Faculty of Nursing, Thammasat University, Klong Neung, Khlong Luang, Pathumthani, Thailand.
College of Nursing, The University of Illinois at Chicago, Chicago, Illinois, USA.
Res Nurs Health. 2022 Oct;45(5):580-591. doi: 10.1002/nur.22255. Epub 2022 Aug 3.
Loneliness is a significant risk factor for depression in adults. Sexual and gender minority (SGM) individuals are at risk for loneliness and depression due to stigma and discrimination. However, little is known about the influences of loneliness on the mental health of SGM populations. Guided by the Minority Stress and Integrative Mediation Frameworks, the authors aimed to examine loneliness's direct and indirect effects on the relationships between minority stressors and depression among Thai SGM adults. Data were drawn from a larger cross-sectional survey. Standardized measures of minority stressors (discrimination, victimization, identity concealment, and internalized sexual stigma), loneliness, and depression were selected and translated by expert panels. A convenience sample was recruited, and data were collected using online and in-person methods. Participants (N = 411, M = 29.5 years) were primarily male (90.5%), gay (79.3%), and cisgender (76.6%). More than 40% of participants reported clinically significant levels of loneliness (M = 38.59, standard deviation [SD] = 11.11) and depression (M = 9.46, SD = 8.43). Discrimination, identity concealment, and internalized sexual stigma were directly associated with loneliness (all p < 0.05). Minority stressors were significantly related to depression through indirect associations via loneliness accounting for 33%-54% of the total effect. Indirect effects (95% confidence interval) were 0.25 [0.12, 0.40] for discrimination, -0.41 [-0.67, -0.18] for identity concealment, and 0.42 [0.06, 0.79] for internalized sexual stigma. Loneliness was prevalent and played a mediating role in the associations between minority stressors and depression. Study findings have implications for the development of intervention research.
孤独感是成年人抑郁的一个重要风险因素。由于污名化和歧视，性少数群体（SGM）个体面临孤独和抑郁的风险。然而，人们对孤独感对 SGM 人群心理健康的影响知之甚少。本研究以少数群体应激和综合中介框架为指导，旨在检验孤独感对泰国 SGM 成年人的少数群体应激源与抑郁之间关系的直接和间接影响。数据来自于一项更大的横断面调查。选择并由专家小组翻译了少数群体应激源（歧视、受害、身份隐瞒和内化性污名）、孤独感和抑郁的标准化测量工具。采用便利抽样方法，通过在线和面对面的方式收集数据。参与者（N=411，M=29.5 岁）主要为男性（90.5%）、同性恋（79.3%）和顺性别（76.6%）。超过 40%的参与者报告孤独感处于临床显著水平（M=38.59，标准差[SD]=11.11）和抑郁（M=9.46，SD=8.43）。歧视、身份隐瞒和内化性污名与孤独感直接相关（均 p<0.05）。少数群体应激源通过孤独感的间接关联与抑郁显著相关，孤独感解释了总效应的 33%-54%。间接效应（95%置信区间）分别为歧视 0.25[0.12，0.40]，身份隐瞒-0.41[-0.67，-0.18]和内化性性污名 0.42[0.06，0.79]。孤独感普遍存在，并在少数群体应激源与抑郁之间的关系中发挥中介作用。研究结果对干预研究的发展具有重要意义。
