Klein David A, Ahmed Anwar E, Murphy Mikela A, Pearlman Arielle T, Johnson Nia, Gray Joshua C, Schvey Natasha A
Arch Suicide Res. 2023 Jul-Sep;27(3):1091-1098. doi: 10.1080/13811118.2022.2075815. Epub 2022 May 24.
Prior research suggests sexual and gender minority (SGM) youth are profoundly impacted by levels of parental support. This study assessed mediating effects of generalized family acceptance and conflict on lifetime suicidal behaviors among a large diverse sample comprising both SGM and non-SGM youth in early adolescence, when intervention to optimize family dynamics may be critical.
Using data from the first-year follow-up of the Adolescent Brain Cognitive Development Study based in the United States, mediation was tested using a binary logistic regression model fitted with a generalized structural equation. Models included SGM status as the independent variable, family acceptance or family conflict sum score as the mediator, and the presence of lifetime suicidal behaviors as the dependent variable. Models adjusted for age, birth-assigned sex (as reported by the parent/guardian), and race/ethnicity.
Of 11,235 youths, lifetime suicidal behaviors were reported by 1.5% ( = 164). Youths with SGM identities reported 40% less parental acceptance and 47% greater family conflict, compared to non-SGM peers. Both parental acceptance and family conflict partially mediated associations between SGM identification and odds of lifetime suicidal behavior (s = .001).
Identification of modifiable risk factors for suicidality in this vulnerable population, including parental acceptance and family conflict, is critical to improving health outcomes. Clinicians should work with SGM youth and their families starting in childhood to optimize family dynamics and bolster acceptance to potentially reduce adverse health outcomes. HIGHLIGHTSYouths with SGM identity reported 40% less parental acceptance than non-SGM peers.Parental acceptance was associated with lower odds of lifetime suicidal behaviors.Family factors partially mediated associations between SGM status and suicidal behaviors.
先前的研究表明，性取向和性别少数群体（SGM）青少年受到父母支持程度的深刻影响。本研究评估了广义家庭接纳和冲突对一大群处于青春期早期的SGM和非SGM青少年终生自杀行为的中介作用，此时优化家庭动态的干预可能至关重要。
利用美国青少年大脑认知发展研究第一年随访的数据，使用拟合广义结构方程的二元逻辑回归模型检验中介作用。模型包括将SGM身份作为自变量，家庭接纳或家庭冲突总分作为中介变量，以及终生自杀行为的存在作为因变量。模型对年龄、父母/监护人报告的出生时指定性别以及种族/族裔进行了调整。
在11235名青少年中，1.5%（n = 164）报告有终生自杀行为。与非SGM同龄人相比，具有SGM身份的青少年报告的父母接纳度低40%，家庭冲突高47%。父母接纳和家庭冲突均部分中介了SGM身份认同与终生自杀行为几率之间的关联（s = .001）。
识别这一脆弱人群自杀行为的可改变风险因素，包括父母接纳和家庭冲突，对于改善健康结果至关重要。临床医生应从儿童期开始与SGM青少年及其家庭合作，以优化家庭动态并增强接纳度，从而有可能减少不良健康结果。
要点
具有SGM身份的青少年报告的父母接纳度比非SGM同龄人低40%。
父母接纳与终生自杀行为的较低几率相关。
家庭因素部分中介了SGM身份与自杀行为之间的关联。
