title: A compensatory model of risk and resilience applied to adolescent sexual orientation disparities in nonsuicidal self-injury and suicide attempts.
abstract: This study investigated and applied a compensatory model of risk and resilience to differences in past-year nonsuicidal self-injury (NSSI) and suicide attempts by sexual orientation using representative data from the 2007 Massachusetts Youth Risk Behavior Survey (n = 3,131). Self-identified lesbian, gay, bisexual, and questioning (LGBQ) adolescents comprised 7% of the sample, but accounted for 67% of NSSI and 80% of suicide attempts. Compared with heterosexuals, LGBQ adolescents had an increased odds of NSSI (adjusted Odds Ratio (aOR) = 2.76; 95% Confidence Interval (CI) [2.00, 3.81] and suicide attempts (aOR = 2.73; 95% CI [1.47, 5.08]. NSSI was highly associated with suicidality (aOR = 10.87; 95% CI [6.17, 19.18]. Family support was independently associated with a decreased odds of both NSSI (aOR = 0.56; 95% CI [0.35, 0.89] and suicidality (aOR = 0.48; 95% CI [0.29, 0.79] supporting a compensatory model of resilience. Screening and preventive interventions for LGBQ adolescents are warranted, including at the family level. Sexual orientation should be included as a standard demographic to monitor health disparities.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health.
authors.forename: Sari L
authors.initials: SL
authors.lastname: Reisner
authors.affiliation: Department of Epidemiology, Harvard School of Public Health.
authors.forename: Katie
authors.initials: K
authors.lastname: Biello
authors.affiliation: The Fenway Institute, Fenway Health.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Perry
authors.affiliation: Basic and Applied Social Psychology, Graduate Center at the City University of New York (CUNY).
authors.forename: Kristi E
authors.initials: KE
authors.lastname: Gamarel
authors.affiliation: Department of Epidemiology, Harvard School of Public Health.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Mimiaga
mesh_terms: D000293:Adolescent; D001727:Bisexuality / Q000706:statistics & numerical data*; D005260:Female; D006716:Homosexuality / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008960:Models, Psychological; D055500:Resilience, Psychological; D012306:Risk; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*