Raney Julia H, Weinstein Shayna, Testa Alexander, Ganson Kyle T, Memon Zain, Glidden David V, Baker Fiona C, Brindis Claire D, Nagata Jason M
Division of Adolescent and Young Adult Medicine (JH Raney, S Weinstein, Z Memon, CD Brindis, and JM Nagata), Department of Pediatrics, University of California, San Francisco.
Division of Adolescent and Young Adult Medicine (JH Raney, S Weinstein, Z Memon, CD Brindis, and JM Nagata), Department of Pediatrics, University of California, San Francisco; School of Public Health (S Weinstein), University of Berkeley, Berkeley, Calif.
Acad Pediatr. 2025 Jan-Feb;25(1):102555. doi: 10.1016/j.acap.2024.07.022. Epub 2024 Aug 10.
To determine disparities in adverse childhood experiences (ACEs) by sexual identity in a national cohort of early adolescents.
We analyzed cross-sectional data from year 2 of the Adolescent Brain Cognitive Development study (N = 10,934, 2018-20, ages 10-14 years). Disparities in ACE scores across lesbian, gay, or bisexual (LGB), not sure, and heterosexual adolescents were assessed using multinomial logistic regression analyses. Logistic regressions estimated the associations between sexual identity and each individual ACE. Analyses were adjusted for potential confounders.
In adjusted models, LGB adolescents had a higher risk of experiencing 2, 3, or ≥4 ACEs (relative risk ratios [RRR] = 1.57, 95% Confidence Interval (CI) 1.01-2.42), 3 (RR = 1.78, 95% CI 1.100-2.88), or ≥4 ACEs (RRR = 3.20, 95% CI 1.92-5.32), and not sure adolescents had a higher risk of having ≥4 ACEs (RRR = 2.17, 95% CI 1.22-3.87), compared to heterosexual adolescents. LGB and not sure adolescents had higher risks of reporting emotional abuse ("yes" OR = 4.21, 95% CI 1.84-9.61; "maybe" OR = 6.20, 95% CI 2.91-13.19) and parent mental illness ("yes" OR = 1.95, 95% CI 1.48-2.57; "maybe" OR = 1.63, 95% CI 1.21-2.18) compared to heterosexual adolescents.
LGB adolescents and those questioning their sexual identity were at greater risk of having higher ACE scores, with LGB adolescents experiencing the highest risk of experiencing ACEs. LGB adolescents also had higher odds of reporting emotional and parent mental illness. Recognizing this heightened risk of ACEs in early adolescence is critical for designing clinic and school-based interventions.
确定全国早期青少年队列中性取向在童年不良经历(ACEs)方面的差异。
我们分析了青少年大脑认知发展研究第二年的横断面数据(N = 10934,2018 - 2020年,年龄10 - 14岁)。使用多项逻辑回归分析评估女同性恋、男同性恋或双性恋(LGB)、不确定以及异性恋青少年在ACE得分上的差异。逻辑回归估计了性取向与每个单独ACE之间的关联。分析对潜在混杂因素进行了调整。
在调整模型中,与异性恋青少年相比,LGB青少年经历2次、3次或≥4次ACEs的风险更高(相对风险比[RRR]=1.57,95%置信区间[CI]1.01 - 2.42)、3次(RR = 1.78,95% CI 1.100 - 2.88)或≥4次ACEs(RRR = 3.20,95% CI 1.92 - 5.32),不确定青少年经历≥4次ACEs的风险更高(RRR = 2.17,95% CI 1.22 - 3.87)。与异性恋青少年相比,LGB和不确定青少年报告情感虐待(“是”OR = 4.21,95% CI 1.84 - 9.61;“可能”OR = 6.20,95% CI 2.91 - 13.19)和父母精神疾病(“是”OR = 1.95,95% CI 1.48 - 2.57;“可能”OR = 1.63,95% CI 1.21 - 2.18)的风险更高。
LGB青少年以及那些对自己性取向存疑的青少年有更高ACE得分的风险更大,其中LGB青少年经历ACEs的风险最高。LGB青少年报告情感虐待和父母精神疾病的几率也更高。认识到青春期早期ACEs的这种高风险对于设计基于诊所和学校的干预措施至关重要。