Predicting adverse outcomes among sexual minorities and heterosexuals from a prospective study of adolescent health and wellbeing

通过青少年健康和福祉的前瞻性研究预测性少数群体和异性恋者的不良后果

• 批准号: 9760277
• 负责人: Hunter Andres Hahn
• 金额: $ 3.32万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-01 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9760277
• 关键词: 19 year old; AIDS/HIV problem; Address; Adolescence; Adolescent; Adult; Affect; Affective; Age; Age-Years; Alcohol or Other Drugs use; Anxiety; Anxiety Disorders; Asthma; Cardiovascular Diseases; Caucasians; Characteristics; Child Rearing; Cognitive; Data; Data Set; Depression and Suicide; Development; Discrimination; Documentation; Eating Disorders; Ethnic Origin; Expectancy; Family; Feeling hopeless; Gender; Goals; Health; Heterosexuals; Individual; Individual Differences; Lead; Lesbian Gay Bisexual; Life; Literature; Longitudinal prospective study; Machine Learning; Maintenance; Malignant Neoplasms; Measures; Mediating; Mediation; Mediator of activation protein; Mental Depression; Mental Health; Methods; Minority; Modeling; Mood Disorders; Morbidity - disease rate; Nature; Ohio; Outcome; Pathway interactions; Personal Satisfaction; Population; Population Heterogeneity; Predictive Factor; Predictive Value; Prevention; Prevention program; Preventive Intervention; Process; Prospective Studies; Psyche structure; Psychological adjustment; Psychopathology; Psychosocial Factor; Questionnaires; Race; Randomized; Research; Resources; Risk; Risk Factors; Sampling; Schools; Screening procedure; Sex Orientation; Sleep; Sleep disturbances; Socioeconomic Status; Specific qualifier value; Spirituality; Standardization; Statistical Methods; Stress; Suicide; System; Temperament; Testing; Time; Training; Victimization; Vulnerable Populations; Youth; adolescent health; adverse outcome; age group; analytical method; base; cancer risk; career; emerging adult; emotion dysregulation; emotion regulation; experience; health disparity; high risk; improved; insight; multilevel analysis; non-heterosexual; outcome prediction; peer; peer influence; peer victimization; physical conditioning; prevent; prospective; psychologic; psychosocial; racial diversity; racial minority; resilience; sexual identity; sexual minority; sexual risk behavior; social; stressor; substance misuse; theories; treatment disparity; young adult

PROJECT SUMMARY Sexual minorities (lesbian, gay, bisexual and other non-heterosexual individuals) are at increased risk for numerous adverse physical and mental health outcomes, including anxiety, depression, suicidality, substance use, HIV/AIDS, asthma, cardiovascular disease, and certain forms of cancer. Despite clear documentation and replication of these health disparities, relatively little is known about their development from adolescence into adulthood. Two theories primarily dominate the literature. Minority stress models describe unique life stressors experienced only by sexual minorities (e.g., victimization and discrimination based on sexual orientation) as primary contributors to health disparities. Other models implicate both minority stress and normative psychosocial processes together as contributors to health disparities. Some such normative processes include (1) psychological adjustment and characteristics (e.g., emotion regulation/dysregulation, substance use expectancies), (2) disrupted social systems (e.g., family, peers, school), and (3) individual differences (e.g., race/ethnicity, socioeconomic status, temperament). To date, most studies of both minority stress and normative processes are limited by use of cross-sectional samples of primarily Caucasian adults. Although much has been learned from these studies, they do not permit analysis of emerging health disparities across development. Existing research is therefore limited in terms of both generalizability to diverse populations, and validity of directionality inferences between observed ‘predictors’ and ‘outcomes’. My long-term career goals are to identify mechanisms leading to disparities among sexual minorities, with the goal of improving treatments for these disparities, and to develop screening tools to identify high-risk youth who would benefit from prevention programs. To reach this goal, in this project, I address existing limitations to the literature using a prospective sample of individuals who were 14-19 years old at baseline and followed for over 4 years. My goal is to describe developmental trajectories and mechanisms of health disparity development for sexual minority youth compared with heterosexual youth across a 10-year developmental window spanning ages 14- 23 years. Longitudinal outcomes include depression/anxiety, suicidality, delinquency, sleep, general physical health, disordered eating and substance use. Developmental trajectories for these outcomes will be charted by gender and sexual orientation. Confirmatory analyses based on existing literature will be conducted to examine relations between minority stress and adverse outcomes. Then, I will use machine learning to identify as-yet unknown predictors of adverse outcomes and health disparities and characterize any changes in prediction across time. Finally, I will use state-of-the art intervening variable analyses (mediation, moderation) to evaluate longitudinal mechanisms through which health disparities emerge. Findings should provide insight into mechanisms of disparity development and maintenance, informing prevention and intervention strategies.

项目摘要 性少数群体（女同性恋、男同性恋、双性恋和其他非异性恋者） 许多不良的身心健康结果，包括焦虑、抑郁、自杀、物质 吸毒、艾滋病毒/艾滋病、哮喘、心血管疾病和某些形式的癌症。尽管有明确的文件和 这些健康差异的复制，相对而言，人们对他们从青春期到成年的发展知之甚少。 成年两种理论主要支配着文献。少数压力模型描述了独特的生活压力源 只有性少数群体才经历过（例如，受害和基于性取向的歧视）， 造成健康差距的主要因素。其他模型涉及少数民族的压力和规范 心理社会过程共同造成健康差距。一些此类规范性进程包括 (1)心理调节和特征（例如，情绪调节/失调，物质使用 （2）社会系统的破坏（例如，家庭、同伴、学校），和（3）个体差异（例如， 种族/民族、社会经济地位、气质）。到目前为止，大多数关于少数民族的研究都强调， 规范性过程受到主要是高加索成年人的横断面样本的限制。虽然 虽然从这些研究中已经学到了很多，但它们不允许分析新出现的健康差距， 发展因此，现有研究在对不同人群的普遍性方面受到限制， 观察到的“预测因子”和“结果”之间的方向性推断的有效性。我的长期职业目标 确定导致性少数群体之间差异的机制，目标是改善 治疗这些差异，并开发筛选工具，以确定高危青年谁将受益 预防方案。为了达到这个目标，在这个项目中，我解决了现有的文献限制， 基线时年龄为14-19岁并随访4年以上的前瞻性样本。我 目的是描述性别健康差异发展的发展轨迹和机制， 少数民族青年与异性恋青年在10年的发展窗口中的比较， 23年纵向结果包括抑郁/焦虑、自杀倾向、青少年犯罪、睡眠、一般身体状况、 健康、饮食失调和物质使用。这些成果的发展轨迹将由以下人员绘制： 性别和性取向。将根据现有文献进行验证性分析， 少数民族压力和不良后果之间的关系。然后，我将使用机器学习来识别 不良结局和健康差异的未知预测因素，并描述预测结果的任何变化 穿越时空最后，我将使用最先进的干预变量分析（调解，适度）来评估 纵向机制，通过健康差距出现。调查结果应提供深入了解 发展和维持差距的机制，为预防和干预战略提供信息。