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Allen L, Zelazny J. Suicidal Ideation and Behaviors Among LGBTQ+ Adolescents and Young Adults Who Have Experienced Sexual Violence: A Scoping Review of the Literature. JOURNAL OF FORENSIC NURSING 2024:01263942-990000000-00100. [PMID: 39102311 DOI: 10.1097/jfn.0000000000000505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
INTRODUCTION The relationship between sexual violence (SV) experiences and suicidal ideation (SI) is known. However, when applied to lesbian, gay, bisexual, transgender, queer, and more (LGBTQ+) populations, the impact that experiences with SV have on the severity and magnitude of SI continues to be explored. A scoping review of the literature was conducted to summarize the current literature related to SI experienced by LGBTQ+ adolescents and young adults (AYAs) who have experienced SV. METHODS Studies were found by searching electronic databases. To be included in the review, the study must have (a) been written in the English language, (b) been conducted in the United States, (c) presented empirical data, (d) been exclusively focused on LGBTQ+ AYAs, (e) focused on experiences with SV or have analyses separate from other types of violence, and (f) investigated suicidality as an outcome. All relevant studies published to date were included. Forty-one articles were retrieved for full-text review, of which five were determined to meet eligibility. RESULTS LGBTQ+ AYAs were significantly associated with increased rates of SI compared with their cisgender heterosexual peers. LGBTQ+ AYAs were also associated with higher rates of SV victimization, ranging from intimate partner violence to previous child sexual abuse. Higher rates of depression were also associated with the population studied in each included article. CONCLUSION The relationship between SV and SI in this population is not well studied, as highlighted through this completed review. Targeting this knowledge gap through future research can lead to intervention development for this population niche.
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Perrin N, Guillaume D, Bloom T, Alexander K, Olawole W, Clough A, Turner R, Glass N. Dating Violence Victimization, Perpetration and Suicidality Among Adolescents. Compr Child Adolesc Nurs 2024:1-13. [PMID: 39052900 DOI: 10.1080/24694193.2024.2377205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/27/2024] [Indexed: 07/27/2024]
Abstract
Few studies have focused on evaluating the relationship between dating violence (DV) and suicide during the critical period of adolescence, particularly for transgender and gender-diverse (TGD) youth. The study examined the relationship between experiencing DV victimization and perpetration in the past 6 months and suicidality (ideation and attempts) among male, female, and TGD adolescents. This study used data from a longitudinal randomized trial examining the effectiveness of myPlan, a healthy relationship and safety planning app intervention for adolescents, to a control website. Data for this study was collected virtually, in which participants completed surveys through online platforms. A convenience sample was recruited through youth organizations and posting on online platforms including social media. N = 610 adolescents age 15-17 years, who resided in the U.S. experienced DV in the past 6 months, had access to a safe device, and were able to access online surveys were included in this study. The majority were female (63.8%) with (19.5%) TGD and 16.7% male. Nearly 22% of the sample identified as Hispanic/Latino and 61.0% as white. Participants completed an online survey consisting of measures of socio demographics, DV victimization and perpetration via the Conflict of Adolescent Dating Relationships Inventory (CADRI), and suicidality. The primary outcome was the association between DV victimization and perpetration on suicidality. Different forms of DV were accounted for including emotional/relational, physical, and sexual DV. Logistic regressions determined differences in the rate of DV victimization and perpetration on suicidality between gender groups (cisgender female, cisgender male, and TGD). A stratified analysis was conducted to test if the relationship between DV and suicidality differed across gender identity. Approximately one-third (32.2%) of adolescents reported suicidality in the past 6 months. TGD adolescents were more likely to report suicidality compared to males (20.6%, p < .05) and females (32.7%, p > .05). The overall odds of suicidality increased as frequency of emotional/relational DV victimization (OR = 1.37, p < .001), physical DV victimization (OR = 1.59, p < .001) and sexual DV victimization (OR = 1.42, p < .001) increased. These relationships were not significant for DV perpetration. When stratifying findings by gender groups, all forms of DV victimization significantly increased the odds of suicidality for females as well as female perpetration of physical violence. For males, all forms of DV victimization and perpetration were associated with increased odds of suicidality, although not significant due to the smaller sample size. While DV victimization is associated with increased odds of suicidality for TGD, perpetration of DV is associated with decreased odds of suicidality, although not significant due to small sample size. The findings from this study provide further insight into experiences of DV and suicidality among gender diverse youth and can guide future interventions aimed at preventing DV and suicide among adolescents.
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Affiliation(s)
- Nancy Perrin
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Tina Bloom
- College of Nursing, Notre Dame of Maryland University, Baltimore, Maryland, USA
| | - Kamila Alexander
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Wuraola Olawole
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Amber Clough
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rachael Turner
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nancy Glass
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
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Terry E, Pharr JR, Batra R, Batra K. Protective and Risk Factors for Suicidal Ideation and Behavior Among Sexual Minority Women in the United States: A Cross-Sectional Study. LGBT Health 2024; 11:392-405. [PMID: 38324060 DOI: 10.1089/lgbt.2023.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Purpose: The purpose of this study was to understand the factors associated with suicidal ideation and behavior and serious suicidal ideation and behavior among sexual minority women (SMW), including resilience, discrimination, mental health, and sociodemographic characteristics. Methods: Web-based surveys were conducted with SMW from across the United States during January-February, 2022 using psychometric valid tools. Bivariate, hierarchical regression, and logistic regression analyses were used to analyze the data. Results: Of 497 participants, 70% were identified as bisexual and 30% as lesbian. The mean scores for anxiety, depression, and stress were significantly higher among bisexual women compared to their lesbian counterparts (p < 0.05). The proportion of serious suicidal ideation and behavior was higher among bisexual women compared to lesbian women (53.9% vs. 41.2%, p = 0.012). Conversely, the mean scores of resilience were lower among bisexual women compared to lesbian women (139.7 ± 33.4 vs. 147.5 ± 33.6, p = 0.024). Lesbian women had nearly 57.4% lower odds of having serious suicidal ideation and behavior as compared to bisexual women (adjusted odds ratio = 0.426; p = 0.023). Experiencing anxiety, depression, victimization distress, and family discrimination distress were positively associated with serious suicidal ideation and behavior, whereas personal resilience and family cohesion were negatively associated with serious suicidal ideation and behavior. Conclusions: Tackling structural inequities such as racism and homophobia remains vital to improving the mental health of SMW. Interventions to strengthen social and familial supports may be particularly impactful, especially at the family level.
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Affiliation(s)
- Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Ravi Batra
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
- Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
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Manges ME, Bryan C, Bryan A, Bauder CR, Wastler HM. Suicidal thoughts and behaviors among gender and sexual minorities: Adults ages 18-24 show highest rates of past month suicidal thoughts. Suicide Life Threat Behav 2024. [PMID: 38771173 DOI: 10.1111/sltb.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/03/2024] [Indexed: 05/22/2024]
Abstract
INTRODUCTION Sexual and gender minority (SGM) people are at increased risk for suicidal thoughts and behaviors relative to their cisgender heterosexual peers. However, most research in this area has focused on youth, limiting our understanding of suicide risk among SGM adults. METHODS To address this gap in the literature, the present study examined suicidal thoughts and behaviors among SGM adults across different age groups using a sample of 10,620 US adults. RESULTS Consistent with the literature on youth, SGM adults showed higher rates of suicidal thoughts and behaviors than cisgender heterosexual adults. When examining prevalence rates across various age groups, young adults (18-24) showed greater lifetime and past month suicidal thoughts and behaviors relative to adults ages 45+. Adults ages 18-24 also showed greater past month suicidal ideation than adults ages 25-44; however, there were no group differences in lifetime suicidal thoughts and behaviors and past month suicidal behavior between adults ages 18-24 and 25-44. CONCLUSIONS Although suicidal thoughts and behaviors are most common among young SGM adults, other age groups do still show concerning rates of suicidal thoughts and behaviors, suggesting that this risk might extend to later years of life. Additional resources for SGM adults that are not only tailored toward youth and young adults are warranted.
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Affiliation(s)
- M E Manges
- The Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - C Bryan
- The Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - A Bryan
- The Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - C R Bauder
- The Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - H M Wastler
- The Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Espino E, Jiménez-Díaz O, Del Rey R, Elipe P. Outlining Individual and Contextual Factors Related to LGBTQ+ Bullying: A Systematic Review of Two Decades of Research. TRAUMA, VIOLENCE & ABUSE 2024; 25:898-917. [PMID: 37078578 DOI: 10.1177/15248380231165724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Scientific interest in lesbian, gay, bisexual, transgender, queer and any other sexual orientation, gender identity and/or expression (LGBTQ+) bullying in educational settings has grown exponentially in recent years. However, the varied ways of measuring its occurrence and associated factors have made it difficult to achieve a holistic understanding of this problem. Therefore, this systematic review aimed to provide an updated overview of individual and contextual factors related to LGBTQ+ bullying over the past two decades, based on the measurement approach to this phenomenon. Studies published from 2000 to 2020 were analyzed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses strategy. Inclusion and exclusion criteria were applied in a staggered process, and 111 articles met all the criteria. Studies focusing on LGBTQ+ bullying victimization or aggression were eligible for inclusion. Our analysis revealed LGBTQ+ bullying is usually examined by measures of general aggressions (47.8%) from the victims' perspective (87.3%). The best-represented factors across studies were individual characteristics (63.1%; n = 70), especially participants' sexual orientation and gender identity and expression (68.5%). Boys/males, from a binary gender perspective, and sexual and gender minority youth in general, were more at risk of being targeted for LGBTQ+ bullying. Although contextual factors were far less well-represented, the results revealed that gay-straight alliances, anti-homophobia policies, and social support act as protective factors. This review highlights the need to analyze LGBTQ+ bullying considering the full spectrum of sexual and gender diversity, to examine in more detail its contextual risk/protective factors, and to design public policies and psychoeducational programs in order to address the low effectiveness of generic interventions. Implications for future research and practice are discussed.
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Berny LM, Tanner-Smith EE. Interpersonal violence and suicide risk: Examining buffering effects of school and community connectedness. CHILDREN AND YOUTH SERVICES REVIEW 2024; 157:107405. [PMID: 38371909 PMCID: PMC10871710 DOI: 10.1016/j.childyouth.2023.107405] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Background Exposure to interpersonal violence is associated with elevated suicide risk. Preventing suicide among high-risk adolescents is most often discussed from a clinical treatment perspective, resulting in a gap in research examining whether school and community connectedness can buffer the relationships between forms of interpersonal violence and suicide risk in clinical samples of adolescents. Methods Baseline data from 294 adolescents who received substance use treatment were analyzed to help fill this gap in research. Adolescents in this sample were at greater risk for suicidal thoughts and behaviors given their histories of substance use disorders and high rates of interpersonal violence, with 57% reporting experiencing at least one form of abuse/violence. Independent variables included lifetime exposure to physical abuse, sexual abuse, and weapon violence; moderators included various measures of school and community connectedness. Multinomial logistic regression models were estimated to examine the main and interaction effects predicting a three-category measure of suicide risk: non-suicidal, suicidal ideation only, and prior suicide attempts. Results Sexual abuse survivors had the highest predicted probability of a prior suicide attempt when reporting lower levels of teacher support, school-based positive peer interactions, or neighborhood social connection, but at higher levels of these protective factors, their predicted probability was similar to those not exposed to sexual abuse. The same protective pattern was observed for physical abuse survivors with high neighborhood social connection. Conclusion The buffering effects observed in this study identified dimensions of school and community social connectedness as protective factors for youth exposed to abuse. Although promoting social connectedness is often cited as a universal suicide prevention approach, tailored efforts to enhance connectedness within this population may also be a promising secondary prevention strategy. Thus, in addition to clinical treatment, more emphasis should be placed on systems-level approaches to reducing risk among youth most vulnerable to suicide.
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Affiliation(s)
- Lauren M. Berny
- University of Oregon, Department of Counseling Psychology and Human Services, USA
- University of Oregon, Prevention Science Institute, USA
| | - Emily E. Tanner-Smith
- University of Oregon, Department of Counseling Psychology and Human Services, USA
- University of Oregon, Prevention Science Institute, USA
- University of Oregon, HEDCO Institute for Evidence-Based Educational Practice, USA
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Manges ME, Bryan CJ, Bryan AO, Bauder CR, Wastler HM. Suicidal thoughts and behaviors among gender and sexual minorities: Adults ages 25-44 show highest rates of past month suicidal thoughts. Suicide Life Threat Behav 2023. [PMID: 38100270 DOI: 10.1111/sltb.13029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/26/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Sexual and gender minority (SGM) people are at increased risk for suicidal thoughts and behaviors relative to their cisgender heterosexual peers. However, most research in this area has focused on youth, limiting our understanding of suicide risk among SGM adults. METHODS To address this gap in the literature, the present study examined suicidal thoughts and behaviors among SGM adults across different age groups using a sample of 10,620 US adults. RESULTS Consistent with the literature on youth, SGM adults showed higher rates of suicidal thoughts and behaviors than cisgender heterosexual adults. When examining prevalence rates across various age groups, young adults (18-25) showed greater suicidal thoughts and behaviors relative to adults ages 45+. However, adults ages 25-44 actually showed the highest rate of past month suicidal thoughts compared to adults ages 18-25. CONCLUSION These findings suggest that suicide risk for SGM extends beyond youth and highlights the need for more research on middle-age SGM adults. Additional resources for SGM adults that are not only tailored toward youth and young adults are warranted.
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Affiliation(s)
- Margaret E Manges
- The Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Craig J Bryan
- The Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - AnnaBelle O Bryan
- The Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Christina Rose Bauder
- The Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Heather M Wastler
- The Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Simon GE. Sexual Orientation and Suicidal Behavior: Is It Getting Better? Am J Psychiatry 2023; 180:629-630. [PMID: 37654116 DOI: 10.1176/appi.ajp.20230536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Sönmez İ, Palamar JJ. Trends in Self-Injurious Thoughts and Behaviors Among US Adults, 2015-2019: Differential Risk According to Sexual Orientation. Arch Suicide Res 2023; 27:956-965. [PMID: 35801497 PMCID: PMC9825676 DOI: 10.1080/13811118.2022.2096519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Suicide continues to be one of the leading causes of death in the United States and lesbian, gay, and bisexual (LGB) individuals are disproportionately at risk of suicide in comparison to heterosexuals. METHODS We examined data from adults participating for five waves (2015-2019) of the National Survey on Drug Use and Health. We first determined whether there is differential risk of suicidal thoughts, suicide plans, and suicide attempts (self-injurious thoughts and behaviors [SITBs]) in the past year according to current sexual orientation. We then estimated linear trends in prevalence of each SITB outcome stratified by each sexual orientation category. RESULTS We estimate that compared to heterosexual men and women, gay and bisexual men and lesbian and bisexual women are at greater odds of past-year suicidal thoughts, suicide plans, and suicide attempts, respective to their sexes. Between 2015 and 2019, suicidal thoughts increased among bisexual men (by 34.3%, p = 0.037), lesbian women (by 18.4%, p = 0.033), and bisexual women (by 15.7%, p < 0.001). Prevalence of suicide plans increased among heterosexual men (by 15.3%, p = 0.017), gay men (by 28.5%, p = 0.037), and bisexual women (by 23.2%, p < 0.001). Suicide attempts increased among bisexual women by 26.6% (p < 0.001). CONCLUSIONS Sexual minority identity is a risk factor for SITBs. Bisexual women in particular are not only at greater risk for SITBs, but estimated prevalence has increased in recent years. More attention needs to be paid to LGB populations regarding future suicide prevention efforts.
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Fink BN. Experiences of sexual violence and their associations with suicidal ideation and behavior in the past year: an analysis of adults from the 2021 Ace Community Survey. J Inj Violence Res 2023; 15:147-155. [PMID: 37482690 PMCID: PMC10915876 DOI: 10.5249/jivr.v15i2.1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 07/17/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND This research assessed forms of sexual violence and their associations with suicidal ideation among adults identifying on the asexual identity spectrum. METHODS A secondary data analysis was conducted among adults, identifying on the asexual spectrum of asexual, gray-asexual, or demisexual, from the 2021 Ace Community Survey (n = 8,715). Multiple logistic regression analyses determined potential associations between sexual violence and suicidal ideation, adjusting for the covariates of age group, gender, education, racial/ethnic minority, employment, and asexual spectrum identity. RESULTS Demisexual individuals were at statistically greater odds of suicidality compared to gray-asexual and asexual individuals. Sexual violence victims were more likely to be suicidal compared to non-victims. This was especially true for attempted rape and suicidal consideration (OR = 2.10, 95% CI (1.60, 2.75), planning (OR = 1.76, 95% CI (1.32, 2.34), and attempts (OR = 3.15, 95% CI (2.07, 4.81). CONCLUSIONS Asexual victims of sexual violence were more likely to be suicidal compared to non-victims. Demisexual individuals were more likely to be suicidal compared to asexual individuals. These findings demonstrate the need for additional research on sexual violence and suicide.
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Affiliation(s)
- Brian N Fink
- University of Toledo Health Science Campus, Department of Population Health, 3000 Arlington Ave., MS# 1027, Toledo, Ohio 43614, United States of America.
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Alvarez-Hernandez LR, Mowbray O. Trends in Suicide Among Lesbian, Gay, and Bisexual Hispanic Individuals: National Violent Death Reporting System Data from 2012-2016. JOURNAL OF HOMOSEXUALITY 2023; 70:1225-1239. [PMID: 34990312 DOI: 10.1080/00918369.2021.2018878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Due to multiple minority stressors, persons who are Hispanic and lesbian, gay or bisexual (LGB) can experience an increased risk of injury and death, including suicide. We examined trends and correlates of deaths by suicide among LGB Hispanic individuals using data from the National Violent Death Reporting System from 2012 to 2016 (N = 1,132). A multilevel mixed-effects logistic regression model examined time-series trends associated with suicide between LGB and heterosexual individuals, controlling for sociodemographic and clinical characteristics. Over time, increases in suicide were larger among LGB Hispanic individuals. Increased odds associated with suicide were also attributed to women, individuals with a higher education level, those who experienced mental health problems, those with alcohol-related problems, and individuals with a history of mental illness. LGB Hispanic individuals continue to see an increased risk for suicidality. Health intervention and policy efforts should focus on the multiple minority stressors experienced by this population.
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Affiliation(s)
| | - Orion Mowbray
- School of Social Work, The University of Georgia, Athens, Georgia, USA
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Ellis ÉM, Tate A. Is Trauma Exposure More Harmful for Sexual Minority Youth? Differences in Trauma-Suicide Associations in a Nationally Representative Sample of U.S. Youth and Implications for Suicide Prevention. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:173-182. [PMID: 37234833 PMCID: PMC10205931 DOI: 10.1007/s40653-022-00475-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 05/28/2023]
Abstract
Purpose Lesbian, gay, and bisexual (LGB) youth experience disproportionately high rates of suicidality and exposure to traumatic events, such as sexual violence and teen dating violence. Rates of suicidality and exposure to traumatic events also vary by sexual minority subgroup. The purpose of this study was to: (1) explore the impact of LGB identity on the relationship between violence exposure and suicide; and (2) to examine variations by sexual identity. Method A subsample of respondents who reported on their sexual identity in the Youth Risk Behavior Survey (n = 14,690) was used to examine if the associations between sexual and dating violence with suicide outcomes (suicidal ideation, planning, and suicide attempt) depended on the sexual identity of the respondent. Logistic regression models were fitted with an interaction effect to quantify heterogeneity of associations across identity strata. Results Overall interaction tests mostly indicated heterogeneity of associations between sexual violence and physical dating violence. Several contrast of strata associations suggested substantive probability differences between sexual minority respondents and their heterosexual peers. Conclusion While exposure to violence was broadly associated with increased probability of experiencing any type of suicidality, LGB and questioning youth were significantly more likely to experience suicidality compared to their heterosexual peers. Gay and lesbian youth demonstrated the strongest probability of experiencing suicidal thoughts and behaviors among survivors of sexual violence, while bisexual youth may be more at risk following dating violence. Implications for future research and suicide prevention are discussed.
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Affiliation(s)
- Émilie M. Ellis
- College of Public Health, University of Georgia, 101 Buck Rd, 30606 Athens, GA USA
| | - Allan Tate
- College of Public Health, University of Georgia, 101 Buck Rd, 30606 Athens, GA USA
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Liu X, Yang Z, Yang M, Ighaede-Edwards IG, Wu F, Liu Q, Lai X, Lu D. The relationship between school bullying victimization and mental health among high school sexual minority students in China: A cross-sectional study. J Affect Disord 2023; 334:69-76. [PMID: 37080492 DOI: 10.1016/j.jad.2023.04.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 04/02/2023] [Accepted: 04/14/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND School bullying has become a matter of global concern for the general public. Sexual minority youth (SMY) may experience minority stress and victimization which are known to adversely affect mental health and happiness. However, a few scholars explored and linked sexual orientation with campus bullying, depression, and anxiety symptoms under the specific cultural background of China. OBJECTIVE This study was to examine the effect of traditional and cyber bullying victimization on depression and anxiety among Chinese sexual minority adolescents. METHODS This is a cross-sectional survey with a total of 3841 subjects among senior high school students in Hunan Province, China. Related information was collected through a series of self-reported questionnaires. The association between variables was examined via a set of logistic regressions. RESULTS Homosexuality (OR: 6.398; 95 % CI: 3.321 to 12.325), bisexuality (OR: 3.146; 95 % CI: 1.499 to 6.603) and uncertainty of sexual orientation (OR: 2.341; 95 % CI: 1.516 to 3.615) were significantly associated with a combination of traditional and cyber bullying victimization. Compared to the heterosexual group, the sexual minority students, especially the bisexual students has a higher risk of depressive mood (OR: 2.349; 95 % CI: 1.664 to 3.316) and anxiety mood (OR: 3.049; 95 % CI: 2.150 to 4.324). Further multivariate binary hierarchical regression showed that the effects of sexual orientation and mental health were statistically significant only among those who are not involved in bullying victimization, OR values are from 1.929 (95 % CI: 1.061 to 3.507) to 3.209 (95 % CI: 2.090 to 4.927). CONCLUSIONS Homosexuals are most likely to be victims of a combination of traditional and cyber bullying victims. Bisexuals are most at risk for emotional problems. Sexual minorities in particular, showed differences in mental health risks between bullied and non-bullied groups. More attention needs to be paid to bullying and mental health among sexual minority students in China.
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Affiliation(s)
- Xiaoqun Liu
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhengmin Yang
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China
| | - Mengsi Yang
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China.
| | | | - Fang Wu
- Department of Medical Records, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Qianwen Liu
- Changsha Center for Disease Control and Prevention, Changsha, China
| | - Xin Lai
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China
| | - Dali Lu
- Department of Pediatric Psychology, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China.
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Mandatori F, Paez GR, Briones Robinson R, Severson R. Comparing the Effects of Victimization, School Connectedness, and Social Support on Heterosexual and Sexual Minority Adolescent Suicidality in the United States: A Partial Test of Minority Stress Theory. JOURNAL OF INTERPERSONAL VIOLENCE 2023:8862605231168822. [PMID: 37066807 DOI: 10.1177/08862605231168822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
In the United States, sexual minority adolescents are among the subpopulations at the highest risk for suicide; yet, predictors of suicidality among this unique group remain significantly understudied. Drawing from Meyer's minority stress theory (MST), this study examines whether general stressors act as predictors of adolescent suicidality and whether differences exist in the variation of these effects between heterosexual and sexual minority adolescents. Specifically, multivariate logistic regression models were developed to examine the impact that victimization, school connectedness, and social support have on heterosexual and sexual minority adolescent suicidality using a sample of 166,176 U.S. adolescents drawn from the 2019 Minnesota Student Survey. Participants ranged from 10 to 18 years of age and identified as heterosexual, bisexual, gay or lesbian, questioning, pansexual, queer, or as none of these. Findings highlight that sexual minorities (Exp(B) = 1.870, p < .001) were roughly twice as likely to report suicidality compared to their heterosexual peers. All victimization measures were highly predictive of suicidality among heterosexual and sexual minority adolescents. Overall, adolescents who were less connected to their school setting and more socially isolated were also more likely to experience suicidality; however, such effects were not reflected uniformly in every item measuring school connectedness and social support. Findings highlight important avenues for policies implementation aimed at mitigating the effects of multiple sources of stressors on adolescents' mental health and reducing adolescents' suicide rates. Interventions tailored to the unique needs of sexual minority adolescents are needed to address their disproportionate representation among those at risk for suicide.
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Gender-Affirming Care and Comprehensive Sexuality Education. JOURNAL OF FORENSIC NURSING 2023; 19:E11-E13. [PMID: 37205622 DOI: 10.1097/jfn.0000000000000432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
ABSTRACT Every year, an estimated 246 million children are subject to some form of gender-based violence, including mistreatment, bullying, psychological abuse, and sexual harassment. Lesbian, gay, bisexual, transgender, two-spirit, or questioning youth are at a heightened risk of experiencing violence and have unique health, educational, and social needs. Fostering an atmosphere of support and acceptance can help alleviate many of these negative outcomes.
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16
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Sherman ADF, Smith SK, Moore SE, Coleman CL, Hughes TL, Dorsen C, Balthazar MS, Klepper M, Mukerjee R, Bower KM. Nursing pre-licensure and graduate education for LGBTQ health: A systematic review. Nurs Outlook 2023; 71:101907. [PMID: 36623984 PMCID: PMC10133000 DOI: 10.1016/j.outlook.2022.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/09/2022] [Accepted: 12/13/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, and queer plus (LGBTQ) people experience discrimination and health disparities compared to heterosexual cisgender people. Clinicians report discomfort and insufficient preparation for providing care to LGBTQ people and nursing has been slow to integrate LGBTQ health into curricula. PURPOSE Conduct a systematic review to examine and critically appraise peer-reviewed literature on nursing student knowledge, skills, and attitudes (KSAs) regarding LGBTQ health and the development/evaluation of LGBTQ health content in nursing curricula. METHODS A systematic review was conducted (N = 1275 articles from PubMed, LGBT Health, CINAHL, ERIC, and Health Source-Nursing/Academic Edition). FINDINGS Twenty articles met inclusion criteria. Twelve studies described curricular interventions; however, there were few validated tools to evaluate content coverage or KSAs. Four themes emerged specific to LGBTQ health content inclusion. DISCUSSION While an emerging science of LGBTQ nursing education has been identified, more work is needed to build and evaluate a comprehensive curricular approach for full programmatic integration of LGBTQ health. CONCLUSION As nursing programs build LGBTQ content into nursing curricula, care must be taken to integrate this content fully with the depth of curricular content in population health, social determinants of health, social justice, intersectionality, cultural competence, and political advocacy. TWEETABLE ABSTRACT Greater integration of LGBTQ health content into nursing education should be a priority for nursing education.
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Affiliation(s)
| | - Sheila K Smith
- School of Nursing, University of Minnesota, Minneapolis, MN
| | - Scott Emory Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | | | | | | | - Monique S Balthazar
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA; Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA
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Bishop MD, Ioverno S, Russell ST. Sexual minority youth's mental health and substance use: The roles of victimization, cybervictimization, and non-parental adult support. CURRENT PSYCHOLOGY 2023; 42:5075-5087. [PMID: 38344657 PMCID: PMC10857851 DOI: 10.1007/s12144-021-01812-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 01/03/2023]
Abstract
Victimization is a well-established driver of sexual minority youth's (SMY) mental health and substance use risk. The current study examined and extended this research by exploring how victimization, cybervictimization, and non-parental supportive adults contribute to SMY's vulnerability to poor mental health and substance use. Using data from the first representative sample of Texas youth that measures sexual identity, we analyzed sex-stratified models of the association between sexual identity, mental health, and substance use, and the confounding effects of victimization, cybervictimization, and non-parental adult support. Victimization was more common among SMY and accounted for a greater proportion of sexual identity disparities on mental health and substance use, especially for males. Sexual minority females were more likely to report cybervictimization than heterosexual youth, and cybervictimization was associated with mental health risk. SMY reported fewer available non-parental supportive adults, which was associated with more sadness, suicidality, and polysubstance use. Our study adds to extant evidence that victimization drives SMY's increased susceptibility to mental health and substance use risk. Schools should implement inclusive policies that prohibit bullying based on sexual minority identity and offer professional development opportunities for supporting SMY.
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Affiliation(s)
- Meg D. Bishop
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, TX 78712, USA
| | - Salvatore Ioverno
- Department of Sociology, Ghent University, St. Pietersnieuwstraat 33, 9000 Ghent, Belgium
| | - Stephen T. Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, TX 78712, USA
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Baishya ML, Martinasek M, Bell L, Wheldon CW. Adverse Childhood Experiences and Adult Tobacco Use Among Sexual and Gender Minority Populations: Examining the Role of Mental, Social, and Community Health. LGBT Health 2022; 10:211-219. [PMID: 36520611 DOI: 10.1089/lgbt.2021.0343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose: We sought to evaluate the relationship between adverse childhood experiences (ACEs) and tobacco use, to assess the intersection of sexual orientation or gender identity (SOGI), and to explore risk and protective aspects of mental, social, and community health. Methods: This was a secondary analysis of the sexual and gender minorities (SGM) subsample (n = 1102) from a 2019 Community Health Needs Assessment. Nested binary logistic regression models were created to evaluate associations between ACEs and type of tobacco use: (1) cigarette use versus no cigarette or electronic nicotine delivery systems (ENDS) use, (2) ENDS use versus no cigarette or ENDS use, and (3) dual use versus use of either cigarettes or ENDS. Results: The sample population that reported four or more ACEs and ENDS use had statistically significant adjusted odds ratios (aORs) when adjusting the models for sociodemographic variables (aOR = 2.55; 95% confidence intervals [CIs]: 1.54-4.22), SOGI (aOR = 2.44; 95% CI: 1.46-4.10), current mental health (aOR = 2.23; 95% CI: 1.32-3.75), and social and community health (aOR = 2.19; 95% CI: 1.30-3.71). The sample population that reported poor mental health had statistically significant aORs when adjusting the models for sociodemographic variables, SOGI, and mental health (aOR = 2.26; 95% CI: 1.32-3.89) and social and community health (aOR = 2.06; 95% CI: 1.17-3.54). There was no statistically significant finding related to the other tobacco use variables (tobacco use and dual use). Conclusion: We found that high-risk ACEs were positively associated with cigarette use and ENDS use. SGM populations have differing experiences when considering community and social support.
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Affiliation(s)
- Mona L. Baishya
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Mary Martinasek
- Department of Health Sciences and Human Performance, University of Tampa, Tampa, Florida, USA
| | - Lisa Bell
- Community Benefit, BayCare Health System, Clearwater, Florida, USA
| | - Christopher W. Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
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Trends and Disparities in Suicidality Among Heterosexual and Sexual Minority/Two-Spirit Indigenous Adolescents in Canada. J Adolesc Health 2022; 71:713-720. [PMID: 36241494 DOI: 10.1016/j.jadohealth.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 07/06/2022] [Accepted: 07/12/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE To explore trends in sexual orientation group differences in suicidality among Indigenous adolescents and evaluate whether gaps between heterosexual and sexual minority/Two-Spirit adolescents have changed over time. METHODS Leveraging pooled school-based population data from five waves of the British Columbia Adolescent Health Survey (1998-2018), we used age-adjusted logistic regression models, separately for boys and girls, to examine 20-year trends and disparities in past year suicidal ideation and suicide attempts among heterosexual and sexual minority/Two-Spirit Indigenous adolescents (N = 13,788). RESULTS Suicidal ideation increased among all sexual orientation groups in 2018 compared to previous survey waves. Suicide attempts spiked for heterosexual girls in 2003, remained stable for heterosexual boys, and decreased for sexual minority/Two-Spirit boys and girls over time. Compared to their heterosexual peers, sexual minority/Two-Spirit boys had higher odds of suicidal ideation since 1998, whereas sexual minority/Two-Spirit girls had higher odds of suicidal ideation since 2003. Sexual minority/Two-Spirit (vs. heterosexual) boys were approximately 4-7 times more likely to attempt suicide since 2008, whereas sexual-minority/Two-Spirit (vs. heterosexual) girls were approximately 3-4 times more likely to attempt suicide since 2003. These gaps in suicidality were persistent across time. DISCUSSION Sexual minority/Two-Spirit Indigenous adolescents are at an elevated risk for suicidality compared to their heterosexual Indigenous peers. While trends of suicidal ideation worsened for all Indigenous adolescents, suicide attempts either lessened or remained stable over time. Greater efforts are needed to help reduce suicidality among Indigenous adolescents in Canada, especially among sexual minority/Two-Spirit young people.
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20
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Lowry R, Kennedy K, Johns MM, Harper CR, Wilkins NJ. Associations Between School Absence and School Violence by Sexual Identity. Am J Prev Med 2022; 63:384-391. [PMID: 35715302 DOI: 10.1016/j.amepre.2022.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Sexual minority youth are disproportionately exposed to school violence compared with their heterosexual peers. It is unknown whether the associations between school absence and exposure to school violence vary by sexual identity. METHODS In 2021, data were combined from the 2015, 2017, and 2019 national Youth Risk Behavior Surveys to produce nationally representative samples of U.S. high-school students who identified as gay/lesbian (n=1,061), identified as bisexual (n=3,210), were not sure of their sexual identity (n=1,696), or identified as heterosexual (n=35,819). Associations were examined between 3 school violence exposures (being threatened/injured with a weapon at school, being bullied at school, and being in a physical fight at school) and school absence due to safety concerns. In each sample, multivariable logistic regression models were used to calculate adjusted prevalence ratios adjusted for sex, race/ethnicity, grade, current substance use, being offered/sold drugs at school, feeling sad/hopeless, and suicidal thoughts. Adjusted prevalence ratios were considered statistically significant if 95% CIs did not include 1.0. RESULTS Exposure to school violence and school absence due to safety concerns were more prevalent among sexual minority students than among heterosexual students. Associations between exposure to school violence and school absence due to safety concerns were similar across sexual identity groups. For example, school absence was associated with being threatened/injured with a weapon at school among gay/lesbian (adjusted prevalence ratio=3.00), bisexual (adjusted prevalence ratio=3.66), those not sure (adjusted prevalence ratio=4.56), and heterosexual (adjusted prevalence ratio=3.75) students. CONCLUSIONS Associations between school absenteeism and school violence exist in each sexual identity group. Therefore, programs providing safe and supportive school environments may result in reduced absenteeism among all students.
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Affiliation(s)
- Richard Lowry
- Office of the Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Katrina Kennedy
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Michelle M Johns
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher R Harper
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natalie J Wilkins
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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21
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Smith DM, Fox KR, Carter ML, Thoma BC, Hooley JM. Emotional changes following discrimination induction in gender- and sexuality-diverse adolescents. Emotion 2022; 22:920-930. [PMID: 32757568 PMCID: PMC7908812 DOI: 10.1037/emo0000862] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Sexual and gender minority (SGM)-identifying adolescents are particularly vulnerable to negative psychological outcomes, including engagement in nonsuicidal self-injury (NSSI). However, little is known about why these relationships exist. We used experimental methods to test the psychological mediation framework in an online sample of 328 adolescents who reported female sex at birth and a range of sexual and gender identities. Participants reported on depressive symptoms, self-criticism (both self-report and implicit), NSSI, and discrimination. They also completed a discrimination-based mood induction to test emotional reactivity. At baseline, SGM participants reported higher levels of implicit and self-reported self-criticism, depressive symptoms, discrimination, and higher rates of NSSI compared with cisgender, heterosexual participants (ps < .03). Following the discrimination induction, SGM-identifying participants exhibited larger emotional reactivity compared with cisgender heterosexual participants, as measured by change in negative mood, F(1, 326) = 7.33, p = .01, ηp2 = .02, and state self-criticism, F(1, 326) = 4.67, p = .03, ηp2 = .014, but not implicit affect toward the self. This effect was associated with baseline depressive symptoms, self-criticism, NSSI history, and discrimination. Post hoc analyses revealed that participants who tended to reframe experiences of discrimination as opportunities for growth exhibited attenuated emotional reactivity to the induction; findings remained significant after adjusting for SGM status and event severity (ps < .001). Results indicate that adolescents identifying as SGM may experience elevated psychological distress compared with their cisgender heterosexual peers and that stigma-related stressors may increase emotion dysregulation and maladaptive cognitive styles, paralleling previously proposed psychological mediation models. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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22
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Streed CG. Health Communication and Sexual Orientation, Gender Identity, and Expression. Med Clin North Am 2022; 106:589-600. [PMID: 35725226 PMCID: PMC9219031 DOI: 10.1016/j.mcna.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The purpose of this article is to provide guidance on completing a thorough, competent, and culturally appropriate health history with details specific to the care of lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) persons and communities.
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Affiliation(s)
- Carl G Streed
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA; Center for Transgender Medicine and Surgery, Boston Medical Center, 801 Massachusetts Avenue, Room 2082, Boston, MA 02118, USA.
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23
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Poon JA, Galione JN, Grocott LR, Horowitz KJ, Kudinova AY, Kim KL. Dialectical behavior therapy for adolescents (DBT-A): Outcomes among sexual minorities at high risk for suicide. Suicide Life Threat Behav 2022; 52:383-391. [PMID: 35019159 PMCID: PMC9233065 DOI: 10.1111/sltb.12828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/27/2021] [Accepted: 01/02/2022] [Indexed: 11/29/2022]
Abstract
The alarming rates and pervasiveness of suicidal and self-destructive behaviors (e.g., non-suicidal self-injury) among young sexual minorities represent a major public health concern. We set out to examine whether an empirically driven treatment for suicide and self-harm, dialectical behavior therapy for adolescents (DBT-A), provides benefits for adolescents who identify as gay, lesbian, bisexual, or questioning (LGBQ). LGBQ adolescents (n = 16) were compared with non-LGBQ peers (n = 23). Psychological measures were collected before and after participation in a comprehensive DBT-A program. LGBQ participants demonstrated significant improvements in emotion regulation, depression, borderline symptoms, and coping strategies; changes were comparable to their heterosexual peers.
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Affiliation(s)
- Jennifer A. Poon
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Janine N. Galione
- Department of Psychiatry and Human Behavior, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Lauren R. Grocott
- Department of Psychology, University of Wisconsin – Milwaukee, Milwaukee, Wisconsin, USA
| | - Karyn J. Horowitz
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Anastacia Y. Kudinova
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Kerri L. Kim
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Marchi M, Arcolin E, Fiore G, Travascio A, Uberti D, Amaddeo F, Converti M, Fiorillo A, Mirandola M, Pinna F, Ventriglio A, Galeazzi GM. Self-harm and suicidality among LGBTIQ people: a systematic review and meta-analysis. Int Rev Psychiatry 2022; 34:240-256. [PMID: 36151841 DOI: 10.1080/09540261.2022.2053070] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Research evidence has consistently documented a higher risk of suicidality in the Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ) population. This systematic review and meta-analysis aimed to report a detailed description of research data regarding the risk of Attempted Suicide (SA), Suicide Ideation (SI), and Non-Suicidal Self-Injury (NSSI) behaviours for LGBTIQ people and their subgroups. Medline, Scopus, PsycINFO, and EMBASE were searched for studies reporting a comparative estimation of SA, SI, and NSSI rates among LGBTIQ population and the general population (i.e. heterosexual/cisgender), without restrictions on participants' age and setting for the enrolment. Pooled analyses were based on odds ratios (ORs, with 95% CIs), estimated through inverse variance models with random effects. Fifty studies were selected for the quantitative synthesis and included fifty samples involving 3.735.601 controls and 87.252 LGBTIQ people. LGBTIQ people reported an increased risk of SA (OR:4.36[95%CI:3.32;5.71]), SI (OR:3.76[95%CI:3.02;4.69]), and NSSI (OR:4.24[95%CI:3.23;5.55]). Among LGBTIQ subgroups, the Bisexual group has shown the highest risk of suicidality (SA, OR:6.71; SI, OR:5.04; NSSI, OR: 5.03), followed by the Lesbian-Gay for attempted suicide (SA, OR:6.03), and the Transgender-Intersex-Queer for suicide ideation and non-suicidal self-injury (SI and NSSI, OR:3.42). The quality of the evidence ranged from low to moderate. Our findings have shown that LGBTIQ people report a higher risk of suicidality compared with their cisgender/heterosexual peers. This evidence may contribute to the public awareness on LGBTQI mental health needs and suggest supportive strategies as well as preventive interventions (e.g. supportive programs, counselling, and destigmatizing efforts) as parts of a tailored health-care planning aimed to reduce psychiatric morbidity and mortality in this at-risk population.
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Affiliation(s)
- Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisa Arcolin
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Gianluca Fiore
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonio Travascio
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Uberti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Massimo Mirandola
- Department of Diagnostics and Public Health, Infectious Diseases Section, University of Verona, Verona, Italy.,School of Health Sciences, University of Brighton, Brighton, UK
| | - Federica Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Hill AO, Lyons A, Power J, Amos N, Ferlatte O, Jones J, Carman M, Bourne A. Suicidal Ideation and Suicide Attempts Among Lesbian, Gay, Bisexual, Pansexual, Queer, and Asexual Youth: Differential Impacts of Sexual Orientation, Verbal, Physical, or Sexual Harassment or Assault, Conversion Practices, Family or Household Religiosity, and School Experience. LGBT Health 2022; 9:313-324. [PMID: 35420458 DOI: 10.1089/lgbt.2021.0270] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: This article examines factors associated with suicidal ideation and suicide attempts in the past 12 months among lesbian, gay, bisexual, pansexual, queer, asexual, or other non-heterosexual identifying youth (LGBQA+). Methods: A national Australian cross-sectional online survey was conducted involving 4370 cisgender LGBQA+ participants aged 14-21 years from September to October 2019. Multivariable logistic regression analyses were performed to examine significant factors associated with suicidal ideation and suicide attempts in the past 12 months. Research ethics approval for the WTI4 study was granted by the La Trobe University Human Research Ethics Committee and the ACON Research Ethics Review Committee. Results: Overall, 56.4% of participants reported suicidal ideation and 8.9% a suicide attempt in the past 12 months. Multivariable regression results show that participants aged younger than 18 years, lesbian (compared with gay) identifying, those living in rural or remote locations (compared with inner city), those reporting any verbal, physical, or sexual harassment or assault based on sexual orientation or gender identity, or who had a religious family or household, or had experienced conversion practices in the past 12 months reported higher levels of suicidal ideation or suicide attempts. Those who reported feeling part of their school reported lower levels of suicidal ideation and suicide attempts. Conclusion: High levels of suicidal ideation and suicide attempts among young LGBQA+ people in Australia highlight a need for the ongoing inclusion of LGBQA+ youth as a priority population for suicide prevention. The findings illustrate key factors associated with a greater risk of suicidality among young LGBQA+ people. These findings can be used to inform the provision of tailored support services, including culturally safe suicide prevention programs and efforts to address stigma, discrimination, and conversion practices.
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Affiliation(s)
- Adam O Hill
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Jennifer Power
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Natalie Amos
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Olivier Ferlatte
- École de Santé Publique de l'Université de Montréal, Montreal, Canada.,Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Jami Jones
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Marina Carman
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Kirby Institute, University of New South Wales, Sydney, Australia
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26
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Marraccini ME, Ingram KM, Naser SC, Grapin SL, Toole EN, O'Neill JC, Chin AJ, Martinez RR, Griffin D. The roles of school in supporting LGBTQ+ youth: A systematic review and ecological framework for understanding risk for suicide-related thoughts and behaviors. J Sch Psychol 2022; 91:27-49. [PMID: 35190078 PMCID: PMC8906061 DOI: 10.1016/j.jsp.2021.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/25/2021] [Accepted: 11/30/2021] [Indexed: 01/20/2023]
Abstract
The extant literature on suicide-related thoughts and behaviors (STB) has highlighted increased patterns of risk among specific minoritized populations, including lesbian, gay, bisexual, transgender, questioning, intersex, two spirit, and queer (LGBTQ+) youth. Compared to their heterosexual and cisgender peers, LGBTQ+ youth are at increased risk for having STB. Identity-specific stressors such as homonegativity and anti-queerness are among the unique factors posited to contribute to this risk and inhibit factors that protect against suicide. The school setting has been a focal point for suicide prevention and intervention and may also play a key role in linking students to care; however, schools also hold the potential to provide supports and experiences that may buffer against risk factors for STB in LGBTQ+ students. This systematic literature review presents findings from 44 studies examining school-related correlates of STB in LGBTQ+ students, informing an ecological approach to suicide prevention for school settings. Findings underscore the importance of school context for preventing STB in LGBTQ+ youth. Approaches that prioritize safety and acceptance of LGBTQ+ youth should span multiple layers of a student's ecology, including district and state level policies and school programs and interventions, such as Gender and Sexuality Alliances and universal bullying prevention programs. Beyond their role as a primary access point for behavioral health services, schools offer a unique opportunity to support suicide prevention by combating minority stressors through promoting positive social relationships and a safe community for LGBTQ+ students.
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Affiliation(s)
- Marisa E Marraccini
- School of Education, University of North Carolina at Chapel Hill, United States of America.
| | - Katherine M Ingram
- School of Education, University of North Carolina at Chapel Hill, United States of America
| | - Shereen C Naser
- College of Sciences and Health Professions, Cleveland State University, United States of America
| | - Sally L Grapin
- Psychology Department, Montclair State University, United States of America
| | - Emily N Toole
- School of Education, University of North Carolina at Chapel Hill, United States of America
| | - J Conor O'Neill
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, United States of America
| | - Andrew J Chin
- School of Education, University of North Carolina at Chapel Hill, United States of America
| | - Robert R Martinez
- School of Education, University of North Carolina at Chapel Hill, United States of America
| | - Dana Griffin
- School of Education, University of North Carolina at Chapel Hill, United States of America
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Schrager SM, Mamey MR, Rhoades H, Goldbach JT. Adolescent stress experiences over time study (ASETS) protocol: design and methods of a prospective longitudinal study of sexual minority adolescents in the USA. BMJ Open 2022; 12:e054792. [PMID: 35264352 PMCID: PMC8915334 DOI: 10.1136/bmjopen-2021-054792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Sexual minority adolescents (SMA) report higher rates of anxiety, self-harm, depression and suicide than heterosexual peers. These disparities appear to persist into adulthood and may worsen for certain subgroups, yet the mechanisms that drive these concerns remain poorly understood. Minority stress theory, the predominant model for understanding these disparities, posits that poorer outcomes are due to the stress of living in a violently homophobic and discriminatory culture. Although numerous studies report associations between minority stress and behavioural health in adolescence, no study has comprehensively examined how minority stress may change throughout the course of adolescence, nor how stress trajectories may predict health outcomes during this critical developmental period. METHODS AND ANALYSIS Between 15 May 2018 and 1 April 2019, we recruited a US national sample of diverse SMA (n=2558) age 14-17 through social media and respondent-driven sampling strategies. A subset of participants (n=1076) enrolled in the longitudinal component and will be followed each 6 months until 1 July 2022. Primary outcomes include symptoms of depression, anxiety and post-traumatic stress disorder; suicidality and self-harm and substance use. The key predictor is minority stress, operationalised as the Sexual Minority Adolescent Stress Inventory. We will use parallel cohort-sequential latent growth curve models to test study hypotheses within a developmental framework. ETHICS AND DISSEMINATION All participants provided assent to participate, and longitudinal participants provided informed consent at the first follow-up survey after reaching age 18. All study procedures were reviewed and approved by the University of Southern California Social-Behavioral Institutional Review Board, including a waiver of parental permission given the potential for harm due to unintentional 'outing' to a parent during the consent process. The final anonymous data set will be available on request, and research findings will be disseminated through academic channels and products tailored for the lay community.
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Affiliation(s)
- Sheree M Schrager
- California State University, Dominguez Hills, Carson, California, USA
| | - Mary Rose Mamey
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Harmony Rhoades
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Jeremy T Goldbach
- The Brown School, Washington University in St Louis, St. Louis, Missouri, USA
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Berny LM, Tanner-Smith EE. Differential Predictors of Suicidal Ideation and Suicide Attempts: Internalizing Disorders and Substance Use in a Clinical Sample of Adolescents. J Dual Diagn 2022; 18:59-69. [PMID: 34982653 PMCID: PMC8960344 DOI: 10.1080/15504263.2021.2016343] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: Dually diagnosed adolescents are a high-risk population for experiencing suicidal thoughts and behavior. Given that research suggests risk factors for suicidal ideation and suicide attempts may be different, this study examined whether internalizing disorder severity, frequency of substance use, and the interaction between them differentiated adolescents who attempted suicide from those who ideated. Methods: Baseline data from 287 adolescents who received formal substance use disorder (SUD) treatment were used in this analysis. Major depressive disorder (MDD) and generalized anxiety disorder (GAD) severity as well as past-3 month use of alcohol, cannabis, and other illicit drugs were considered. The outcome of interest was a three-category measure of suicide risk: no reported suicidal ideation or attempts, suicidal ideation only, and suicide attempts. Results: Over half of the sample disclosed prior suicidal ideation (30.0%) or attempts (27.9%). Multinomial logistic regression models indicated more severe MDD and GAD symptomology differentiated ideators from non-suicidal adolescents, but internalizing disorder severity did not differ between ideators and attempters. Substance use frequency did not differ between suicide risk groups. MDD severity and frequency of alcohol use interacted to increase the risk of attempts, yet the effects were minimal. Instead, prior weapon violence victimization and sexual abuse were the largest differentiators between attempters and ideators. Conclusions: Findings suggest that internalizing disorder severity and prior traumatic experiences put adolescents with SUD histories at higher risk of suicidal thoughts and behaviors. Thus, integrating evidence-based suicide prevention and intervention efforts into SUD treatment is critical, particularly for dually diagnosed adolescents who meet these risk profiles. Psychotherapy and medication may help curtail the development of ideation by reducing symptoms of MDD and GAD, whereas adolescents with prior traumatic experiences may benefit from additional treatments shown to lower risk of suicide attempts.
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Affiliation(s)
- Lauren M Berny
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
| | - Emily E Tanner-Smith
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA.,Prevention Science Institute, University of Oregon, Eugene, OR, USA
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29
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Hammarström S, Alehagen S, Kilander H. Violence and sexual risk taking reported by young people at Swedish youth clinics. Ups J Med Sci 2022; 127:7823. [PMID: 35140876 PMCID: PMC8788656 DOI: 10.48101/ujms.v127.7823] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 11/26/2021] [Accepted: 12/01/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Early identification of sexual risk taking and exposure to violence is fundamental when seeking to strengthen young people's health. The purpose of this study was to study factors associated with sexual risk taking and ill health, as well as to study gender differences, and the associations amongst exposure to multiple forms of violence, sexual risk taking and ill health. METHODS This was a cross-sectional study based on data from 3,205 young people answering a questionnaire belonging to the Sexual health Identification Tool (SEXIT 2.0), during consultations at 12 youth clinics in Sweden. The analyses are based on descriptive statistics and nominal multiple regression analysis. RESULTS Male, transgender and non-binary youths reported significantly more events of sexual risk taking and ill health compared to women. Those who reported sexual initiation before the age of 15 (OR 2.87, CI 1.81-4.56), three or more sexual partners in the past 12 months (OR 2.68, CI 1.70-4.22) and to have ever experienced an unintended pregnancy (OR 2.29, CI 1.32-3.97) were more than twice as likely to report exposure to physical, emotional and sexual violence. Transgender, non-binary youths and women were more exposed to multiple violence (OR 3.68, 13.50) compared to men. CONCLUSIONS Transgender and non-binary youths are exposed to significantly more violence compared to women and men. Experiences of sexual risk taking and ill health demonstrated strong associations with exposure to multiple violence.
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Affiliation(s)
- Sofia Hammarström
- Region Västra Götaland, Knowledge Center for Sexual Health, Gothenburg, Sweden
- Division of Society and Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Siw Alehagen
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Helena Kilander
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Obstetrics and Gynaecology, Eksjö Hospital, Jönköping, Sweden
- Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Sweden
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30
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Goldbach JT, Rhoades H, Mamey MR, Senese J, Karys P, Marsiglia FF. Reducing behavioral health symptoms by addressing minority stressors in LGBTQ adolescents: a randomized controlled trial of Proud & Empowered. BMC Public Health 2021; 21:2315. [PMID: 34949171 PMCID: PMC8696968 DOI: 10.1186/s12889-021-12357-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 11/30/2021] [Indexed: 11/11/2022] Open
Abstract
Background Minority stress may lead to poorer mental health for sexual and gender minority adolescents, yet no interventions have been tested through an RCT to address these concerns. Methods We report on an RCT of an intervention—Proud & Empowered—with four high schools. Measures assess the intervention’s impact on mental health symptoms. Results Compared to the control, participants in the treatment condition reported significant differences in minority stress, anxiety, and depressive symptoms. Moderation analyses showed that the intervention significantly moderated the relationship between minority stress and PTSD (b = -1.28, p = .032), depression (b = -0.79, p = .023), and suicidality (b = 0.14, p = .012) symptoms; those in the intervention condition had mitigated relationships between measures of stress and health outcomes compared to those in the control condition. Conclusions Results suggest that Proud & Empowered help reduce mental health symptoms and exposure to minority stressors and build coping strategies. Trial Registration The intervention was registered on clinicaltrials.gov on August 1, 2019 under Trial #NCT04041414.
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Affiliation(s)
- Jeremy T Goldbach
- The Brown School, Washington University in St. Louis, 1 Brookings Dr, MO, 63130, St. Louis, USA.
| | - Harmony Rhoades
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th St., MRF Bldg, CA, 90089-0411, Los Angeles, USA
| | - Mary Rose Mamey
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th St., MRF Bldg, CA, 90089-0411, Los Angeles, USA
| | - John Senese
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th St., MRF Bldg, CA, 90089-0411, Los Angeles, USA
| | - Peter Karys
- The LGBT Community Center, 208 W. 13th St, 10011, New York, NY, USA
| | - Flavio F Marsiglia
- School of Social Work, Arizona State University, 411 N. Central Ave., Suite 720, 85004, Phoenix, AZ, USA
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Dorol-Beauroy-Eustache O, Mishara BL. Systematic review of risk and protective factors for suicidal and self-harm behaviors among children and adolescents involved with cyberbullying. Prev Med 2021; 152:106684. [PMID: 34538376 DOI: 10.1016/j.ypmed.2021.106684] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 01/31/2023]
Abstract
Cyberbullying is associated with increased risk of suicidal and self-harm behaviors in children and adolescents. However, no review to date has explored factors that exacerbate and mitigate this relationship. This systematic review concerns research on factors that influence the impact of cyberbullying on suicidal and self-harm behaviors. Four bibliographic databases were explored and references in included articles were searched. We identified 727 articles and retained 66 that met inclusion criteria. Research has identified multiple risk factors which have been associated with increased suicide risk in general (mental health problems, substance abuse, loneliness, stress, sexual orientation/gender identity issues and violent behaviors). Others risk factors more specific to cyberbullying were: Autism Spectrum Disorder, Intellectual and Developmental Disorders, obesity, having asthma and severity of cyberbullying. Fewer studies concern protective factors. School connectedness, restrictive style of parenting, parental support, life satisfaction, having a healthy diet, personal skills and having family dinners were associated with less risk of suicidal and self-harm behaviors following cyberbullying. These protective factors suggest prevention strategies to reduce the impacts of cyberbullying by teaching better personal skills, promoting school social connections and proposing family interventions. More research is needed including exploration of the differential impacts of different forms of cyberbullying, and evaluations of the impacts of programs to increase personal skills, improve family relationships and foster school connectedness to reducing suicidal and self-harm behaviors in this vulnerable population.
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Affiliation(s)
- Ophely Dorol-Beauroy-Eustache
- Psychology Department, Centre for Research and Intervention on Suicide Prevention, Ethical Issues and End of Life Practices (CRISE), Université du Québec à Montréal, Canada.
| | - Brian L Mishara
- Psychology Department, Centre for Research and Intervention on Suicide Prevention, Ethical Issues and End of Life Practices (CRISE), Université du Québec à Montréal, Canada.
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32
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Kutok ER, Doria N, Dunsiger S, Patena JV, Nugent NR, Riese A, Rosen RK, Ranney ML. Feasibility and Cost of Using Instagram to Recruit Adolescents to a Remote Intervention. J Adolesc Health 2021; 69:838-846. [PMID: 34059428 DOI: 10.1016/j.jadohealth.2021.04.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE The purpose of this study was to describe the feasibility, cost-effectiveness, and generalizability of a strategy for recruiting adolescents into research studies through social media. METHODS We designed and tested six Instagram advertisements (ads) with a combination of Instagram campaign objectives (Traffic vs. Reach) and types of placement (Story vs. Feed). The goal was to obtain remote assent and screen for a larger remote behavioral intervention study. The eligibility criteria for screening were being aged 13-17 years, residing in the United States, and English-speaking. The eligibility for the larger study was past year cybervictimization and smartphone ownership. A target sample was 80 participants, randomly assigned to a control or intervention group and followed up for 16 weeks. Recruitment rates and cost-per-enrolled participant with different advertising strategies, demographics, and retention were examined using descriptive statistics. RESULTS The six ads were run over 907.5 hours, generating 1,069,747 impressions, 2,051 click-throughs, and 663 completed screening surveys. Of 493 eligible participants, 24.4% assented to participate, 69.4% completed enrollment, and 4.8% dropped/withdrew after randomization. Average advertising costs were $52/participant; the lowest-cost strategy (Traffic campaign + Feed ad placement) was $19/enrolled participant. The study sample was largely white (81.3%), non-Hispanic (87.5%), and female (77.5%) with an average age of 15.33 years. Nearly half of the participants were identified as lesbian, gay, or bisexual. More than 96% of participants were retained at the 16-week follow-up. CONCLUSIONS Instagram can be a feasible and cost-effective way to recruit adolescents for a remote study. This method may be ideal for recruiting hard-to-reach audiences.
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Affiliation(s)
- Emily R Kutok
- Brown-Lifespan Center For Digital Health, Brown University, Providence, Rhode Island
| | - Nicole Doria
- Dalhousie University, School of Health and Human Performance, Halifax, Nova Scotia, Canada
| | - Shira Dunsiger
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, Rhode Island
| | - John V Patena
- Brown-Lifespan Center For Digital Health, Brown University, Providence, Rhode Island
| | - Nicole R Nugent
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
| | - Alison Riese
- Department Pediatrics and Medial Science, Alpert Medical School of Brown University, Providence, Rhode Island; Rhode Island Hospital, Hasbro Children's Hospital, Providence, Rhode Island
| | - Rochelle K Rosen
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, Rhode Island; Center For Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
| | - Megan L Ranney
- Brown-Lifespan Center For Digital Health, Brown University, Providence, Rhode Island; Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, Rhode Island.
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33
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Holland KJ, Cipriano AE, Huit TZ. LGBTQ and Straight Sexual Assault Survivors’ Interactions with Counseling in a Campus Counseling Center and Women’s Center. WOMEN & THERAPY 2021. [DOI: 10.1080/02703149.2021.1961439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kathryn J. Holland
- Department of Psychology and Women’s & Gender Studies Program, University of Nebraska, Lincoln, Nebraska, USA
| | | | - T. Zachary Huit
- Department of Psychology, University of Nebraska, Lincoln, Nebraska, USA
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Kutok ER, Dunsiger S, Patena JV, Nugent NR, Riese A, Rosen RK, Ranney ML. A Cyberbullying Media-Based Prevention Intervention for Adolescents on Instagram: Pilot Randomized Controlled Trial. JMIR Ment Health 2021; 8:e26029. [PMID: 34524103 PMCID: PMC8482167 DOI: 10.2196/26029] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/10/2021] [Accepted: 04/12/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Between 15% and 70% of adolescents report experiencing cybervictimization. Cybervictimization is associated with multiple negative consequences, including depressed mood. Few validated, easily disseminated interventions exist to prevent cybervictimization and its consequences. With over 97% of adolescents using social media (such as YouTube, Facebook, Instagram, or Snapchat), recruiting and delivering a prevention intervention through social media and apps may improve accessibility of prevention tools for at-risk youth. OBJECTIVE This study aims to evaluate the feasibility and acceptability of and obtain preliminary outcome data on IMPACT (Intervention Media to Prevent Adolescent Cyber-Conflict Through Technology), a brief, remote app-based intervention to prevent and reduce the effect of cyberbullying. METHODS From January 30, 2020, to May 3, 2020, a national sample of 80 adolescents with a history of past-year cybervictimization was recruited through Instagram for a randomized control trial of IMPACT, a brief, remote research assistant-led intervention and a fully automated app-based program, versus enhanced web-based resources (control). Feasibility and acceptability were measured by consent, daily use, and validated surveys. Although not powered for efficacy, outcomes (victimization, bystander self-efficacy, and well-being) were measured using validated measures at 8 and 16 weeks and evaluated using a series of longitudinal mixed models. RESULTS Regarding feasibility, 24.5% (121/494) of eligible participants provided contact information; of these, 69.4% (84/121) completed full enrollment procedures. Of the participants enrolled, 45% (36/80) were randomized into the IMPACT intervention and 55% (44/80) into the enhanced web-based resources groups. All participants randomized to the intervention condition completed the remote intervention session, and 89% (77/80) of the daily prompts were answered. The retention rate was 99% (79/80) at 8 weeks and 96% (77/80) at 16 weeks for all participants. Regarding acceptability, 100% (36/36) of the intervention participants were at least moderately satisfied with IMPACT overall, and 92% (33/36) of the participants were at least moderately satisfied with the app. At both 8 and 16 weeks, well-being was significantly higher (β=1.17, SE 0.87, P=.02 at 8 weeks and β=3.24, SE 0.95, P<.001 at 16 weeks) and psychological stress was lower (β=-.66, SE 0.08, P=.04 at 8 weeks and β=-.89, SE 0.09, P<.001 at 16 weeks) among IMPACT users than among control group users. Participants in the intervention group attempted significantly more bystander interventions than those in the control group at 8 weeks (β=.82, SE 0.42; P=.02). CONCLUSIONS This remote app-based intervention for victims of cyberbullying was feasible and acceptable, increased overall well-being and bystander interventions, and decreased psychological stress. Our findings are especially noteworthy given that the trial took place during the COVID-19 pandemic. The use of Instagram to recruit adolescents can be a successful strategy for identifying and intervening with those at the highest risk of cybervictimization. TRIAL REGISTRATION ClinicalTrials.gov NCT04259216; http://clinicaltrials.gov/ct2/show/NCT04259216.
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Affiliation(s)
- Emily R Kutok
- Brown-Lifespan Center for Digital Health, Providence, RI, United States
| | - Shira Dunsiger
- Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - John V Patena
- Brown-Lifespan Center for Digital Health, Providence, RI, United States
| | - Nicole R Nugent
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, United States
| | - Alison Riese
- Department Pediatrics and Medial Science, Alpert Medical School of Brown University, Providence, RI, United States.,Hasbro Children's Hospital, Providence, RI, United States
| | - Rochelle K Rosen
- Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States.,Center for Behavioral and Preventive Medicine at The Miriam Hospital, Providence, RI, United States
| | - Megan L Ranney
- Brown-Lifespan Center for Digital Health, Providence, RI, United States.,Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, United States
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Baiden P, Mengo C, Small E. History of Physical Teen Dating Violence and Its Association With Suicidal Behaviors Among Adolescent High School Students: Results From the 2015 Youth Risk Behavior Survey. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP9526-NP9547. [PMID: 31271096 DOI: 10.1177/0886260519860087] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Although studies have investigated and found physical teen dating violence (TDV) has a significant negative impact on mental health outcomes, few studies are yet to investigate the effect of physical TDV on suicidal behaviors among adolescents. The objectives of this study are to examine the prevalence of physical TDV, suicidal ideation, suicide plan, and suicide attempt among adolescents aged 14 to 18 years and the association between physical TDV and these suicidal behaviors. Data for this study were obtained from the 2015 Youth Risk Behavior Survey. A sample of 9,693 adolescents aged 14 to 18 years (50.4% males) was analyzed using logistic regression with suicidal ideation, suicide plan, and suicide attempt as outcome variables and physical TDV as the main explanatory variable. About 17% of the adolescent students experienced suicidal ideation, 13.7% made a suicide plan, and 7.6% attempted suicide during the past 12 months. Among those who were dating, 9.9% experienced physical TDV. In the multivariate logistic regression, adolescent students who experienced physical TDV were 1.92 times more likely to have experienced suicidal ideation, 1.67 times more likely to have made a suicide plan, and 2.42 times more likely to have attempted suicide during the past 12 months when compared with their counterparts who were dating but experienced no physical TDV. Other significant predictors of suicidal behaviors include being a sexual minority, experiencing forced sex, bullying, feeling sad or hopeless, and binge drinking. Having sufficient sleep lowered the odds of suicidal ideation and suicide plan. The topic of physical TDV and its association with suicidal behaviors among adolescents is such an important issue for researchers, policymakers, and practitioners in the United States and around the world. Prevention and intervention efforts should be culturally tailored to reflect the unique experiences with physical TDV and suicide among minority populations such as sexual minority adolescents.
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Tan RKJ, Low TQY, Le D, Tan A, Tyler A, Tan C, Kwok C, Banerjee S, Cook AR, Wong ML. Experienced Homophobia and Suicide Among Young Gay, Bisexual, Transgender, and Queer Men in Singapore: Exploring the Mediating Role of Depression Severity, Self-Esteem, and Outness in the Pink Carpet Y Cohort Study. LGBT Health 2021; 8:349-358. [PMID: 34142861 PMCID: PMC8252908 DOI: 10.1089/lgbt.2020.0323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose: No prior study has been published on suicide-related behaviors among gay, bisexual, transgender, and queer (GBTQ) men in Singapore, where sexual relations between men are criminalized. This study explores the association and mediational pathways between experienced homophobia and suicidal ideation or suicide attempts among young GBTQ men in Singapore. Methods: Results of this study were derived from baseline data of the Pink Carpet Y Cohort Study, Singapore's first prospective cohort study among young GBTQ men. The sample comprised 570 young GBTQ men 18 to 25 years of age who were HIV negative or unsure of their HIV status. Statistical analyses were conducted through descriptive statistics, multivariable logistic regression, and structural equation modeling techniques. Results: Of 570 participants, 58.9% (n = 308) reported ever contemplating suicide, whereas 14.2% (n = 76) had ever attempted suicide. Controlling for key demographic variables, multivariable logistic regression revealed that experienced homophobia and depression severity were positively associated with a history of suicidal ideation, whereas depression severity and outness were positively associated with a history of suicide attempts. Mediation analyses revealed that depression severity and self-esteem partially accounted for the relationship between experienced homophobia and suicidal ideation, whereas depression severity and outness partially accounted for the relationship with suicide attempts. Conclusions: The prevalence of suicidal ideation and past suicide attempts was found to be high in a sample of young GBTQ men in Singapore. Interventions to address experienced homophobia and discrimination among young GBTQ men are needed urgently in Singapore.
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Affiliation(s)
- Rayner Kay Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Timothy Qing Ying Low
- Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - Daniel Le
- Action for AIDS Singapore, Singapore, Singapore
| | - Avin Tan
- Action for AIDS Singapore, Singapore, Singapore
| | | | - Calvin Tan
- Action for AIDS Singapore, Singapore, Singapore
| | | | | | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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37
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Juárez-Chávez E, Cooney EE, Hidalgo A, Sánchez J, Poteat T. Violence Experiences in Childhood and Adolescence Among Gay Men and Transgender Women Living in Perú: A Qualitative Exploration. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:4235-4255. [PMID: 30049246 PMCID: PMC11331432 DOI: 10.1177/0886260518787811] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The overall goal of this study was to qualitatively explore the different types of violence experienced by gay men (GM) and transgender women (TW) living in Peru during childhood and adolescence, as well as their potential consequences and sources of protection. Participants were selected using purposive sampling. Recruitment took place in a community-based organization in Lima, Peru. In all, 32 GM and 23 TW participated in a total of four Focus Group Discussions (FGD) and 25 in-depth interviews (IDI). Qualitative data collection was conducted between July and October 2016. Four FGD took place with GM (n = 21) and one with TW (n = 9). In addition, 11 IDI with GM and 14 with TW were conducted. Data were analyzed using descriptive inductive analysis. Three main types of violence were experienced in childhood and adolescence: (a) violence occurring in the home or otherwise perpetrated by family members, (b) school-based violence, and (c) sexual violence. Both GM and TW experience violence within and outside school and home. School systems should make teachers and parents aware of the impact of homophobic and transphobic bullying and violence. Certain modifications in schools, such as having all-gender bathrooms and promoting activities that are not grounded in gender roles, could be very effective at reducing homophobic and transphobic violence. Schools should also address sexual violence more actively, among both male and female students. Parents' attitudes toward homosexuality and gender diversity need to be addressed by future interventions.
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Affiliation(s)
| | - Erin E. Cooney
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alberto Hidalgo
- Centro de Promoción y Defensa de los Derechos Sexuales y Reproductivos-PROMSEX, Lima, Perú
| | - Jorge Sánchez
- Asociación Civil Impacta Salud y Educación (IMPACTA), Lima, Peru
| | - Tonia Poteat
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Feelemyer J, Duncan DT, Dyer TV, Geller A, Scheidell JD, Young KE, Cleland CM, Turpin RE, Brewer RA, Hucks-Ortiz C, Mazumdar M, Mayer KH, Khan MR. Longitudinal Associations between Police Harassment and Experiences of Violence among Black Men Who Have Sex with Men in Six US Cities: the HPTN 061 Study. J Urban Health 2021; 98:172-182. [PMID: 33821426 PMCID: PMC8079523 DOI: 10.1007/s11524-021-00526-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 10/21/2022]
Abstract
Interactions with the police may result in police brutality, particularly for people of color. Black men who have sex with men (BMSM) face disproportionate risk of police contact and may experience elevated violence risk. We measured longitudinal associations between discriminatory police harassment (DPH) and subsequent risk of a range of interpersonal violence experiences, including intimate partner violence (IPV). In this study, we estimated associations between DPH motivated by racism, homophobia, or both, and subsequent violent experiences (being physically harassed, hit, threatened with weapons, and intimate partner violence) among BMSM. Bivariate and multivariable regression analyses were used to control for demographic and behavioral factors. Among 1160 BMSM included at 12-month follow-up, experiencing DPH motivated by racism and homophobia was associated with over four times the odds of being threatened with violence (AOR 4.85, 95% CI 3.20, 7.33), four times the odds of or experiencing violence defined as being punched, kicked, or beaten, or having an object thrown at them (AOR 4.51, 95% CI 2.82, 7.19), and nearly three times the odds of physical partner abuse (AOR 3.49, 95% CI 1.69, 7.19). Findings suggest that for BMSM, DPH is associated with the threat and experience of violence, with a dose-response relationship between DPH motivated by one or more causes. Given that BMSM are a population particularly vulnerable to both police harassment related to race and sexual orientation and violence coupled with stigma, additional research evaluating mechanisms linking these associations is needed in order to develop additional supportive interventions.
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Affiliation(s)
- Jonathan Feelemyer
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
| | - Dustin T Duncan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Typhanye V Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Amanda Geller
- Department of Criminology, Law, and Society, University of California, Irvine, Irvine, CA, USA
| | - Joy D Scheidell
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Kailyn E Young
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Charles M Cleland
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Rodman E Turpin
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | | | | | - Medha Mazumdar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health and Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Maria R Khan
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Leon K, O'Bryan J, Wolf-Gould C, Turell SC, Gadomski A. Prevalence and Risk Factors for Nonsuicidal Self-Injury in Transgender and Gender-Expansive Youth at a Rural Gender Wellness Clinic. Transgend Health 2021; 6:43-50. [PMID: 33644321 DOI: 10.1089/trgh.2020.0031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose: Transgender and gender-expansive (TGE) populations are at increased risk for nonsuicidal self-injury (NSSI). Rural TGE populations are understudied and underserved in terms of mental health services. The purpose of this study was to determine lifetime prevalence of NSSI among TGE youth at a rural gender wellness clinic and identify demographic and clinical characteristics associated with NSSI. Methods: The Gender Wellness Center Pediatric Patient Registry, a comprehensive database of 185 TGE youth ≤25 years of age, provided an estimate of the lifetime prevalence of NSSI. Univariate logistic regression models were utilized to test associations between patient demographic and clinical characteristics and NSSI. Variables that met the threshold for significance in the univariate analyses (p<0.05) were entered into a multivariate logistic regression model. All statistical analyses were conducted in SAS v.9.4. Results: Prevalence of NSSI in the sample was 36.8% (n=68). In unadjusted logistic regression models, risk factors for NSSI included female assigned sex at birth, transmasculine spectrum gender identity, history of mood disorder, history of suicidal ideation (SI) or attempt, and history of abuse (p<0.05). In the adjusted model, variables significantly associated with NSSI included female assigned sex at birth, history of mood disorder, and history of SI or attempt. Conclusion: NSSI was highly prevalent in this sample of rural TGE youth, confirming the need for screening and early interventions that target the unique vulnerabilities of TGE youth. The complex interplay of sex assigned at birth, mood disorders, and NSSI requires further research.
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Affiliation(s)
- Kimberly Leon
- Columbia-Bassett Program, Columbia University Vagelos College of Physicians & Surgeons, Cooperstown, New York, USA
| | - Jane O'Bryan
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Carolyn Wolf-Gould
- The Gender Wellness Center/Susquehanna Family Practice, A.O. Fox Hospital, Bassett Healthcare Network, Oneonta, New York, USA
| | - Susan C Turell
- The Gender Wellness Center/Susquehanna Family Practice, A.O. Fox Hospital, Bassett Healthcare Network, Oneonta, New York, USA
| | - Anne Gadomski
- Bassett Medical Center, Bassett Research Institute, Cooperstown, New York, USA
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Johns MM, Lowry R, Hipp TN, Robin L, Shafir S. Differences in Adolescent Experiences of Polyvictimization and Suicide Risk by Sexual Minority Status. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2021; 31:240-252. [PMID: 33232570 PMCID: PMC8048776 DOI: 10.1111/jora.12595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Sexual minority adolescents (SMA) report more suicide risk behaviors than heterosexual adolescents. Polyvictimization (co-occurrence of multiple types of victimization) may be an important, underresearched correlate of this disparity. With the 2017 national Youth Risk Behavior Survey (N = 13,179), national estimates of polyvictimization and suicide risk were assessed among high school students by sexual minority status (SM vs. heterosexual), and multivariate relationships between sexual minority status, polyvictimization, and suicide risk were tested. Additionally, risk profiles of those who experienced polyvictimization (2 + types of victimization; n = 1,932) were compared across sexual minority status. Results confirm that SMA are more likely to experience polyvictimization than heterosexual adolescents (31.8% v. 12.9%, respectively); however, also indicate that polyvictimization does not fully explain elevated suicide risk among SMA.
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Affiliation(s)
| | - Richard Lowry
- CDC National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, USA
| | | | - Leah Robin
- CDC Division of Adolescent and School Health, USA
| | - Shira Shafir
- The Trevor Project and University of California Los Angeles, USA
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Association between sexual abuse victimization during the life course and suicidal behaviors in male and female college students in China: Timing, duration, types and patterns. J Affect Disord 2021; 280:30-38. [PMID: 33221605 DOI: 10.1016/j.jad.2020.11.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/15/2020] [Accepted: 11/08/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND A certain link between sexual abuse (SA) victimization and suicidal behaviors has been confirmed, but it remains unclear whether this association varies with regard to SA characteristics and gender. METHODS Participants were 4034 college students drawn from a cross-sectional study conducted in Hefei, China. Gender-stratified latent class analysis (LCA) and logistic regression models were used to examine the relationships between timing, duration, types and patterns of SA victimization and suicidal behaviors. RESULTS For the males, SA in the elementary school or earlier period was associated with suicidal ideation (OR: 3.29, 95%CI: 2.20-5.38), plans (OR: 3.44, 95% CI: 1.54-7.77) and preparations (OR:3.05, 95% CI: 1.19-7.74). All types of SA were significantly associated with the four types of suicidal behaviors. Dose-response relationship and cumulative effect were found between duration, types of SA victimization and suicidal behaviors. Three latent classes of SA victimization were identified for males and females, respectively. For males, the "moderate SA" class and "persistent SA" class were associated with the four types of suicidal behaviors. For the females, SA during the university period was associated with suicidal ideation (OR: 2.47, 95% CI: 1.24-4.93). Only suicidal ideation was associated with the "moderate SA" class. LIMITATIONS The cross-sectional survey design did not allow to conclude any causality. CONCLUSIONS The relationship between SA victimization and suicidal behaviors varies in terms of SA victimization characteristics and the relationships were stronger in males than in females.
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Ramírez EGL, Delgado YK, Volpato RJ, de Claudio JCM, Pinho PH, de Vargas D. Suicidal ideation in gender and sexual minority students in the largest Brazilian University. Arch Psychiatr Nurs 2020; 34:467-471. [PMID: 33280668 DOI: 10.1016/j.apnu.2020.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/22/2020] [Accepted: 08/07/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Identifying the presence of suicidal ideation and associated factors among university students from a public university in Brazil. METHODS A cross-sectional study was performed with 72 university students between 18 and 29 years old. Were used a sociodemographic data questionnaire and the Beck's Suicidal Ideation Scale. RESULTS The suicidal ideation was significantly in the participants, as well as the association of gender, gender identity, sexual orientation and housing with it. CONCLUSIONS The suicidal ideation in this population is important, and there is a need to explore the factors related, such as gender, sexual orientation, gender identity and housing.
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Affiliation(s)
| | | | | | | | | | - Divane de Vargas
- School of Nursing, University of São Paulo (USP), São Paulo, SP, Brazil
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Self-Injurious Thoughts and Behaviors Among Sexual and Gender Minority Youth: a Systematic Review of Recent Research. CURRENT SEXUAL HEALTH REPORTS 2020. [DOI: 10.1007/s11930-020-00295-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Fulginiti A, Rhoades H, Mamey MR, Klemmer C, Srivastava A, Weskamp G, Goldbach JT. Sexual Minority Stress, Mental Health Symptoms, and Suicidality among LGBTQ Youth Accessing Crisis Services. J Youth Adolesc 2020; 50:893-905. [PMID: 33206318 DOI: 10.1007/s10964-020-01354-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/02/2020] [Indexed: 12/18/2022]
Abstract
Sexual and gender minority youth are at elevated risk for suicide. Studies have separately established the relation between minority stress and mental health symptoms, as well as minority stress and suicidality. However, no known research has simultaneously examined different mental health mechanisms whereby minority stress may be associated with different suicidal experiences (e.g., suicidal ideation, suicide attempts). The present study used data from a national sample of 572 sexual and gender minority youth aged 12 to 24 (mean age = 17.59; SD = 3.13) recruited from an LGBTQ youth-focused suicide crisis prevention provider. Nearly one-third of the sample (30.2%) identified as transgender, genderqueer, or questioning. Nearly one quarter of the sample (24.3%) identified as gay, 17.1% as pansexual, 16.8% as bisexual, and 15.2% as lesbian. Structural equation modeling was used for mediation analyses to explain suicidal ideation and suicide attempts. Serial mediation models were determined to be the best fit for both suicide-related outcomes. Minority stress was associated with depressive and PTSD symptoms, which were linked with suicidal ideation and attempt through hopelessness. The findings supported the hypotheses that minority stress would be associated with suicidality not just directly, but also indirectly through multiple mental health symptom pathways.
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Affiliation(s)
- Anthony Fulginiti
- Graduate School of Social Work, University of Denver, 2148S. High St., Denver, CO, 80208, USA.
| | - Harmony Rhoades
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 663W. 34th St., Los Angeles, CA, 90089, USA
| | - Mary Rose Mamey
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 663W. 34th St., Los Angeles, CA, 90089, USA
| | - Cary Klemmer
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 663W. 34th St., Los Angeles, CA, 90089, USA
| | - Ankur Srivastava
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 663W. 34th St., Los Angeles, CA, 90089, USA
| | - Garrett Weskamp
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 663W. 34th St., Los Angeles, CA, 90089, USA
| | - Jeremy T Goldbach
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 663W. 34th St., Los Angeles, CA, 90089, USA
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Sang JM, Louth-Marquez W, Henderson ER, Egan JE, Chugani CD, Hunter SC, Espelage D, Friedman MS, Coulter RWS. "It's Not Okay for You to Call Me That": How Sexual and Gender Minority Youth Cope with Bullying Victimization. JOURNAL OF HOMOSEXUALITY 2020:1-20. [PMID: 33164708 PMCID: PMC8106687 DOI: 10.1080/00918369.2020.1826831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sexual and gender minority youth (SGMY) have higher rates of bullying than their heterosexual peers and must disproportionately cope with bullying victimization. The purpose of this research is to highlight various coping strategies employed by SGMY. We conducted 20 cross-sectional, semi-structured online interviews with SGMY about their bullying experiences and coping strategies. We coded interviews with descriptive qualitative research to illustrate a comprehensive summary of bullying-related coping methods. We found SGMY engage in multiple coping strategies that include (1) emotion-focused coping-rumination; self-harm and considering or attempting suicide; seeking social and emotional support; engaging in creative endeavors; self-acceptance and community connectedness-and (2) problem-focused coping-reporting the bully; confronting the bully; conceal orientation; ignoring the bullying; and changing environment. Additionally, most SGMY reported using multiple coping techniques or changing how they coped over time (i.e., coping flexibility). These findings can inform future interventions to promote positive coping mechanisms among SGMY.
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Affiliation(s)
- Jordan M Sang
- Graduate School of Public Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - William Louth-Marquez
- Graduate School of Public Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Emmett R Henderson
- Graduate School of Public Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James E Egan
- Graduate School of Public Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Carla D Chugani
- Department of Pediatrics, Division of Adolescent and Young Adult Health, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Simon C Hunter
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland
| | - Dorothy Espelage
- Department of Psychology, University of Florida, Gainesville, Florida, USA
| | - Mark S Friedman
- Mark S. Friedman Psychotherapy, Pittsburgh, Pennsylvania, USA
| | - Robert W S Coulter
- Graduate School of Public Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Sisler SM, Schapiro NA, Nakaishi M, Steinbuchel P. Suicide assessment and treatment in pediatric primary care settings. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2020; 33:187-200. [PMID: 32573060 PMCID: PMC7666006 DOI: 10.1111/jcap.12282] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 04/28/2020] [Accepted: 06/07/2020] [Indexed: 12/14/2022]
Abstract
TOPIC This article will briefly review screening for depression and suicidal ideation in primary care and school-based clinics, with a focus on in-depth screening for imminent suicide risk, developing a safety plan, and incorporating handoffs to urgent and emergency mental health care personnel. The article will cover current definitions of levels of suicidal risk and clinic-based protocols for a team approach to adolescents in crisis. PURPOSE To provide primary care and behavioral health nurses with evidence-based suicide risk screening and assessment tools and best practices for using them in patient-centered encounters with adolescents with suicidal thinking or behavior. SOURCES USED Journal articles, books, and reports. CONCLUSION Past studies have shown that many individuals who died by suicide had seen a primary care provider in 30 days before their deaths. Nurses in primary care settings should develop clinic-based protocols for screening all adolescents for suicide risk, developing safety plans, and providing suicidal youth and families with monitoring, appropriate referrals, follow-up, and support.
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Affiliation(s)
- Shawna M. Sisler
- College of Nursing, Emma Eccles Jones Nursing Research CenterUniversity of UtahSalt Lake CityUtahUSA
| | - Naomi A. Schapiro
- Department of Family Health Care Nursing, School of NursingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Michelle Nakaishi
- Department of Family Health Care Nursing, School of NursingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Petra Steinbuchel
- Department of Family Health Care Nursing, School of NursingUniversity of CaliforniaSan FranciscoCaliforniaUSA
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Hotton AL, Chen YT, Schumm P, Khanna AS, Brewer R, Skaathun B, Issema RS, Ramani S, Ramachandran A, Ozik J, Fujimoto K, Harawa NT, Schneider JA. Socio-Structural and Neighborhood Predictors of Incident Criminal Justice Involvement in a Population-Based Cohort of Young Black MSM and Transgender Women. J Urban Health 2020; 97:623-634. [PMID: 32180129 PMCID: PMC7560631 DOI: 10.1007/s11524-020-00428-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Black men who have sex with men (MSM) and transgender women are disproportionately affected by criminal justice involvement (CJI) and HIV. This study recruited 618 young Black MSM and transgender women in Chicago, IL, using respondent-driven sampling between 2013 and 2014. Random effects logistic regression evaluated predictors of incident CJI over 18 months of follow-up. Controlling for respondent age, gender and sexual identity, spirituality (aOR 0.56, 95% CI 0.33-0.96), and presence of a mother figure (aOR 0.41, 95% CI 0.19-0.89) were protective against CJI. Economic hardship (financial or residential instability vs. neither aOR 2.23, 95% CI 1.10-4.51), two or more past episodes of CJI vs. none (aOR 2.66, 95% CI 1.40-5.66), and substance use (marijuana use vs. none aOR 2.79, 95% CI 1.23-6.34; other drug use vs. none aOR 4.49, 95% CI 1.66-12.16) were associated with CJI during follow-up. Research to identify and leverage resilience factors that can buffer the effects of socioeconomic marginalization may increase the effectiveness of interventions to address the socio-structural factors that increase the risk for CJI among Black MSM and transgender women. Given the intersection of incarceration, HIV and other STIs, and socio-structural stressors, criminal justice settings are important venues for interventions to reduce health inequities in these populations.
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Affiliation(s)
- Anna L Hotton
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA.
| | - Yen-Tyng Chen
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Phil Schumm
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Aditya S Khanna
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Russell Brewer
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Britt Skaathun
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Rodal S Issema
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Santhoshini Ramani
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Arthi Ramachandran
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Jonathan Ozik
- Consortium for Advanced Science and Engineering, University of Chicago, Chicago, IL, USA.,Decision and Infrastructure Sciences Division, Argonne National Laboratory, Lemont, IL, USA
| | | | | | - John A Schneider
- Departments of Medicine and Public Health Sciences, Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
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Turpin RE, Rosario AD, Dyer TV. Substance Use and Suicide Attempts Among Adolescent Males Who Are Members of a Sexual Minority: A Comparison of Synthesized Substance-Use Measures. Am J Epidemiol 2020; 189:900-909. [PMID: 32280963 DOI: 10.1093/aje/kwaa055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 11/12/2022] Open
Abstract
Adolescent sexual minority males (ASMM) are among the highest risk groups for suicide in the United States, with substance use as a significant risk factor. We tested for an association between substance use and suicidality among ASMM from the 2015 and 2017 Youth Risk Behavior Survey (n = 849). We compared several approaches to synthesizing measures of marijuana, cocaine, heroin, ecstasy, methamphetamines, synthetic marijuana, and prescription drug abuse, including several categorized and continuous indices, latent class analysis based on any use of each substance, and latent profile analysis based on use frequency. Using all approaches, substance use was positively associated with suicide attempts independent of covariates. A continuous cumulative index was the best fit to our data (quasi-information criterion = 853.9969) and detected the largest association, with the highest prevalence of suicide attempts among ASMM who used all substances compared with those who used none (adjusted prevalence ratio = 3.35, 95% confidence interval: 2.41, 4.66). A 3-latent-class model had the second best fit to the data (quasi-information criterion = 878.4464), with the highest prevalence of suicide attempts (adjusted prevalence ratio = 2.54, 95% confidence interval: 1.80, 3.57) among the high-substance-use class compared with the low-use class. Substance use is an especially important focal point for targeted interventions reducing suicidality among ASMM.
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Alcohol Use and Suicidality by Sexual Orientation Among U.S. Youth, 2009-2017. Am J Prev Med 2020; 59:394-403. [PMID: 32446749 PMCID: PMC7483808 DOI: 10.1016/j.amepre.2020.03.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/07/2020] [Accepted: 03/06/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Alcohol use and suicidality remain serious risks for U.S. youth. Research has established that disparities exist in these outcomes between heterosexual and sexual minority youth. However, research into the associations between alcohol use and suicidality has yet to consider the differential role of sexual orientation. METHODS Using a pooled, diverse sample from the 2009-2017 Youth Risk Behavior Survey, associations of alcohol use and suicidality by sex and sexual orientation, and changes in these outcomes over time, were investigated. Analyses were conducted in 2019. RESULTS Suicidality was highest among nonheterosexuals, who ranged from twofold to sevenfold higher odds to report suicidality across all time points, with the most striking disparities among male sexual minority youth. Rates among all students remained stable or increased over time; notable exceptions included a decrease in suicide attempts among bisexual students. Among all students, current alcohol use was associated with elevated levels of suicidality. For female students, the association between drinking and suicidality did not significantly differ by sexual identity; for male students, it was significant regardless of sexual identity and most pronounced among not sure youth. CONCLUSIONS These results emphasize the need for additional research into the relationship between contemporaneous alcohol use and suicidality, with attention to differences based on sex, sexual orientation, and other factors that may impact these relationships. There is a particular need for research to examine the temporal nature of the association such that evidence-informed, high-impact interventions can be developed to improve suicidality outcomes among sexual minority youth.
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Johns MM, Lowry R, Haderxhanaj LT, Rasberry CN, Robin L, Scales L, Stone D, Suarez NA. Trends in Violence Victimization and Suicide Risk by Sexual Identity Among High School Students - Youth Risk Behavior Survey, United States, 2015-2019. MMWR Suppl 2020; 69:19-27. [PMID: 32817596 PMCID: PMC7440203 DOI: 10.15585/mmwr.su6901a3] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Lesbian, gay, and bisexual (LGB) youths continue to experience more violence victimization and suicide risk than heterosexual youths; however, few studies have examined whether the proportion of LGB youths affected by these outcomes has varied over time, and no studies have assessed such trends in a nationally representative sample. This report analyzes national trends in violence victimization and suicide risk among high school students by self-reported sexual identity (LGB or heterosexual) and evaluates differences in these trends among LGB students by sex (male or female) and race/ethnicity (non-Hispanic black, non-Hispanic white, or Hispanic). Data for this analysis were derived from the 2015, 2017, and 2019 cycles of CDC’s Youth Risk Behavior Survey (YRBS), a cross-sectional, school-based survey conducted biennially since 1991. Logistic regression models assessed linear trends in prevalence of violence victimization and indicators of suicide risk among LGB and heterosexual students during 2015–2019; in subsequent models, sex-stratified (controlling for race/ethnicity and grade) and race/ethnicity-stratified (controlling for sex and grade) linear trends were examined for students self-identifying as LGB during 2015–2019. Results demonstrated that LGB students experienced more violence victimization and reported more suicide risk behaviors than heterosexual youths. Among LGB youths, differences in the proportion reporting violence victimization and suicide risk by sex and race/ethnicity were found. Across analyses, very few linear trends in these outcomes were observed among LGB students. Results highlight the continued need for comprehensive intervention strategies within schools and communities with the express goal of reducing violence victimization and preventing suicide risk behaviors among LGB students.
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