Association between sexual minority status and suicidal behavior among Chinese adolescents: A moderated mediation model
Association between sexual minority status and suicidal behavior among Chinese adolescents: A moderated mediation model
复制标题
中国青少年性少数地位与自杀行为的关联：有调节的中介模型
DOI：
10.1016/j.jad.2018.07.004
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发表时间：
2018-10-15
影响因子：
6.6
通讯作者：
Lu, Ciyong
中科院分区：
文献类型：
--
作者：
Huang, Yeen;Li, Pengsheng;Lu, Ciyong
背景：有证据表明，由于少数民族应激源或缺乏社会支持，性少数族裔青少年自杀的风险比他们的异性恋同龄人更高，但这些影响因素的综合作用如何影响这一人群的自杀行为尚不清楚。本研究采用多阶段、分层整群随机抽样的方法，考察学校受害是否在青少年性少数地位与自杀行为之间起到中介作用，并探讨这种中介作用是否受到人际关系的调节。方法：我们采用多阶段、分层整群随机抽样的方法，抽取了具有全国代表性的7-12年级学生数据(《2015年中国青少年学校健康调查》)。本研究以123,459名在校学生为被试，对他们的性别少数群体状况、自杀意念、自杀企图、学校受害、同学关系、师生关系等进行了问卷调查。结果：采用中介模型发现，学校受害在性别少数群体地位对自杀意念(间接效应=0.0296，95%可信区间=0.0259~0.0333)和自杀未遂(间接效应=0.0086，95%CI=0.0074~0.0100)之间起中介作用。这些间接效应受到人际关系的调节，在同学关系或师生关系较差的少数民族性别学生中影响更大。限制：我们的研究样本只包括在校学生，由于横断面设计，对观察到的联想的方向的解释有限。结论：人际关系调节了学校受害对性别少数民族地位与自杀行为关联的间接影响。及早干预解决校园暴力问题，并改善与学校同龄人的关系质量，将有助于防止性少数群体青少年自杀。
Background: Evidence shows sexual minority adolescents have a higher risk of suicidality than their heterosexual peers due to minority stressors or lack of social support, but it remains unclear how the combined effects of these influence factors impact suicidality in this population. In this study, we examine whether school victimization mediates association between sexual minority status and suicidal behavior of adolescents and explore whether such mediation is moderated by interpersonal relationships.Methods: We sampled a large nationally representative dataset comprising data collected from 7th to 12th graders (the 2015 School-based Chinese Adolescents Health Survey) using a multistage, stratified-cluster, random-sampling method. Our sample consisted of 123,459 students who completed questionnaires regarding their sexual minority status, suicidal ideation, suicide attempts, school victimization, classmate relations, and teacher-classmate relations.Results: Using a moderated mediation model, we found that school victimization mediated the effects of sexual minority status on suicidal ideation (indirect effect = 0.0296, 95% confidence intervals (CI) = 0.0259-0.0333) and suicide attempts (indirect effect = 0.0086, 95% CI = 0.0074-0.0100). These indirect effects were moderated by interpersonal relationships, and a greater effect was seen among sexual minority students with poor classmate or teacher-classmate relations.Limitations: Our study sample included only students attending school, and interpretation of the direction of the observed associations is limited due to the cross-sectional design.Conclusions: Interpersonal relationships moderate the indirect effects of school victimization on association between sexual minority status and suicidal behavior. Early intervention addressing school violence combined with improving the quality of relationships with school peers would help prevent suicidality in sexual minority adolescents.