Sexual Identity, Adverse Childhood Experiences, and Suicidal Behaviors

Overview

Journal J Adolesc Health

Publisher Elsevier

Specialty Pediatrics

Date 2017 Dec 11

PMID 29223563

Citations 21

Authors

Kristen Clements-Nolle

Taylor Lensch

Amberlee Baxa

Christopher Gay

Sandra Larson

Wei Yang

Affiliations

Soon will be listed here.

Abstract

Purpose: The objective of this study was to examine the influence of sexual identity and adverse childhood experiences (ACEs) on suicidal behaviors in a population-based sample of high school students.

Methods: A two-stage cluster random sampling design was used to recruit 5,108 students from 97 high schools. A total of 4,955 students (97%) provided information that allowed for classification of sexual identity into three groups: (1) lesbian, gay, or bisexual (LGB) (10%); (2) not sure (4.6%); and (3) heterosexual (85.4%). Five measures of childhood abuse and household dysfunction were summed, and the ACE score was categorized as 0, 1, 2, and 3-5 ACEs. Weighted logistic regression was used to assess the influence of sexual identity, ACEs, and their interaction on suicide ideation and attempts in the past 12 months.

Results: Compared with heterosexual students, those who were LGB and were not sure had higher odds of suicide ideation and attempts. There was also a graded relationship between cumulative ACE exposure and suicidal behaviors. Although sexual identity/ACE interaction was not observed, LGB/not sure students who experienced a high number of ACEs were disproportionately affected. Compared with heterosexual students with 0 ACE, LGB/not sure students with 0 ACE (adjusted odds ratio [AOR] = 3.32, 95% confidence interval [CI] = 1.96-5.61), 1 ACE (AOR = 6.58, 95% CI = 4.05-10.71), 2 ACEs (AOR 13.50, 95% CI = 8.45-21.58), and 3-5 ACEs (AOR = 14.04, 95% CI = 8.72, 22.62) had higher odds of suicide ideation. A similar pattern was observed for suicide attempts.

Conclusions: LGB and students not sure of their sexual identity with greater exposure to ACEs have disproportionately high levels of suicide ideation and attempts. Trauma-informed interventions for these populations are warranted.

Citing Articles

Sexual identity-related inequalities in associations between adverse childhood experiences and health in late adolescence-A national cohort study.

Chandrasekar R, Karamanos A, Learoyd A, Khanolkar A PLoS One. 2024; 19(12):e0312161.

PMID: 39661575 PMC: 11633990. DOI: 10.1371/journal.pone.0312161.

Sexual Identity Is Associated With Adverse Childhood Experiences in US Early Adolescents.

Raney J, Weinstein S, Testa A, Ganson K, Memon Z, Glidden D Acad Pediatr. 2024; 25(1):102555.

PMID: 39134208 PMC: 11805669. DOI: 10.1016/j.acap.2024.07.022.

Adverse Childhood Experiences and Health Outcomes Among Sexual and Gender Minorities: A Systematic Review.

Solberg M, Carr K, Peters R J Child Adolesc Trauma. 2024; 17(2):627-639.

PMID: 38938948 PMC: 11199470. DOI: 10.1007/s40653-023-00576-4.

Childhood Adversity and Adolescent Smartphone Use Across Sexual Orientation and Gender Expression.

Zheng X, Jiang W, Peng S, Liu Q, He Y, Huang C JAMA Netw Open. 2024; 7(4):e246448.

PMID: 38607622 PMC: 11015349. DOI: 10.1001/jamanetworkopen.2024.6448.

The Association Between Sexual Identity, Depression, and Adolescent Substance Use.

Bhatia D, Berg O, Davies R, Mikulich Gilbertson S, Sakai J Child Psychiatry Hum Dev. 2023; .

PMID: 38019347 DOI: 10.1007/s10578-023-01630-w.

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