Department of Psychology, University of Exeter, Exeter, UK.
Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong.
Eur Child Adolesc Psychiatry. 2024 Nov;33(11):3993-4002. doi: 10.1007/s00787-024-02444-4. Epub 2024 Apr 26.
Sexual minority adolescents (SMA) have a disproportionately high prevalence of victimisation, self-harm, and depressed mood, relative to the general population. Yet, the contributing and mechanistic factors are unclear. We aim to explore the directional relationship between victimisation and self-harm and depressed mood, with poor sleep quality as a possible mediator. A secondary data analysis was conducted using a nationally representative birth cohort in the United Kingdom, where participants self-identified as sexual minority (N = 1922, aged 11-13, 67.1% female) and their parents completed questionnaires and interviews when the participants were aged 11, 14 and 17. Logistic and linear regression were used to test whether victimisation prospectively predicted self-harm and depressed mood with mediation analyses conducted to assess if sleep onset latency and nocturnal awakening mediated their relationships. After adjusting for demographic factors and baseline self-harm and depressed mood, victimisation at age 11 significantly predicted self-harm (OR = 1.40, p < .01) and depressed mood (B = 0.024, SE = 0.01, p < .05) at age 17. In the mediation analyses, frequent nocturnal awakening at age 14, but not sleep onset latency, significantly mediated the effect of victimisation at age 11 on self-harm (indirect effect B = 0.008, SE = 0.004, 95%CI = 0.001-0.017) and depressed mood (indirect effect B = 0.005, SE = 0.002 95%CI = 0.001-0.010) at age 17. Our findings supported that victimisation contributed to negative mental health among SMA. Poor sleep quality could be an indicator of maladjustment with victimisation, which further increased vulnerability to negative mental health. Victimisation and sleep quality could be important assessment targets in mental health campaign among sexual minority adolescents.
性少数青少年（SMA）相对于普通人群，其受害、自残和情绪低落的比例过高。然而，促成因素和机制尚不清楚。我们旨在探索受害与自残和情绪低落之间的方向关系，并探讨睡眠质量较差是否可能作为中介因素。我们使用英国一个具有全国代表性的出生队列进行了二次数据分析，其中参与者自我认同为性少数群体（N=1922，年龄为 11-13 岁，67.1%为女性），当参与者 11、14 和 17 岁时，他们的父母完成了问卷调查和访谈。我们使用逻辑回归和线性回归来测试受害是否可以预测未来的自残和情绪低落，同时进行中介分析以评估睡眠潜伏期和夜间觉醒是否可以调节他们的关系。在调整人口统计学因素以及基线自残和情绪低落后，11 岁时的受害显著预测了 17 岁时的自残（OR=1.40，p<.01）和情绪低落（B=0.024，SE=0.01，p<.05）。在中介分析中，14 岁时频繁的夜间觉醒，但不是睡眠潜伏期，显著调节了 11 岁时受害对 17 岁时自残（间接效应 B=0.008，SE=0.004，95%CI=0.001-0.017）和情绪低落（间接效应 B=0.005，SE=0.002，95%CI=0.001-0.010）的影响。我们的研究结果支持了受害会导致 SMA 负面心理健康的观点。睡眠质量差可能是受害导致适应不良的一个指标，这进一步增加了 SMA 对负面心理健康的脆弱性。受害和睡眠质量可能是 SMA 心理健康运动中的重要评估目标。
