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#9 - Suicide et ORIENTATION SEXUELLE - 30 janvier 2012

Du 5 au 11 février, la 22e Semaine de prévention du suicide du Québec battra son plein. Sous le thème « Ici, on tient à chacun. Le suicide n’est pas une option » http://www.aqps.info/semaine, des centaines d’activités se dérouleront dans l’ensemble des régions du Québec. L’Association québécoise de prévention du suicide en effectuera le lancement officiel mardi, le 31 janvier, au Centre Saint-Pierre à Montréal. L’un des groupes à risque identifiés par l’AQPS cette année sont les gais, lesbiennes, bisexuels et transsexuels (http://www.aqps.info/semaine/lutter-contre-homophobie-prevenir-suicide-178.html). Dans son plan d’action de lutte contre l’homophobie (http://www.justice.gouv.qc.ca/francais/ministere/dossiers/homophobie/plan_action_homo_FR.pdf), le gouvernement du Québec a inclus plusieurs actions en lien avec la prévention et la recherche sur le suicide. La liste de cette semaine portera donc sur cette question.

Pour vous abonner à notre liste d'envoi, complétez le formulaire en-ligne.

Beck, F., Firdion, J.-M., Legleye, S., & Schiltz, M.-A. (2010). Les minorités sexuelles face au risque suicidaire: Acquis des sciences sociales et perspectives (No. 978-2-9161-9222-2). Saint-Denis: Institut national de prévention et d'éducation pour la santé (INPES).
Résumé:Depuis la fin des années 1990 (aux Etats-Unis d'abord, puis dans d'autres pays dont la France), les enquêtes les plus probantes ont mis en évidence un risque suicidaire plus élevé parmi les jeunes sexuelles - gays, lesbiennes, bisexuel(le)s, transgenres - et ceux qui se questionnent sur leur identité sexuelle ou de genre.
Il existe en France des initiatives de prévention de ces discriminations et du risque suicidaire qui gagneraient à être mieux connues et parfois généralisées. Autre piste de travail: la sensibilisation des professionnels en contact avec les jeunes, qu'ils viennent des champs éducatif, sanitaire, social, judiciaire... Enfin, pour continuer à améliorer nos connaissances, il semble essentiel d'intégrer plus nettement, en amont de la conception des enquêtes, ces phénomènes spécifiques que sont l'homophobie, la lesbophobie, la transphobie et le sexisme.
http://www.inpes.fr/CFESBases/catalogue/pdf/1291.pdf

Lhomond, B., & Saurel-Cubizolles, M.-J. (2009). Orientation sexuelle et santé mentale : une revue de la littérature. Revue d'épidémiologie et de santé publique, 57(6), 437-450.
Résumé: Position du problème: Le but de cet article est de faire le point des connaissances disponibles sur l’orientation sexuelle et la santé mentale, en particulier pour les femmes. Méthode: Les articles publiés de 1997 à 2007 en langue anglaise ou française, ont été sélectionnés dans Pubmed. Pour être retenus, les articles devaient présenter des résultats d’enquêtes quantitatives comparant la situation de personnes adultes « homosexuelles » à celle de personnes « hétérosexuelles ». Au total, cette revue analyse 22 articles, dont deux portent sur la même base de données. Résultats: Cette revue montre un tableau cohérent d’une moins bonne santé mentale pour les personnes homosexuelles et surtout bisexuelles. Les études sont particulièrement convergentes à propos du risque plus élevé de tentatives de suicide.
http://dx.doi.org/10.1016/j.respe.2009.07.068

Russell, S. T., Van Campen, K. S., Hoefle, J. M., & Boor, J. K. (2011). Suicide risk and lesbian, gay, bisexual, and trangender college students. In D. A. Lamis & D. Lester (Eds.), Understanding and Preventing College Student Suicide (pp. 146-156). Springfield, Illinois, US: Charles C Thomas Publisher Ltd.
Résumé:In this chapter, we provide a brief review of what is known about lesbian, gay, bisexual and transgender (LGBT) college students and suicide. Because empirical research on suicide among LGBT college students is limited, we briefly review this work in the context of the larger research literature on LGBT suicide. Given the prominence of the social environment in explanations for compromised mental health and suicidality, we then consider the ways that anti-LGBT prejudice and discrimination may characterize campus life for many students. We then consider the possibilities for supporting LGBT students through campus-based efforts in student affairs, mental health servides, and academic inclusion. Finally, we discuss the gaps in knowledge and important areas of further inquiry and make recommendations for campus institutional efforts to support the health and well-being of LGBT college students.

Marshal, M. P., Dietz, L. J., Friedman, M. S., Stall, R., Smith, H. A., McGinley, J., et al. (2011). Suicidality and depression disparities between sexual minority and heterosexual youth: a meta-analytic review. Journal of Adolescence Health, 49(2), 115-123.
Résumé: PURPOSE: To examine disparities between sexual minority youth (SMY) and heterosexual youth in rates of suicidality and depression symptoms. METHODS: Separate meta-analyses were conducted to examine suicidality and depression disparities. Studies were included if the average age of the participants was <18 years, and if suicidality or depression symptoms were compared across SMY and heterosexual youth. RESULTS: SMY reported significantly higher rates of suicidality and depression symptoms as compared with the heterosexual youth. Disparities increased with the increase in the severity of suicidality, suicide attempts, suicide attempts requiring medical attention. Effects did not vary across gender, recruitment source, and sexual orientation definition. CONCLUSIONS: Disparities in suicidality and depression may be influenced by negative experiences including discrimination and victimization. Clinicians should assess sexual orientation, analyze psychosocial histories to identify associated risk factors, and promote prevention and intervention opportunities for SMY and their families.
http://dx.doi.org/10.1016/j.jadohealth.2011.02.005

Hong, J. S., Espelage, D. L., & Kral, M. J. (2011). Understanding suicide among sexual minority youth in America: An ecological systems analysis. Journal of Adolescence, 34(5), 885-894.
Résumé: This article examines major risk factors for suicide among sexual minority youth using Bronfenbrenner's ecological systems theory. Although suicidal behavior among sexual minority youth is a major public concern in the United States, understanding of this phenomenon has been limited since the majority of empirical research studies have addressed individual level characteristics without much consideration to the larger environmental contexts. This review integrates past and current empirical findings on suicidal behaviors of sexual minority youth within the context of micro-, meso-, exo-, macro-, and chrono-systems levels. Finally, it draws implications for assessment, prevention, and intervention strategies.
http://dx.doi.org/10.1016/j.adolescence.2011.01.002

Haas, A. P., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., D'Augelli, A. R., et al. (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations. Journal of Homosexuality, 58(1), 10-51.
Résumé: Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice.
http://dx.doi.org/10.1080/00918369.2011.534038

Hatzenbuehler, M. L. (2011). The social environment and suicide attempts in lesbian, gay, and bisexual youth. Pediatrics, 127(5), 896-903.
Résumé: Objective: To determine whether the social environment surrounding lesbian, gay, and bisexual youth may contribute to their higher rates of suicide attempts, controlling for individual-level risk factors. Methods: A total of 31 852 11th grade students (1413 [4.4%] lesbian, gay, and bisexual individuals) in Oregon completed the Oregon Healthy Teens survey in 2006-2008. We created a composite index of the social environment in 34 counties, including (1) the proportion of same-sex couples, (2) the proportion of registered Democrats, (3) the presence of gay-straight alliances in schools, and (4) school policies (nondiscrimination and antibullying) that specifically protected lesbian, gay, and bisexual students. Results: Lesbian, gay, and bisexual youth were significantly more likely to attempt suicide in the previous 12 months, compared with heterosexuals (21.5% vs 4.2%). Among lesbian, gay, and bisexual youth, the risk of attempting suicide was 20% greater in unsupportive environments compared to supportive environments. A more supportive social environment was significantly associated with fewer suicide attempts, controlling for sociodemographic variables and multiple risk factors for suicide attempts, including depressive symptoms, binge drinking, peer victimization, and physical abuse by an adult. Conclusions: This study documents an association between an objective measure of the social environment and suicide attempts among lesbian, gay, and bisexual youth. The social environment appears to confer risk for suicide attempts over and above individual-level risk factors. These results have important implications for the development of policies and interventions to reduce sexual orientation-related disparities in suicide attempts.
http://dx.doi.org/10.1542/peds.2010-3020

Diamond, G. M., Diamond, G. S., Levy, S., Closs, C., Ladipo, T., & Siqueland, L. (2011). Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: A treatment development study and open trial with preliminary findings. Psychotherapy, [Epub].
Résumé: The objective of this paper is to adapt attachment-based family therapy (ABFT) for use with suicidal lesbian, gay, and bisexual (LGB) adolescents and to obtain preliminary data on the feasibility and efficacy of the treatment with this population. In Phase I, a treatment development team modified ABFT to meet the unique needs of LGB suicidal youth. In Phase II, 10 suicidal LGB youth were offered 12 weeks of LGB sensitive ABFT. Adolescents' report of suicidal ideation, depressive symptoms, and maternal attachment-related anxiety and avoidance were gathered at pretreatment, 6 weeks, and 12 weeks (posttreatment). In Phase I, the treatment was adapted to: (a) include more individual time working with parents in order to process their disappointments, pain, anger, and fears related to their adolescent's minority sexual orientation; (b) address the meaning, implications, and process of acceptance; and (c) heighten parents' awareness of subtle yet potent invalidating responses to their adolescents' sexual orientation. Results of Phase II suggest this population can be recruited and successfully treated with a family based therapy, evidenced by high levels of treatment retention and significant decreases in suicidal ideation, depressive symptoms, and maternal attachment-related anxiety and avoidance. This is the first family-based treatment adapted and tested specifically for suicidal LGB adolescents. Though promising, the results are preliminary and more research on larger samples is warranted.
http://dx.doi.org/10.1037/a0026247
Other related document: http://www.rtc.pdx.edu/PDF/fpS0706.pdf

Poteat, V. P., Mereish, E. H., Digiovanni, C. D., & Koenig, B. W. (2011). The effects of general and homophobic victimization on adolescents' psychosocial and educational concerns: The importance of intersecting identities and parent support. Journal of Counseling Psychology, 58(4), 597-609.
Résumé: Many adolescents experience peer victimization, which often can be homophobic. Applying the minority stress model with attention to intersecting social identities, this study tested the effects of general and homophobic victimization on several educational outcomes through suicidality and school belonging among 15,923 adolescents in Grades 7 through 12 on account of their sexual orientation and race/ethnicity. Parent support also was tested as a moderator of these effects. Homophobic victimization had different effects on suicidality across groups, indicating the importance of considering individuals' multiple social identities. However, homophobic victimization had universal negative effects on school belonging for all groups. Nearly all indirect effects of general and homophobic victimization on reported grades, truancy, and importance of graduating were significant through suicidality and school belonging across groups. Parent support was most consistent in moderating the effects of general and homophobic victimization on suicidality for heterosexual White and racial/ethnic minority youth. In nearly all cases, it did not moderate the effects of general or homophobic victimization for lesbian, gay, bisexual, transgender, and questioning youth. Furthermore, in most cases, parent support did not moderate the effects of general or homophobic victimization on school belonging. Findings underscore the need for counseling psychologists to work with parents of all youth on ways to provide support to those who experience homophobic victimization. Furthermore, they highlight the need for counseling psychologists to be involved as social justice advocates in the passage and implementation of school policies that address homophobic bullying and other forms of bias-based bullying and harassment.
http://dx.doi.org/10.1037/a0025095

House, A. S., Van Horn, E., Coppeans, C., & Stepleman, L. M. (2011). Interpersonal trauma and discriminatory events as predictors of suicidal and nonsuicidal self-injury in gay, lesbian, bisexual, and transgender persons. Traumatology, 17(2), 75-85.
Résumé: Recent research suggests that gay, lesbian, bisexual, and transgender (GLBT) persons are at greater risk for mental health problems, including suicidal and nonsuicidal self-injury, than heterosexuals. However, few studies have investigated factors that may be linked to this increased risk. This study investigated interpersonal violence, victimization, and discriminatory events as possible predictors of suicidal and nonsuicidal self-injury in a sample of sexual minorities (i.e., a GLBT sample). Participants were 1,126 self-identified gay, lesbian, bisexual, and/or transgender (GLBT) individuals who responded to an Internet-based survey. Results indicated that both experiences of interpersonal trauma and sexual discrimination were associated with increased likelihoods of engaging in suicidal and nonsuicidal self-injury. In addition, participants at the greatest risk were those experiencing high levels of both interpersonal trauma and sexual discrimination. Clinical implications of these results are discussed.
http://dx.doi.org/10.1177/1534765610395621

Goldman, L., & Livoti, V. M. (2011). Grief in GLBT populations: Focus on gay and lesbian youth. In R. A. Neimeyer, D. L. Harris, H. R. Winokuer & G. F. Thornton (Eds.), Grief and bereavement in contemporary society: Bridging research and practice. (pp. 249-259): New York, NY, US: Routledge/Taylor & Francis Group.
Résumé:The researcher-practitioner dialogue within this chapter explicates the sociocultural underpinnings of bereavement, depression, and suicide in gay and lesbian youth populations. Through an examination of both the causal factors and the subsequent therapeutic responses, we will explain how the "coming-out" experience for many gay and lesbian youth is both a literal and symbolic grieving process largely established and reinforced through the mechanisms of contemporary Western media. This dialogue will conclude with approaches to personal empowerment and counseling for gay and lesbian young people as they strive to positively embrace their identity. As a caveat, the chapter will focus exclusively on the developmental experience of gay and lesbian and questioning youth in the United States and Canada. Though social stigma is present across Westernized cultures, and the issue of homosexuality continues to be a matter of life and death in some parts of the world,' the writers' experiences and research foci center primarily on the psychosocial dynamics of homosexuality in these two countries. Although the grief issues facing transgendered, intersexed, and bisexual youth are equally as important, the writers are conscious that treatment of those diverse perspectives from this standpoint would be projective at best.

Russell, S. T., & Toomey, R. B. (2010). Men's sexual orientation and suicide: Evidence for adolescent-specific risk. Social Science and Medicine, [Epub].
Résumé: There is strong consensus in the research literature that adolescent and adult men who report same-sex sexual orientations, identities, and behaviors are at higher risk for suicide. Recent studies of general adolescent suicide risk have identified developmental trajectories that peak during the teenage years. Because the adolescent years are characterized by the development and heightened awareness of gender roles and sexual scripts closely tied to dominant cultural ideals of masculinity and heterosexuality, an adolescent-focused developmental trajectory for suicide risk might be particularly relevant for males with adolescent same-sex sexual orientations. We provide the first prospective examination of adolescent-specific risk for suicidality based on adolescent same-sex sexual orientation using data from the United States, the National Longitudinal Study of Adolescent Health. Tracing suicide ideation and attempts across four assessments from adolescence (Wave 1 average age 15.3 years) to young adulthood (Wave 4 average age 28.2), we documented that the risk for suicidal thoughts and attempts for adolescent same-sex attracted males is developmental in nature. Specifically, the risk for suicidal thoughts and attempts for males with same-sex attractions is largely limited to the adolescent years. These results offer new insights for suicide prevention and intervention for male adolescents and adults with same-sex sexual orientations.
http://dx.doi.org/10.1016/j.socscimed.2010.07.038

Mustanski, B. S., Garofalo, R., & Emerson, E. M. (2010). Mental health disorders, psychological distress, and suicidality in a diverse sample of lesbian, gay, bisexual, and transgender youths. American Journal of Public Health, 100(12), 2426-2432.
Résumé: Objectives. We examined associations of race/ethnicity, gender, and sexual orientation with mental disorders among lesbian, gay, bisexual, and transgender (LGBT) youths. Methods. We assessed mental disorders by administering a structured diagnostic interview to a community sample of 246 LGBT youths aged 16 to 20 years. Participants also completed the Brief Symptom Inventory 18 (BSI 18). Results. One third of participants met criteria for any mental disorder, 17% for conduct disorder, 15% for major depression, and 9% for posttraumatic stress disorder. Anorexia and bulimia were rare. Lifetime suicide attempts were frequent (31%) but less so in the prior 12 months (7%). Few racial/ethnic and gender differences were statistically significant. Bisexually identified youths had lower prevalences of every diagnosis. The BSI 18 had high negative predictive power (90%) and low positive predictive power (25%) for major depression. Conclusions. LGBT youths had higher prevalences of mental disorder diagnoses than youths in national samples, but were similar to representative samples of urban, racial/ethnic minority youths. Suicide behaviors were similar to those among representative youth samples in the same geographic area. Questionnaires measuring psychological distress may overestimate depression prevalence among this population.
http://dx.doi.org/10.2105/AJPH.2009.178319

Lucassen, M. F., Merry, S. N., Robinson, E. M., Denny, S., Clark, T., Ameratunga, S., et al. (2011). Sexual attraction, depression, self-harm, suicidality and help-seeking behaviour in New Zealand secondary school students. Australian and New Zealand Journal of Psychiatry, 45(5), 376-383.
Résumé: Objective: To describe the sexual attractions of New Zealand secondary school students and investigate the associations between sexual attraction and self-reported depression, self-harm, suicidality and help-seeking behaviour. Method: Multiple logistic regression was used to examine the associations between sexual attraction and depressive symptoms, suicidality, self-harming and help-seeking behaviours in a nationally representative secondary school health and well-being survey, undertaken in 2007. Results: Of the students surveyed, 92% were attracted to the opposite sex, 1% to the same sex, 3% to both sexes, 2% were not sure and 2% were attracted to neither sex. Students who were attracted to the same or to both sexes consistently had higher prevalence estimates of depression, suicidality and self-harmin. Odds ratios were highest for students who reported they were attracted to both sexes for depressive symptoms, self-harm and attempted suicide. Students not exclusively attracted to the opposite sex were more likely to report having seen a health professional for an emotional worry and were more likely to have difficulty accessing help for emotional concerns. Conclusions: The study findings highlight significant mental health disparities faced by students attracted to the same or both sexes, with those attracted to both sexes appearing particularly vulnerable. There is a vital need to ensure primary care and mental health services have the capacity and capability to screen and provide appropriate responsive care for youth who are attracted to the same or both sexes.
http://dx.doi.org/10.3109/00048674.2011.559635

O'Donnell, S., Meyer, I., & Schwartz, S. (2011). Increased risk of suicide attempts among Black and Latino lesbians, gay men, and bisexuals. American Journal of Public Health, 101(6), 1055-1059.
Résumé: Members of racial/ethnic minority groups have a lower lifetime prevalence than have Whites of mental disorders, a risk factor for suicide attempts; paradoxically, however, lesbian, gay, and bisexual (LGB) ethnic minority youths may be at increased risk for suicide attempts relative to White LGB youths. We found that the increased risk of suicide attempts among racial/ethnic minority LGB respondents in our sample relative to White respondents was not explained by excess youth onset of depression and substance abuse or by a higher susceptibility to suicide in the racial/ethnic minority LGB group.
http://dx.doi.org/10.2105/ajph.2010.300032

Mathy, R. M., Cochran, S. D., Olsen, J., & Mays, V. M. (2011). The association between relationship markers of sexual orientation and suicide: Denmark, 1990–2001. Social Psychiatry and Psychiatric Epidemiology, 46(2), 111-117.
Résumé: Objective: Minority sexual orientation has been repeatedly linked to elevated rates of suicide attempts. Whether this translates into greater risk for suicide mortality is unclear. We investigated sexual orientation-related differences in suicide mortality in Denmark during the initial 12- year period following legalization of same-sex registered domestic partnerships (RDPs). Method: Using data from death certificates issued between 1990 and 2001 and population estimates from the Danish census, we estimated suicide mortality risk among individuals classified into one of three marital/cohabitation statuses: current/formerly in same-sex RDPs; current/formerly heterosexually married; or never married/registered. Results: Risk for suicide mortality was associated with this proxy indicator of sexual orientation, but only significantly among men. The estimated age-adjusted suicide mortality risk for RDP men was nearly eight times greater than for men with positive histories of heterosexual marriage and nearly twice as high for men who had never married. Conclusions: Suicide risk appears greatly elevated for men in same-sex partnerships in Denmark. To what extent this is true for similar gay and bisexual men who are not in such relationships is unknown, but these findings call for targeted suicide prevention programs aimed at reducing suicide risk among gay and bisexual men.
http://dx.doi.org/10.1007/s00127-009-0177-3

Bolton, S. L., & Sareen, J. (2011). Sexual orientation and its relation to mental disorders and suicide attempts: findings from a nationally representative sample. Canadian Journal of Psychiatry = Revue canadienne de psychiatrie, 56(1), 35-43.
Résumé: Objective: To compare the rates of all Axis I and II mental disorders and suicide attempts in sexual orientation minorities with rates in heterosexuals using a nationally representative sample. Method: Data used were from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2 (n = 34 653, response rate = 70.2%). Cross-tabulations and multivariate logistic regression analyses were performed to determine differences in rates of mental disorders and suicide attempts by sexual orientation. All analyses were stratified by sex. Results: Compared with their heterosexual counterparts, lesbians and bisexual women demonstrated a 3-fold increased likelihood of substance use disorders, and gay and bisexual men showed twice the rate of anxiety disorders and schizophrenia and (or) psychotic illness, even after accounting for mental disorder comorbidity. Suicide attempts were independently associated with bisexuality, with odds 3 times higher than in heterosexuals. Conclusion: Findings from our study emphasize the fact that sexual orientation minorities are vulnerable to poor mental health outcomes, including suicide attempts. Clinicians need to be aware of these specific negative mental health consequences when assessing sexual orientation minorities.
http://proquest.umi.com/pqdlink?did=2277206581&sid=1&Fmt=3&clientId=13816&RQT=309&VName=PQD

Sivasubramanian, M., Mimiaga, M. J., Mayer, K. H., Anand, V. R., Johnson, C. V., Prabhugate, P., et al. (2011). Suicidality, clinical depression, and anxiety disorders are highly prevalent in men who have sex with men in Mumbai, India: Findings from a community-recruited sample. Psychology, Health & Medicine, 16(4), 450-462.
Résumé: In India men who have sex with men (MSM) are a stigmatized and hidden population, vulnerable to a variety of psychosocial and societal stressors. This population is also much more likely to be HIV-infected compared to the general population. However, little research exists about how psychosocial and societal stressors result in mental health problems. A confidential, quantitative mental-health interview was conducted among 150 MSM in Mumbai, India at The Humsafar Trust, the largest non-governmental organization serving MSM in India. The interview collected information on sociodemographics and assessed self-esteem, social support and DSM-IV psychiatric disorders using the Mini International Neuropsychiatric Interview (MINI). Participants' mean age was 25.1 years; 21% were married to women. Forty-five percent reported current suicidal ideation, with 66% low risk, 19% moderate risk, and 15% high risk for suicide per MINI guidelines. Twenty-nine percent screened in for current major depression and 24% for any anxiety disorder. None of the respondents reported current treatment for any psychiatric disorder. In multivariable models controlling for age, education, income, and sexual identity, participants reporting higher levels of self-esteem and greater levels of satisfaction with the social support they receive from family and friends were at lower risk of suicidality and major depression. Those who reported greater social support satisfaction were also at lower risk of a clinical diagnosis of an anxiety disorder. MSM in Mumbai have high rates of suicidal ideation, depression, and anxiety. Programs to improve self-esteem and perceived social support may improve these mental health outcomes. Because they are also a high-risk group for HIV, MSM HIV prevention and treatment services may benefit from incorporating mental health services and referrals into their programs.
http://dx.doi.org/10.1080/13548506.2011.554645

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UQAM - Université du Québec à Montréal  ›  Mise à jour : février 2006