Predicting adverse outcomes among sexual minorities and heterosexuals from a prospective study of adolescent health and wellbeing

通过青少年健康和福祉的前瞻性研究预测性少数群体和异性恋者的不良后果

• 批准号: 9760277
• 负责人: Hunter Andres Hahn
• 金额: $ 3.32万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-01 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9760277
• 关键词: 19 year old; AIDS/HIV problem; Address; Adolescence; Adolescent; Adult; Affect; Affective; Age; Age-Years; Alcohol or Other Drugs use; Anxiety; Anxiety Disorders; Asthma; Cardiovascular Diseases; Caucasians; Characteristics; Child Rearing; Cognitive; Data; Data Set; Depression and Suicide; Development; Discrimination; Documentation; Eating Disorders; Ethnic Origin; Expectancy; Family; Feeling hopeless; Gender; Goals; Health; Heterosexuals; Individual; Individual Differences; Lead; Lesbian Gay Bisexual; Life; Literature; Longitudinal prospective study; Machine Learning; Maintenance; Malignant Neoplasms; Measures; Mediating; Mediation; Mediator of activation protein; Mental Depression; Mental Health; Methods; Minority; Modeling; Mood Disorders; Morbidity - disease rate; Nature; Ohio; Outcome; Pathway interactions; Personal Satisfaction; Population; Population Heterogeneity; Predictive Factor; Predictive Value; Prevention; Prevention program; Preventive Intervention; Process; Prospective Studies; Psyche structure; Psychological adjustment; Psychopathology; Psychosocial Factor; Questionnaires; Race; Randomized; Research; Resources; Risk; Risk Factors; Sampling; Schools; Screening procedure; Sex Orientation; Sleep; Sleep disturbances; Socioeconomic Status; Specific qualifier value; Spirituality; Standardization; Statistical Methods; Stress; Suicide; System; Temperament; Testing; Time; Training; Victimization; Vulnerable Populations; Youth; adolescent health; adverse outcome; age group; analytical method; base; cancer risk; career; emerging adult; emotion dysregulation; emotion regulation; experience; health disparity; high risk; improved; insight; multilevel analysis; non-heterosexual; outcome prediction; peer; peer influence; peer victimization; physical conditioning; prevent; prospective; psychologic; psychosocial; racial diversity; racial minority; resilience; sexual identity; sexual minority; sexual risk behavior; social; stressor; substance misuse; theories; treatment disparity; young adult

PROJECT SUMMARY Sexual minorities (lesbian, gay, bisexual and other non-heterosexual individuals) are at increased risk for numerous adverse physical and mental health outcomes, including anxiety, depression, suicidality, substance use, HIV/AIDS, asthma, cardiovascular disease, and certain forms of cancer. Despite clear documentation and replication of these health disparities, relatively little is known about their development from adolescence into adulthood. Two theories primarily dominate the literature. Minority stress models describe unique life stressors experienced only by sexual minorities (e.g., victimization and discrimination based on sexual orientation) as primary contributors to health disparities. Other models implicate both minority stress and normative psychosocial processes together as contributors to health disparities. Some such normative processes include (1) psychological adjustment and characteristics (e.g., emotion regulation/dysregulation, substance use expectancies), (2) disrupted social systems (e.g., family, peers, school), and (3) individual differences (e.g., race/ethnicity, socioeconomic status, temperament). To date, most studies of both minority stress and normative processes are limited by use of cross-sectional samples of primarily Caucasian adults. Although much has been learned from these studies, they do not permit analysis of emerging health disparities across development. Existing research is therefore limited in terms of both generalizability to diverse populations, and validity of directionality inferences between observed ‘predictors’ and ‘outcomes’. My long-term career goals are to identify mechanisms leading to disparities among sexual minorities, with the goal of improving treatments for these disparities, and to develop screening tools to identify high-risk youth who would benefit from prevention programs. To reach this goal, in this project, I address existing limitations to the literature using a prospective sample of individuals who were 14-19 years old at baseline and followed for over 4 years. My goal is to describe developmental trajectories and mechanisms of health disparity development for sexual minority youth compared with heterosexual youth across a 10-year developmental window spanning ages 14- 23 years. Longitudinal outcomes include depression/anxiety, suicidality, delinquency, sleep, general physical health, disordered eating and substance use. Developmental trajectories for these outcomes will be charted by gender and sexual orientation. Confirmatory analyses based on existing literature will be conducted to examine relations between minority stress and adverse outcomes. Then, I will use machine learning to identify as-yet unknown predictors of adverse outcomes and health disparities and characterize any changes in prediction across time. Finally, I will use state-of-the art intervening variable analyses (mediation, moderation) to evaluate longitudinal mechanisms through which health disparities emerge. Findings should provide insight into mechanisms of disparity development and maintenance, informing prevention and intervention strategies.

项目摘要 性少数民族（女同性恋，同性恋，双性恋和其他非异性恋者）的风险增加 许多不利的身体和心理健康成果，包括焦虑，抑郁，自杀，物质 使用，艾滋病毒/艾滋病，哮喘，心血管疾病和某些形式的癌症。尽管文档清晰，并且 这些健康分布的复制，对它们从青少年发展到 成年。两种理论主要主导了文献。少数派压力模型描述了独特的生活压力源 只有性少数群体（例如，基于性取向的胜利和歧视）经历 健康分配的主要贡献者。其他模型也暗示了少数压力和正常 心理社会过程共同作为健康差异的贡献者。一些这样的正常过程包括 （1）心理调整和特征（例如，情绪调节/失调，药物使用 期望），（2）被破坏的社会制度（例如家庭，同龄人，学校）和（3）个体差异（例如， 种族/种族，社会经济地位，温度）。迄今为止，大多数对少数派压力和 正常过程受到使用原发性高加索成年人的横截面样品的限制。虽然 从这些研究中学到了很多东西，它们不允许分析各种新兴健康差异 发展。因此 观察到的“预测因子”和“结果”之间的方向性推断的有效性。我的长期职业目标 确定导致性少数群体差异的机制，目的是改善 这些分发的治疗方法，并开发筛查工具来识别将受益的高风险青年 来自预防计划。为了达到这个目标，在这个项目中，我使用 一个预期的样本，以基线为14-19岁，遵循超过4年的样本。我的 目标是描述性发展的发展轨迹和性发展的机制 少数族裔青年与在10年的发展窗口中相比，跨越了14岁的年轻人 23年。纵向结果包括抑郁/焦虑，自杀，犯罪，睡眠，一般身体 健康，饮食不足和使用物质。这些结果的发展轨迹将由 性别和性取向。将根据现有文献进行确认性分析以检查 少数派压力与不利结果之间的关系。然后，我将使用机器学习来识别 不良结果和健康差异的未知预测指标，并表征了预测的任何变化 跨时间。最后，我将使用最先进的干预变量分析（中介，节制）来评估 纵向机制出现了健康差异。调查结果应洞悉 差异发展和维护的机制，为预防和干预策略提供了信息。