Yeen Huang1, Pengsheng Li1, Zhisheng Lai2, Xiaofei Jia3, Di Xiao1, Tian Wang1, Lan Guo1, Ciyong Lu4. 1. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China. 2. Yuexiu District Center for Disease Control and Prevention, Guangzhou 510080, People's Republic of China. 3. Tianhe District Center for Disease Control and Prevention, Guangzhou 510655, People's Republic of China. 4. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China. Electronic address: luciyong@mail.sysu.edu.cn.
Abstract
BACKGROUND: Evidence shows sexual minority adolescents have a higher risk of suicidality than their heterosexual peers due to minority stressors or lack of social support, but it remains unclear how the combined effects of these influence factors impact suicidality in this population. In this study, we examine whether school victimization mediates association between sexual minority status and suicidal behavior of adolescents and explore whether such mediation is moderated by interpersonal relationships. METHODS: We sampled a large nationally representative dataset comprising data collected from 7th to 12th graders (the 2015 School-based Chinese Adolescents Health Survey) using a multistage, stratified-cluster, random-sampling method. Our sample consisted of 123,459 students who completed questionnaires regarding their sexual minority status, suicidal ideation, suicide attempts, school victimization, classmate relations, and teacher-classmate relations. RESULTS: Using a moderated mediation model, we found that school victimization mediated the effects of sexual minority status on suicidal ideation (indirect effect = 0.0296, 95% confidence intervals (CI) = 0.0259-0.0333) and suicide attempts (indirect effect = 0.0086, 95% CI = 0.0074-0.0100). These indirect effects were moderated by interpersonal relationships, and a greater effect was seen among sexual minority students with poor classmate or teacher-classmate relations. LIMITATIONS: Our study sample included only students attending school, and interpretation of the direction of the observed associations is limited due to the cross-sectional design. CONCLUSIONS: Interpersonal relationships moderate the indirect effects of school victimization on association between sexual minority status and suicidal behavior. Early intervention addressing school violence combined with improving the quality of relationships with school peers would help prevent suicidality in sexual minority adolescents.
BACKGROUND: Evidence shows sexual minority adolescents have a higher risk of suicidality than their heterosexual peers due to minority stressors or lack of social support, but it remains unclear how the combined effects of these influence factors impact suicidality in this population. In this study, we examine whether school victimization mediates association between sexual minority status and suicidal behavior of adolescents and explore whether such mediation is moderated by interpersonal relationships. METHODS: We sampled a large nationally representative dataset comprising data collected from 7th to 12th graders (the 2015 School-based Chinese Adolescents Health Survey) using a multistage, stratified-cluster, random-sampling method. Our sample consisted of 123,459 students who completed questionnaires regarding their sexual minority status, suicidal ideation, suicide attempts, school victimization, classmate relations, and teacher-classmate relations. RESULTS: Using a moderated mediation model, we found that school victimization mediated the effects of sexual minority status on suicidal ideation (indirect effect = 0.0296, 95% confidence intervals (CI) = 0.0259-0.0333) and suicide attempts (indirect effect = 0.0086, 95% CI = 0.0074-0.0100). These indirect effects were moderated by interpersonal relationships, and a greater effect was seen among sexual minority students with poor classmate or teacher-classmate relations. LIMITATIONS: Our study sample included only students attending school, and interpretation of the direction of the observed associations is limited due to the cross-sectional design. CONCLUSIONS: Interpersonal relationships moderate the indirect effects of school victimization on association between sexual minority status and suicidal behavior. Early intervention addressing school violence combined with improving the quality of relationships with school peers would help prevent suicidality in sexual minority adolescents.
Authors: A Jess Williams; Christopher Jones; Jon Arcelus; Ellen Townsend; Aikaterini Lazaridou; Maria Michail Journal: PLoS One Date: 2021-01-22 Impact factor: 3.240