Chang Cindy J, Fischer Ian C, Depp Colin A, Norman Sonya B, Livingston Nicholas A, Pietrzak Robert H
VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA.
National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
J Psychiatr Res. 2023 May;161:477-482. doi: 10.1016/j.jpsychires.2023.03.042. Epub 2023 Apr 1.
This study examined sociodemographic, military, and trauma characteristics, and mental health concerns that differ by sexual orientation in a nationally representative sample of U.S. military veterans. Data were analyzed from 4069 veterans who participated in the National Health and Resilience Veterans Study (NHRVS). Compared with veterans who self-reported as heterosexual (n = 3,491, 94.7%), sexual minority veterans (n = 161, 5.3%) were more likely to be younger, women, Hispanic, unmarried/partnered, have lower household income, and to have enlisted in the military, and served for 4-9 years (relative to 3 or less or 10 or more). After adjusting for demographic variables, sexual minority veterans remained more likely to report childhood sexual abuse (odds ratio [OR] = 2.82), military sexual trauma (OR = 2.29), adverse childhood experiences (Cohen's d = 0.11), current and lifetime drug use disorder (ORs = 3.66 and 2.41, respectively), current alcohol use disorder (OR = 1.62), current and lifetime posttraumatic stress disorder (PTSD; ORs = 2.03 and 1.55, respectively), non-suicidal self-injury (NSSI; OR = 3.19), and future suicide intent (OR = 2.65). Among sexual minority veterans, more years of military service was associated with greater odds of lifetime PTSD, and lower annual household income with greater odds of lifetime drug use disorder and NSSI. Consistent with research in non-veterans, results suggest that sexual minority veterans experience greater trauma and mental health burden relative to their heterosexual peers. They further underscore the importance of interventions that prevent and mitigate adverse mental health outcomes in this population.
本研究在美国退伍军人的全国代表性样本中，考察了按性取向划分的社会人口统计学、军事和创伤特征以及心理健康问题。对参与全国退伍军人健康与恢复力研究（NHRVS）的4069名退伍军人的数据进行了分析。与自我报告为异性恋的退伍军人（n = 3491，94.7%）相比，性少数群体退伍军人（n = 161，5.3%）更有可能年龄较小、为女性、西班牙裔、未婚/有伴侣、家庭收入较低，并且更有可能入伍并服役4至9年（相对于3年及以下或10年及以上）。在对人口统计学变量进行调整后，性少数群体退伍军人仍然更有可能报告童年期性虐待（优势比[OR]=2.82）、军事性创伤（OR = 2.29）、童年不良经历（科恩d值=0.11）、当前和终生药物使用障碍（OR分别为3.66和2.41）、当前酒精使用障碍（OR = 1.62）、当前和终生创伤后应激障碍（PTSD；OR分别为2.03和1.55）、非自杀性自伤（NSSI；OR = 3.19）以及未来自杀意图（OR = 2.65）。在性少数群体退伍军人中，服役年限越长，终生患PTSD的几率越高，家庭年收入越低，终生药物使用障碍和NSSI的几率越高。与非退伍军人的研究一致，结果表明，相对于异性恋同龄人，性少数群体退伍军人经历了更大的创伤和心理健康负担。它们进一步强调了预防和减轻该人群不良心理健康结果的干预措施的重要性。
