Understanding the role of self-stigma and shame in suicidality and self-harm among lesbian, gay, bisexual and transgender young people: a mixed method

重点研究问题有自杀和/或自残行为的LGB和T青年的自我污名和羞耻感程度如何？关于性和性别认同的自我污名和羞耻感是如何导致LGBT青少年自杀和自残的？在LGBT青少年的自杀和自残行为中，挫败感和诱捕感的作用是什么？LGB和T年轻人在经历自我耻辱和羞耻的方式上有什么不同吗？这些经历如何与最近或过去的自杀行为/自我伤害联系在一起？采用顺序探索性混合方法设计：第一阶段：采用半结构化访谈对LGBT年轻人进行定性研究，探讨他们如何经历与性和性别认同相关的自我污名和羞耻感；以及这些经历是如何与自杀和自残联系在一起的。定性数据将按主题进行分析。第一阶段的结果将指导研究的定量部分（第二阶段）。第二阶段：前瞻性研究，选取14-25岁的LGBT青年为研究对象，调查自我污名化、内在和外在羞耻、挫败感和诱捕感、情绪、自杀倾向和自残的日常经历。方法可能包括在线每日日记或生态瞬间评估（EMA）。将与一个LGBT青年咨询小组进行一系列利益相关方磋商，共同制定研究报告，并就具体方法的可用性和可接受性征求意见。招募：将从各种渠道招募LGBT青年，包括诺丁汉跨性别健康中心；性别情报等国家组织；东米德兰兹和西米德兰兹的LGBT青年团体；社交媒体广告。第三阶段：将对定性访谈和前瞻性研究的结果进行综合和回顾，并结合现有文献，为LGBT年轻人自杀和自残的新理论模型的发展提供信息。

Key research questions1. What are the levels of self-stigma and shame in LGB and T young people who have engaged in suicidal behaviours and/or self-harm?2. How does self-stigma and shame about one's sexual and gender identity could lead to suicidality and self-harm in LGBT youth?3. What is the role of perceptions of defeat and entrapment in LGBT youth suicidality and self-harm?4. Are there differences between LGB and T young people in how they experience self-stigma and shame and how these experiences could be associated with recent or past suicidal behaviour/self-harm?Methodology and techniques to be employedA sequential exploratory mixed methods design will be adopted:Phase 1: A qualitative study using semi-structured interviews with LGBT young people exploring how they experience self-stigma and shame associated with their sexual and gender identity; and, how these experiences are/have been implicated in suicidality and self-harm. Qualitative data will be analysed thematically. Findings from Phase 1 will guide the quantitative component of the study (Phase 2). Phase 2: A prospective study investigating daily experiences of self-stigma, internal and external shame, perceptions of defeat and entrapment, mood, suicidality and self-harm will be carried out with a representative group of LGBT young people aged 14-25 years old. Methods could include online daily diaries or ecological momentary assessments (EMA). A series of stakeholder consultations with an LGBT youth advisory group will take place to co-produce the study and seek advice on usability and acceptability of specific methods. Recruitment: LGBT young people will be recruited from various sources including the Nottingham Centre for Transgender Health; national organisations such as Gendered Intelligence; LGBT youth groups in East and West Midlands; social media advertising. Phase 3: Findings from the qualitative interviews and the prospective study will be synthesized and reviewed in relation to the extant literature to inform the development of a novel theoretical model of suicidality and self-harm in LGBT young people.