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

项目摘要/摘要 有色人种LGBTQ抑郁和自杀率增加(LGBTQ-POC)是一种 至关重要的公共卫生问题。LGBTQ-POC经历了系统性压力的累积- 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， 马季奇的童年经历，以及有差别地获得精神卫生保健和资源。尽管对 早期预防和临床实践，在理解抑郁症和自杀相关行为方面仍存在重要差距 LGBTQ-PoC中的IOR。个别研究中样本的减少和方法学的限制 我们从发展的角度理解抑郁和自杀的能力。我建议用一种- 序列队列设计和综合数据分析(IDA)用于检查儿童的纵向轨迹 LGBTQ-POC青少年的抑郁和自杀倾向RDA将个人级别的数据从 将多个独立研究合并到单个数据集。IDA提供了更强的统计能力、更高的频率 低基率行为，以及研究未被充分代表的亚群的扩大样本的能力。此外， 我将在众多纵向研究中探索重叠的年龄队列，使用顺序联合- 短设计，这将提供对发展的更广泛的理解。建议进行的研究 将青少年纳入18项随机预防试验，他们被确认为LGBTQ-POC(N=2,029)。研究人员 调查参与者的时间间隔从1岁到15.25岁不等。在基线水平上，参加研究的青年人数为7至7岁 19岁(男性=12.7岁)。考虑到试验的时间长度，拟议的研究将审查一个相当大的发展 期限从7年到34年不等。在目标1中，我将使用多层增长混合模型(MGMM)来检验长期增长 LGBTQ-POC中抑郁和自杀相关行为的态度轨迹。在《目标2》中，我会及早确定 抑郁症状与自杀意念和行为的纵向轨迹有关。最后，目标3 将考察早期个人内部和人际保护因素对儿童行为纵向轨迹的影响 抑郁和自杀。这些目标与NIMH的战略目标2和3紧密地结合在一起，即“检查心理 疾病在整个生命周期中的轨迹“和”强调努力改善预防和治疗之间的相互关系 发明。“此外，这一奖学金的目的可以支持补救精神上系统性不平等的努力。 对LGBTQ-POC产生不成比例影响的医疗保健。这些见解可以提供新的证据，并具有可操作性。 补充现有干预措施和针对关键发展时期和关键时期的预防工作的工具 高需求群体充分利用LGBTQ-POC的优势和保护因素。最后，这一奖学金 将使我在发展科学、心理健康预防和量化方面建立坚实的背景 以LGBTQ-POC青少年的健康和幸福为重点的方法。

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.