HUBUNGAN ADVERSE CHILDHOOD EXPERIENCES (ACES) DENGAN GEJALA DEPRESI PADA REMAJA AWAL BERDASARKAN ORIENTASI SEKSUAL (ANALISIS DATA SEKUNDER: GLOBAL EARLY ADOLESCENT STUDY GELOMBANG 1 TAHUN 2018)
Annisa' Arifatul Hikmah, dr. Ifta Choiriyyah. MSPH., Ph.D ; dr. Amirah Ellyza Wahdi, MSPH
2024 | Tesis | S2 Ilmu Kesehatan Masyarakat
Latar Belakang: Adverse
childhood experiences (ACEs) merupakan pengalaman negatif di masa kecil,
termasuk pelecehan fisik, emosional, atau seksual, pemisahan orang tua,
kekerasan dalam rumah tangga, ketidakstabilan keluarga, kemiskinan, atau
kurangnya sosok orang tua. Penelitian di 15 negara GEAS menunjukkan bahwa setengah
dari remaja awal pernah mengalami peristiwa negatif di masa kecil. Riwayat ACEs
ini lebih sering di alami oleh individu dengan orientasi seksual minoritas
dibandingkan dengan individu heteroseksual. Berbagai penelitian di Amerika
Serikat menunjukkan adanya hubungan antara ACEs dan depresi remaja, tetapi masih
sedikit penelitian yang melihat perbedaan hubungan antara ACEs dan depresi berdasarkan
orientasi seksual. Tujuan: Mengeksplorasi hubungan antara ACEs dan
gejala depresi pada remaja awal berdasarkan orientasi seksual. Metode: Analisis
ini menggunakan data survei GEAS gelombang I tahun 2018 (baseline), yang
mewawancarai remaja awal usia 10-14 tahun. Analisis deskriptif dilakukan untuk
mengetahui proporsi gejala depresi dan ACEs berdasarkan orientasi seksual.
Analisis bivariabel menggunakan uji chi-square dan regresi logistik dilakukan
untuk mengetahui faktor-faktor yang berhubungan dengan gejala depresi. Analisis
multivariabel dilakukan dengan regresi logistik, uji efek interaksi, dan
stratifikasi orientasi seksual untuk melihat ada tidaknya perbedaan risiko
gejala depresi berdasarkan ACEs menurut orientasi seksual. Hasil: Dari
4684 responden GEAS baseline, terpilih 3155 remaja awal untuk terlibat
dalam penelitian ini. Sebanyak
74,9% terkategorikan heteroseksual, 3,6% minoritas seksual, dan 21,5?lum
pernah jatuh cinta atau tidak dapat terkategori. Remaja minoritas seksual
memiliki persentase lebih tinggi dalam mengalami >4 ACEs (44,2%) dan
>3 gejala depresi (29,2%). Terdapat hubungan signifikan antara >3 gejala
depresi dengan mengalami >4 ACEs (aOR: 3,57 95%CI:2,23–5,70),
namun tidak ditemukan adanya perbedaan hubungan berdasarkan orientasi seksual.
Status ekonomi sangat miskin, lingkungan tidak aman, keinginan putus sekolah,
aktivitas seksual berat, intensitas bertemu teman yang sering terbukti
berhubungan dengan gejala depresi pada remaja awal. Kesimpulan: Sosialisasi mengenai kelompok remaja dan orientasi
seksual kepada masyarakat dan petugas kesehatan penting untuk dilakukan,
begitupun dengan penekanan pendidikan seksual komprehensif di sekolah untuk
mendorong kesadaran akan pentingnya inklusifitas dalam setiap program
kesehatan. Studi longitudinal dan kualitatif terkait topik ini untuk
memperdalam wawasan mengenai kesehatan mental, ACEs, dan orientasi seksual pada
remaja di Indonesia.
Background:
Adverse childhood experiences (ACEs) are negative
experiences in childhood, including physical, emotional, or sexual abuse,
parental separation, domestic violence, family instability, poverty, or lack of
parental figures. Research in 15 countries of adolescents based on sexual
orientation. Methods: This analysis uses data from the GEAS wave I survey in
2018 (baseline), which interviewed early adolescents aged 10-14 years.
Descriptive analysis was conducted to determine the proportion of depression
symptoms and ACEs based on sexual orientation. Bivariate analysis used chi-square
tests and logistic regression to identify factors associated with depression
symptoms. Multivariable analysis was performed with logistic regression,
interaction effect tests, and sexual orientation stratification to see if there
were differences in the risk of depression symptoms based on ACEs according to
sexual orientation. Results: Out of 4684 baseline GEAS respondents, 3155
early adolescents were selected for this study. A total of 74.9% were
categorized as heterosexual, 3.6% as sexual minorities, and 21.5% had never
fallen in love or could not be categorized. Sexual minority adolescents had a
higher percentage of experiencing >4 ACEs (44.2%) and >3 symptoms of
depression (29.2%). There was a significant association between >3 symptoms
of depression and experiencing >4 ACEs (aOR: 3.57 95%CI:2.23–5.70), but no
difference was found in the relationship based on sexual orientation. Very poor
economic status, unsafe environment, desire to drop out of school, heavy sexual
activity, and frequent intensity of meeting friends proved to be related to
symptoms of depression in early adolescence. Conclusion: Socialization
about adolescent groups and sexual orientation to the community and health
workers is important to carry out, as well as emphasizing comprehensive sexual
education in schools to encourage awareness of the importance of inclusivity in
every health program. Longitudinal and qualitative studies are also needed to
deepen insights regarding mental health, ACEs, and sexual orientation in
adolescents in Indonesiathe GEAS showed that half of the early adolescents had
experienced negative events in childhood. Individuals with a sexual minority
orientation more often experience this history of ACEs compared to heterosexual
individuals. Various studies in the United States show a relationship between
ACEs and adolescent depression, but there is still little research that looks
at the differences in the relationship between ACEs and depression based on
sexual orientation. Objective: To explore the relationship between ACEs
and symptoms of depression in early
Kata Kunci : Adverse childhood experiences, depression, sexual and gender minorities, adolescent