Causes and Impact of Minority Stress on Health and Development in Youth

少数民族压力对青少年健康和发展的原因和影响

• 批准号: 7932904
• 负责人: S BRYN AUSTIN
• 金额: $ 69.42万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-15 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7932904
• 关键词: Abdominal Pain; Address; Adolescence; Adolescent; Adult; Affect; Age; Alcohol or Other Drugs use; Alcohols; Attitude; Awareness; Behavior; Biological; Biological Markers; Bisexual; Child; Childhood; Cohort Studies; Communities; Data; Data Collection; Dependence; Development; Dimensions; Discrimination; Distress; Eating Disorders; Education; Epidemiologic Studies; Epidemiology; Family; Family Violence; Friends; Gays; Gender; Headache Syndrome; Health; Health behavior; Heterosexuals; Homosexuality; Homosexuals; Hydrocortisone; Individual; Lead; Lesbian; Life; Link; Mediating; Mediator of activation protein; Minority; Morbidity - disease rate; Mothers; Neurosecretory Systems; Nurses' Health Study; Outcome; Parent-Child Relations; Pathway interactions; Patient Self-Report; Pattern; Phase; Physiological; Population; Population Heterogeneity; Prejudice; Prevalence; Process; Psychological adjustment; Relative (related person); Reporting; Research; Research Personnel; Risk Behaviors; Sampling; Severities; Sex Orientation; Societies; Stigmatization; Stress; Subgroup; Surveys; Symptoms; Syndrome; Testing; Time; Tobacco; United States National Institutes of Health; Verbally abusive behavior; Victimization; Violence; Work; Youth; base; career; chronic pain; cohort; coping; dehydroepiandrosterone; depressive symptoms; early adolescence; emerging adult; emerging adulthood; epidemiologic data; experience; health disparity; high risk behavior; improved; pain adaptation; peer; physical conditioning; prospective; psychologic; psychological distress; psychosocial adjustment; public health relevance; response; self esteem; sex; stressor; theories

DESCRIPTION (provided by applicant): Sexual orientation group disparities in several critical health domains are now well documented, with sexual minorities reporting more psychological distress, substance use and dependence, and eating disorders symptoms. Little is known about the reasons underlying higher risk behaviors among sexual minorities relative to heterosexuals. Herein, we propose to explain these sexual orientation disparities by testing our Sexual Minority Stress Theory (SMST). SMST is based on society's stigmatization of homosexuality. Gay-related stress, the experience by a sexual-minority individual of society's stigmatization, consists of external stressors (such as prejudice, discrimination, verbal abuse, physical violence) perpetrated by known individuals (such as kin, heterosexual friends) and strangers in the community. Gay-related stress also consists of internal stress, in which the sexual-minority individual internalizes society's stigmatization, such as possessing negative attitudes toward homosexuality. Our proposed research will address the impact of gay-related stress on disparities between and among sexual orientation subgroups in psychological distress, physiological distress (cortisol, DHEA), health behaviors, chronic pain, adaptation, and adjustment in emerging adulthood, and examine moderators, such as the effect of parent-child relationships on the relations between sexual orientation and gay-related stress and the effect of coping on the relations between gay-related stress and both psychological and physiological distress. Gay-related stress may be particularly important in influencing a sexual minority youth's development and psychosocial adjustment in emerging adulthood. Our research will be sensitive to important precursors of gay-related stress, such as gender nonconformity. It will also examine how sex, age at experiencing gay-related stress, sexual minority status and transitions in status, concordant vs. nonconcordant orientation patterns among sexual minorities, and sexual identity development vary with gay-related stress, health, adaptation, and adjustment outcomes. We will collect new self-report survey and biological data to investigate these critical issues in the Growing Up Today Study (GUTS), a longitudinal cohort study of 16,882 U.S. adolescents and emerging adults begun in 1996 and ongoing. Specifically, we will add 3 data collection phases to more than 10 years of data collected from GUTS and link the youths' data with those of their mothers, who comprise the Nurses' Health Study II. We will examine disparities in violence victimization in childhood and adolescence and other forms of gay-related stress and the impact of these over time on subsequent psychological and physiological distress, substance use and eating disordered behaviors, chronic pain, adaptation, and adjustment in emerging adulthood. PUBLIC HEALTH RELEVANCE: Disturbing evidence exists of disparities in tobacco, alcohol, and other substance use and dependence, eating disorder symptoms, and a number of other important health indicators adversely affecting sexual-minority youth relative to heterosexual peers. Our proposed research will address the critical need for new epidemiologic investigations into the impact of violence victimization, harassment, and other gay- related stressors on the health of this underserved and understudied population, providing valuable data to researchers and clinicians working to improve the health of all youth.

描述（由申请人提供）：几个关键健康领域的性取向群体差异现已得到充分记录，性少数群体报告更多的心理困扰、物质使用和依赖以及饮食失调症状。对于性少数群体相对于异性恋者更高风险行为的原因知之甚少。在此，我们建议通过测试我们的性少数压力理论（SMST）来解释这些性取向差异。 SMST 是基于社会对同性恋的污名化。与同性恋相关的压力是性少数群体经历的社会耻辱，由社区中的已知个体（如亲属、异性朋友）和陌生人施加的外部压力源（如偏见、歧视、言语虐待、身体暴力）组成。与同性恋相关的压力还包括内部压力，即性少数个体将社会的污名化内化，例如对同性恋持有消极态度。我们提出的研究将解决同性恋相关压力对性取向亚群之间在心理困扰、生理困扰（皮质醇、脱氢表雄酮）、健康行为、慢性疼痛、适应和成年初期调整方面的差异的影响，并研究调节因素，例如亲子关系对性取向和同性恋相关压力之间关系的影响，以及应对对性取向和同性恋相关压力之间关系的影响。 同性恋相关的压力以及心理和生理上的困扰。与同性恋相关的压力对于影响性少数青少年的发展和成年初期的心理社会调整可能特别重要。我们的研究将对同性恋相关压力的重要前兆敏感，例如性别不一致。它还将研究性别、经历同性恋相关压力的年龄、性少数群体地位和地位转变、性少数群体中一致与不一致的取向模式以及性身份发展如何随着同性恋相关压力、健康、适应和调整结果而变化。我们将收集新的自我报告调查和生物学数据，以在“今日成长研究”(GUTS) 中调查这些关键问题，该研究是一项针对 16,882 名美国青少年和新兴成年人的纵向队列研究，于 1996 年开始并持续进行。具体来说，我们将在 GUTS 收集的 10 多年数据的基础上添加 3 个数据收集阶段，并将青少年的数据与其母亲的数据联系起来，这些数据构成了护士健康研究 II。我们将研究儿童期和青春期暴力受害情况的差异以及其他形式的同性恋相关压力，以及这些随着时间的推移对成年初期的心理和生理困扰、物质使用和饮食失调行为、慢性疼痛、适应和调整的影响。公共卫生相关性：令人不安的证据表明，与异性恋同龄人相比，性少数青少年在烟草、酒精和其他物质的使用和依赖、饮食失调症状以及许多其他重要健康指标方面存在差异，对性少数青少年产生不利影响。我们提出的研究将解决对暴力受害、骚扰和其他同性恋相关压力因素对这一服务不足和研究不足的人群的健康影响进行新的流行病学调查的迫切需要，为致力于改善所有青少年健康的研究人员和临床医生提供有价值的数据。