Sexual Identity, Adverse Childhood Experiences, and Suicidal Behaviors
Sexual Identity, Adverse Childhood Experiences, and Suicidal Behaviors
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DOI：
10.1016/j.jadohealth.2017.09.022
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发表时间：
2018-02-01
影响因子：
7.6
通讯作者：
Yang, Wei
中科院分区：
文献类型：
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作者：
Clements-Nolle, Kristen;Lensch, Taylor;Yang, Wei
目的：本研究的目的是探讨性别认同和不良童年经历（ACE）对高中生自杀行为的影响，以人口为基础的样本。方法：采用两阶段整群随机抽样设计，从97所高中招募5,108名学生。共有4，955名学生（97%）提供了将性别身份分为三类的信息：（1）女同性恋，男同性恋或双性恋（LGB）（10%）;（2）不确定（4.6%）;（3）异性恋（85.4%）。总结了儿童期虐待和家庭功能障碍的五项指标，ACE评分分为0、1、2和3-5 ACE。结果：与异性恋学生相比，LGB学生和不确定性别的学生有更高的自杀意念和企图发生率。累积ACE暴露与自杀行为之间也存在分级关系。虽然没有观察到性别认同/ACE相互作用，LGB/不确定谁经历了大量的ACE学生不成比例的影响。与ACE为0的异性恋学生相比，LGB/ACE为0的不确定学生（校正比值比[AOR] = 3.32，95%置信区间[CI] = 1.96-5.61），1例ACE（AOR = 6.58，95% CI = 4.05-10.71）、2例ACE（AOR = 13.50，95% CI = 8.45-21.58）和3-5例ACE（AOR = 14.04，95% CI = 8.72，22.62）的自杀意念发生率较高。一个类似的模式被观察到自杀attempts.Conclusions：LGB和学生不确定自己的性身份，更大的接触ACE有不成比例的高水平的自杀意念和企图。有必要对这些人群进行创伤知情干预。(C)2017年青少年健康和医学协会。All rights reserved.
Purpose: The objective of this study was to examine the influence of sexual identity and adverse childhood experiences (ACEs) on suicidal behaviors in a population-based sample of high school students.Methods: A two-stage cluster random sampling design was used to recruit 5,108 students from 97 high schools. A total of 4,955 students (97%) provided information that allowed for classification of sexual identity into three groups: (1) lesbian, gay, or bisexual (LGB) (10%); (2) not sure (4.6%); and (3) heterosexual (85.4%). Five measures of childhood abuse and household dysfunction were summed, and the ACE score was categorized as 0, 1, 2, and 3-5 ACEs. Weighted logistic regression was used to assess the influence of sexual identity, ACEs, and their interaction on suicide ideation and attempts in the past 12 months.Results: Compared with heterosexual students, those who were LGB and were not sure had higher odds of suicide ideation and attempts. There was also a graded relationship between cumulative ACE exposure and suicidal behaviors. Although sexual identity/ACE interaction was not observed, LGB/not sure students who experienced a high number of ACEs were disproportionately affected. Compared with heterosexual students with 0 ACE, LGB/not sure students with 0 ACE (adjusted odds ratio [AOR] = 3.32, 95% confidence interval [CI] = 1.96-5.61), 1 ACE (AOR = 6.58, 95% CI = 4.05-10.71), 2 ACEs (AOR 13.50, 95% CI = 8.45-21.58), and 3-5 ACEs (AOR = 14.04, 95% CI = 8.72, 22.62) had higher odds of suicide ideation. A similar pattern was observed for suicide attempts.Conclusions: LGB and students not sure of their sexual identity with greater exposure to ACEs have disproportionately high levels of suicide ideation and attempts. Trauma-informed interventions for these populations are warranted. (C) 2017 Society for Adolescent Health and Medicine. All rights reserved.