title: Negative Treatment by Family as a Predictor of Depressive Symptoms, Life Satisfaction, Suicidality, and Tobacco/Alcohol Use in Vietnamese Sexual Minority Women.
abstract: Research linking family rejection and health outcomes in sexual minority people is mostly limited to North America. We assessed the associations between negative treatment by family members and depressive symptoms, life satisfaction, suicidality, and tobacco/alcohol use in sexual minority women (SMW) in Viet Nam.
  
  
  
  Data were from an anonymous internet survey (n = 1936). Latent class analysis characterized patterns of negative treatment by family members experienced by respondents. Latent class with distal outcome modeling was used to regress depressive symptoms, life satisfaction, suicidality, and tobacco/alcohol use on family treatment class, controlling for predictors of family treatment and for two other types of sexual prejudice.
  
  
  
  Five latent family treatment classes were extracted, including four negative classes representing varying patterns of negative family treatment. Overall, more than one negative class predicted lower life satisfaction, more depressive symptoms, and higher odds of attempted suicide (relative to the non-negative class), supporting the minority stress hypothesis that negative family treatment is predictive of poorer outcomes. Only the most negative class had elevated alcohol use. The association between family treatment and smoking status was not statistically significant. The most negative class, unexpectedly, did not have the highest odds of having attempted suicide, raising a question about survivor bias.
  
  
  
  This population requires public health attention, with emphasis placed on interventions targeting the family to promote acceptance and to prevent negative treatment, and interventions supporting those SMW who encounter the worst types of negative family treatment.
authors.affiliation: 1 Department of Mental Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.|2 Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.|3 Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.|4 Institute for Studies of Society , Economy and Environment, Ha Noi, Viet Nam.
authors.forename: Trang Quynh
authors.initials: TQ
authors.lastname: Nguyen
authors.affiliation: 3 Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Karen
authors.initials: K
authors.lastname: Bandeen-Roche
authors.affiliation: 2 Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Danielle
authors.initials: D
authors.lastname: German
authors.affiliation: 4 Institute for Studies of Society , Economy and Environment, Ha Noi, Viet Nam.|5 Health Strategy and Policy Institute , Ha Noi, Viet Nam.
authors.forename: Nam T T
authors.initials: NT
authors.lastname: Nguyen
authors.affiliation: 1 Department of Mental Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Judith K
authors.initials: JK
authors.lastname: Bass
authors.affiliation: 2 Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Knowlton
mesh_terms: D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D020407:Internet; D008960:Models, Psychological; D010549:Personal Satisfaction; D011287:Prejudice; D000072339:Sexual and Gender Minorities / Q000523:psychology*; D013315:Stress, Psychological; D013405:Suicide / Q000523:psychology*; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000523:psychology*; D014744:Vietnam; D055815:Young Adult
keywords: family rejection; latent class model; mental health; sexual minority women (SMW); substance use; suicidality