性少数群体和性别少数群体成年人的不良童年经历、感知歧视和心理健康:比较压力积累模型和压力敏感化模型。

IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH LGBT health Pub Date : 2024-10-03 DOI:10.1089/lgbt.2023.0296
Phillip W Schnarrs, Armin A Dorri, Stephen T Russell, Timothy J Grigsby, Ruby Charak, Hayden Dawes, Amy L Stone, R Andrew Yockey, Joshua G Rosenberger
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引用次数: 0

摘要

目的:本研究旨在评估美国性与性别少数群体(SGM)成年人童年不良经历(ACEs)暴露、感知到的歧视与焦虑和抑郁症状之间的关系。调查方法来自全国 Qualtrics 研究小组的受访者(n = 4445)完成了一项网络调查。在压力扩散(中介模型)和压力敏感化(调节模型)模型的指导下,我们研究了 ACE 与感知到的歧视以及成年后焦虑和抑郁症状严重程度之间的关系。研究结果累积的 ACE 与日常歧视量表(EDS)得分呈正相关。ACE和EDS得分与焦虑和抑郁症状有显著的直接联系。我们发现,EDS 是焦虑(β = 0.12,p < 0.001)和抑郁症状(β = 0.14,p < 0.001)的介导因素,而 ACE 是 EDS 与焦虑(β = -0.04,p = 0.004)和抑郁症状(β = -0.05,p = 0.001)之间关系的调节因素。结论这些研究结果表明,压力增殖和压力敏感化可能会导致上海通用汽车成人焦虑和抑郁症状的差异。这一发现支持将社会安全和少数群体压力的观点结合起来,以解决上海通用汽车人群的健康差异问题。早期生活中的逆境可能会改变神经发育,进而增加成年后缺乏社会安全的意识,降低应对少数群体压力的能力,最终导致焦虑和抑郁症状的增加。预防工作的重点应放在培养积极的补偿性童年经历上。
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Adverse Childhood Experiences, Perceived Discrimination, and Mental Health in Sexual and Gender Minoritized Adults: Comparing Stress Accumulation and Stress Sensitization Models.

Purpose: The purpose of this study was to assess the relationship between adverse childhood experiences (ACEs) exposure, perceived discrimination, and anxiety and depressive symptoms in sexual and gender minoritized (SGM) adults in the United States. Methods: Respondents (n = 4445) from a national Qualtrics research panel completed a web-based survey. Guided by the stress proliferation (mediation model) and stress sensitization (moderation model) models, we examined the relationships between ACEs and perceived discrimination and the severity of anxiety and depressive symptoms in adulthood. Results: Cumulative ACEs exposure was positively associated with everyday discrimination scale (EDS) scores. ACEs and EDS scores had a significant direct association with anxiety and depressive symptoms. We found support for EDS as a mediator for anxiety (β = 0.12, p < 0.001) and depressive symptoms (β = 0.14, p < 0.001) and for ACEs as a moderator of the relationship between EDS and anxiety (β = -0.04, p = 0.004) and depressive (β = -0.05, p = 0.001) symptoms. Conclusions: These findings suggest that both stress proliferation and stress sensitization likely contribute to disparities in anxiety and depressive symptoms in SGM adults. This finding supports the integration of social safety and minority stress perspectives regarding health disparities in SGM populations. Exposure to early life adversity likely alters neurodevelopment, which in turn increases awareness of the lack of social safety in adulthood, reduces capacity to cope with minority stress exposure, and ultimately contributes to increased anxiety and depressive symptoms. Prevention efforts should focus on building positive and compensatory childhood experiences.

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来源期刊
LGBT health
LGBT health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -
CiteScore
6.60
自引率
6.20%
发文量
80
期刊介绍: LGBT Health is the premier peer-reviewed journal dedicated to promoting optimal healthcare for millions of sexual and gender minority persons worldwide by focusing specifically on health while maintaining sufficient breadth to encompass the full range of relevant biopsychosocial and health policy issues. This Journal aims to promote greater awareness of the health concerns particular to each sexual minority population, and to improve availability and delivery of culturally appropriate healthcare services. LGBT Health also encourages further research and increased funding in this critical but currently underserved domain. The Journal provides a much-needed authoritative source and international forum in all areas pertinent to LGBT health and healthcare services. Contributions from all continents are solicited including Asia and Africa which are currently underrepresented in sex research.
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