Developmental trajectories of depression and suicide among LGBTQ people of color: An Integrative Data Analysis of 18 prevention trials.

LGBTQ 有色人种抑郁和自杀的发展轨迹：18 项预防试验的综合数据分析。

• 批准号: 10604573
• 负责人: Alberto Valido Delgado
• 金额: $ 3.81万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-11-01 至 2024-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10604573
• 关键词: 19 year old; Address; Adolescent; Adult; African American; Age; Area; Behavior; Black race; Childhood; Clinical; Crime; Data; Data Analyses; Data Set; Depression and Suicide; Development; Discrimination; Enrollment; Ethnic Origin; Exposure to; Extramural Activities; Family; Feeling suicidal; Fellowship; Frequencies; Funding; Future; Gender; Goals; Growth; Health; Health Professional; Health Resources; Individual; Inequality; Intervention; Latinx; Length; Lesbian Gay Bisexual Transgender Queer; Literature; Longevity; Longitudinal Studies; Mental Health; Mental Health Services; Mental disorders; Mentors; Mentorship; Methodology; Modeling; National Institute of Mental Health; Neighborhoods; Outcome; Participant; Pattern; Personal Satisfaction; Prevention; Prevention trial; Public Health; Race; Randomized; Records; Research; Research Personnel; Research Training; Risk; Sample Size; Sampling; Science; Secure; Signal Transduction; Source; Stress; Subgroup; Suicide attempt; Surveys; Symptoms; Techniques; Therapeutic Intervention; Training; Training Programs; Trust; Universities; Youth; adverse childhood events; associated symptom; base; career; clinical practice; cohort; critical period; depressive symptoms; design; experience; family support; improved; insight; low socioeconomic status; mental development; minority children; multi-racial; next generation; people of color; preventive intervention; protective factors; sexual identity; suicidal behavior; suicidal risk; tool

Project Summary / Abstract Increased rates of depression and suicidality among LGBTQ people of color (LGBTQ-POC) is a critically important public health concern. LGBTQ-POC experience the cumulative stress of systemic in- equality and discrimination, including lower socioeconomic status, higher exposure to neighborhood crime, trau- matic childhood experiences, and differential access to mental health care and resources. Although critical for early prevention and clinical practice, essential gaps remain to understand depression and suicide-related behav- iors among LGBTQ-POC. Reduced samples in individual studies and methodological limitations have restricted our ability to understand depression and suicidality from a developmental perspective. I propose using a se- quential cohort design and Integrative Data Analysis (IDA) to examine longitudinal trajectories of depression and suicidality among LGBTQ-POC adolescents. IDA combines individual-level data from multiple independent studies into a single dataset. IDA provides increased statistical power, increased frequency of low base-rate behaviors, and the ability to study an expanded sample of underrepresented subgroups. Further, I will explore overlapping age cohorts across numerous longitudinal studies using a sequential co- hort design, which will provide a much broader understanding of development. The proposed study includes adolescents in 18 randomized prevention trials who identified as LGBTQ-POC (N = 2,029). Researchers surveyed participants at varying intervals from 1 to 15.25 years. At baseline, youth enrolled in the studies were 7 to 19 years of age (M = 12.7). Given the length of the trials, the proposed study will examine a sizable developmental period from 7 up to 34 years. In Aim 1, I will use multilevel growth mixture modeling (MGMM) to examine longi- tudinal trajectories of depression and suicide-related behaviors among LGBTQ-POC. In Aim 2, I will identify early depression symptoms associated with longitudinal trajectories of suicide ideation and behaviors. Lastly, Aim 3 will examine the impact of early intrapersonal and interpersonal protective factors on longitudinal trajectories of depression and suicidality. These aims closely align with strategic Goals 2 and 3 of NIMH to “examine mental illness trajectories throughout the lifespan” and “highlight efforts to improve preventive and therapeutic inter- ventions.” Further, the aims of this fellowship can support efforts to remediate systemic inequalities in mental healthcare that disproportionately impact LGBTQ-POC. These insights could offer new evidence and actionable tools to supplement existing interventions and target prevention efforts to critical periods of development and groups of high need capitalizing on the strengths and protective factors of LGBTQ-POC. Lastly, this fellowship will allow me to build a strong background in developmental science, mental health prevention, and quantitative methodology with a focus on the health and well-being of LGBTQ-POC adolescents.

项目概要/摘要 LGBTQ 有色人种 (LGBTQ-POC) 的抑郁症和自杀率上升是一个 LGBTQ-POC 经历着系统性的累积压力。 平等和歧视，包括社会经济地位较低、邻里犯罪风险较高、创伤 童年经历以及获得心理保健和资源的机会存在差异，尽管这对他们来说至关重要。 早期预防和临床实践中，对于抑郁症和自杀相关行为的理解仍存在重大差距。 LGBTQ-POC 中的个体研究样本减少和方法学限制限制了这一点。 我们从发展的角度理解抑郁和自杀的能力，我建议使用一个SE- 队列设计和综合数据分析（IDA）来检查纵向轨迹 IDA 结合了来自 LGBTQ-POC 青少年的抑郁和自杀数据。 IDA 将多个独立研究整合到一个数据集中，提供了更高的统计能力和频率。 低基础率行为，以及研究代表性不足的亚组的扩大样本的能力。 我将使用连续的共同研究来探索大量纵向研究中重叠的年龄组 简短的设计，这将提供对开发更广泛的理解。 纳入了 18 项随机预防试验中被确定为 LGBTQ-POC 的青少年（N = 2,029）。 以 1 至 15.25 岁的不同时间间隔对参与者进行了调查。 在基线时，参与研究的青少年年龄为 7 至 15.25 岁。 19 岁（M = 12.7）考虑到试验的长度，拟议的研究将检查相当大的发育过程。 在目标 1 中，我将使用多级增长混合模型 (MGMM) 来检查长期。 在目标 2 中，我将尽早确定 LGBTQ-POC 中抑郁症和自杀相关行为的轨迹。 抑郁症状与自杀意念和行为的纵向轨迹相关。最后，目标 3。 将研究早期的内心和人际保护因素对纵向轨迹的影响 这些目标与 NIMH 的战略目标 2 和 3“检查心理”密切相关。 整个生命周期的疾病轨迹”和“强调改善预防和治疗间相互作用的努力” 此外，该研究金的目的可以支持纠正精神方面系统性不平等的努力 这些见解可以提供新的证据并具有可操作性。 补充现有干预措施并将预防工作瞄准发展和关键时期的工具 高需求群体利用 LGBTQ-POC 的优势和保护因素。 将使我在发展科学、心理健康预防和定量方面建立强大的背景 方法，重点关注 LGBTQ-POC 青少年的健康和福祉。