Schnarrs Phillip W, Dorri Armin A, Russell Stephen T, Grigsby Timothy J, Charak Ruby, Dawes Hayden, Stone Amy L, Yockey R Andrew, Rosenberger Joshua G
Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA.
Texas Institute for Sexual and Gender Minority Health Research, The University of Texas at Austin, Austin, Texas, USA.
LGBT Health. 2025 May-Jun;12(4):286-294. doi: 10.1089/lgbt.2023.0296. Epub 2024 Oct 3.
The purpose of this study was to assess the relationship between adverse childhood experiences (ACEs) exposure, perceived discrimination, and anxiety and depressive symptoms in sexual and gender minoritized (SGM) adults in the United States. Respondents ( = 4445) from a national Qualtrics research panel completed a web-based survey. Guided by the stress proliferation (mediation model) and stress sensitization (moderation model) models, we examined the relationships between ACEs and perceived discrimination and the severity of anxiety and depressive symptoms in adulthood. Cumulative ACEs exposure was positively associated with everyday discrimination scale (EDS) scores. ACEs and EDS scores had a significant direct association with anxiety and depressive symptoms. We found support for EDS as a mediator for anxiety ( = 0.12, < 0.001) and depressive symptoms ( = 0.14, < 0.001) and for ACEs as a moderator of the relationship between EDS and anxiety ( = -0.04, = 0.004) and depressive ( = -0.05, = 0.001) symptoms. These findings suggest that both stress proliferation and stress sensitization likely contribute to disparities in anxiety and depressive symptoms in SGM adults. This finding supports the integration of social safety and minority stress perspectives regarding health disparities in SGM populations. Exposure to early life adversity likely alters neurodevelopment, which in turn increases awareness of the lack of social safety in adulthood, reduces capacity to cope with minority stress exposure, and ultimately contributes to increased anxiety and depressive symptoms. Prevention efforts should focus on building positive and compensatory childhood experiences.
本研究的目的是评估美国性取向和性别少数群体（SGM）成年人中童年不良经历（ACEs）暴露、感知到的歧视与焦虑和抑郁症状之间的关系。来自全国Qualtrics研究小组的4445名受访者完成了一项基于网络的调查。在应激扩散（中介模型）和应激敏感化（调节模型）的指导下，我们研究了ACEs与感知到的歧视以及成年期焦虑和抑郁症状严重程度之间的关系。累积ACEs暴露与日常歧视量表（EDS）得分呈正相关。ACEs和EDS得分与焦虑和抑郁症状有显著的直接关联。我们发现支持EDS作为焦虑（β = 0.12，p < 0.001）和抑郁症状（β = 0.14，p < 0.001）的中介，以及ACEs作为EDS与焦虑（β = -0.04，p = 0.004）和抑郁（β = -0.05，p = 0.001）症状之间关系的调节因素。这些发现表明，应激扩散和应激敏感化可能都导致了SGM成年人焦虑和抑郁症状的差异。这一发现支持了将社会安全和少数群体应激观点整合到SGM人群健康差异研究中。早年生活逆境的暴露可能会改变神经发育，进而增加成年后对社会安全缺失的认识，降低应对少数群体应激暴露的能力，并最终导致焦虑和抑郁症状增加。预防工作应侧重于构建积极的补偿性童年经历。
