGB)青年从自杀意念到自杀未遂的自杀倾向连续体。这项横断面研究的数据包括451名在2017年全国青少年风险行为调查中自我认定为拉丁裔LGB的参与者。该分析在双变量和多变量层面探讨了微观、中观和宏观层面因素与三种自杀倾向结果(意念、计划和未遂)之间的关联。由于结果变量是二分变量,因此使用了单变量逻辑回归和向后排除逻辑回归。最常报告的自杀行为是意念(n = 173;40%),其次是计划(n = 150;34%),然后是未遂(n = 64;21%)。关于自杀意念的向后排除逻辑回归结果表明,最佳的一组自变量是在学校被欺负(优势比[OR] = 2.81;置信区间:1.61 - 4.89)、遭受性侵犯(OR = 2.32;置信区间:1.32 - 4.07)、出现抑郁症状(OR = 1.99;置信区间:1.07 - 3.69)、使用大麻(OR = 1.76;置信区间:1.08 - 2.89)以及女性(OR = 1.72;置信区间:1.01 - 2.93)。对于自杀计划,该模型表明,出现抑郁症状(OR = 3.21;置信区间:1.74 - 5.91)、使用大麻(OR = 2.46;置信区间:1.49 - 4.07)、在学校被欺负(OR = 2.04;置信区间:1.17 - 3.58)以及遭受性侵犯(OR = 1.88;置信区间:1.07 - 3.31)表现出最强的关系。自杀未遂与使用大麻(OR = 3.12;置信区间:1.60 - 6.08)、出现抑郁(OR = 2.89;置信区间:1.30 - 6.43)、遭受性侵犯(OR = 2.77;置信区间:1.34 - 5.71)以及在学校被欺负(OR = 2.34;置信区间:1.12 - 4.91)显著相关。鉴于本研究的结果,必须制定针对性的自杀预防措施,以独特地解决种族/族裔和性取向的交叉问题,以及这种交叉如何影响与拉丁裔LGB青少年自杀意念、计划和未遂相关的微观、中观和宏观因素。