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在一个多样化的性少数女性社区样本中,测试受害经历和少数群体压力源的组合是否会加剧创伤后应激障碍(PTSD)的风险。

Testing whether the combination of victimization and minority stressors exacerbate PTSD risks in a diverse community sample of sexual minority women.

作者信息

Veldhuis Cindy B, Juster Robert-Paul, Corbeil Thomas, Wall Melanie, Poteat Tonia, Hughes Tonda L

机构信息

School of Nursing, Columbia University.

Department of Psychiatry and Addiction, Université de Montréal.

出版信息

Psychol Sex. 2023;14(1):252-278. doi: 10.1080/19419899.2022.2106147. Epub 2022 Aug 1.

Abstract

Informed by minority stress and intersectionality frameworks, we examined: 1) associations of sexual identity and race/ethnicity with probable diagnosis of post-traumatic stress disorder (PTSD-PD) among sexual minority women (SMW; e.g., lesbian, bisexual); and 2) potential additive and interactive associations of minority stressors (discrimination, stigma consciousness, and internalized homonegativity) and potentially traumatic childhood and adulthood events (PTEs) with PTSD-PD. Data come from a large and diverse community sample of SMW ( = 662; age range: 18-82; = 40.0, = 14.0). The sample included 35.8% Black, 23.4% Latinx, and 37.2% White participants. Logistic regressions tested associations of sexual identity and race/ethnicity, minority stressors, and PTEs with PTSD-PD. More than one-third of SMW (37.2%) had PTSD-PD with significantly higher prevalence among bisexual, particularly White bisexual women, than lesbian women. Discrimination, stigma consciousness, and internalized homonegativity were each associated with higher odds of PTSD-PD, but only internalized homonegativity was additively associated with PTSD-PD in mutually adjusted models above and beyond effects of PTEs. No evidence for interactive effects between PTEs and minority stressors was found. In a diverse community sample of sexual minority women, PTSD is strongly associated with potentially traumatic childhood events and with minority stressors above and beyond the associations with other potentially traumatic events and stressors in adulthood. Our findings suggest a strong need for therapists to address the effects of stigma and homophobia in treatment for PTSD, as these minority stressors likely maintain and exacerbate the effects of past traumas.

摘要

基于少数群体压力和交叉性框架,我们进行了以下研究:1)性少数女性(SMW,如女同性恋、双性恋)的性取向和种族/族裔与创伤后应激障碍(PTSD-PD)可能诊断之间的关联;2)少数群体压力源(歧视、污名意识和内化的同性恋厌恶感)以及潜在的童年和成年创伤性事件(PTEs)与PTSD-PD之间潜在的累加和交互关联。数据来自一个多样化的SMW社区样本(n = 662;年龄范围:18 - 82岁;M = 40.0,SD = 14.0)。样本包括35.8%的黑人、23.4%的拉丁裔和37.2%的白人参与者。逻辑回归检验了性取向和种族/族裔、少数群体压力源以及PTEs与PTSD-PD之间的关联。超过三分之一的SMW(37.2%)患有PTSD-PD,双性恋女性,尤其是白人双性恋女性的患病率显著高于女同性恋女性。歧视、污名意识和内化的同性恋厌恶感均与PTSD-PD的较高几率相关,但在相互调整的模型中,仅内化的同性恋厌恶感在PTEs的影响之外与PTSD-PD存在累加关联。未发现PTEs与少数群体压力源之间存在交互作用的证据。在一个多样化的性少数女性社区样本中,PTSD与潜在的童年创伤性事件以及少数群体压力源密切相关,这些关联超出了与成年期其他潜在创伤性事件和压力源的关联。我们的研究结果表明,治疗师在治疗PTSD时迫切需要解决污名和恐同症的影响,因为这些少数群体压力源可能会维持并加剧过去创伤的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8095/10978045/b35dde521761/nihms-1933393-f0001.jpg

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