Sexual orientation, attraction and risk for deliberate self-harm: Findings from a nationally representative sample

Adam J Mann; Tapan A Patel; Eric B Elbogen; Patrick S Calhoun; Nathan A Kimbrel; Sarah M Wilson

doi:10.1016/j.psychres.2020.112863

Sexual orientation, attraction and risk for deliberate self-harm: Findings from a nationally representative sample

Psychiatry Res. 2020 Feb 10:286:112863. doi: 10.1016/j.psychres.2020.112863. Online ahead of print.

Authors

Adam J Mann¹, Tapan A Patel², Eric B Elbogen³, Patrick S Calhoun⁴, Nathan A Kimbrel⁴, Sarah M Wilson⁵

Affiliations

¹ Durham Veterans Affairs Medical Center, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA. Electronic address: Adam.mann@duke.edu.
² Durham Veterans Affairs Medical Center, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center; Durham, NC, USA.
³ Durham Veterans Affairs Medical Center, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA.
⁴ Durham Veterans Affairs Medical Center, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center; Durham, NC, USA; Duke University Medical Center, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA.
⁵ Durham Veterans Affairs Medical Center, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA.

Abstract

To date, there has been limited investigation identifying predictors of deliberate self-harm (DSH) among sexual minority adults. The present study examined the likelihood of DSH by sexual minority status as measured by self-reported sexual identity and sexual attraction in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Among respondents who answered both the sexual identity and attraction items on the NESARC (N = 34,273), the link between sexual minority status and DSH was examined. Univariate analyses yielded greater risk of DSH for all sexual minority identities compared to heterosexual identity. Individuals with same-sex only attraction did not differ from those with different-sex only attraction. At the multivariate level, respondents reporting bisexual and unsure identity and bisexual attraction were at two to three times greater risk of DSH compared to their heterosexual/different-sex counterparts. Same-sex attracted and gay/lesbian individuals did not differ from different-sex attracted or heterosexual individuals in adjusted multivariate models. Findings from this nationally representative sample are consistent with previous research suggesting that sexual minority status is a risk factor for DSH. There is a vital need to incorporate varying measures of sexual minority status within research and in clinics, as well as to inquire about DSH among sexual minorities.

Keywords: Bisexual; LGBT; Nonsuicidal self-injury; Questioning; Self-injury; Sexual attraction; Sexual minority.

Grants and funding

IK2 HX002398/HX/HSRD VA/United States