Developmental trajectories of depression and suicide among LGBTQ people of color: An Integrative Data Analysis of 18 prevention trials.

LGBTQ 有色人种抑郁和自杀的发展轨迹：18 项预防试验的综合数据分析。

• 批准号: 10604573
• 负责人: Alberto Valido Delgado
• 金额: $ 3.81万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-11-01 至 2024-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10604573
• 关键词: 19 year old; Address; Adolescent; Adult; African American; Age; Area; Behavior; Black race; Childhood; Clinical; Crime; Data; Data Analyses; Data Set; Depression and Suicide; Development; Discrimination; Enrollment; Ethnic Origin; Exposure to; Extramural Activities; Family; Feeling suicidal; Fellowship; Frequencies; Funding; Future; Gender; Goals; Growth; Health; Health Professional; Health Resources; Individual; Inequality; Intervention; Latinx; Length; Lesbian Gay Bisexual Transgender Queer; Literature; Longevity; Longitudinal Studies; Mental Health; Mental Health Services; Mental disorders; Mentors; Mentorship; Methodology; Modeling; National Institute of Mental Health; Neighborhoods; Outcome; Participant; Pattern; Personal Satisfaction; Prevention; Prevention trial; Public Health; Race; Randomized; Records; Research; Research Personnel; Research Training; Risk; Sample Size; Sampling; Science; Secure; Signal Transduction; Source; Stress; Subgroup; Suicide attempt; Surveys; Symptoms; Techniques; Therapeutic Intervention; Training; Training Programs; Trust; Universities; Youth; adverse childhood events; associated symptom; base; career; clinical practice; cohort; critical period; depressive symptoms; design; experience; family support; improved; insight; low socioeconomic status; mental development; minority children; multi-racial; next generation; people of color; preventive intervention; protective factors; sexual identity; suicidal behavior; suicidal risk; tool

Project Summary / Abstract Increased rates of depression and suicidality among LGBTQ people of color (LGBTQ-POC) is a critically important public health concern. LGBTQ-POC experience the cumulative stress of systemic in- equality and discrimination, including lower socioeconomic status, higher exposure to neighborhood crime, trau- matic childhood experiences, and differential access to mental health care and resources. Although critical for early prevention and clinical practice, essential gaps remain to understand depression and suicide-related behav- iors among LGBTQ-POC. Reduced samples in individual studies and methodological limitations have restricted our ability to understand depression and suicidality from a developmental perspective. I propose using a se- quential cohort design and Integrative Data Analysis (IDA) to examine longitudinal trajectories of depression and suicidality among LGBTQ-POC adolescents. IDA combines individual-level data from multiple independent studies into a single dataset. IDA provides increased statistical power, increased frequency of low base-rate behaviors, and the ability to study an expanded sample of underrepresented subgroups. Further, I will explore overlapping age cohorts across numerous longitudinal studies using a sequential co- hort design, which will provide a much broader understanding of development. The proposed study includes adolescents in 18 randomized prevention trials who identified as LGBTQ-POC (N = 2,029). Researchers surveyed participants at varying intervals from 1 to 15.25 years. At baseline, youth enrolled in the studies were 7 to 19 years of age (M = 12.7). Given the length of the trials, the proposed study will examine a sizable developmental period from 7 up to 34 years. In Aim 1, I will use multilevel growth mixture modeling (MGMM) to examine longi- tudinal trajectories of depression and suicide-related behaviors among LGBTQ-POC. In Aim 2, I will identify early depression symptoms associated with longitudinal trajectories of suicide ideation and behaviors. Lastly, Aim 3 will examine the impact of early intrapersonal and interpersonal protective factors on longitudinal trajectories of depression and suicidality. These aims closely align with strategic Goals 2 and 3 of NIMH to “examine mental illness trajectories throughout the lifespan” and “highlight efforts to improve preventive and therapeutic inter- ventions.” Further, the aims of this fellowship can support efforts to remediate systemic inequalities in mental healthcare that disproportionately impact LGBTQ-POC. These insights could offer new evidence and actionable tools to supplement existing interventions and target prevention efforts to critical periods of development and groups of high need capitalizing on the strengths and protective factors of LGBTQ-POC. Lastly, this fellowship will allow me to build a strong background in developmental science, mental health prevention, and quantitative methodology with a focus on the health and well-being of LGBTQ-POC adolescents.

项目总结/摘要 LGBTQ有色人种（LGBTQ-POC）中抑郁和自杀率的增加是一个 这是一个非常重要的公共卫生问题。LGBTQ-POC经历了系统性的累积压力， 平等和歧视，包括较低的社会经济地位，较高的邻里犯罪风险，创伤， 童年的经历，以及获得精神卫生保健和资源的差别。虽然对于 早期预防和临床实践中，重要的差距仍然是了解抑郁症和自杀相关的自杀， 在LGBTQ-POC中。个体研究中样本的减少和方法学限制限制了 我们从发展的角度理解抑郁和自杀倾向的能力。我建议用一个- 序贯队列设计和综合数据分析（IDA），以检查 LGBTQ-POC青少年的抑郁和自杀倾向。IDA结合了来自 多个独立的研究整合到一个数据集中。IDA提供了更高的统计能力，更高的频率 低基本率的行为，以及研究代表性不足的亚组的扩大样本的能力。此外，本发明还 我将探索重叠的年龄组在众多的纵向研究中使用一个连续的共同- 霍特，这将提供一个更广泛的理解发展。拟定研究 包括18项随机预防试验中确定为LGBTQ-POC的青少年（N = 2，029）。研究人员 调查参与者在不同的时间间隔从1到15.25年。在基线时，参加研究的年轻人为7至 19岁（M = 12.7）。鉴于试验的长度，拟议的研究将审查一个相当大的发展 从7岁到34岁。在目标1中，我将使用多层次增长混合模型（MGMM）来检查长距离数据。 LGBTQ-POC中抑郁和自杀相关行为的纵向轨迹。在目标2中，我将尽早确定 抑郁症状与自杀意念和行为的纵向轨迹相关。最后，目标3 将研究早期自我和人际保护因素对纵向轨迹的影响， 抑郁和自杀倾向这些目标与NIMH的战略目标2和3密切相关，即“检查心理健康状况”。 疾病的轨迹在整个生命周期”和“强调努力改善预防和治疗间， ventions”此外，该奖学金的目的可以支持努力纠正精神方面的系统性不平等， 医疗保健不成比例地影响LGBTQ-POC。这些见解可以提供新的证据和可操作的 补充现有干预措施的工具，并将预防工作针对发展的关键时期， 高度群体需要利用LGBTQ-POC的优势和保护因素。最后，这个奖学金 这将使我能够在发展科学，心理健康预防和定量方面建立强大的背景。 方法，重点关注LGBTQ-POC青少年的健康和福祉。