Anti-LGBT Victimization, Fear of Violence at School, and Suicide Risk Among Adolescents

Characterizing Life Stress Exposure Among Sexual Minority Adolescents: Temporality, Content, And Mediating Role in Mental Health Disparities

Though sexual minority adolescents face a wide array of deleterious stressors, few studies have examined the role of specific types of stress exposure (i.e., chronic vs. episodic, interpersonal vs. non-interpersonal) on mental health disparities. This study utilizes a contextual threat-based assessment to (a) compare levels of stress exposure types between sexual minority and non-sexual minority adolescents, and (b) examine stress type as a mediator between sexual orientation and two outcomes: depressive symptoms and emotion dysregulation. Data comes from a longitudinal sample (14-17 years-old, N = 241; 17.6% sexual minority; 54% assigned female at birth; 73.9% White), with two time-points (T1 and T2) utilized. Sexual minority adolescents reported higher chronic interpersonal stress, but no differences in non-interpersonal chronic or episodic stress, relative to non-sexual minority adolescents. Chronic interpersonal stress exposure mediated the link between membership in an oppressed group (i.e., sexual minority teens) and the primary outcomes (emotion dysregulation and depressive symptoms) at both T1 and T2. Findings demonstrate the utility of contextual threat-based assessments within sexual minority research.

Trends in Suicidality and Bullying among New York City Adolescents across Race and Sexual Identity: 2009-2019

Despite evidence showing rising suicidality among lesbian, gay, and bisexual (LGB) and Black adolescents, separately, there is scant research on suicide risk trajectories among youth groups across both racial and sexual identities. Thus, we examined trajectories of self-reported suicidal ideation and attempt and their associations with bullying among New York City-based adolescents. We analyzed 2009-2019 NYC Youth Risk Behavior Survey data. We ran weighted descriptive and logistic regression analyses to test for trends in dichotomous suicidal ideation, suicide attempt, bullying at school, and e-bullying variables among students across both race/ethnicity and sexual identity. We assessed associations between suicidality trends and bullying with logistic regressions. Models controlled for age and sex. Suicidal ideation and attempt were 2 and 5 times more likely among LGB than heterosexual participants, respectively. Bullying at school and e-bullying were 2 times more likely among LGB than heterosexual participants. Black LGB participants were the only LGB group for which both suicidal ideation (AOR = 1.04, SE = .003, p < .001) and attempt (AOR = 1.04, SE = .004, p < .001) increased over time. Both increased at accelerating rates. Conversely, White LGB participants were the only LGB group for which both suicidal ideation (AOR = 0.98, SE = .006, p < .001) and attempt (AOR = 0.92, SE = .008, p < .001) decreased over time. These changes occurred in parallel with significant bullying increases for Black and Latina/o/x LGB adolescents and significant bullying decreases for White LGB adolescents. Bullying was positively associated with suicidal ideation and attempt for all adolescents. Findings suggest resources aimed at curbing rising adolescent suicide should be focused on Black LGB youth.

Mental health and help-seeking in Czech sexual minorities: a nationally representative cross-sectional study

AIMS

The mental health of sexual minority (SM) individuals remains overlooked and understudied in Czechia. We aimed to estimate (1) the prevalence rate and (2) the relative risk of common mental disorders and (3) the mental distress severity among the Czech SM people compared with the heterosexual population. In addition, we aimed to investigate help-seeking for mental disorders in SM people.

METHODS

We used data from a cross-sectional, nationally representative survey of Czech community-dwelling adults, consisting of 3063 respondents (response rate = 58.62%). We used the Mini-International Neuropsychiatric Interview to assess the presence of mental disorders. In individuals scoring positively, we established help-seeking in the past 12 months. We assessed symptom severity using the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale. We computed the prevalence of mental disorders and the treatment gap with 95% confidence intervals. To assess the risk of having a mental disorder, we used binary logistic regression.

RESULTS

We demonstrated that the prevalence of current mental disorders was 18.85% (17.43-20.28), 52.27% (36.91-67.63), 33.33% (19.5-47.17) and 25.93% (13.85-38) in heterosexual, gay or lesbian, bisexual and more sexually diverse individuals, respectively. Suicidal thoughts and behaviours were present in 5.73% (4.88-6.57), 25.00% (11.68-38.32), 22.92% (10.58-35.25) and 11.11% (2.45-19.77) of heterosexual, gay or lesbian, bisexual and more sexually diverse individuals, respectively. After confounder adjustment, gay or lesbian individuals were more likely to have at least one current mental disorder compared with heterosexual counterparts (odds ratio = 3.51; 1.83-6.76). For bisexual and sexually more diverse individuals, the results were consistent with a null effect (1.85; 0.96-3.45 and 0.89; 0.42-1.73). The mean depression symptom severity was 2.96 (2.81-3.11) in heterosexual people and 4.68 (2.95-6.42), 7.12 (5.07-9.18) and 5.17 (3.38-6.95) in gay or lesbian, bisexual and more sexually diverse individuals, respectively. The mean anxiety symptom severity was 1.97 (1.85-2.08) in heterosexual people and 3.5 (1.98-5.02), 4.63 (3.05-6.2) and 3.7 (2.29-5.11) in gay or lesbian, bisexual and more sexually diverse individuals, respectively. We demonstrated broadly consistent levels of treatment gap in heterosexual and SM individuals scoring positively for at least one current mental disorder (82.91%; 79.5-85.96 vs. 81.13%; 68.03-90.56).

CONCLUSIONS

We provide evidence that SM people in Czechia have substantially worse mental health outcomes than their heterosexual counterparts. Systemic changes are imperative to provide not only better and more sensitive care to SM individuals but also to address structural stigma contributing to these health disparities.

The Mental Health Costs of Online Heterosexism Among LGBTQ+ Individuals: Development and Initial Validation of the Perceived Online Heterosexism Scale

Experiences of heterosexism are rampant online, where bias and harassment against LGBTQ+ individuals spread conveniently and widely. Yet, research has been limited in understanding the exposure to online heterosexism among LGBTQ+ individuals partly due to the lack of a quantitative measure to advance this research. Thus, the current study developed and examined the psychometric properties of the Perceived Online Heterosexism Scale (POHS). Items were developed via a literature review, a survey of social media platforms, and an expert review. Exploratory (N = 288) and confirmatory (N = 653) factor analyses yielded a 4-factor structure and produced a 20-item scale with the following subscales: (1) Heterosexist Cyberaggression (4 items), (2) Online Heterosexist Stereotyping (4 items), (3) Online Exposure to Systemic Heterosexism (8 items), and (4) Heterosexist Online Media (four items). Internal consistency estimates ranged from .91 to .96, and the POHS accounted for 65.9% of the variance. Examination of a second-order model suggested that a total scale score can also be used. Initial construct validity was evidenced as POHS scores were associated with an existing heterosexism measure, anxiety and depressive symptoms, internalized heterosexism, and LGBTQ+ community connectedness in line with theory and empirical evidence. Implications for research practice are discussed.

Sexual Orientation-Based Victimization and Internalized Homonegativity Among Latinx Sexual Minority Youth: The Moderating Effects of Social Support and School Level

Latinx sexual minority adolescents and young adults experience sexual orientation-based victimization at school and may internalize these heterosexist experiences. However, social support may buffer the deleterious contributions of sexual orientation-based victimization. The current study explored associations between sexual orientation-based victimization and internalized homonegativity in different social contexts (family, peer, school adult) and across development (high school versus college) among 238 Latinx sexual minority adolescents and young adults (M = 19.03, SD = 2.28). Results indicated that sexual orientation-based victimization was positively associated with internalized homonegativity among Latinx sexual minority adolescents and young adults. Such associations were moderated by family support and the school level in the family context, such that in high school, family support exacerbated the association between sexual orientation-based victimization and internalized homonegativity. Yet, in college, family support mitigated that association. Findings also indicated that peer support exacerbated the association between sexual orientation-based victimization and internalized homonegativity in high school and college. No moderation of school adult support emerged in the context of school adults. Findings support the application of the minority stress model in Latinx sexual minority adolescents and young adults and highlight the complex moderating effect of social support across social contexts and development.

Utilizing User Preferences in Designing the AGILE (Accelerating Access to Gender-Based Violence Information and Services Leveraging on Technology Enhanced) Chatbot

INTRODUCTION

Technology advancements have enhanced artificial intelligence, leading to a user shift towards virtual assistants, but a human-centered approach is needed to assess for acceptability and effectiveness. The AGILE chatbot is designed in Kenya with features to redefine the response towards gender-based violence (GBV) among vulnerable populations, including adolescents, young women and men, and sexual and gender minorities, to offer accurate and reliable information among users.

METHODS

We conducted an exploratory qualitative study through focus group discussions (FGDs) targeting 150 participants sampled from vulnerable categories; adolescent girls and boys, young women, young men, and sexual and gender minorities. The FGDs included multiple inquiries to assess knowledge and prior interaction with intelligent conversational assistants to inform the user-centric development of a decision-supportive chatbot and a pilot of the chatbot prototype. Each focus group comprised 9-10 members, and the discussions lasted about two hours to gain qualitative user insights and experiences. We used thematic analysis and drew on grounded theory to analyze the data.

RESULTS

The analysis resulted in 14 salient themes composed of sexual violence, physical violence, emotional violence, intimate partner violence, female genital mutilation, sexual reproductive health, mental health, help-seeking behaviors/where to seek support, who to talk to, and what information they would like, features of the chatbot, access of chatbot, abuse and HIV, family and community conflicts, and information for self-care.

CONCLUSION

Adopting a human-centered approach in designing an effective chatbot with as many human features as possible is crucial in increasing utilization, addressing the gaps presented by marginalized/vulnerable populations, and reducing the current GBV epidemic by moving prevention and response services closer to people in need.

Effects of Bullying on Anxiety, Depression, and Posttraumatic Stress Disorder Among Sexual Minority Youths: Network Analysis

BACKGROUND

Bullying victimization is highly prevalent among sexual minority youths, particularly in educational settings, negatively affecting their mental health. However, previous studies have scarcely explored the symptomatic relationships among anxiety, depression, and posttraumatic stress disorder (PTSD) among sexual minority youths who experienced bullying on college campuses.

OBJECTIVE

The objectives of our study were to (1) characterize the anxiety-depression-PTSD network structures of gay or lesbian, bisexuals, and other sexual minority youths previously bullied on college campuses; and (2) compare symptomatic associations in the anxiety-depression-PTSD networks among bullied sexual minority youths and heterosexual youths' groups.

METHODS

This cross-sectional study recruited college participants from Jilin Province, China. Data were analyzed using a subset of the data extracted after screening for sexual orientation and history of bullying victimization. Sexual minority youths were then divided into 3 subgroups: gay or lesbian (homosexual), bisexual, and other. Mental health symptom severity was assessed using scales: the 7-item Generalized Anxiety Disorder Scale measuring anxiety, the 9-item Patient Health Questionnaire measuring depression, and the 10-item Trauma Screening Questionnaire measuring PTSD symptoms. Combining the undirected and Bayesian network analyses, the anxiety-depression-PTSD networks were compared among sexual minority youths subgroups, and the difference between heterosexual youths and sexual minority youths was investigated. Chi-square tests were used to compare the difference in categorical variables, while independent-sample t tests were run on continuous variables.

RESULTS

In this large-scale sample of 89,342 participants, 12,249 identified as sexual minority youths, of which 1603 (13.1%, 95% CI 12.5%-13.7%) reported being bullied on college campuses in the past year. According to the expected influence (EI) and bridge expected influence (bEI) index, in the global network structure of anxiety, depression, and PTSD, sad mood (EI=1.078, bEI=0.635) and irritability (EI=1.077, bEI=0.954) were identified as central and bridge symptoms; emotional cue reactivity (EI=1.015) was a central symptom of PTSD in this global network. In the anxiety-depression-PTSD Bayesian network, anhedonia had the highest prediction priority for activating other symptoms; and feeling afraid linked symptoms from anxiety to the PTSD community. Compared to their heterosexual counterparts, sexual minority youths exhibited a stronger association between difficulty concentrating and appetite. The "sad mood-appetite" edge was strongest in the gay or lesbian network; the "irritability-exaggerated startle response" edge was strongest in the bisexual network.

CONCLUSIONS

For the first time, this study identified the most central and bridge symptoms (sad mood and irritability) within the depression-anxiety-PTSD network of sexual minority youths with past bullying-victim experiences on college campuses. Emotional cue reactivity, anhedonia, and feeling afraid were other vital symptoms in the comorbid network. Symptomatic relationships existed showing heterogeneity in bullied heterosexual youths and sexual minority youth networks, which also was present within the sexual minority youth subgroups. Consequently, refined targeted interventions are required to relieve anxiety, depression, and PTSD symptoms.

Comparing the Effects of Victimization, School Connectedness, and Social Support on Heterosexual and Sexual Minority Adolescent Suicidality in the United States: A Partial Test of Minority Stress Theory

In the United States, sexual minority adolescents are among the subpopulations at the highest risk for suicide; yet, predictors of suicidality among this unique group remain significantly understudied. Drawing from Meyer's minority stress theory (MST), this study examines whether general stressors act as predictors of adolescent suicidality and whether differences exist in the variation of these effects between heterosexual and sexual minority adolescents. Specifically, multivariate logistic regression models were developed to examine the impact that victimization, school connectedness, and social support have on heterosexual and sexual minority adolescent suicidality using a sample of 166,176 U.S. adolescents drawn from the 2019 Minnesota Student Survey. Participants ranged from 10 to 18 years of age and identified as heterosexual, bisexual, gay or lesbian, questioning, pansexual, queer, or as none of these. Findings highlight that sexual minorities (Exp(B) = 1.870, p < .001) were roughly twice as likely to report suicidality compared to their heterosexual peers. All victimization measures were highly predictive of suicidality among heterosexual and sexual minority adolescents. Overall, adolescents who were less connected to their school setting and more socially isolated were also more likely to experience suicidality; however, such effects were not reflected uniformly in every item measuring school connectedness and social support. Findings highlight important avenues for policies implementation aimed at mitigating the effects of multiple sources of stressors on adolescents' mental health and reducing adolescents' suicide rates. Interventions tailored to the unique needs of sexual minority adolescents are needed to address their disproportionate representation among those at risk for suicide.

Latent Class Analysis of Victimization Patterns and Associated Protective Factors among LGBTQ Youth

Youth victimization in schools remains a fervent public health issue, despite increased awareness of this issue, and this is especially true for marginalized populations like lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. Youth violence has been studied widely, but less research has sought to understand factors protective of violence victimization, particularly protective factors shared across multiple forms of violence. In the current study, we utilized latent class analysis to test patterns of three types of victimization: peer victimization (PV), homophobic name-calling victimization (HNCV), and sexual harassment victimization (SHV). In addition, we tested protective factors associated with experiencing these types of violence. Our sample included 4778 9-11th graders in the United States, of which about 15% identified as LGBTQ. Three unique classes of victimization emerged, suggesting that concurrent forms of violence occur among some groups of adolescents. LGBTQ youth were more likely to be members of classes which demonstrated higher levels of victimization. Consistent with previous literature, medical access, counseling access, family support, peer support, and spirituality emerged as significant protective factors associated with a lower risk of victimization. We discuss the implications of our findings with specific attention to protecting the wellbeing of SGM youth.

Parental Support, Depressive Symptoms, and LGBTQ Adolescents: Main and Moderation Effects in a Diverse Sample

OBJECTIVE

Research has documented the importance of parental support as a protective factor against depressive symptoms among lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. In this study, we assessed the relations between LGBTQ-specific parental support and depressive symptoms.

METHOD

Participants were 6,837 LGBTQ youth (ages 13-17) with diverse racial and ethnic, gender, and sexual identities. Main effect and moderation analyses examined interactions between LGBTQ-specific parental support with demographic variables on depressive symptoms, considering demographics as moderators.

RESULTS

We found that participants of color reported less LGBTQ-specific parental support than their White counterparts, that transgender and genderqueer participants reported less LGBTQ-specific parental support than their cisgender counterparts, and that non-monosexual participants reported less LGBTQ-specific parental support than their monosexual counterparts. Disparities in depressive symptoms were found for individuals who identified as Native American and Latinx, non-monosexual, and transgender and genderqueer, such that these groups reported higher levels of depressive symptoms. Further, we found a significant interaction between LGBTQ-specific parental support and ethnicity, with LGBTQ-specific parental support being less strongly associated with participants who identified as Latinx compared to those who did not identify as Latinx. We also found a significant interaction between LGBTQ-specific parental support and gender identity, with LGBTQ-specific parental support being more strongly related to depressive symptoms among participants who did not identify as boys compared to cisgender boys .

DISCUSSION

We discuss how to assess the impact of interlocking systems of oppression when working with LGBTQ youth and their parental figures.

The roles of school in supporting LGBTQ+ youth: A systematic review and ecological framework for understanding risk for suicide-related thoughts and behaviors

The extant literature on suicide-related thoughts and behaviors (STB) has highlighted increased patterns of risk among specific minoritized populations, including lesbian, gay, bisexual, transgender, questioning, intersex, two spirit, and queer (LGBTQ+) youth. Compared to their heterosexual and cisgender peers, LGBTQ+ youth are at increased risk for having STB. Identity-specific stressors such as homonegativity and anti-queerness are among the unique factors posited to contribute to this risk and inhibit factors that protect against suicide. The school setting has been a focal point for suicide prevention and intervention and may also play a key role in linking students to care; however, schools also hold the potential to provide supports and experiences that may buffer against risk factors for STB in LGBTQ+ students. This systematic literature review presents findings from 44 studies examining school-related correlates of STB in LGBTQ+ students, informing an ecological approach to suicide prevention for school settings. Findings underscore the importance of school context for preventing STB in LGBTQ+ youth. Approaches that prioritize safety and acceptance of LGBTQ+ youth should span multiple layers of a student's ecology, including district and state level policies and school programs and interventions, such as Gender and Sexuality Alliances and universal bullying prevention programs. Beyond their role as a primary access point for behavioral health services, schools offer a unique opportunity to support suicide prevention by combating minority stressors through promoting positive social relationships and a safe community for LGBTQ+ students.

Factors Promoting Posttraumatic Growth in Sexual Minority Adults Following Adolescent Bullying Experiences

The minority stress model posits that stigmatized identities expose sexual minority individuals to chronic stressors that contribute to health disparities, but that individual-level resources may mitigate psychological distress. Sexual minority adolescents experience one such stressor, bullying victimization, at higher rates than heterosexual peers. Whereas negative consequences of sexual identity-based bullying are well documented, potential positive outcomes are not well understood. The present work examined hypothesized pathways to posttraumatic growth (PTG)-positive psychological changes stemming from trauma-in sexual minority adults following adolescent bullying experiences. We predicted that attributing bullying to one's sexual identity, as opposed to other factors (e.g., weight/appearance, personality), would exacerbate perceived bullying severity but, in turn, enhance PTG. We also predicted that outness about sexual identity would enhance social support and, in turn, facilitate PTG. The hypothesized conceptual model was tested in two samples of sexual minority adults who had experienced bullying during adolescence (Sample 1: Community Sample [N = 139]; Sample 2: National Online Sample [N = 298]), using structural equation modeling with Bayesian estimation. Mediation hypotheses were tested using the PROCESS v3.4 macro. Participants reported their adolescent experiences with bullying, attributions for bullying, outness, social support, and PTG as a result of adolescent bullying experiences, in addition to demographics. Supporting the hypothesized model, in both samples, attributions to sexual identity-based bullying directly and indirectly (via bullying severity) predicted greater PTG, and outness predicted greater PTG through proximal impact on social support. This research underscores the importance of supportive responses to individuals who disclose sexual minority identities and of (re)framing attributions about bullying to facilitate growth.

Intersecting Structural Oppression and Suicidality Among Black Sexual Minority Male Adolescents and Emerging Adults

This study examined associations between structural racism, anti-LGBTQ policies, and suicide risk among young sexual minority men (SMM). Participants were a 2017-2018 Internet-based U.S. national sample of 497 Black and 1536 White SMM (ages 16-25). Structural equation modeling tested associations from indicators of structural racism, anti-LGBTQ policies, and their interaction to suicide risk factors. For Black participants, structural racism and anti-LGBTQ policies were significantly positively associated with depressive symptoms, heavy drinking, perceived burdensomeness, thwarted belongingness, self-harm, and suicide attempt. There were significant interaction effects: Positive associations between structural racism and several outcomes were stronger for Black participants in high anti-LGBTQ policy states. Structural racism, anti-LGBTQ policies, and their interaction were not significantly associated with suicide risk for White SMM.

Sexual Minority Status, Bullying Exposure, Emotion Regulation Difficulties, and Delinquency Among Court-Involved Adolescent Girls

Sexual minority adolescent girls are overrepresented in the justice system. This study used the minority stress model and psychological mediation framework to investigate a pathway for this disparity among court-involved girls ages 14-18 (N = 226; mean age: 15.58; 48% sexual minority). The hypotheses were that sexual minority status would be associated with delinquency, bullying exposure would be associated with delinquency indirectly via emotion regulation difficulties, and the relationship between bullying exposure and emotion regulation difficulties would be stronger for sexual minority girls. Bullying exposure and emotion regulation difficulties were not related. Sexual minority status was related to delinquency, and emotion regulation difficulties mediated this relationship. The findings suggest interventions to build emotion regulation skills may reduce delinquency for sexual minority girls.

Fear of Heterosexism Among Sexuality and Gender Diverse Staff and Students

Fear of heterosexism-as distinct from actual experiences of heterosexism-plays a significant role in staff and students lives on campus. Ambient workplace heterosexism provides a context for staff and students about what to expect from their peers and colleagues, and shapes the daily activities of those who perceive heterosexism as a regulating force. In this article, we consider the psychometrics of the Fear of Heterosexism Scale (FoHS), which was integrated into a campus climate survey of Western Sydney University staff and students (N = 3,106; n = 412). This scale was considered in relation to a range of associated factors, including perceived safety on campus, bystander efficacy, responsibility to intervene, and awareness of lesbian, gay, bisexual, transgender, intersex, queer/questioning, asexual, and many other terms such as nonbinary and pansexual (LGBTIQA+) issues. In turn, the results of the FoHS are considered across a range of demographic factors such as gender, sexuality, role, dis/ability, and membership of campus-based support organizations. Supporting the findings from the initial operationalization of the FoHS by Fox and Asquith in 2018, this research identifies the consequences of fear of heterosexism on daily activities and engagement with study/work. Understanding the factors associated with fear of heterosexism is critical in creating more inclusive and respectful university environments.

Disparities in Perpetrators, Locations, and Reports of Victimization for Sexual and Gender Minority Adolescents

PURPOSE

Sexual and gender minority (SGM) adolescents are more likely to become victims of bullying and harassment than heterosexual, cisgender adolescents, but little is known about the contextual details of these victimization experiences. This study aims to examine by whom and where adolescents are bullied or harassed, to whom adolescents report such victimization, and whether these experiences differ between SGM and heterosexual, cisgender adolescents.

METHODS

Participants in this nationally representative study were 29,879 students (mean age = 14.1) from 136 Dutch middle/high schools across grades 7-12 (14.5% sexual minority, 2.7% gender minority) who completed a survey about their school-based experiences.

RESULTS

Perpetrators of victimization of SGM students were more often teachers and school staff compared with heterosexual, cisgender adolescents. Furthermore, SGM students experienced victimization in private locations (in the rest- or changing rooms/parking lots, at home), more often than heterosexual, cisgender students. Finally, SGM students felt less safe than their heterosexual, cisgender peers to report these experiences to teachers or parents, and were more likely to report their experiences to the police or the school janitor. SGM students who reported victimization experiences were less likely to receive support: the problems were less often acted on and persisted more often than those of heterosexual, cisgender students.

CONCLUSIONS

SGM adolescents are not only victimized more often, but also by different perpetrators (teachers, other school staff) and in more private places. Their victimization is also less likely to be recognized or acted on by those responsible for adolescent's safety: teachers or parents.

Motivation to Move Out of the Community as a Moderator of Bullying Victimization and Delinquent Behavior: Comparing Non-Heterosexual/Cisgender and Heterosexual African American Adolescents in Chicago's Southside

A growing body of research documents that bullying victimization is associated with delinquent behavior. There is an increasing need to better illuminate the factors that might moderate this relationship. This study examined whether the motivation to move out of low-resourced neighborhoods and sexual orientation/gender identity moderated the relationship between bullying victimization and delinquent behavior among a sample of 450 heterosexual and 91 non-heterosexual/cisgender African American youths. Measures considered were bullying victimization, delinquent behavior, sexual orientation/gender identity, motivation to move out, and family demographics. Sexual orientation/gender identity was not associated with youth delinquent behavior after controlling for covariates. Being motivated to move out moderated the association between bullying victimization and delinquent behavior. Sexual orientation/gender identity and being motivated to move out of low-resourced communities jointly contributed to the moderating effect between bullying victimization and delinquent behavior. For non-heterosexual/cisgender youth, bullying victimization is correlated with increased delinquent behavior for those with low motivation to move out of their communities compared with those with an average or higher level of motivation to stay. However, such a moderating effect was not shown for heterosexual youth.

Advances in Research on Adolescent Suicide and a High Priority Agenda for Future Research

Suicide is the second leading cause of death for adolescents in the United States, yet remarkably little is known regarding risk factors for suicidal thoughts and behaviors (STBs), relatively few federal grants and scientific publications focus on STBs, and few evidence-based approaches to prevent or treat STBs are available. This "decade in review" article discusses five domains of recent empirical findings that span biological, environmental, and contextual systems and can guide future research in this high priority area: (1) the role of the central nervous system; (2) physiological risk factors, including the peripheral nervous system; (3) proximal acute stress responses; (4) novel behavioral and psychological risk factors; and (5) broader societal factors impacting diverse populations and several additional nascent areas worthy of further investigation.

Teen, Queer, and Asian: Lesbian, Gay, Bisexual, Transgender, Queer, Plus Asian American Students' Experiences in Schools

BACKGROUND

The experiences of youth with intersecting LGBTQ+ and Asian American (AA) identities have been largely unexplored. This study explored these experiences of LGBTQ+ AA California youth with mental health, school climate, and school victimization.

METHODS

Drawing from the 2016-2017 California Healthy Kids Survey (N = 326,124), this study utilized secondary data analyses to examine mental health, school climate, and school victimization among students of specific AA ethnicities (eg, Cambodian, Hmong, Vietnamese) and LGBTQ+ identities. The participants in this study included 7th, 9th, and 11th graders from California public schools, with subsamples of lesbian or gay students (N = 13,291), bisexual students (N = 30,127), and transgender students (N = 7916).

RESULTS

The results indicated that Asian Indian, Cambodian, Hmong, Japanese, Korean, Laotian, and Other Asian LGBTQ+ students experienced more negative school climate and victimization compared to their Chinese, Filipino, Vietnamese, and white LGBTQ+ peers. For instance, 41.1% of Cambodian transgender students reported they were beaten up compared to 27.1% of white transgender students. Mental health differences between LGBTQ+ AA and LGBTQ+ white students were also found.

CONCLUSIONS

This study's findings can inform school administrators and teachers how to best support LGBTQ+ AA populations.

Associations of Discrimination, Suicide Ideation Severity and Attempts, and Depressive Symptoms Among Sexual and Gender Minority Youth

We examined the unique associations among discrimination, suicidal thoughts, suicide attempts, and depressive symptoms in a sample of sexual and gender minority (SGM) youth as well as interpersonal mediators of these associations. Participants included 94 SGM youth (M_age = 18; SD = 2.88) recruited from SGM-specific drop-in centers. We used mediation analyses to test the mediating effects of perceived burdensomeness and thwarted belongingness on the associations between discrimination and suicidal ideation, suicide attempts, and depressive symptoms, accounting for childhood trauma and sociodemographic variables (age, gender identity, race, and sexual orientation). Within our nonclinical community sample of SGM youth, 49% reported a lifetime suicide attempt, 84% reported current suicide ideation, and 82% reported current depressive symptoms. Experiencing discrimination was associated with greater likelihood of suicide attempts and depressive symptoms, and greater perceived burdensomeness and thwarted belongingness, over and above the effects of childhood trauma and sociodemographic variables. Discrimination was indirectly associated with greater depressive symptoms through perceived burdensomeness and thwarted belongingness, and with greater severity of suicidal ideation through perceived burdensomeness. Findings suggest clinicians should assess for discrimination and include a focus on perceived burdensomeness and thwarted belongingness as targets of intervention for suicide and depression.

Evaluation of sexual minority identity as a moderator of the association between intimate partner violence and suicidal ideation and attempts among a national sample of youth

Sexual minority (SM) youth are at high risk for intimate partner violence (IPV) and suicidal ideation/attempts compared to their heterosexual peers. We examined whether SM identity enhanced the relationship between experiences of IPV and suicidal ideation/attempts. Weighted logistic regression models were run using the 2017 Youth Risk Behavior Survey. All main effects were significant; each SM identity and both physical and sexual IPV were significantly associated with suicidal ideation and suicide attempts. The interaction between bisexual identity and physical IPV was significant for suicidal ideation; as physical IPV experiences increased, the difference between bisexual identity and heterosexual youth was non-significant. Findings suggest exploring trauma and suicidal ideation by aggregate groups and increasing support for SM youth in schools and communities.

Association between prescription opioid misuse and dimensions of suicidality among college students

Suicide rates among young adults have increased in recent years. Prescription opioid misuse is not only associated with depression onset but misuse has also been reported as means to manage existing depressive symptoms. College students are at increased risk for psychological distress compared to other populations. The current cross-sectional study aimed to fill a literature gap by examining a relationship between prescription opioid misuse and 3 dimensions of suicidality among a large sample of college students (n = 889). Binomial logistic regression examined relationships between prescription opioid misuse and suicidality while adjusting for the effect of important demographic and substance use covariates. Among this sample 38.8% reported suicidal ideation, 11.6% reported making a plan to kill themselves, and 7.8% reported at least one suicide attempt in the past 12 months. Past year prescription opioid misuse was common (21.6% of participants) and significantly associated with each dimension of suicidality. Though the relationships were attenuated, past year prescription opioid misuse remained significantly associated with suicidal ideation, planning, and attempts following covariate adjustment. At a local level, University health promotion specialists should give particular consideration to individuals exhibiting prescription opioid misuse as this may serve as an indicator of underlying psychological distress and possible suicidality.

An Investigation of the LGBTQ+ Youth Suicide Disparity Using National Violent Death Reporting System Narrative Data

PURPOSE

This study explored law enforcement and medical examiner reports about adolescent and young adult deaths by suicide for novel and understudied risk factors and described variability by sexual orientation and gender identity in those risk factors' prevalence. It also sought to explain why the suicide disparity between lesbian, gay, bisexual, transgender, queer/questioning, and other sexual/gender minority (LGBTQ+) youth and non-LGBTQ+ youth is wider in adolescence than in young adulthood.

METHODS

This study involved coding of law enforcement and medical examiner reports from the National Violent Death Reporting System (NVDRS) for all 394 LGBTQ+ youth who died by suicide in NVDRS participating states between 2013 (the year that NVDRS began coding for sexual orientation and transgender status) and 2016 (the latest year of NVDRS available), along with 394 non-LGBTQ+ cases matched with them on dimensions of sex, urbanicity, race, and military service.

RESULTS

Fifty-nine percent of 12- to 17-year-old LGBTQ+'s cases mentioned an LGBTQ+-specific contributing circumstance, whereas only 30% of 18- to 29-year-old LGBTQ+'s cases mentioned an LGBTQ+-specific contributing circumstance. However, there were 3.6 times as many cases of LGBTQ+ 18- to 29-year-olds as there were of LGBTQ+ 12- to 17-year-olds. Cases of gay males, bisexual males, and bisexual females were particularly likely to include family/peer rejection and bullying as contributing circumstances, while lesbians' cases more often mentioned romantic breakups.

CONCLUSIONS

The LGBTQ+/non-LGBTQ+ suicide disparity may be greater for adolescents because LGBTQ+-specific contributing circumstances are more prevalent among adolescents. Prevention efforts should be tailored to clients' age and specific LGBTQ+ subgroup.

Sexual minorities and teen suicide attempts in a southeastern state with prominent exclusionary policies

This study examines differences in suicide-related behaviors between heterosexual and sexual minority youth in a southeastern state with exclusionary policies. Furthermore, it seeks to further knowledge regarding risk factors for suicide attempts among sexual minority high school students. Utilizing the 2017 Youth Risk Behavior Survey data, descriptive analysis tests, and logistic regression tests were conducted. Findings indicate that sexual minorities were three times as likely to experience suicidal thoughts and plans but four times as likely to attempt suicide. Risk factors were noted for sexual minority youth. Policy advocacy is recommended to decrease suicide-related behaviors among this population.