Abstract

Introduction

Prior research suggests sexual and gender minority (SGM) youth are profoundly impacted by levels of parental support. This study assessed mediating effects of generalized family acceptance and conflict on lifetime suicidal behaviors among a large diverse sample comprising both SGM and non-SGM youth in early adolescence, when intervention to optimize family dynamics may be critical.

Materials

Using data from the first-year follow-up of the Adolescent Brain Cognitive Development Study based in the United States, mediation was tested using a binary logistic regression model fitted with a generalized structural equation. Models included SGM status as the independent variable, family acceptance or family conflict sum score as the mediator, and the presence of lifetime suicidal behaviors as the dependent variable. Models adjusted for age, birth-assigned sex (as reported by the parent/guardian), and race/ethnicity.

Results

Of 11,235 youths, lifetime suicidal behaviors were reported by 1.5% (n = 164). Youths with SGM identities reported 40% less parental acceptance and 47% greater family conflict, compared to non-SGM peers. Both parental acceptance and family conflict partially mediated associations between SGM identification and odds of lifetime suicidal behavior (ps = .001).

Conclusions

Identification of modifiable risk factors for suicidality in this vulnerable population, including parental acceptance and family conflict, is critical to improving health outcomes. Clinicians should work with SGM youth and their families starting in childhood to optimize family dynamics and bolster acceptance to potentially reduce adverse health outcomes.

• HIGHLIGHTS

• Youths with SGM identity reported 40% less parental acceptance than non-SGM peers.

• Parental acceptance was associated with lower odds of lifetime suicidal behaviors.

• Family factors partially mediated associations between SGM status and suicidal behaviors.

中文翻译：

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家庭接纳度和冲突对性和性别少数青少年自杀的中介作用

摘要

介绍

先前的研究表明，性少数和性别少数（SGM）青少年受到父母支持水平的深刻影响。这项研究评估了包括青春期早期 SGM 和非 SGM 青少年在内的大量不同样本中普遍家庭接受度和冲突对终生自杀行为的中介作用，此时优化家庭动态的干预可能至关重要。

材料

利用美国青少年大脑认知发展研究第一年随访的数据，使用符合广义结构方程的二元逻辑回归模型测试了中介作用。模型包括作为自变量的 SGM 状态、作为中介变量的家庭接受度或家庭冲突总得分以及作为因变量的终生自杀行为的存在。模型根据年龄、出生性别（由父母/监护人报告）和种族/民族进行调整。

结果

在 11,235 名青少年中，有 1.5% 的人有终生自杀行为（n  = 164）。与非 SGM 的同龄人相比，拥有 SGM 身份的青少年表示，父母的接受度要低 40%，家庭冲突要高 47%。父母的接受度和家庭冲突都部分调节了 SGM 识别与终生自杀行为几率之间的关联 ( p s = .001)。

结论

确定这一弱势群体自杀的可改变风险因素，包括父母的接受度和家庭冲突，对于改善健康结果至关重要。临床医生应从童年开始就与 SGM 青少年及其家人合作，优化家庭动态并增强接受度，从而可能减少不良健康后果。

• 强调

• 拥有 SGM 身份的青少年表示，父母对他们的接受度比非 SGM 同龄人低 40%。

• 父母的接受与终生自杀行为的几率较低有关。

• 家庭因素部分介导了 SGM 状态与自杀行为之间的关联。