Article

Sexual orientation and suicide attempt: A longitudinal study of the general Norwegian adolescent population

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Abstract

Past and future suicide attempt rates among gay, lesbian, and bisexual (GLB) young people were compared with those of heterosexual young people. A sample of Norwegian students (N = 2.924; grades 7-12) was followed in 3 data collection waves. Risk factors included previous suicide attempt,depressed mood, eating problems, conduct problems, early sexual debut, number of sexual partners, pubertal timing, self-concept, alcohol and drug use, atypical gender roles, loneliness, peer relations, social support, parental attachment, parental monitoring, and suicidal behavior among family and friends. When homosexual attraction, homosexual identity, and same-sex sexual behavior were entered to predict suicide attempt, only same-sex sexual behavior was significantly predictive. The increased odds could not be attributed to GLB students' greater exposure to risk factors for suicide attempt.

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... Associations have been identified between depressive symptoms in emerging adulthood and other social risk factors, such as social exclusion stemming from discrimination linked to ethnicity, gender, physical disability, sexual orientation, immigrant status, or religion (Grant et al., 2013;Kerr, Santurri, & Peters, 2013;Miranda, Polanco-Roman, Tsypes, & Valderrama, 2013;Wichstrøm & Hegna, 2003). ...
... Furthermore, the results of the present study confirmed a higher level of depressive symptoms in students who indicated being attracted to people of the same sex or of both sexes, probably linked in part to the discrimination that these individuals can suffer (Grant et al., 2013;Wichstrøm & Hegna, 2003). This link might well have been even stronger if the measure had taken into account sexual experiences or bullying/teasing related to sexual orientation instead of sexual orientation alone (Lencl & Matuga, 2010;Wichstrøm & Hegna, 2003). ...
... Furthermore, the results of the present study confirmed a higher level of depressive symptoms in students who indicated being attracted to people of the same sex or of both sexes, probably linked in part to the discrimination that these individuals can suffer (Grant et al., 2013;Wichstrøm & Hegna, 2003). This link might well have been even stronger if the measure had taken into account sexual experiences or bullying/teasing related to sexual orientation instead of sexual orientation alone (Lencl & Matuga, 2010;Wichstrøm & Hegna, 2003). ...
Article
This study aimed to identify and rank the personal, family-related, social, and academic correlates of depressive symptoms in first-year college students. A questionnaire that included the Beck Depression Inventory-II (BDI-II) was administered to 389 first-year college students (mean age = 18.9; SD = 3.38; 59.4% female). Eight variables contributed uniquely to the variance of depressive symptoms and were, in decreasing order of importance: (1) the absence of personal goals, (2) a high level of anxiety and (3) of dysfunctional thoughts regarding success, (4) a lack of emotional adjustment to college, (5) being female, (6) receiving little warmth and encouragement of autonomy from one’s mother and (7) from one’s father, and (8) being attracted to members of the opposite or both sexes. These results suggest that a multimodal intervention is required to support students’ mental health.
... Sexual minority youth reported significantly lower levels of self-esteem at 13 and 17 years, higher levels of depressive symptomatology at 16 and 18 years and higher levels of past-year SISH at 16 and 20 years. These findings are in keeping with research involving mainly non-UK samples (Wichstrøm and Hegna, 2003;King et al., 2008;Yean et al., 2013;Plöderl and Tremblay, 2015;Coulter et al., 2016;Jackman et al., 2016). The presence of self-esteem disparities at age 13 years raises the possibility that precursors to later self-harm and suicidality may start even earlier in childhood (La Roi et al., 2016) and prevention strategies may need to begin at younger ages. ...
... In the first pathway, lower self-esteem mediated the relationship between sexual minority status and the increased likelihood of SISH. This contrasts with previous negative findings (Wichstrøm and Hegna, 2003;Rosario et al., 2005), which may be due to the smaller sample sizes utilised and shorter duration of follow-up (Rosario et al., 2005). ...
... Consistent with previous research (Wichstrøm and Hegna, 2003;Fox et al., 2015), females had higher rates of SISH. Our findings extend the results from a cross-sectional study (Grossman and Kerner, 1998) by providing longitudinal evidence for a stronger relationship between depression and self-esteem in female sexual minority youth. ...
Article
Background Sexual minority youth have elevated suicidal ideation and self-harm compared with heterosexual young people; however, evidence for mediating mechanisms is predominantly cross-sectional. Using a longitudinal design, we investigated self-esteem and depressive symptoms as mediators of increased rates of suicidal ideation or self-harm (SISH) among sexual minority youth, and the roles of childhood gender nonconformity (CGN) and sex as moderators of these relationships. Method In total, 4274 youth from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort reported sexual orientation at age 15 years, and past-year SISH at age 20 years. Self-esteem and depressive symptoms were assessed at ages 17 and 18 years, respectively. CGN was measured at 30–57 months. Covariates included sociodemographic variables and earlier measures of mediator and outcome variables. Mediation pathways were assessed using structural equation modelling. Results Sexual minority youth (almost 12% of the sample) were three times more likely than heterosexual youth to report past-year SISH (95% confidence interval 2.43–3.64) at 20 years. Two mediation pathways were identified: a single mediator pathway involving self-esteem and a multiple-mediated pathway involving self-esteem and depressive symptoms. Although CGN was associated with past-year SISH, it did not moderate any mediation pathways and there was no evidence for moderation by sex. Conclusions Lower self-esteem and increased depressive symptoms partly explain the increased risk for later suicidal ideation and self-harm in sexual minority youth. Preventive strategies could include self-esteem-enhancing or protecting interventions, especially in female sexual minority youth, and treatment of depression.
... Los factores que son únicos para el estatus LGBT son rara vez incluidos en este enfoque. De hecho, comparado con los heterosexuales, las poblaciones LGBT muestran aumento en los factores de riesgo psicológico general, incluyendo, entre otros, baja autoestima (Plöderl & Fartacek, 2005;Wichstrom & Hegna, 2003;Ziyadeh et al., 2007), desregulación emocional (Hatzenbuehler, McLaughlin, & Nolen-Hoeksema, 2008;Matthews, Hughes, Johnson, Razzano, & Cassidy, 2002) y aislamiento social (Eisenberg & Resnick, 2006;Plöderl & Fartacek, 2005;Safren & Heimberg, 1999;Wichstrom & Hegna, 2003). ...
... Los factores que son únicos para el estatus LGBT son rara vez incluidos en este enfoque. De hecho, comparado con los heterosexuales, las poblaciones LGBT muestran aumento en los factores de riesgo psicológico general, incluyendo, entre otros, baja autoestima (Plöderl & Fartacek, 2005;Wichstrom & Hegna, 2003;Ziyadeh et al., 2007), desregulación emocional (Hatzenbuehler, McLaughlin, & Nolen-Hoeksema, 2008;Matthews, Hughes, Johnson, Razzano, & Cassidy, 2002) y aislamiento social (Eisenberg & Resnick, 2006;Plöderl & Fartacek, 2005;Safren & Heimberg, 1999;Wichstrom & Hegna, 2003). ...
Book
Este libro busca completar lo expuesto en el primer volumen de esta colección, referido a recoger el trabajo de destacados investigadores de diferentes universidades chilenas que han dedicado sus esfuerzo al estudio del bienestar y las variables que se asocian a esta temática en nuestro país. Los estudios sobre bienestar han ganado relevancia durante el último tiempo, entregando aportes significativos a la comprensión de la conducta humana. Esto se ve reflejado en la multiplicación de artículos y revistas especializadas dedicadas a este tema, así como en la calidad de las investigaciones y los métodos utilizados. Este fenómeno se ha dado también en Chile, donde investigadores del área de la psicología, la sociología y otras ciencias sociales han avanzado en el desarrollo de líneas específicas de investigación en bienestar para nuestro país.
... However, many studies theorize that psychopathology functions as a mediating factor (Garofalo et al., 1999;Herrell et al., 1999;Russell & Joyner, 2001). Careful consideration of confounding within the context of sexual orientation and suicidality is needed (Wichstrøm & Hegna, 2003). In this study, we additionally examined the possible confounding role of pre-existing psychopathology. ...
... Given stigmatizing beliefs about sexual orientation, the prevalence of sexual minority status is likely underreported in the current study. Fourth, while we were able to examine various groups of sexual orientation, our categorization remains crude (Wichstrøm & Hegna, 2003). Past research has utilized a Likert scale of identification or attraction, which may be more appropriate to capture variation within groups (Remafedi et al., 1998). ...
Article
Background: Research has demonstrated that individuals who identify as a sexual minority (e.g., gay/lesbian, bisexual) are at increased risk for suicidality-related outcomes. However, previous research is primarily limited by the lack of adjustment for unmeasured (i.e., genetic and environmental) confounding factors and previous psychopathology. Methods: Using the Child and Adolescent Twin Study in Sweden, we employed a co-twin control design to examine the extent to which the association between sexual orientation and adolescent suicide attempt and self-harm (SA/SH) was independent of genetic and environmental factors shared by twins, as well as measured symptoms of childhood psychopathology. Results: Adolescents who identified as a sexual minority (i.e., gay/lesbian, bisexual, or other sexual orientation) were at two-fold increased odds for SA/SH (OR, 2.01 [95% confidence interval, 1.63-2.49) compared to heterosexual adolescents. When adjusting for all genetic and shared environmental factors that make twins similar and for measured childhood psychopathology, the association remained positive but attenuated to OR, 1.55 (1.11-2.16). Conclusions: Identifying as a sexual minority was associated with approximately 50% increased odds of SA/SH in adolescence after adjusting for unmeasured genetic and environmental factors shared by twins and for childhood psychopathology. The results support that environmental factors specifically associated with identifying as a sexual minority likely increase risk for SA/SH. Our findings highlight the need to monitor suicidality risk among this group.
... Los factores que son únicos para el estatus LGBT son rara vez incluidos en este enfoque. De hecho, comparado con los heterosexuales, las poblaciones LGBT muestran aumento en los factores de riesgo psicológico general, incluyendo, entre otros, baja autoestima (Plöderl & Fartacek, 2005;Wichstrom & Hegna, 2003;Ziyadeh et al., 2007), desregulación emocional (Hatzenbuehler, McLaughlin, & Nolen-Hoeksema, 2008;Matthews, Hughes, Johnson, Razzano, & Cassidy, 2002) y aislamiento social (Eisenberg & Resnick, 2006;Plöderl & Fartacek, 2005;Safren & Heimberg, 1999;Wichstrom & Hegna, 2003). ...
... Los factores que son únicos para el estatus LGBT son rara vez incluidos en este enfoque. De hecho, comparado con los heterosexuales, las poblaciones LGBT muestran aumento en los factores de riesgo psicológico general, incluyendo, entre otros, baja autoestima (Plöderl & Fartacek, 2005;Wichstrom & Hegna, 2003;Ziyadeh et al., 2007), desregulación emocional (Hatzenbuehler, McLaughlin, & Nolen-Hoeksema, 2008;Matthews, Hughes, Johnson, Razzano, & Cassidy, 2002) y aislamiento social (Eisenberg & Resnick, 2006;Plöderl & Fartacek, 2005;Safren & Heimberg, 1999;Wichstrom & Hegna, 2003). ...
Book
La felicidad de los chilenos: Estudios sobre bienestar Vol. II busca completar lo expuesto en el primer volumen de esta colección, referido a recoger el trabajo de destacados investigadores de diferentes universidades chilenas que han dedicado sus esfuerzo al estudio del bienestar y las variables que se asocian a esta temática en nuestro país.Este tomo comienza con el capítulo de Alfaro, Oyarzún, Reyes y Benavente, quienes revisan los estudios sobre bienestar subjetivo de tipo cognitivo en jóvenes, afirmando la validez estructural y de criterio de escalas como el PWI (Personal Well-Being Index).El segundo capítulo sintetiza los resultados de un estudio acerca del bienestar subjetivo en los adultos mayores, el cual fue evaluado a partir de un ítem de satisfacción vital presente en la Encuesta CASEN (Caracterización Socioeconómica Nacional) en los años 2011 y 2013. Los autores Alvarado, Vargas, Reynaldos y Oyanedel, destacan que los factores que se asocian al bienestar en los adultos mayores son los mismos que en la población en general.En el tercer capítulo, Hatibovic, Wlodarczyk, Bobowik, Páez y Valencia presentan un análisis del bienestar colectivo bajo una perspectiva socio-emocional a partir de dos estudios. Utilizando los datos de la encuesta acerca de Bienestar Subjetivo del PNUD (Programa de las Naciones Unidas para el Desarrollo), comparan el clima socioemocional en diferentes zonas de Chile.Barrientos, Cárdenas, Guzmán, Gómez y Bahamondes- Correa abordan el impacto del prejuicio y la discriminación en las personas gay y lesbianas. Los autores plantean que la población LGBT muestra más síntomas de problemas de salud mental. Los procesos de estrés, estigmatización y exclusión social que resultan en un menor bienestar y menor felicidad de las minorías, quedan reflejados en la evidencia que señala que los hombres gay poseen menores niveles de felicidad con respecto a la población general y en comparación con los hombres heterosexuales, es decir, poseen una peor evaluación de sus lazos con la sociedad y su comunidad.Moyano realiza una revisión crítica del concepto de felicidad mostrando su complejidad y el disenso en torno a su definición. El autor pone de relieve la importancia del malestar y su relación con el desarrollo económico: evidencia que a mayor desarrollo económico, se ha registrado un incremento del suicidio en Chile.El séptimo capítulo muestra una revisión de la relación entre economía y bienestar realizada por Vera Villarroel, Celis Atenas, Lillo y Contreras.Los estudios realizados y sintetizados por los autores muestran que a mayor estatus socioeconómico mayor bienestar hedónico y eudaimónico. También muestran que la percepción de los ingresos y la satisfacción con ellos explican mejor el bienestar que la variable objetiva de los ingresos percibidos. En el último capítulo, Martínez Zelaya, Muratori, García, Páez, y Zubieta examinan otro correlato social importante del bienestar: la victimización o ser víctima de la delincuencia y el miedo al delito. Los autores plantean que, en muestras latinoamericanas, más que lavictimización «objetiva» o el hecho de ser víctima de robos, etc., es el miedo al delito o la representación subjetiva de la delincuencia la que se asocia a un menor bienestar social hedónico o clima de emocional y eudaimónico o social
... Gender and ethnicity were included in the first demographic aspect, some studies revealed that lesbians have more SA risks than gay men 17,18,74,134 . One Norwegian study indicated that lesbian and bisexual girls are at increased risk for SA in late adolescence and early adulthood 135 . Our survey got the same result that gender is also identified as a predictive factor for SA in the decision tree model. ...
Thesis
Le suicide est la deuxième cause de décès à l'adolescence aux États-Unis et dans les pays européens dont la France, l'un des principaux risques de décès par suicide étant la présence d'antécédent(s) de tentative de suicide (TS). Les facteurs de risque connus de TS sont nombreux à l'adolescence en population générale. Les adolescents ayant une attirance homosexuelle et/ou bisexuelle (LGB) pourraient présenter davantage de stress, de stigmatisation et de pression que leurs pairs hétérosexuels. Cependant, les facteurs de risque et de protection possibles ont été peu explorés dans la littérature. Une meilleure connaissance de ces facteurs pourrait permettre de proposer des interventions adaptées. L'enquête française « Portraits d'adolescents », réalisée en 2013, apporte des données sur de nombreuses variables dont l'attirance sexuelle et la TS. Parmi les 14 265 adolescents, 637 (4,5%) se décrivent comme LGB. Parmi eux, 30,7 % rapportent avoir fait une TS (vs 10,6 % des adolescents hétérosexuels). Différents types de méthodes statistiques (test du Chi 2, modèle de régression logistique, modèle de machine learning decision tree) ont été réalisés pour comparer les groupes LGB et hétérosexuels et identifier les facteurs de risque ou de protection de TS. Nos différents modèles statistiques sont parvenus à des conclusions similaires. A la fois chez les adolescents LGB et hétérosexuels, la consommation de substances (alcool, tabac, cocaïne, ecstasy, amphétamine) apparait comme le facteur de risque le plus évident et le soutien parental comme le facteur de protection le plus important. Cependant, le soutien d'un ami rencontré sur Internet semble un facteur significatif de protection de TS seulement chez les jeunes homosexuels, alors qu'il s'agit du soutien d'un ami réel chez les jeunes hétérosexuels. Ainsi, il apparait essentiel de formuler des recommandations pour développer des outils pertinents incluant les pairs, les parents et les professionnels, dont le soutien joue un rôle essentiel. Des mesures de prévention doivent être élaborées et mises en oeuvre chez les jeunes des minorités sexuelles. Des interventions anti-stigmatisation au niveau sociétal sont nécessaires afin de réduire le risque de victimisation et sensibiliser l'entourage. Mots clefs : tentative de suicide, adolescent, minorité sexuelle, facteur de risque et protection, prévention-2-Abstract: Suicide remains the second leading cause of death in adolescence in the United States and European countries including France, one main risk of death by suicide is history of attempted suicide (SA). The known risk factors for SA are numerous in adolescence. Adolescents with homosexual or bisexual attraction (LGB) could experience more stress, stigma and pressure than their heterosexual peers. However, the possible risk and protective factors have not been fully explored in the literature. A better knowledge of these factors in LGB youth could help to propose appropriate prevention. The French survey "Portraits d'adolescents" (2013) includes many important variables including sexual attraction and SA. Among the 14,265 adolescents, 637 (4.5%) described themselves as LGB. 30.7% attempted suicide (vs. 10.6% of heterosexual adolescents). Different types of statistical methods (Chi-square test, logistic regression model, Machine Learning decision tree model) were carried out to compare LGB and heterosexual groups and to identify risk and protective factors for SA. Different statistical models have reached consistent conclusions. In both LGB and heterosexual youth, substance consumption (alcohol, tobacco, cocaine, ecstasy, amphetamine) is the highest risk factor and parental support is the most important protective factor for SA. However, internet friend support was reported as a protective factor only in homosexual youth, whereas support of real-life friend was an important factor only in heterosexual youth. Thus, it is essential to build recommendations in order to develop relevant tools including peers, parents and professionals, whose support plays a crucial role. Effective preventive measures among sexual minority youth need to be developed and implemented. Societal-level anti-stigma interventions are needed to reduce the risk of victimization and awareness should be raised among family and friends.
... Childhood experiences of prejudice and discrimination related to gender and sexual orientation are some of the earliest forms of violence to which youth are exposed and have far-reaching consequences such as psychological distress, suicidal ideation (e.g., Wichstrøm & Hegna, 2003), and substance abuse (e.g., Russell, Driscoll, & Truong, 2002). An often overlooked outcome of prejudicial treatment in childhood and adolescence is its contribution to the evolution of adverse relationship experiences. ...
Chapter
Full-text available
In recent years, researchers and clinicians around the world have been taken aback by the high prevalence of relationship violence, particularly among school-age children as young as 12. Many have also documented the close relationship between prejudice and discrimination on the basis of gender identity, sexual orientation and racial identity, and young people’s experiences of dating violence. In this chapter, we begin by visiting the issue of dating violence in young people around the world and why it merits such careful study. We review scientific evidence and discuss the unique and salient role that prejudicial and discriminatory experiences of gender and sexual minorities, particularly when intersecting with minority racial and disability standings, play in the development and ongoing experiences of relationship violence in childhood and well into adulthood. We will further review existing knowledge on the risk factors which add to minority youths’ existing vulnerabilities, as well as protective factors which may facilitate resilience.
... 13,16 Women use milder methods including drug overdose, while hanging was a more frequent aggressive method used in men. 17,18 Our findings were also congruent with other studies done in other areas of Islamic Republic of Iran. 19,20 On the other hand those subjects having a history of suicide used milder methods compared to those who didn't. ...
Article
Objectives: Suicide is a conscious act in which the individual deliberately commit and unusual act with the intention of self-harm. The present study aims to examine some epidemiological factors affecting attempted and completed suicide rate during 2012–2016 in NajafAbad, a city in Isfahan province. Methods: This is a cross-sectional study. The subjects are 2138 cases involved in suicide attempt during 2012–2016 that gone to Montazeri and Al-Zahra hospital. Chi-square, logistic regression and Cochran–Armitage test was used for data analysis. Result: Totally, 1385 (64.8%) patients were female and 47.8% were younger than 24 years of age. The most common method of suicide was medication overdose (91.1%). In multivariable analysis, male gender (OR: 2.67; CI 95% 1.53 to 4.64) was a risk factor for fatal suicide and application of chemical methods (OR: 0.018; CI 95% 0.010 to 0.032) was a protective factor. Results regarding completed suicide trend analysis shows that this trend has had a significant statistical difference in men (p=0.019) but in women this trend doesn't statistically significant difference. (p=0.209). Conclusions: According to the findings of the present study, attempted and completed suicide rate in Najafabad is relatively high compared to other regions in Islamic Republic of Iran. The completed suicide rate was significant in men which achieved its greatest value in 2015. Suicide attempt rate didn't show a significant statistical difference in both men and women.
... In the U.S., a report released in 2016 by the Centers for Disease Control and Prevention revealed that sexual minorities are more likely than their heterosexual peers to be victims of violence, engage in premarital sex (and thus, are more likely to contract a STI and/or become pregnant), and use alcohol, tobacco, and illicit drugs (Kann et al., 2016). Other studies showed sexual minority adolescents in Europe, Guam, and New Zealand were at a greater risk for suicide attempts (Fleming, Merry, Robinson, Denny, & Watson, 2007;Pinhey & Millman, 2004;van Heeringen & Hincke, 2000;Wichstrom & Henga, 2003). Of course, it is important to remember that most sexual minority adolescents, at least in the U.S., lead healthy lives; their sexual minority status makes it more likely that they will engage in those risk behaviors, but most do not (Kann et al., 2016). ...
Chapter
This chapter explores what it means to be an adolescent using the three domains of development—biological, cognitive, and socio‐emotional—through a cultural lens to reveal similarities and differences in the adolescent experience. It also explores the close connections between adolescent development and cultural context. Adolescents face many health challenges unique to their developmental period. They must navigate puberty and address threats to their reproductive and sexual health, including adolescent pregnancy. Cognitive development, an increasing capacity for complex thinking, during adolescence may be universal, but the style of cognitive development, its application to specific situations, and its extent clearly vary by culture. Social and emotional development during adolescence is vast and varied—it includes relationships with friends, family, and romantic partners. At the heart of this domain is identity development, building a sense of self in light of the influence of cultural values and traditions.
... Many studies showed that sexual minority status (eg, individuals who experience same-sex attraction [SSA]; self-identify as gay, lesbian, or bisexual; or engage in same-sex sexual behavior) is a well-known risk factor for suicidality in adolescents. 5, 6 Meyer's minority stress theory suggests that difficulties in dealing with sexual minority stressors (prejudice, discrimination, and stigma due to same-sex orientation) may lead to a higher risk of suicidality in sexual minority adolescents. 7 In addition, a previous systematic review showed that a clear majority of studies reported an elevated risk of suicidal ideation and suicide attempts among sexual minority adolescents, 8 ...
Article
Full-text available
Background: Studies suggest that sexual minority adolescents experience higher rates of sleep disturbance than their heterosexual peers, and disturbed sleep is a well-known risk factor for suicidality. This study aimed to explore whether sleep quality had mediating effects on the relationship between sexual minority status and suicidal behavior in Chinese adolescents. Methods: We analyzed data collected from 7th to 12th graders from seven randomly selected provinces of People’s Republic of China in the 2015 School-Based Chinese Adolescents Health Survey. The 123,459 students who completed questionnaires regarding sexual attraction, the Pittsburgh Sleep Quality Index, past-year suicidal ideation, and past-year suicide attempts were included in our study (response rate: 95.9%). Results: After adjustment for covariates, sexual minority status was associated with suicidal ideation (adjusted odds ratio =1.82, 95% CI=1.69–1.95) and suicide attempts (adjusted odds ratio =2.16, 95% CI=1.82–2.56). Sleep quality partially mediated the effects of sexual minority status on suicidal ideation (standardized β estimate=0.009, 95% CI=0.007–0.012) and suicide attempts (standardized β estimate=0.004, 95% CI=0.003–0.005). Conclusion: Poor sleep quality partially explained the increased risk of suicidality for Chinese sexual minority adolescents. To prevent subsequent suicidality, suicide interventions targeting sexual minorities should be made, with a focus on their disparities in sleep disturbance and sleep health promotion.
... 9 The problem of substance use among university students in Nigeria is a recognized phenomenon. 11 A study among university students in Ilorin reported a current use of one or more psychoactive substance of 40.4% with a lifetime prevalence of 78%. 12 The negative impacts of psychoactive substances on students are far reaching, and diverse. These include disruption of interpersonal relationships especially within the family, criminal behaviour, academic failure, vocational failure and a lack of commensurate achievement. ...
Article
Background: Psychoactive substance use is a proliferating public health and social problem leading to negative multi-dimensional impact especially among young people. This study was done to determine the prevalence and factors predisposing to psychoactive substance use among undergraduates in University of Uyo, Nigeria. Methodology: This was a cross-sectional descriptive study carried out among 350 undergraduates in the University of Uyo, Nigeria between March and July 2016. Data collection was done using a self-administered semi-structured questionnaire and was analyzed using the Statistical Package for the Social Sciences, version 23. Results: The average age of the respondents was 21.571.96 years. The prevalence of psychoactive substance use was 27.5% and was more in females (37.7%) than males (18.2%). Peer group influence (94.3%), Stress (70.5%), Curiosity (58.7%), were the most common factors perceived to predispose to psychoactive substance use among undergraduate students. Among the 89 substance users in the study, alcohol 89 (100.0%), codeine 71 (79.8%), tramadol 66(74.2%) and cigarette 37(41.6%) were the most commonly used substances. The commonest source of substances was from friends 76 (85.4%), while the commonest reasons for substance use were to boost confidence, 82 (92.1%) and to read for exams, 76 (85.4%). A statistically significant association existed between substance use and age, sex, intra family relationship, family member substance use, peer group use of psychoactive substance and academic performance (p<0.05). Conclusion: Psychoactive substance use was high among the study group. A multidimensional approach is needed in curbing substance use among undergraduate students both at the educational institution and family levels.
... A short five-item version of the SSQ (Wichstrøm & Hegna, 2003), modelled after Sarason et al.'s (1983) full version of 27 items and adapted to adolescents, was used to measure perceived social support. The SSQ examines to whom adolescents can turn in five hypothetical situations involving informational support, emotional support, and crisis intervention (see Table S1 for further information). ...
Article
Full-text available
Social support may be of particular importance for vulnerable adolescents' development and health and can help them to cope with stressful life events. However, knowledge of perceived social support among adolescents in Residential Youth Care (RYC) is sparse. The present study therefore aimed to investigate perceived social support among adolescents in Norwegian RYC (N = 304, mean age 16.3 years, girls 57.2%), using a short form of the Social Support Questionnaire. The results were compared with adolescents in the general population. The findings revealed that adolescents in RYC reported a lower number of support persons compared with the general population. Both populations reported a decreasing number of support persons as they aged, except for girls in RYC. The adolescents in both populations were satisfied with the support perceived, especially those with the highest number of support persons. However, social support providers differed between the two populations; RYC adolescents reported their extended family, other sources of support, and the institutional staff more often and their parents less. The findings are important for adolescents living in RYC, as knowledge of their social support network could influence the current practices and ensure contact with important support persons, affecting their development and health.
... Speciellt allvarligt är de stora andelarna med självmordstankar och själmordsförsök i gruppen. Dessa resultat är i linje med tidigare undersökningar, där man i samma studie har jämfört självmordstankar och självmordsförsök bland homo-och bisexuella ungdomar och unga vuxna och jämfört med heterosexuella unga Faulkner & Cranston, 1998;Fergusson et al., 1999;Garofalo et al., 1998;Remafedi et al., 1998;Wichstrom & Hegna, 2003). Motsvarande mönster med den stora andelen av självmordstankar och självmordsförsök bland homo-och bisexuella jämfört med heterosexuella gäller också för vuxna (Bagley & Tremblay, 1997;Cochran & Mays, 2000;Gilman et al., 2001;Herrell et al., 1999;Jorm et al., 2002). ...
... Most of these early studies, however, lacked heterosexual control groups and recruited participants from the gay community, resulting in a possible bias that may over-or underestimate the prevalence of mental health problems among LGB individuals [18,19,20,21]. Since the 1990s, the quality of studies has substantially improved by using innovative research methodologies such as birth cohorts [22,23], prospective designs [24,25], twin registries [26,27], matching LGB individuals with their heterosexual siblings [28], and using multiple dimensions of sexual orientation [1,2,29,30,31,32], or combined dimensions of sexual orientation [33]. In these improved studies, LGB individuals continued to report increased mental health problems and suicidality compared with heterosexuals. ...
Chapter
Lesbian, gay, bisexual, transgender, and intersex (LGBTI) individuals face specific mental health challenges, as will be described in this chapter. Many studies reported elevated mental health problems for LGB individuals compared with their heterosexual counterparts. Fewer studies are available for trans(-gender) and inter(-sex) individuals, but the majority reported increased levels of mental health problems compared with their cisgendered or non-inter counterparts. Current explanatory models centre on the pathogenic effect of homonegativity, transnegativity, and internegativity, as well as the underlying rigid gender roles, resulting in minority stressors that LGBTI individuals and those who are perceived as LGBTI are faced with. Such experienced or internalized minority stress can explain mental health disparities well. This contrasts with the long-standing medical view that LGBTI conditions are inherently pathological. Evidence-based LGBTI-specific prevention and intervention programmes are emerging.
... To address the limitations of this study and to gain a more systematic understanding of the health disparities of the Korean LGB population, nationally representative surveys should include sexual orientation in their questionnaires. A growing number of health surveys in North America and Europe include sexual orientation as a demographic variable, based on which many studies are conducted to investigate health disparities of sexual minorities [1][2][3]6,7,9,10,36,37]. The Korea Youth Risk Behavior Web-based Survey is the only national-level health survey in Korea measuring sexual orientation by asking respondents to indicate the gender of the person with whom they had a sexual intercourse. ...
... Recent studies have shown significant sexual orientation differences in the prevalence of alcohol abuse, recreational drug use, and tobacco smoking, with sexual minorities (i.e., those self-identifying as lesbian, gay, or bisexual [LGB] or those reporting same-sex sexual experiences) reporting greater substance use than heterosexuals [1][2][3][4][5][6][7][8]. Large differences also exist in mental health problems such as depression, anxiety disorders, and suicide attempts between sexual minorities and heterosexuals [9][10][11][12][13][14][15]. These disparities in substance use and mental health problems emerge early in development, persists across the life course, and expose sexual minorities to a greater risk of potentially avoidable diseases than heterosexuals [16][17][18][19][20]. ...
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Purpose: Although strong evidence documents the elevated prevalence of both substance use and mental health problems among sexual minorities (i.e., gay, lesbian, and bisexuals), relatively less research has examined whether risk of the co-occurrence of these factors is elevated among sexual minorities compared to heterosexuals. The object of this study was to (1) explore sexual orientation-based differences in substance use, psychological distress, and their co-occurrence in a representative sample in Sweden, and (2) examine if greater exposure to stressors, such as discrimination, victimization/threats, and social isolation, could explain these potential disparities and their co-occurrence. Methods: Data come from the cross-sectional Swedish National Public Health Survey, which collected random samples of individuals (16-84 years of age) annually from 2008 to 2015, with an overall response rate of 49.7% (n = 79,568 individuals; 1673 self-identified as lesbian, gay, or bisexual). Population-level sexual orientation differences in substance use (i.e., alcohol, tobacco, and cannabis) and psychological distress were examined. Results: Our findings showed significantly elevated prevalence of high-risk alcohol use, cannabis use, and daily tobacco smoking, among sexual minorities compared to heterosexuals. These substantial disparities in substance use more often co-occurred with psychological distress among sexual minorities than among heterosexuals. The elevated risk of co-occurring psychological distress and substance use was most notable among gay men relative to heterosexual men (adjusted odds ratio [AOR] = 2.65, CI 1.98, 3.55), and bisexual women relative to heterosexual women (AOR = 3.01, CI 2.43, 3.72). Multiple mediation analyses showed that experiences of discrimination, victimization, and social isolation partially explained the sexual orientation disparity in these co-occurring problems. Conclusions: This study adds to a growing body of research showing that sexual minorities experience multiple threats to optimal health and points toward future interventions that address the shared sources of these overlapping health threats in stigma-related stress.
... Sexual orientation and gender identity. Lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth show elevated prevalence of suicidal ideation and suicide attempt than heterosexual youth (Fergusson, Horwood, & Beautrais, 1999;Haas et al., 2010;Wichstrøm & Hegna, 2003). Related to the aforementioned point on race, the impact of sexual minority status may vary across Note. ...
Article
Background: Suicide is a leading cause of death and a complex clinical outcome. Here, we summarize the current state of research pertaining to suicidal thoughts and behaviors in youth. We review their definitions/measurement and phenomenology, epidemiology, potential etiological mechanisms, and psychological treatment and prevention efforts. Results: We identify key patterns and gaps in knowledge that should guide future work. Regarding epidemiology, the prevalence of suicidal thoughts and behaviors among youth varies across countries and sociodemographic populations. Despite this, studies are rarely conducted cross-nationally and do not uniformly account for high-risk populations. Regarding etiology, the majority of risk factors have been identified within the realm of environmental and psychological factors (notably negative affect-related processes), and most frequently using self-report measures. Little research has spanned across additional units of analyses including behavior, physiology, molecules, cells, and genes. Finally, there has been growing evidence in support of select psychotherapeutic treatment and prevention strategies, and preliminary evidence for technology-based interventions. Conclusions: There is much work to be done to better understand suicidal thoughts and behaviors among youth. We strongly encourage future research to: (1) continue improving the conceptualization and operationalization of suicidal thoughts and behaviors; (2) improve etiological understanding by focusing on individual (preferably malleable) mechanisms; (3) improve etiological understanding also by integrating findings across multiple units of analyses and developing short-term prediction models; (4) demonstrate greater developmental sensitivity overall; and (5) account for diverse high-risk populations via sampling and reporting of sample characteristics. These serve as initial steps to improve the scientific approach, knowledge base, and ultimately prevention of suicidal thoughts and behaviors among youth.
... Although clear evidence exists that sexual minorities represent a disproportionately high-risk group for mental distress, physical health concerns, and other indicators of poor life satisfaction Bränström et al., 2016;Chakraborty et al., 2011;Cochran et al., 2003;Plöderl & Fartacek, 2005;Sandfort et al., 2001;Wichstrøm & Hegna, 2003), no known study has examined sexual minority wellbeing as a function of differences in structural stigma across countries or potential mechanisms of this association. The present study takes advantage of an unprecedented opportunity to examine the association between structural stigma (operationalized as national laws, policies, and attitudes This document is copyrighted by the American Psychological Association or one of its allied publishers. ...
Article
Objective: Although structural stigma (i.e., discriminatory laws, policies, and community attitudes) toward sexual minorities predicts adverse health and wellbeing, this association has typically only been examined within a single country and potential mechanisms remain unknown. Consequently, we examined the association between structural stigma and sexual minorities' life satisfaction across 28 countries, identity concealment as a potential mechanism of this association, and, in high-stigma countries, the potential for concealment to protect sexual minorities from discrimination and victimization, and therefore even poorer life satisfaction than they would otherwise experience in those countries. Method: Sexual minority adults (n = 85,582) from 28 European countries responded to questions regarding sexual minority stigma, identity concealment, and life satisfaction. Structural stigma was assessed as national laws, policies, and attitudes affecting sexual minorities in each country. Results: Country-level structural stigma explained 60% of country-level variation in life satisfaction and more than 70% of country-level variation in sexual orientation concealment. Sexual orientation concealment mediated the association between structural stigma and life satisfaction. Especially in high-stigma countries, concealment also protected against even lower life satisfaction than would be experienced if a sexual minority individual did not conceal in those countries because it partially protected against discrimination and victimization. Conclusions: Sexual minorities' life satisfaction varies greatly across countries largely due to the structural stigma of those countries and associated demands to conceal one's sexual orientation. Findings highlight the importance of reducing structural stigma to promote equitable life satisfaction and tailoring affirmative psychotherapies to address the structural context surrounding sexual minorities who seek treatment. (PsycINFO Database Record
... This trend could reflect distinct age and life course-specific effects. Given the higher proportion of respondents who identify as bisexual in surveys of adolescents, as compared with surveys of adults (Denny et al., 2016;Hatzenbuehler, 2011), samples of bisexual adolescents may be more likely to include individuals who are still questioning their sexuality, which in turn is associated with psychological distress (D'Augelli, Hershberger, & Pilkington, 2001;Meyer, Teylan, & Schwartz, 2015;Wichstrom & Hegna, 2003). By contrast, the subsequent period of young adulthood (i.e., twenties) may afford some protection from the stressors of adolescence, as some bisexual individuals begin to find social connection and support in communities of bisexual and bisexual-ally peers. ...
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Sexual minorities are at increased risk of suicide; however, it is unclear whether there are within-sexual minority differences in risk across specific sexual identities—notably between bisexual and lesbian/gay subgroups. We therefore conducted a systematic review and meta-analysis to quantify associations between bisexual identity and self-reported suicide ideation and attempt and the moderation of these associations by gender/sex, age, sampling strategy, and measurement of sexuality. Abstracts and full texts were independently screened by two reviewers, resulting in a total of 46 studies that met inclusion criteria and reported 12-month or lifetime prevalence estimates for suicide ideation or attempt. A consistent gradient was observed across all four outcomes, whereby bisexual respondents reported the highest proportion of suicide ideation or attempt, lesbian/gay respondents the next highest proportion, and heterosexual respondents the lowest proportion. Random-effects meta-analysis comparing bisexual individuals with lesbian/gay individuals yielded odds ratios (ORs) ranging between 1.22–1.52 across the four outcomes examined. Between-study variability in ORs was large. Thirty-one percent of heterogeneity was explained by sample type (e.g., probability vs. non-probability) and 17% by gender/sex. ORs were consistently larger for women (range: 1.48–1.95, all statistically significant at p < .05) than for men (range: 1.00–1.48, all p > .05), suggesting that gender/sex moderates the association between bisexual identity and suicide risk. Within-sexual minority differences in suicide risk may be attributed to structural and interpersonal experiences of monosexism, bisexual erasure and invisibility, or lack of bisexual-affirming social support, each of which may be experienced differently across gender/sex identities.
... Together with this study's results, these findings imply that using a concept or umbrella term as 'substance use' might miss nuances. This study is not the first to not find strong support for psychological mediation processes (Austin et al. 2004;Wichstrøm and Hegna 2003;Ziyadeh et al. 2007), although prior studies used sexual identity as a proxy for minority stressors. Despite efforts to measure indicators of minority stressors, no support was found for psychological mediation processes. ...
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Lesbian, gay, and bisexual (LGB) adolescents experience elevated levels of internalizing problems and use more substances than heterosexual adolescents. The minority stress and psychological mediation framework are complementary theoretical frameworks that were developed to explain these disparities. However, limited empirical research has integrated both frameworks to study health disparities between heterosexual and LGB adolescents. This study attempts such an integration, using data from the first five waves (participant age 11–22) of the TRacking Adolescents’ Individual Lives Survey (TRAILS), a cohort study of Dutch adolescents (N = 1738; 151 LGB; 54.8% girls). It was tested whether an LGB identity was linked to internalizing problems and substance use through a serial mediation process, in which sexual identity would be associated with peer victimization and negative relationships with parents (first set of mediators, in keeping with the minority stress framework), which in turn would be associated with fear of negative social evaluation and a lack of social support (second set of mediators, in keeping with the psychological mediation framework), and eventually increasing the risk for internalizing problems and elevated levels of substance use. Moreover, it was tested whether the link between minority stress and substance use was mediated by peers’ substance use levels, as hypothesized by the psychological mediation framework. Compared to heterosexual participants, LGB participants reported more internalizing problems, smoked more cigarettes, and used more marijuana, but did not consume more alcohol. The relation between sexual identity and internalizing problems was mediated by peer victimization and parental rejection, which is in line with the minority stress framework. No statistically significant support was found for the psychological mediation framework. These findings provide a better understanding of the pathways through which sexual identity disparities in mental wellbeing and substance use come about.
... 9 In Norway, Wichstrøm and Hegna found that youth reporting experience of same-sex sexual behaviour were more likely to attempt suicide in comparison to youth with no such behaviour. 14 Research in Sweden has further demonstrated higher levels of co-occurrence of alcohol and drug use and psychological distress among gay and bisexual persons (but not among lesbian women), compared with the general population. 1 However, despite these results, few studies have focused specifically on mental health of the younger strata of LGB identified persons or those engaging in same-sex sexual relationships. Violence, including physical and sexual violence, is a major global public health concern and may particularly affect LGB identified persons and those who engage in same-sex sexual relations and could at least partly explain the high levels of poor mental health within these populations. ...
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Objectives To assess prevalence and correlates of same-sex sexuality and its relationship to poor mental health and experiences of violence among youth and young adults in Sweden. A secondary aim was to estimate the same-sex sexuality attributable fractions. Design A population-based cross-sectional survey. Setting Southern Sweden. Participants 2968 respondents out of 7000 youth and young adults between 18 and 29 years old, resident in southern Sweden, selected randomly by the Swedish Central Population Registry (final sample=2931 respondents, 318 with same-sex sexuality and 2613 without). Outcome measures The outcome measures were self-reported poor mental health (depression and anxiety) and experience of violence (physical violence, sexual violence and sexual coercion). Results Increased odd of high scores of depression (adjusted OR 1.8, 95% CI 1.39 to 2.26) and anxiety (adjusted OR 1.6, 95% CI 1.28 to 2.07) were observed among youth and young adults with same-sex sexuality. Similarly, increased odds of experience of physical violence (OR 1.8, 95% CI 1.23 to 2.51), sexual violence (OR 2.8, 95% CI 1.96 to 3.89) and sexual coercion (OR 2.5, 95% CI 1.95 to 3.30) were observed with same-sex sexuality. Within the entire young population, same-sex sexuality accounted for 4.7% and 4.1% of the self-reported experience of depression and anxiety, respectively. The estimated same-sex sexuality attributable fractions of violence within the entire population of young people were 4.5% for physical violence, 7.3% for sexual violence and 6.4% for sexual coercion. Conclusions This study findings suggest that same-sex sexuality is associated with poor self-rated mental health and experience of violence among youth and young adults in Sweden. Some differences were observed between males and females, indicating that the vulnerabilities and experiences vary between young males and females. Further research is needed in order to gain a deeper knowledge of the factors underlying these associations and the gender differences observed.
... For instance, epidemiologic research shows that minority stressors (e.g., discrimination) account for some, but not all, of the variation in mental health as a function sexual orientation (Mays & Cochran, 2001). In addition, sexual orientation disparities in mental health of the same magnitude as those found in the United States are reported in countries with objectively more accepting cultures and social norms regarding nonheterosexual sexual orientations and identities (e.g., Norway: Wichstrøm & Hegna, 2003;Sweden: Bränström, 2017). These findings, at odds with the predictions of minority stress theory, suggest that other processes, unaccounted for by minority stress theory, might be relevant in the context of gay and bisexual men's mental health. ...
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Social stressors stemming from within the gay community might render gay and bisexual men vulnerable to mental health problems. The 20-item intraminority Gay Community Stress Scale (GCSS) is a reliable measure of gay community stress, but the scale’s length limits its widespread use in sexual minority mental health research. Using three independent samples of gay and bisexual men, the present research developed two abbreviated versions of the GCSS using nonparametric item response modeling and validated them. Results indicated that eight items provided maximal information about the gay community stress construct; these items were selected to form the eight-item GCSS. The eight-item GCSS reproduced the factor structure of the parent scale, and gay community stress scores obtained from it correlated with other identity-specific social stress constructs and mental health symptoms. Associations between gay community stress and mental health symptoms remained significant even after controlling for related identity-specific stressors, general life stress, and relevant demographics. A four-item version was also developed and assessed, showing good structural, convergent, criterion, and incremental validity and adequate reliability. The eight- and four-item versions of the GCSS offer efficient measures of gay community stress, an increasingly recognized source of stress for gay and bisexual men.
... same-sexual behavior 1-7.5% and identifying as gay, lesbian, or bisexual from 2.5-9.3% (Fish & Baams, 2018;Graham et al., 2011;Kann et al., 2016;Mosher et al., 2005;Savin-Williams & Ream, 2007;Wichstrom & Hegna, 2003). Given that rates of same and both-sex attraction are the highest (encompassing a broader group than behavior or identity) there is a rationale for focusing on attraction in research. ...
Article
Introduction: This study examined mental health, substance use, and sexual health across sexual attraction groups. Methods: 428 adolescents recruited from school-based health centers completed self-report measures. 72% were only opposite-sex attracted, 19% both-sex attracted, 3% same-sex attracted, 4% not sure. Results: Reported partners did not always align with reported attraction. Compared to opposite-sex attracted youth, 1) both-sex attracted youth had significantly higher rates of marijuana use (OR = 1.75, p = .04), depressive symptoms (OR = 2.62, p = .001) and inconsistent condom use (OR = 1.71, p = .05); 2) the “not sure” group had higher anxiety symptoms (OR = 4, p = .01). Conclusion: This study highlights the importance of considering sexual attraction in providing quality care to young people.
... In addition to identity-related risk factors, studies demonstrate that interpersonal and psychological risk factors (e.g., lack of social support, emotion dysregulation, rumination) help to explain the associations between stigma-related minority stressors and psychological distress (e.g., Hatzenbuehler, Dovidio, Nolen-Hoeksema, & Phills, 2009). Social support, particularly from family, has been found to be related to less suicidality among sexual minority individuals (Eisenberg & Resnick, 2006;Plöderl & Fartacek, 2005;Safren & Heimberg, 1999;Wichstrøm & Hegna, 2003), whereas social isolation is one of the strongest and most reliable predictors of suicidal ideation and behavior (Van Orden et al., 2010). According to the Interpersonal Theory of Suicide (Joiner, 2005), the desire for suicide arises as a result of thwarted belongingness and perceived burdensomeness. ...
Article
Introduction The present study examined whether sexual identity (bisexual/pansexual versus gay/lesbian) moderated associations between risk factors and lifetime suicide attempt (SA). Method Community/college adults who identified as sexual minorities (N = 231) completed a survey examining suicide-related risk factors. Results Greater discrimination and less social support from friends and significant others were associated with greater odds of lifetime SA for both groups, whereas greater emotion dysregulation and rumination were only associated with greater odds of lifetime SA for bisexual/pansexual individuals. Conclusion There are common and unique risk factors for SA among subgroups of sexual minorities, which may have intervention implications.
... Thus, early puberty resulting from early adversity may be a mechanism by which suicide risk is instantiated or exacerbated in vulnerable adolescents. Finally, it is important to acknowledge that sexual orientation and identification as a sexual minority are increasingly being recognized as risk factors for STBs [150]; more research in this area is critically needed. ...
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Suicide is the second leading cause of death among adolescents. While clinicians and researchers have begun to recognize the importance of considering multidimensional factors in understanding risk for suicidal thoughts and behaviors (STBs) during this developmental period, the role of puberty has been largely ignored. In this review, we contend that the hormonal events that occur during puberty have significant effects on the organization and development of brain systems implicated in the regulation of social stressors, including amygdala, hippocampus, striatum, medial prefrontal cortex, orbitofrontal cortex, and anterior cingulate cortex. Guided by previous experimental work in adults, we also propose that the influence of pubertal hormones and social stressors on neural systems related to risk for STBs is especially critical to consider in adolescents with a neurobiological sensitivity to hormonal changes. Furthermore, facets of the pubertal transition, such as pubertal timing, warrant deeper investigation and may help us gain a more comprehensive understanding of sex differences in the neurobiological and psychosocial mechanisms underlying adolescent STBs. Ultimately, advancing our understanding of the pubertal processes that contribute to suicide risk will improve early detection and facilitate the development of more effective, sex-specific, psychiatric interventions for adolescents.
... SMY have been reported to have a higher rate of suicidal ideation and suicide attempts than the general population (17,(28)(29)(30). According to previous studies using small convenience samples (31,32), rates of suicidal ideation and suicide attempts among SMY reached 20%-40%, which is 5-6 times higher than those of non-SMY (33)(34)(35). However, less is known about the full range of suicide-related behaviors, including suicidal ideation and plans, and suicide attempts among SMY (30). ...
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Background Despite growing interest in the public health of sexual minority, youth around the world due to the high rates of suicidal ideation and attempts in this population, few studies on the sexual orientation of Korean adolescents have been conducted. Therefore, this study investigated the relationship between the sexual orientation of Korean adolescents and their suicide-related behavior. Methods Raw data from the tenth Korea Youth Risk Behavior Web-based Survey were analyzed by logistic regression analysis. The sample consisted of 3603 adolescents who provided selected demographic variables and reported on their experience of sexual intercourse with the same or the opposite sex, along with lifestyle and suicide-related behaviors. Results Rates of suicidal ideation, plans, attempts, and medically serious attempts were higher in both homosexual and bisexual than heterosexual groups. Suicidal ideation (odds ratio 95% confidence interval: 1.09–2.08), suicidal plans (odds ratio 95% confidence interval: 1.01–2.09), and suicide attempts (odds ratio 95% confidence interval: 1.28–2.88) had the strongest associations with homosexuality after multivariate adjustment. In contrast, bisexuality was only significantly associated with suicidal attempts (odds ratio 95% confidence interval: 1.01–2.97) after multivariate adjustment. Conclusion Effective suicide prevention interventions are required for homosexual and bisexual adolescents, in the form of targeted programs to improve their mental health status and ability to cope with stress.
... Our estimate of the proportion of sexual minority youth is inclusive of adolescents who reported same-sex attractions, rather than the more limited constructs of sexual identity or same-sex sexual behaviour. Therefore, having up to 12% of adolescents reporting these attractions is not surprising, as a greater proportion of young people are likely to have these sexual attractions than those who identify as LGB, or report having had sex with a same-sex partner (Wichstrom and Hegna, 2003). We believe that this review is timely as there has been a recent call to action recommending that there should be more research into the mental health of lesbian, gay, bisexual, transgender and intersex (LGBTI) people, e.g., the recent position statement from the Royal Australian and New Zealand College of Psychiatrists highlighting the need to address the mental health needs of the LGBTI people (Royal Australian and New Zealand College of Psychiatrists, 2016). ...
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Objective: Research has suggested that sexual minority young people are more likely to have depressive symptoms or depressive disorder, but to date most studies in the field have relied on convenience-based samples. This study overcomes this limitation by systematically reviewing the literature from population-based studies and conducting a meta-analysis to identify whether depressive disorder and depressive symptoms are elevated in sexual minority youth. Method: A systematic review and meta-analysis were conducted and informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to determine if rates of depressive symptoms or depressive disorder differ for sexual minority youth, relative to heterosexual adolescents. MEDLINE, PsycINFO, EMBASE and ERIC databases were searched. Studies reporting depressive symptom data or the prevalence of depressive disorder in population-based samples of adolescents, which included sexual minority youth and heterosexual young people, were included in the review. A meta-analysis was conducted to examine differences between groups. Results: Twenty-three articles met the inclusion criteria. The proportion of sexual minority youth in the studies ranged from 2.3% to 12%. Sexual minority youth reported higher rates of depressive symptoms and depressive disorder (odds ratio = 2.94, p < 0.001 and standardized mean difference, d = 0.39, p < 0.001) in comparison to heterosexual young people. Female sexual minority youth were more likely to report depressive symptoms when compared to male sexual minority youth (standardized mean difference, d = 0.34, p < 0.001). Limitations included variations in how sexuality was operationalized and how depressive symptoms or depressive disorder was measured. Conclusions: There is robust evidence that rates of depressive disorder and depressive symptoms are elevated in sexual minority youth in comparison to heterosexual young people. Despite the elevated risk of depressive symptoms or depressive disorder for sexual minority youth, the treatment for this group of young people has received little attention.
... Opiates are among the commonly used substances in Europe, USA and Asia; cocaine in Southern America and cannabis in Africa (UNODC, 2013a). With respect to drug abuse, drugs are substances that have detrimental effects on the user including physical, mental, and emotional as well as behavioural (Whichstrom and Hegna, 2003, Galea et al., 2004, UNODC, 2013b. Drug abuse is now generally defined as excessive or inappropriate use of a psychoactive substance by a person; such user being considered or judged to be illegal (immoral) by the culture *Corresponding author. ...
... Although this finding did court some controversy (Friedman & Downey, 1998 ;Bailey, 1999), populationbased reports (Fergusson et al. 1999 ;Cochran & Mays, 2000a, b ;Sandfort et al. 2001 ;Cochran et al. 2003) and two meta-analyses (Meyer, 2003 ;King et al. 2008) suggest that non-heterosexual men and women have at least twice the risk of mood and anxiety disorders compared with heterosexual individuals of the same gender. Studies also indicate increased rates of suicide attempts among non-heterosexual adolescents (Fergusson et al. 1999 ;Wichstrøm & Hegna, 2003 ;Silenzio et al. 2007) and increased lifetime self-harm and suicidality among adult non-heterosexual men (Herrell et al. 1999 ;King et al. 2003 ;Fergusson et al. 2005 ;de Graaf et al. 2006 ;Cochran et al. 2007) and women (King et al. 2003 ;Fergusson et al. 2005). Understanding the origins of these prevalence patterns is important for mental health professionals working with sexual minority populations. ...
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Background Increased psychiatric morbidity has been widely reported among non-heterosexual individuals (defined as reporting a homosexual/bisexual identity and/or same-sex sexual partners). However, the causes of this psychiatric ill-health are mostly unknown. Method We attempted to estimate the influence of minority stress and familial factors on psychiatric disorder among adults with same-sex sexual partners. Self-report data from a 2005 survey of adults (age 20–47 years, n=17 379) in the population-based Swedish Twin Registry were analysed with regression modelling and co-twin control methodology. Results Rates of depression, generalized anxiety disorder (GAD), eating disorders, alcohol dependence and attention deficit hyperactivity disorder (ADHD) were increased among men and women with same-sex sexual experiences. Adjusting for perceived discrimination and hate crime victimization lowered this risk whereas controlling for familial (genetic or environmental) factors in within-twin pair comparisons further reduced or eliminated it. Conclusions Components of minority stress influence the risk of psychiatric ill-health among individuals with any same-sex sexual partner. However, substantial confounding by familial factors suggests a common genetic and/or environmental liability for same-sex sexual behaviour and psychiatric morbidity.
... As the satisfaction scale only measures satisfaction with the perceived support in each situation, not individually for each provider, and that the adolescents are generally satisfied with the support perceived [8], we chose not to include this scale in our analyses. Instead, in the current study, we used a short 5-item version [60] developed from the original 27-item version [32]. Briefly, the questionnaire examines who the adolescents can turn to (nine possible support persons) in five hypothetical situations, including different social support domains. ...
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Background Residential youth care (RYC) institutions aim to provide care and stability for vulnerable adolescents with several previous and present challenges, such as disrupted attachments, wide-ranging adverse childhood experiences, mental health problems, and poor quality of life (QoL). To the best of our knowledge, the present study is the first to provide knowledge of the associations between perceived social support and QoL and to explore the potential moderating effect of perceived social support on QoL for adolescents who have experienced maltreatment and polyvictimization. Methods All RYC institutions with adolescents between the ages 12–23 in Norway were asked to participate in the study. A total of 86 institutions housing 601 adolescents accepted the invitation, from which 400 adolescents volunteered to participate. The Child and Adolescent Psychiatric Interview was used to gather information on maltreatment histories and degree of victimization; the Kinder Lebensqualität Fragebogen was used to measure QoL through several domains (overall QoL, physical well-being, emotional well-being, and self-esteem); and the Social Support Questionnaire was used to measure perceived social support. Linear regression and independent samples t-test were used to study the associations between perceived social support and QoL as well as the potential moderating effect of perceived social support in the association between maltreatment history and QoL. Results Perceived social support was positively associated with QoL for both girls and boys, with domain-specific findings. A higher number of different types of support persons was associated with overall QoL, emotional well-being, and self-esteem for boys, but only with self-esteem for girls. Individual social support from RYC staff and friends was associated with higher QoL for girls. However, perceived social support did not moderate the association between maltreatment history and reduced QoL for either sex. Conclusions This study emphasizes the importance of maintaining social support networks for adolescents living in RYC, the crucial contribution of RYC staff in facilitating social support, and the potential value of social skills training for these vulnerable adolescents. Furthermore, a wider range of initiatives beyond social support must be carried out to increase QoL among adolescents with major maltreatment and polyvictimization experiences.
... The effectiveness of these two different philosophies will be based upon a consideration of a treatment's ability to produce tangible changes to vocal output, alter listener perceptions and improve patient-reported satisfaction. Because difficulties with genderrole identity have been attributed to higher rates of suicide attempts (D'Augelli et al., 2005;Maguen and Shipherd, 2010: 35;Remafedi et al., 1991Remafedi et al., , 1998Wichstrom and Hegna, 2003), an examination of these opposing approaches for voice modification is of clinical importance, and employing the right strategies in future clinical settings has the potential to improve the quality of life for members of this particularly vulnerable population. ...
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The literal voice is a principal contributor to identity construction. Consequently, it is a common source of gender dysphoria for transgender females undergoing voice feminisation. Much of the research in this field has primarily viewed this phenomenon from a determinist perspective, equating physiology with vocal identity. Although many approaches to voice feminisation rely on this predominately physiological point of view, objective measures defining voice femininity are not always correlated with transgender client satisfaction (Dacakis et al., 2017: 835–37). This evidence demonstrates the need to look at the voice more constructively—or as a conglomeration of many social, physical and cultural factors—in therapeutic voice interventions. Previously reported clinical outcomes and empirical research concerning the links between the voice and gender identity give credence to this constructivist perspective, which must be more heavily emphasised in transgender voice feminisation approaches moving forward.
... In Nigeria, the challenge related to of substance use is a recognized phenomenon in universities (Whichstrom & Hegna, 2003). Students in university experience self-dependence, and lack of supervision from family members, self-decision-making, and rigorous academic pressures, share living quarters with strangers, form new social groups, balance social engagements with academic and other life responsibilities, and may be exposed to normative values valued by the youth culture that differ from parental values while studying (Tesfaye et al. 2014). ...
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Psychoactive substance use among undergraduate students has become an increasing public health and social problem in both developed and developing countries, with mood changing effects, intoxication, or altered self-image as the potential side effect. The study set out to identify the pattern of use, the sources of influence and reasons for, psychoactive substance use among undergraduate students of faculty of Engineering, Bayero University Kano. A cross sectional study design was used. A total of 379 students were recruited using a multi-staging sampling technique. A questionnaire was adopted from model student questionnaire. Data obtained were organized and analyzed with SPSS Version 20. Spearman's ranked order Correlations was used to test age, ethnic group and pattern of psychoactive substance and age with reasons for psychoactive substance use. The results indicated that; majority (90.0%) of the respondents were males with 50.8% within 21-25 years of age (mean age of 24 ±2 years). Most pattern used in abusing drugs were drinking (68.6%), smoking (67.5%), chewing (38.0%) and inhaling (33.0%). The major source of influence included friends (85.6%), parties (78.1%) and truancy (63.1%) although, relief of hunger, cold (n=355, 98.6%), curiosity (n=350, 97.2%), enjoyment (n=316, 87.8%), socialization (n=314, 87.2%), enable prolonged reading (n=311, 86.4%), acceptance (n=217, 60.3%), and relief of psychological stress (n=211, 58.6%) were identified as the most reasons for abusing drugs. Positive correlation was identified between age, ethnic group and pattern of psychoactive substance and age with the reasons for psychoactive substance use. Universities in collaboration with National Agency for Food and Drugs Administration and Control (NAFDAC) and National Drug Law Enforcement Agency (NDLEA) should embark on grassroots awareness and sensitization campaign on the risks and effects of substance abuse.
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Purpose: The objective of this study was to examine the influence of sexual identity and adverse childhood experiences (ACEs) on suicidal behaviors in a population-based sample of high school students. Methods: A two-stage cluster random sampling design was used to recruit 5,108 students from 97 high schools. A total of 4,955 students (97%) provided information that allowed for classification of sexual identity into three groups: (1) lesbian, gay, or bisexual (LGB) (10%); (2) not sure (4.6%); and (3) heterosexual (85.4%). Five measures of childhood abuse and household dysfunction were summed, and the ACE score was categorized as 0, 1, 2, and 3-5 ACEs. Weighted logistic regression was used to assess the influence of sexual identity, ACEs, and their interaction on suicide ideation and attempts in the past 12 months. Results: Compared with heterosexual students, those who were LGB and were not sure had higher odds of suicide ideation and attempts. There was also a graded relationship between cumulative ACE exposure and suicidal behaviors. Although sexual identity/ACE interaction was not observed, LGB/not sure students who experienced a high number of ACEs were disproportionately affected. Compared with heterosexual students with 0 ACE, LGB/not sure students with 0 ACE (adjusted odds ratio [AOR] = 3.32, 95% confidence interval [CI] = 1.96-5.61), 1 ACE (AOR = 6.58, 95% CI = 4.05-10.71), 2 ACEs (AOR 13.50, 95% CI = 8.45-21.58), and 3-5 ACEs (AOR = 14.04, 95% CI = 8.72, 22.62) had higher odds of suicide ideation. A similar pattern was observed for suicide attempts. Conclusions: LGB and students not sure of their sexual identity with greater exposure to ACEs have disproportionately high levels of suicide ideation and attempts. Trauma-informed interventions for these populations are warranted.
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Objectives: This study aims to investigate health disparities between lesbian, gay, and bisexual (LGB) adults and the general population in South Korea, where there is low public acceptance of sexual minorities and a dearth of research on the health of sexual minorities. Methods: The research team conducted a nationwide survey of 2,335 Korean LGB adults in 2016. Using the dataset, we estimated the age-standardized prevalence ratios (SPR) for poor self-rated health, musculoskeletal pain, depressive symptoms, suicidal behaviors, smoking, and hazardous drinking. We then compared the SPR of the LGB adults and the general population, which participated in three different nationally representative surveys in Korea. SPR were estimated for each of the four groups (i.e., gay men, bisexual men, lesbians, and bisexual women). Results: Korean LGB adults had a statistically significantly higher prevalence of depressive symptoms, suicidal ideation and attempt, and musculoskeletal pain compared to the general population. Lesbian and bisexual women had a higher risk of poor self-rated health and smoking than the general female population, whereas gay and bisexual men showed no difference with the general male population. Higher prevalence of hazardous drinking was observed among lesbians, gay men, and bisexual women compared to the general population, but was not observed for bisexual men. Conclusion: The findings suggest that LGB adults have a poorer health status compared to the general population in South Korea. These results suggest that interventions are needed to address the health disparities of Korean LGB adults.
Article
Objectives Suicide is a conscious act in which the individual deliberately commit and unusual act with the intention of self-harm. The present study aims to examine some epidemiological factors affecting attempted and completed suicide rate during 2012–2016 in NajafAbad, a city in Isfahan province. Methods This is a cross-sectional study. The subjects are 2138 cases involved in suicide attempt during 2012–2016 that gone to Montazeri and Al-Zahra hospital. Chi-square, logistic regression and Cochran–Armitage test was used for data analysis. Result Totally, 1385 (64.8%) patients were female and 47.8% were younger than 24 years of age. The most common method of suicide was medication overdose (91.1%). In multivariable analysis, male gender (OR: 2.67; CI 95% 1.53 to 4.64) was a risk factor for fatal suicide and application of chemical methods (OR: 0.018; CI 95% 0.010 to 0.032) was a protective factor. Results regarding completed suicide trend analysis shows that this trend has had a significant statistical difference in men (p = 0.019) but in women this trend doesn't statistically significant difference. (p = 0.209). Conclusions According to the findings of the present study, attempted and completed suicide rate in Najafabad is relatively high compared to other regions in Islamic Republic of Iran. The completed suicide rate was significant in men which achieved its greatest value in 2015. Suicide attempt rate didn't show a significant statistical difference in both men and women. Keywords Suicide Epidemiology Trend Iran
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Objectives Suicidality among sexual minority adolescents has generated worldwide concern in recent decades, and previous Western studies have demonstrated that sexual minority status is associated with adolescent suicidality. However, whether this association exists in Chinese adolescents remains largely unknown. This study aimed to estimate the associations between sexual minority status and suicidal behaviour among Chinese adolescents. Design Cross-sectional survey. Setting A total of 506 high schools in 7 provinces of China. Participants A total of 150 822 students in grades 7–12 who completed the questionnaires (response rate of 95.9%) were included. Main outcome measures Suicidal ideation and suicide attempts were used to measure suicidal behaviour, and sexual attraction (opposite sex, same sex or both sex) was used as a measure for sexual minority status. Results Of the 150 822 adolescents analysed, 4.1% self-reported as sexual minorities and 17.3% were unsure. Compared with heterosexual and unsure adolescents, same-sex romantic attraction (SSA) and both-sex romantic attraction (BSA) adolescents reported a higher prevalence of past-year suicidal ideation (SSA: 21.6% for males and 30.4% for females; BSA: 34.7% for males and 42.3% for females) and suicide attempts (SSA: 6.9% for males and 8.9% for females; BSA: 12.2% for males and 10.9% for females). After adjustment for covariates, SSA and BSA adolescents were more likely to have past-year suicidal ideation and suicide attempts than their heterosexual and unsure peers. BSA adolescents reported the highest risk of suicidal ideation (males: adjusted OR (AOR) 2.42, 95% CI 2.03 to 2.88; females: AOR 2.61, 95% CI 2.41 to 2.82) and suicide attempts (males: AOR 3.83, 95% CI 2.85 to 5.14; females: AOR 2.59, 95% CI 2.19 to 3.06). Conclusions Our study suggested that Chinese sexual minority adolescents were at increased risk of suicidality, and those with BSA had an especially high risk in this population. These findings emphasised the urgent need to develop targeted interventions to effectively address suicide-related problems among Chinese sexual minority adolescents.
Article
Importance Suicide is the second-leading cause of death among adolescents. Sexual minority individuals are at a higher risk of suicide and attempted suicide, but a precise and systematic evaluation of this risk among sexual minority youths has not been documented to our knowledge. Objective To examine the risk of attempted suicide among sexual minority adolescents, differentiating for each sexual minority group. Data Sources Electronic databases (PubMed, Embase, and PsycINFO) were searched for articles published through April 30, 2017, with the following search terms: heterosexual, homosexual, bisexual, transgender, adolescents, teens, and attempted suicide. Study Selection Studies that reported attempted suicide in sexual minority adolescents compared with heterosexual peers were included. Thirty-five studies satisfied criteria for inclusion of 764 records identified. Data Extraction and Synthesis Pooled analyses were based on odds ratios (ORs), with relevant 95% CIs, weighting each study with inverse variance models with random effects. Risk of publication bias and analysis of heterogeneity through univariable and multivariable meta-regressions were also rated. Main Outcomes and Measures The evaluation of increased odds of attempted suicide among sexual minority youths compared with heterosexual peers. Results Thirty-five studies reported in 22 articles that involved a total of 2 378 987 heterosexual and 113 468 sexual minority adolescents (age range, 12-20 years) were included in the analysis. Sexual minority youths were generally at higher risk of attempted suicide (OR, 3.50; 95% CI, 2.98-4.12; c² = 3074.01; P < .001; I² = 99%). If estimated in each sexual minority group, the OR was 3.71 in the homosexual group (95% CI, 3.15-4.37; c² = 825.20; P < .001; I² = 97%) and 4.87 in the bisexual group (95% CI, 4.76-4.98; c² = 980.02; P < .001; I² = 98%); transgender youths were described as an individual group in only 1 study, which reported an OR of 5.87 (95% CI, 3.51-9.82). Meta-regressions weighted for the study weight highlighted that the presence of young participants (12 years old) was associated with heterogeneity in the bisexual group, whereas the year of sampling was associated with heterogeneity in the whole group when combined with other covariates. Conclusions and Relevance Our findings suggest that youths with nonheterosexual identity have a significantly higher risk of life-threatening behavior compared with their heterosexual peers. Public awareness is important, and a careful evaluation of supportive strategies (eg, support programs, counseling, and destigmatizing efforts) should be part of education and public health planning.
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Lesbians, gays, bisexuals, and transgender individuals (LGBT) are at high risk for suicide. This study aimed to examine an integrative psychological model of risk factors among LGBT individuals and explore the psychological pathways connecting social stigma, mental pain, and interpersonal characteristics to suicidal ideation and behavior (SIB) in this population. LGBT adults ( N = 473) responded to an online questionnaire about stigma, mental pain, interpersonal characteristics, as well as suicidal ideation and behaviors. We found group differences between LGBT respondents in the study variables: Transgender people reported the highest levels of SIB and depression, closely followed by bisexuals. The association between stigma-related variables and SIB was mediated by depression, entrapment, and perceived burdensomeness. These results highlight the role of entrapment and burdensomeness in facilitating suicide risk among LGBT adults, as they may increase the damaging effect of negative societal stigma against LGBTs and thus, elevate the suicide risk in this population.
Chapter
The instinct for survival or self-preservation represents the most relevant tendency of the human being, as the development of other instincts and vital functions depends on it. Life and death are interdependent; they exist simultaneously and not consecutively, and they exert an enormous influence on experience and behavior. Our life and hence our experience, behavior, and identity (including gender) are related to experiences of change, pain, risk, symptoms, ambivalence, and loneliness and the experience of “the others,” the grief, the anxiety before death, and the perception of the meaning of life. Based on Pierre Bourdieu’s model, through his work Masculine Domination, we conduct an analysis of how culture and society interfere/interact in our behavior, therefore in our lifestyle, and hence in our identity (from a gender perspective) to the extent that we unconsciously add incorporations (from that culture/society) and subsequently assume them as “natural,” “immovable” aspects that are determined by our sex (“biologically”). However, things are not as simple as that because, if so, we would not feel disagreement with those behaviors/manifestations/ways of feeling that are given to us “naturally,” and that is where the human being (regardless of sex/gender) makes an effort to “take the reins” of what belongs to him: his life, his body. We will thus approach the subject of suicide from some different theoretical perspectives and models, as well as the subject of self-harm, where we will also specifically address self-mutilations, and conclude by providing our reflection.
Chapter
In all likelihood, behavior is a complex trait that is defined by variation in more than one gene, and therefore it cannot be explained, nor properly and fully assessed, by a dichotomous state [e.g., biological sex (female and male) cannot be assumed to perfectly predict sexual orientation]. Like other complex traits, behavior is best assessed by a continuous variable (e.g., height according to the metric system, weight in kilograms, measuring the pressure of the blood in the circulatory system, measuring blood sugar levels, and measuring intelligence quotient from standardized tests designed to compare one’s score to others of their own age). Behavior change is something the dental professional is constantly aiming to change in their patients, via oral hygiene instructions, suggesting changes in diet, suggesting the use of specific at-home products, and/or establishing a regular regimen of follow up visits. Understanding how genetics influence behavior will explain why in many instances, the dentist is not successful in getting their patients to change.
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Depressive symptoms and anxiety symptoms are significantly higher among non-heterosexual individuals compared to heterosexual individuals. Scholars have suggested that this is due to increased stressful social environment that non-heterosexual individuals experience. The current study aimed to explore the difference in depressive and anxiety symptoms between non-heterosexual adolescents and heterosexual adolescents in Iceland. The role of parental social support, peer social support and the experience of sexual abuse were examined as contributors to a higher level of depressive symptoms and anxiety symptoms among non-heterosexual individuals. Results indicated that the non-heterosexual adolescents showed significantly more depressive symptoms and anxiety symptoms compared to their heterosexual peers. Non-heterosexual adolescents were more likely to have experienced sexual abuse and they also experienced lower parental social support compared to their heterosexual peers. Regression analysis showed that higher levels of depressive symptoms and anxiety symptoms among the non-heterosexual sample was only significant when there was no history of sexual abuse. Results are discussed from a theoretical perspective. Longitudinal studies on the development of different sexual attraction patterns are suggested for future research.
Chapter
Sexual orientation and sexual fluidity are examined in this chapter. The antecedents and the environmental and cultural influences on our sexual orientation are described, along with the difference between sexual orientation, identity, behavior, and preference. The chapter ends with an attempt to provide an answer as to whether changing one’s orientation is possible.
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The development of an adequate assessment instrument is a necessary prerequisite for social psychological research on loneliness. Two studies provide methodological refinement in the measurement of loneliness. Study 1 presents a revised version of the self-report UCLA (University of California, Los Angeles) Loneliness Scale, designed to counter the possible effects of response bias in the original scale, and reports concurrent validity evidence for the revised measure. Study 2 demonstrates that although loneliness is correlated with measures of negative affect, social risk taking, and affiliative tendencies, it is nonetheless a distinct psychological experience.
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A special problem in the study of self-esteem is the use of quite different instruments for subjects at different age levels. In the present paper the primary goal was to construct a scale that could be used to assess global self-evaluations in children as well as in adolescents and adults. The scale presented (GSE) based mainly on Rosenberg's Self-Esteem Scale (RSE) was used in this study with 2478 children aged 10 to 15 years. A second goal was to examine the appropriateness of Rosenberg's Stability of Self Scale when used with preadolescents aged 12 to 15. The internal consistency of the new scale (GSE) and of the slightly modified Stability of Self Scale was quite satisfactory (around .80). In addition a principal component analysis showed that the pattern of factor loadings was similar for subjects of different ages, indicating that the items were interpreted and responded to in roughly the same way by fourth through seventh graders. As expected, the GSE Scale correlated quite substantially with self-reports dimensions reflecting social anxiety and frequency of harassment by other students. The results indicate that the GSE Scale is a good unidimensional measure of global self-evaluations that can be used with subjects from age 10 at least and across a considerable age range.
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Synopsis Psychometric and clinical correlates of the Eating Attitudes Test (EAT) are described for a large sample of female anorexia nervosa ( N = 160) and female comparison ( N = 140) subjects. An abbreviated 26-item version of the EAT (EAT-26) is proposed, based on a factor analysis of the original scale (EAT-40). The EAT-26 is highly correlated with the EAT-40 ( r = 0·98) and three factors form subscales which are meaningfully related to bulimia, weight, body-image variables and psychological symptoms. Whereas there are no differces between bulimic and restricter anorexia nervosa patients on the total EAT-26 and EAT-40 scores, these groups do indicate significant differences on EAT-26 fractors. Norms for the anorexia nervosa and female comparison subjects are presented for the EAT-26, EAT-40 and the EAT-26 factors. It is concluded that the EAT-26 is a reliable, valid and economical instrument which may be useful as an objective measure of the symptoms of anorexia nervosa.
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To compare the prevalence of conduct problems (CP) according to level of urbanization and to determine which factors account for the potential difference in prevalence rates. Study 1 used a questionnaire survey of a nationally representative sample of 10,462 Norwegian adolescents. Study 2 used a questionnaire survey of a representative sample of 1,346 adolescents living in Oslo. Self-reported CP included most DSM-III-R criteria for conduct disorder. CP rates were similar in all levels of urbanization, except for the only semimetropolitan city in the country, the capital Oslo, which had CP rates twice those of the rest of the country. This increase rate could not be explained by a series of commonly advocated explanations: family structure and parental practices, social network, socioeconomic status, integration in community activities, religious involvement, and race. However, involvement in "soft" drugs and associating with antisocial peers could explain the statistically differential rates. Furthermore, in the Oslo study, adolescents' CP did not vary according to density of population or region within the city. The results support previous studies showing increased rates of CP in urban areas. However, urbanization must pass a certain threshold before it has this effect. Moreover, the lack of support for commonly advocated explanations for the difference between urban and nonurban areas suggests that investigations specifically addressing potential explanations for this difference should be conducted. The results indicate that the increased rates of substance use in highly urbanized areas may account for the difference in CP rates by prolonging and aggravating CP.
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This study documented risk behaviors among homosexually and bisexually experienced adolescents. Data were obtained from a random sample of high school students in Massachusetts. Violence, substance use, and suicide behaviors were compared between students with same-sex experience and those reporting only heterosexual contact. Differences in prevalence and standard errors of the differences were calculated. Students reporting same-sex contact were more likely to report fighting and victimization, frequent use of alcohol, other drug use, and recent suicidal behaviors. Students with same-sex experience may be at elevated risk of injury, disease, and death resulting from violence, substance abuse, and suicidal behaviors.
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To examine whether sexual orientation is an independent risk factor for reported suicide attempts. Data were from the Massachusetts 1995 Centers for Disease Control and Prevention Youth Risk Behavior Survey, which included a question on sexual orientation. Ten drug use, 5 sexual behavior, and 5 violence/ victimization variables chosen a priori were assessed as possible mediating variables. Hierarchical logistic regression models determined independent predictors of suicide attempts. Public high schools in Massachusetts. Representative, population-based sample of high school students. Three thousand three hundred sixty-five (81%) of 4167 responded to both the suicide attempt and sexual orientation questions. Self-reported suicide attempt in the past year. One hundred twenty-nine students (3.8%) self-identified as gay, lesbian, bisexual, or not sure of their sexual orientation (GLBN). Gender, age, race/ethnicity, sexual orientation, and all 20 health-risk behaviors were associated with suicide attempt (P<.001). Gay, lesbian, bisexual, or not sure youth were 3.41 times more likely to report a suicide attempt. Based on hierarchical logistic regression, female gender (odds ratio [OR], 4.43; 95% confidence interval [CI], 3.30-5.93), GLBN orientation (OR, 2.28; 95% CI, 1.39-3.37), Hispanic ethnicity (OR, 2.21; 95% CI, 1.44-3.99), higher levels of violence/ victimization (OR, 2.06; 95% CI, 1.80-2.36), and more drug use (OR, 1.31; 95% CI, 1.22-1.41) were independent predictors of suicide attempt (P<.001). Gender-specific analyses for predicting suicide attempts revealed that among males the OR for GLBN orientation increased (OR, 3.74; 95% CI, 1.92-7.28), while among females GLBN orientation was not a significant predictor of suicide. Gay, lesbian, bisexual, or not sure youth report a significantly increased frequency of suicide attempts. Sexual orientation has an independent association with suicide attempts for males, while for females the association of sexual orientation with suicidality may be mediated by drug use and violence/victimization behaviors.
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It has been suggested that homosexuality is associated with psychiatric morbidity. This study examined differences between heterosexually and homosexually active subjects in 12-month and lifetime prevalence of DSM-III-R mood, anxiety, and substance use disorders in a representative sample of the Dutch population (N = 7076; aged 18-64 years). Data were collected in face-to-face interviews, using the Composite International Diagnostic Interview. Classification as heterosexual or homosexual was based on reported sexual behavior in the preceding year. Five thousand nine hundred ninety-eight (84.8%) of the total sample could be classified: 2.8% of 2878 men and 1.4% of 3120 women had had same-sex partners. Differences in prevalence rates were tested by logistic regression analyses, controlling for demographics. Psychiatric disorders were more prevalent among homosexually active people compared with heterosexually active people. Homosexual men had a higher 12-month prevalence of mood disorders (odds ratio [OR] = 2.93; 95% confidence interval [CI] = 1.54-5.57) and anxiety disorders (OR = 2.61; 95% CI = 1.44-4.74) than heterosexual men. Homosexual women had a higher 12-month prevalence of substance use disorders (OR = 4.05; 95% CI = 1.56-10.47) than heterosexual women. Lifetime prevalence rates reflect identical differences, except for mood disorders, which were more frequently observed in homosexual than in heterosexual women (OR = 2.41; 95% CI = 1.26-4.63). The proportion of persons with 1 or more diagnoses differed only between homosexual and heterosexual women (lifetime OR = 2.61; 95% CI = 1. 31-5.19). More homosexual than heterosexual persons had 2 or more disorders during their lifetimes (homosexual men: OR = 2.70; 95% CI = 1.66-4.41; homosexual women: OR = 2.09; 95% CI = 1.07-4.09). The findings support the assumption that people with same-sex sexual behavior are at greater risk for psychiatric disorders.
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Describes the Social Support Questionnaire (SSQ) and 4 empirical studies employing it. The SSQ yields scores for (a) perceived number of social supports and (b) satisfaction with social support that is available. Three studies (N = 1,224 college students) dealt with the SSQ's psychometric properties, its correlations with measures of personality and adjustment, and the relation of the SSQ to positive and negative life changes. The 4th study (40 Ss) was an investigation of the relation between social support and persistence in working on a complex, frustrating task. The research reported suggests that the SSQ is a reliable instrument and that social support is (a) more strongly related to positive than negative life changes, (b) more related in a negative direction to psychological discomfort among women than men, and (c) an asset in enabling a person to persist at a task under frustrating conditions. Clinical implications are discussed. (47 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).
Article
This article examines the following areas of 37 Black male adolescent homosexuals' (age range: 16-21) self-identity, family relation, school/work relations, and social adjustment. Information about these areas was collected by using a Likert-type questionnaire that required the respondents to select the answers true or false. A majority of the respondents were comfortable with their sexual identity, although all of them were passing as heterosexuals. A sexual history of the respondents is presented. Even though the respondents understand their sexual minority status, it has not deterred the development of a positive and well-integrated self-perception.
Article
Previous research demonstrated a higher risk for problem behaviors among early as compared to late maturing girls. In the present study, the role of maturational timing was assessed within the framework of a developmental model for adolescent problem behavior. Data obtained twice, one year apart, on 62 girls in early adolescence (11 to 12 years of age) and 193 girls in middle adolescence (14 to 15 years of age) were compared. Girls self-reported information on maturational timing, parental support, peer rejection, self-derogation, transgression proneness, and contacts with deviant peers. In both age cohorts, peer rejection was related to more self-derogation, with both related to more contacts with deviant peers, mediated by transgression proneness in middle adolescence. Parental support protected against such contacts and in middle adolescence protected against transgression proneness and self-derogation. In middle adolescence, early maturation led to more contacts with deviant peers but lower self-derogation; similarly, in early adolescence early maturers reported less peer rejection. Thus, the predictions were generally supported except for the surprising result of lower self-derogation among early maturers.
Article
Different aspects of pubertal timing and of weight were examined in relation to body image, global negative self-evaluations, depressive tendencies, and perceived instability of self-concept among a sample of 1,109 girls and 1,256 boys, aged 13 through 16 years. Perceived early maturation was related significantly to poor body image and global negative self-evaluations in girls in the sixth and eighth grades, and the same tendency was found in seventh graders. Late maturation was generally associated with negative self-evaluations in boys, whereas early maturation was related to more positive evaluations. However, some findings also indicated negative effects of early maturation in boys. The negative effects of perceived early timing in girls could not be explained by overweight. Furthermore, relative overweight showed a significant relationship with poor psychological adjustment, even when controlling for pubertal timing. Thus early timing and overweight appear to contribute independently of each other to girls `negative self-evaluations in this period
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This research identified predictors of past suicide attempts in 194 lesbian, gay, and bisexual youth, 15 through 21 years of age, who attended social and recreational groups in urban community settings. In comparison to youth who made no suicide attempts, attempters reported that they had disclosed more completely their sexual orientation to others, had lost more friends because of their disclosures, and had experienced more victimization due to their sexual orientation. Suicide attempters had lower self-esteem and acknowledged more mental health problems. The loss offriends due to youth 's sexual orientation, and current suicidal ideation were among the strongest predictors of suicide attempts. Youth who reported early awareness of their sexual orientation, disclosure to family and friends, peer rejection, and victimization based on their sexual orientation may be at risk for mental health problems.
Article
83 gay and bisexual male youths (17–23 yrs old) completed questionnaires and a structured interview. Pubertal maturation was associated with self-reported age of 1st orgasm and homosexual activity and frequency of orgasms during junior high school. Unrelated were age of 1st same-sex attractions, sexual orientation, age of 1st heterosexual activity, frequency of orgasms during high school, number of lifetime male and female sex partners, reactions to puberty, and self-esteem. Early and on-time maturers rarely varied from each other on the assessed domains. Youths did not differ in self-esteem level from heterosexual male youths. Gay and bisexual male youths share with heterosexual male youths a similar developmental trajectory in regard to pubertal maturation and self-esteem. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Abstract A sample (N=114) of adolescent female binge-pursers were among the respondents to a nationwide survey on body-image. Relative to female controls (N=114) who were matched on age, height and weight, binge-purgers evaluated their physical appearance, fitness and health much less favourably. However, they reported being man? appearance-oriented and fitness-oriented than controls. Regardless of actual weight, binge-purgers more often distorted their body size as heavier than did controls, displayed more anxious preoccupation about their weight and weight gain and reported much more frequent eating restraint to lose weight, Binge-purgers also considered themselves to be more poorly psychosocially adjusted, with a reported childhood history of appearance-related conflicts. Discriminant function analysis indicated that the above variables were very accurate in classifying the two groups.
Article
This study examined the relations between sexual orientation and certain physical development variables in men. The participants were 318 homosexual and 318 heterosexual men closely matched on age. The participants completed an anonymous, 10-minute, self-report questionnaire that included items on their sexual orientation, height, weight and age of puberty. The results extended previous findings that, compared with heterosexual men, homosexual men are shorter, lighter and younger at the onset of puberty. These results add to an existing body of literature indicating that homosexual men often score in the female-typical direction on sex-dimorphic somatic characteristics.
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A 12-item version of the Eating Attitudes Test (EAT-12) was constructed and applied at 1-year intervals in a non-referred cohort of 1193 adolescents in Norway aged 13-18 years. Eight percent of the girls scored beyond the chosen cut-off point of 9/10 the first time and 9% the second time. Factor analysis demonstrated 3 factors--dieting, bulimia and food preoccupation and oral control. Both the total scores on the EAT-12 and the 3 different factor scores showed a significant relationship between eating behaviour and smoking, level of alcohol consumption, alcohol intoxication, psychopathology and parental bonding.
Article
Studies of human sexuality have noted high rates of suicidality among homosexual youth, but the problem has not been systematically examined. This work was undertaken to identify risk factors for suicide attempts among bisexual and homosexual male youth. Subjects were 137 gay and bisexual males, 14 through 21 years of age, from the upper Midwest and Pacific Northwest. Forty-one subjects (41/137) reported a suicide attempt; and almost half of them described multiple attempts. Twenty-one percent of all attempts resulted in medical or psychiatric admissions. Compared with non-attempters, attempters had more feminine gender roles and adopted a bisexual or homosexual identity at younger ages. Attempters were more likely than peers to report sexual abuse, drug abuse, and arrests for misconduct. The findings parallel previous studies' results and also introduce novel suicide risk factors related to gender nonconformity and sexual milestones.
Article
The relationship of homosexuality to suicidal behavior was explored by questionnaire responses from 52 men in gay-and-lesbian college organizations and 56 men in gay rap groups. A family background of alcoholism and physical abuse, social supports perceived as rejecting of homosexuality, and no religious affiliation were associated with a history of suicidal ideation, reported by 55% of the participants. Racial/ethnic minorities tended to be overrepresented among suicidal as compared to nonsuicidal gay men. Suicide attempts, reported by 20% of the sample, were most often associated with intrapersonal distress, and occurred most often while individuals were "closeted" and/or in the context of recent rejection for being homosexual. Nearly all attempters were aware of their homosexual feelings, but had not yet established a "positive gay identity" at the time of their first suicide attempt. Suicidal behavior in gay youths may be the product both of familial factors that predispose youths to suicidal behavior, and for social and intrapersonal stressors involved in coming to terms with an emerging homosexual identity.
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Describes the development of a new sex-role inventory that treats masculinity and femininity as 2 independent dimensions, thereby making it possible to characterize a person as masculine, feminine, or "androgynous" as a function of the difference between his or her endorsement of masculine and feminine personality characteristics. Normative data, provided by 561 male and 356 female college and junior college students, are presented, as well as the results of various psychometric analyses. Findings indicate that: (a) The dimensions of masculinity and femininity are empirically and logically independent. (b) The concept of psychological androgyny is a reliable one. (c) Highly sex-typed scores do not reflect a general tendency to respond in a socially desirable direction, but rather a specific tendency to describe oneself in accordance with sex-typed standards of desirable behavior for men and women. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The epidemiology and correlates of depressive mood were measured in a representative sample of public high school students in New York State and a subsample matched to their parents. Depressive mood was measured by a self-reported scale validated in a clinical sample. Adolescents with a diagnosis of major depressive disorder scored higher than those with other psychiatric diagnoses. In the general adolescent sample, ex differences in depressive mood paralleled those previously reported for adults, with girls scoring higher than boys. Adolescents reported higher depressive mood than their parents, with the differences greater in daughter-mother than in son-father pairs. If judged by mood differences, adolescence was a stressful period in the life cycle. Lowest levels of adolescent depressive mood correlated with high levels of attachment both to parents and to peers. Sex differences in depressive mood in adolescents may be accounted for by masked depression and increased delinquency among boys as compared with girls.
Article
The Self-Perception Profile for Adolescents (SPPA; Harter, 1988) was administered to a national representative sample of 11,315 Norwegian adolescents of the ages 13 to 20. The original version of SPPA has an idiosyncratic and time-consuming item format, describing two adolescents with opposite characteristics on each item. A revised version of SPPA was developed using only one statement for each item. The original SPPA was administered to a random subsample of 880 subjects, whereas the rest of the total sample completed the revised edition. Concerning the original SPPA, results showed low to adequate reliability and poor replication of the factorial pattern. However, low correlations with the Marlowe-Crowne Social Desirability Index were obtained, and the construct validity was supported. Concerning the revised edition, the a priori factorial pattern was replicated. Further, it had substantially better reliability, better convergent validity, and better factorial validity than the original version. The discriminant validity and the contamination by social desirability bias were the same for both versions. The data thus indicate that there is no need to retain the time-consuming and cumbersome item format of the original SPPA.
Article
An array of psychosocial risk factors for making a suicide attempt were examined in a representative sample of 1,508 older (14- to 18-year-old) high school students, 26 of whom made a suicide attempt during the year following entry into the study. Strongest predictors of future suicide attempt were history of past attempt, current suicidal ideation and depression, recent attempt by a friend, low self-esteem, and having been born to a teenage mother. The results suggest that adolescents who are depressed and those who attempt suicide share many psychosocial risk factors. The efficacy of two screeners (one consisting of 4 items and the other of 6 variables) is reported. Potential usefulness for research and communitywide prevention is discussed.
Article
In a conceptual framework of suicide process, literature on life events and social support in suicide is reviewed. Few studies have centered on these issues, and the existing research has many methodological ambiguities. However, it can be concluded that life events play an important role in suicide process as risk and precipitating factors. The findings on disintegration of social networks and poor social support indicate lack of protective factors. Implications for future research are discussed. Further research focusing on more specific questions on the role of life events and social support as well as their interactions is needed.
Article
This review focuses on psychopathologic risk factors for adolescent suicide and suicidal behavior, namely, affective, disruptive, substance abuse, psychotic, and personality disorders. The interaction of psychopathology with age and gender is discussed. The role of family environmental risk factors and stress events in suicide and suicidal behavior, both alone, and in interaction with psychopathology are reviewed. Research reviewed will include psychological; autopsy studies, longitudinal studies examining predictors of suicide, and epidemiologic studies of suicide attempts.
Article
Measurement and definition of sexual orientations have increasingly become a central focus in both research design and public policy debates. This paper reviews major methods, and their theoretical underpinnings, for the definition and measurement of sexual orientation, highlighting their limitations and pitfalls, both practical and conceptual. The increasing politicization of this area is discussed and cautioned against. Recommendations, both general and geared toward measurement concerns with adolescent populations, are made. A specific measurement strategy, which can be utilized at a number of different levels, is detailed.
Article
The hypothesis that homosexual orientation would be associated with higher rates of body dissatisfaction, dieting, and eating disordered behaviors in males, but lower rates in females, relative to those of heterosexual orientation, was examined. A population-based sample of 36,320 students in Grades 7 through 12 completed a health behavior survey that included questions on sexual orientation, body satisfaction, and weight control behaviors. A subset of heterosexual males (N = 212) and females (N = 182) were selected for comparison with the adolescents who self-identified as homosexual (N = 81 males and N = 38 females) or bisexual (N = 131 males and N = 144 females). Homosexual males were more likely to report a poor body image (27.8% vs. 12.0%), frequent dieting (8.9% vs. 5.5%), binge eating (25.0% vs. 10.6%), or purging behaviors (e.g., vomiting: 11.7% vs. 4.4%) compared with heterosexual males. Homosexual females were more likely than heterosexual females to report a positive body image (42.1% vs. 20.5%). However, they were not less likely to report frequent dieting (20.8% vs. 23.7%), binge eating (25.0% vs. 31.8%), or purging behaviors (e.g. vomiting: 19.4% vs. 12.1%). These results support the hypothesis that homosexual orientation is associated with greater body dissatisfaction and problem eating behaviors in males, but less body dissatisfaction in females. The possible role of sociocultural influences or gender identification on these relationships is discussed.
Article
This study is one of the first to examine the association between sexual orientation and health risk behaviors among a representative, school-based sample of adolescents. This study was conducted on an anonymous, representative sample of 4159 9th- to 12th-grade students in public high schools from Massachusetts' expanded Centers for Disease Control and Prevention 1995 Youth Risk Behavior Survey. Sexual orientation was determined by the following question: "Which of the following best describes you?" A total of 104 students self-identified as gay, lesbian, or bisexual (GLB), representing 2.5% of the overall population. Of GLB youth, 66.7% were male and 70% were white (not Hispanic). Health risk and problem behaviors were analyzed comparing GLB youth and their peers. Those variables found to be significantly associated with GLB youth were then analyzed by multiple logistic regression models. GLB youth were more likely than their peers to have been victimized and threatened and to have been engaged in a variety of risk behaviors including suicidal ideation and attempts, multiple substance use, and sexual risk behaviors. Four separate logistic regression models were constructed. Model I, Onset of Behaviors Before Age 13, showed use of cocaine before age 13 years as strongly associated with GLB orientation (odds ratio [OR]: 6.10; 95% confidence interval [CI] = 2.45-15.20). Early initiation of sexual intercourse (2.15; 10.6-4.38), marijuana use (1.98; 1.04-4.09), and alcohol use (1.82; 1.03-3.23) also was associated with GLB orientation. Model II, Lifetime Frequencies of Behaviors, showed that frequency of crack cocaine use (1.38; 1.06-1.79), inhalant use (1.30; 1.05-1.61), and number of sexual partners (1.27; 1.06-1.43) was associated with GLB orientation. Model III, Frequency of Recent Behaviors, showed smokeless tobacco use in the past 30 days (1.38; 1. 20-1.59) and number of sexual partners in the previous 3 months (1. 47; 1.31-1.65) were associated with GLB orientation. Model IV, Frequency of Behaviors at School, showed having one's property stolen or deliberately damaged (1.23; 1.08-1.40) and using marijuana (1.29; 1.05-1.59) and smokeless tobacco (1.53; 1.30-1.81) were associated with GLB orientation. Overall, GLB respondents engaged disproportionately in multiple risk behaviors, reporting an increased mean number of risk behaviors (mean = 6.81 +/- 4.49) compared with the overall student population (mean = 3.45 +/- 3.15). GLB youth who self-identify during high school report disproportionate risk for a variety of health risk and problem behaviors, including suicide, victimization, sexual risk behaviors, and multiple substance use. In addition, these youth are more likely to report engaging in multiple risk behaviors and initiating risk behaviors at an earlier age than are their peers. These findings suggest that educational efforts, prevention programs, and health services must be designed to address the unique needs of GLB youth.
Article
This study examined the relationship between sexual orientation and suicide risk in a population-based sample of adolescents. Participants were selected from a cross-sectional, statewide survey of junior and senior public high school students. All males (n = 212) and females (n = 182) who described themselves as bisexual/homosexual were compared with 336 gender-matched heterosexual respondents on three outcome measures: suicidal ideation, intent, and self-reported attempts. Logistic regression analyses were used to examine the association between sexual orientation and outcome measures with adjustment for demographic characteristics. Suicide attempts were reported by 28. 1 % of bisexual/homosexual males, 20.5% of bisexual/homosexual females, 14.5% of heterosexual females, and 4.2% of heterosexual males. For males, but not females, bisexual/homosexual orientation was associated with suicidal intent (odds ratio [OR] = 3.61 95% confidence interval [CI = 1.40, 9.36) and attempts (OR=7.10; 95% CI=3.05, 16.53). There is evidence of a strong association between suicide risk and bisexuality or homosexuality in males.
Article
To examine the relationship between the number of male sexual partners of adolescent males and the frequency of victimization at school, missed school because of fear, used drugs at school, and engagement of fighting and weapon carrying both in and out of school. Sexually active male adolescents (N = 3886) in 8th through 12th grades were administered the 1995 Vermont Youth Risk Behavior Survey. A total of 8.7% of male adolescents reported one or more male sexual partners. Alcohol, marijuana, and smokeless tobacco use at school, not attending school because of fear, having been threatened or injured with a weapon at school, and weapon carrying at school accounted for 15.8% of the variation in the number of male sexual partners (p < 0.0001). Suicide attempts, school absence because of fear, cigarette smoking, alcohol use, and smokeless tobacco use at school, frequency of fighting requiring medical treatment, carrying a weapon,aand carrying a weapon at school accounted for 17.2% out of 100% of the variation in the number of male sexual partners (p < or 0.00001). The number of male sexual partners reported by sexually active male adolescents correlated with a higher frequency of victimization, use of violence and drug use at school. Frequency of suicide attempts and fighting outside of school were also correlated with the number of same-sex sexual partners.
Article
The prevalence of depressive mood was examined in a representative and nationwide sample of approximately 12,000 Norwegian adolescents. From the age of 14, girls scored 0.5 SD above boys in depressed mood, a difference that was stable throughout the adolescent period. At the age of 12, no gender difference was found. The gender difference was due to girls becoming more depressed from 13 to 14 years of age. An extended version of the gender intensification hypothesis (J. P. Hill & M. E. Lynch, 1983) was tested as an explanation for the gender difference in depressed mood. Structural equation modeling and regression analyses showed that the gender difference could be explained, in part, by increased developmental challenges for girls--pubertal development, dissatisfaction with weight and attainment of a mature female body, and increased importance of feminine sex role identification. Depressed mood was not associated with masculinity or school change, as had been predicted.
Article
This study examines the extent to which gay, lesbian, and bisexual young people are at increased risk of psychiatric disorder and suicidal behaviors using data gathered on a New Zealand birth cohort studied to age 21 years. Data were gathered during the course of the Christchurch Health and Development Study, a 21-year longitudinal study of a birth cohort of 1265 children born in Christchurch, New Zealand. At 21 years of age, 1007 sample members were questioned about their sexual orientation and relationships with same-sex partners since the age of 16 years. Twenty-eight subjects (2.8%) were classified as being of gay, lesbian, or bisexual sexual orientation. Over the period from age 14 to 21 years, data were gathered on a range of psychiatric disorders that included major depression, generalized anxiety disorder, conduct disorder, and substance use disorders. Data were also gathered on suicidal ideation and suicide attempts. Gay, lesbian, and bisexual young people were at increased risks of major depression (odds ratio [OR], 4.0; 95% confidence interval [CI], 1.8-9.3), generalized anxiety disorder (OR, 2.8; 95% CI, 1.2-6.5), conduct disorder (OR, 3.8; 95% CI, 1.7-8.7), nicotine dependence (OR, 5.0; 95%, CI, 2.3-10.9), other substance abuse and/or dependence (OR, 1.9; 95% CI, 0.9-4.2), multiple disorders (OR, 5.9; 95% CI, 2.4-14.8), suicidal ideation (OR, 5.4; 95% CI, 2.4-12.2), and suicide attempts (OR, 6.2; 95% CI, 2.7-14.3). Findings support recent evidence suggesting that gay, lesbian, and bisexual young people are at increased risk of mental health problems, with these associations being particularly evident for measures of suicidal behavior and multiple disorder.
Article
Several recent studies have found a higher lifetime prevalence of suicide attempts in homosexual males compared with heterosexual control subjects or population rates. These studies used either convenience samples, most without controls, or population-based samples in which confounding factors such as depression and substance abuse were not measured. This study used twins from the population-based Vietnam Era Twin Registry, Hines, Ill. An analytic sample of 103 middle-aged male-male twin pairs from the registry was identified in which one member of the pair reported male sex partners after age 18 years while the other did not. Four lifetime symptoms of suicidality as measured by the Diagnostic Interview Schedule were analyzed: thoughts about death, wanting to die, thoughts about committing suicide, and attempted suicide. A composite measure of reporting at least one suicidality symptom was also assessed. Same-gender sexual orientation is significantly associated with each of the suicidality measures. Unadjusted matched-pair odds ratios follow: 2.4 (95% confidence interval [CI], 1.2 - 4.6) for thoughts about death; 4.4 (95% CI, 1.7 - 11.6) for wanted to die; 4.1 (95% CI, 2.1 - 8.2) for suicidal ideation; 6.5 (95% CI, 1.5 - 28.8) for attempted suicide; and 5.1 (95% CI, 2.4 - 10.9) for any of the suicidal symptoms. After adjustment for substance abuse and depressive symptoms (other than suicidality), all of the suicidality measures remain significantly associated with same-gender sexual orientation except for wanting to die (odds ratio, 2.5 [95% CI, 0.7 - 8.81). The substantially increased lifetime risk of suicidal behaviors in homosexual men is unlikely to be due solely to substance abuse or other psychiatric comorbidity. While the underlying causes of the suicidal behaviors remain unclear, future research needs to address the inadequacies in the measurement of both sexual orientation and suicidality in population-based samples.
Article
In the present study, the researchers examined factors related to depression, hopelessness, and suicidality in gay, lesbian, and bisexual adolescents, compared with demographically similar heterosexual adolescents. Sexual minority adolescents reported greater depression, hopelessness, and past and present suicidality than did heterosexual adolescents. However, when controlling for other psychosocial predictors of present distress, significant differences between the 2 samples disappeared. For past suicidality scores, the effects of sexual orientation were reduced, but still significant, when accounting for the other predictor variables. These results suggest that environmental factors associated with sexual orientation, which can be targeted and changed through prevention and intervention efforts, play a major role in predicting distress in this population.
Article
This study sought to test the relationships between relative body weight and clinical depression, suicide ideation, and suicide attempts in an adult US general population sample. Respondents were 40,086 African American and White participants interviewed in a national survey. Outcome measures were past-year major depression, suicide ideation, and suicide attempts diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The primary predictor was relative body weight, treated both continuously (i.e., body mass index [BMI]) and categorically in logistic regression analyses. Covariates included age, income and education, disease status, and drug and alcohol use. Relative body weight was associated with major depression, suicide attempts, and suicide ideation, although relationships were different for men and women. Among women, increased BMI was associated with both major depression and suicide ideation. Among men, lower BMI was associated with major depression, suicide attempts, and suicide ideation. There were no racial differences. Differences in BMI, or weight status, were associated with the probability of past-year major depression, suicide attempts, and suicide ideation. Longitudinal studies are needed to differentiate the causal pathways and mechanisms linking physical and psychiatric conditions.
Article
To investigate the risk and protective factors for previous and future suicide attempts among adolescents. A representative sample of high school students (N = 9,679) in grades 7 through 12 (aged 12-20 years) were followed from 1992 to 1994. Response rate was 97% at initial testing and 80% at follow-up. Measures of psychiatric symptoms (depressed mood, eating problems, conduct problems), substance use, self-worth, pubertal timing, social network, and social integration were included. A total of 8.2% had ever attempted suicide and 2.7% reported an attempt during the 2-year study period. Logistic regression analysis showed that future attempts were predicted by previous attempt, female gender, young age, perceived early pubertal development (stronger among girls), suicidal ideation, alcohol intoxication, not living with both parents, and poor self-worth. The importance that the clinician ask about previous suicidal behaviors is underscored. Early pubertal timing (particularly among girls), loss of self-worth, and alcohol intoxication may serve as risk factors for future suicide attempts.