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.

项目概要 性少数群体（女同性恋、男同性恋、双性恋和其他非异性恋个体）面临更高的风险 许多不良的身心健康后果，包括焦虑、抑郁、自杀、物质 尽管有明确的文件和记录，但艾滋病毒/艾滋病、哮喘、心血管疾病和某些形式的癌症。 这些健康差异的复制，人们对它们从青春期到成年的发展知之甚少。 文献中主要有两种理论来描述独特的生活压力源。 仅性少数群体经历过（例如，基于性取向的受害和歧视） 其他模型暗示了少数群体压力和规范。 社会心理过程共同导致健康差异，其中一些规范过程包括。 (1) 心理调节特征（例如情绪调节/失调、物质使用 期望），（2）社会系统被破坏（例如家庭、同龄人、学校），以及（3）个体差异（例如， 迄今为止，大多数研究都针对少数群体的压力和性格。 规范过程受到主要是白人成年人的横截面样本的使用的限制。 从这些研究中我们学到了很多东西，但它们不允许分析不同国家之间新出现的健康差异 因此，现有研究在对不同人群的普遍性和适用性方面受到限制。 观察到的“预测因素”和“结果”之间的方向性推断的有效性。 旨在找出导致性少数群体之间差异的机制，目标是改善 解决这些差异的方法，并开发筛查工具来识别可以受益的高风险青少年 为了实现这一目标，在这个项目中，我使用了文献来解决现有的局限性。 基线年龄为 14-19 岁且随访时间超过 4 年的前瞻性样本。 目标是描述性健康差异发展的发展轨迹和机制 少数民族青少年与异性恋青少年跨越 14 岁至 10 年发展窗口的比较 23 年的纵向结果包括抑郁/焦虑、自杀倾向、犯罪、睡眠、一般身体状况。 这些结果的发展轨迹将由以下图表绘制。 将根据现有文献进行验证性分析以检查。 然后，我将使用机器学习来识别少数群体压力与不良结果之间的关系。 不良结果和健康差异的未知预测因子以及描述预测变化的特征 最后，我将使用最先进的干预变量分析（中介、调节）来评估。 研究结果应有助于深入了解健康差异出现的纵向机制。 差异发展和维持的机制，为预防和干预策略提供信息。