Nagata Jason M, Diep Thang, Helmer Christiane K, Domingue Sydnie K, Al-Shoaibi Abubakr A, Raney Julia H, Ganson Kyle T, Testa Alexander, He Jinbo, Brindis Claire D, Baker Fiona C
Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA, 94143, USA.
Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON, M5S 1V4, Canada.
J Eat Disord. 2024 Nov 29;12(1):196. doi: 10.1186/s40337-024-01157-y.
Sexual orientation discrimination increases the risks of negative health outcomes for sexual minorities. Previous studies have found increased rates of eating disorder symptoms in sexual minority individuals, which is attributable to minority stress and discrimination that they experience. Emerging research suggests relationships between sexual orientation discrimination and eating disorder symptoms. However, there is a lack of studies focusing on early adolescents. The objective of this study was to determine prospective associations between discrimination based on sexual orientation and eating disorder symptoms in a national sample of 10-13-year-old early adolescents in the U.S.
We examined prospective data from Year 2 (2018-2020) and Year 3 (2019-2021) of the Adolescent Brain Cognitive Development (ABCD) Study (N = 8976). Multiple logistic regression analyses were used to estimate associations between self-reported experiences of sexual orientation discrimination in Year 2 and eating disorder symptoms in Year 3, adjusting for potential confounders, including eating disorder symptoms in Year 2. Sexual orientation discrimination was assessed based on the Perceived Discrimination Scale, which measures adolescents' perception of being treated unfairly based on various sociodemographic characteristics. Eating disorder symptoms were based on the parent-reported Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5).
In this demographically diverse sample of early adolescents (N = 8976, age range 10-13 years at Year 2), 5.5% of adolescents reported sexual orientation discrimination in Year 2. The prevalence of parent-reported eating disorder symptoms in Year 3 varied from 1.0 to 8.3%. In the adjusted models, sexual orientation discrimination was prospectively associated with worry about weight gain (adjusted odds ratio [aOR] 2.33, 95% confidence interval [CI] 1.15-4.69) and self-worth tied to weight (aOR 1.60, 95% CI 1.01-2.53) one year later.
Early adolescents who have experienced sexual orientation discrimination have higher odds of experiencing eating disorder symptoms, particularly worrying about weight gain and tying self-worth to weight. Clinicians may consider screening for sexual orientation discrimination and providing affirmative, trauma-informed care when evaluating and treating even younger sexual minority adolescents for eating disorder symptoms.
性取向歧视会增加性少数群体出现负面健康结果的风险。先前的研究发现，性少数群体个体饮食失调症状的发生率有所上升，这归因于他们所经历的少数群体压力和歧视。新出现的研究表明了性取向歧视与饮食失调症状之间的关系。然而，缺乏针对青少年早期的研究。本研究的目的是在美国10至13岁青少年早期的全国样本中，确定基于性取向的歧视与饮食失调症状之间的前瞻性关联。
我们研究了青少年大脑认知发展（ABCD）研究第二年（2018 - 2020年）和第三年（2019 - 2021年）的前瞻性数据（N = 8976）。使用多元逻辑回归分析来估计第二年自我报告的性取向歧视经历与第三年饮食失调症状之间的关联，并对潜在的混杂因素进行调整，包括第二年的饮食失调症状。性取向歧视是根据感知歧视量表进行评估的，该量表衡量青少年对基于各种社会人口特征受到不公平对待的感知。饮食失调症状基于家长报告的儿童情感障碍和精神分裂症量表（KSADS - 5）。
在这个人口统计学特征多样的青少年早期样本（第二年N = 8976，年龄范围10 - 13岁）中，5.5%的青少年报告在第二年经历了性取向歧视。第三年家长报告的饮食失调症状患病率在1.0%至8.3%之间。在调整后的模型中，性取向歧视与一年后对体重增加的担忧（调整后的优势比[aOR] 2.33，95%置信区间[CI] 1.15 - 4.69）以及与体重相关的自我价值（aOR 1.60，95% CI 1.01 - 2.53）存在前瞻性关联。
经历过性取向歧视的青少年早期出现饮食失调症状的几率更高，尤其是担心体重增加以及将自我价值与体重联系起来。临床医生在评估和治疗更年轻的性少数群体青少年的饮食失调症状时，可能会考虑筛查性取向歧视并提供肯定性的、创伤知情的护理。
