Wicki Matthias, Marmet Simon, Studer Joseph, Epaulard Olivier, Gmel Gerhard
Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Infectious Disease Unit, Grenoble-Alpes University Hospital, Grenoble, France.
Addict Behav. 2021 Jan;112:106609. doi: 10.1016/j.addbeh.2020.106609. Epub 2020 Aug 13.
It is well documented that individuals with a minority sexual orientation face greater risks of problematic substance use (e.g. heavy episodic drinking, alcohol use disorder) and mental health problems. Far less is known about how that risk varies within this population and their risk of behavioural addictions. This study estimated the risks of problematic substance use, behavioural addiction and poor mental health across the spectrum of sexual orientation.
A sample of young Swiss men (N = 5294; mean age = 25.5, SD = 1.25; representative of 21 of Switzerland's 26 cantons) completed a self-reporting questionnaire on sexual orientation (attraction, 5-point scale) and criterion variables: problematic substance use (e.g. alcohol, cigarettes, cannabis and other illegal drugs), behavioural addictions (gambling, gaming, cybersex, internet, smartphone, work, exercise) and indicators of mental health (e.g. depression, stress). Curvilinear associations between sexual orientation (heterosexual, mostly-heterosexual, bisexual, mostly-homosexual or homosexual individuals) and criterion variables were explored using fractional polynomial regressions.
Although there were differences across criterion variables, in general, the highest risks of problematic substance use, behavioural addictions and mental health problems were estimated for mostly-heterosexual, bisexual or mostly-homosexual men, followed by homosexual men, and with heterosexual men facing the lowest risk.
Aggregating the spectrum of sexual orientations into two or three distinct groups blurs important internal group differences. Outcome-specific explanations beyond minority stress and biphobia are necessary to understand the pathways between sexual orientation and risky behaviours. Considering sexual orientation is important to provide targeted healthcare prevention and interventions.
有充分文献记载，性取向为少数群体的个体面临物质使用问题（如大量饮酒、酒精使用障碍）和心理健康问题的风险更高。对于该群体内部这种风险如何变化以及他们患行为成瘾的风险，我们所知甚少。本研究估计了性取向范围内物质使用问题、行为成瘾和心理健康不佳的风险。
一组瑞士年轻男性（N = 5294；平均年龄 = 25.5，标准差 = 1.25；代表瑞士26个州中的21个）完成了一份关于性取向（吸引力，5分制）和标准变量的自我报告问卷：物质使用问题（如酒精、香烟、大麻和其他非法药物）、行为成瘾（赌博、游戏、网络性爱、互联网、智能手机、工作、锻炼）以及心理健康指标（如抑郁、压力）。使用分数多项式回归探索性取向（异性恋、多数为异性恋、双性恋、多数为同性恋或同性恋个体）与标准变量之间的曲线关联。
尽管各标准变量存在差异，但总体而言，多数为异性恋、双性恋或多数为同性恋的男性物质使用问题、行为成瘾和心理健康问题的风险最高，其次是同性恋男性，异性恋男性面临的风险最低。
将性取向范围汇总为两三个不同群体模糊了重要的群体内部差异。除了少数群体压力和双性恋恐惧症之外，针对特定结果的解释对于理解性取向与危险行为之间的途径是必要的。考虑性取向对于提供有针对性的医疗保健预防和干预措施很重要。
