Drivers of disparity: differences in socially based risk factors of self-injurious and suicidal behaviors among sexual minority college students

Self-Perceived Reasons for Suicide Attempts in Sexual and Gender Minorities in Canada

The aim of this study was to examine the self-perceived reasons of suicide attempts among sexual and gender minorities (SGM). We surveyed SGM living in Canada (n = 2778) and respondents who had attempted suicide answered open-ended questions about their perceived reason(s) of their first/only attempt (FOA) and last attempt (LA) (for those who attempted multiple times). Responses were double-coded and categorized as discrete findings. A quarter (25%, n = 695) of the total sample reported a history of suicide attempt, of whom 72% reported multiple attempts. Respondents described a wide variety of reasons for their suicide attempts, with an important number of individuals reporting multiple reasons (corresponding to 47.5% of FOA and 43% of LA). Emotional issues (FOA:42.1%, LA:44.0%) were the most prevalent category of reasons for suicide attempts followed by experience of mental illness (FOA:30.1%, LA:36.1%). Other common reasons included violence (FOA:23.2%, LA:10.2%), interpersonal conflict (FOA:13.4%, LA:6.0%), stress related to life circumstances (FOA:9.5%, LA:16.7%), relationship issues (FOA:7.9%, LA:13.3%), and minority stress related to sexuality (FOA:11.1%, LA:6.2%) and gender identity (FOA:5.0%, LA:6.8%). SGM assessments of the reasons underlying their suicide attempts yielded a variety of factors, many of which were absent from the literature on SGM suicide but amenable to tailored interventions.

An exploratory analysis of factors related to reporting sexual assault to college officials by LGBTQ student survivors

Sexual assault is a persistent problem on college campuses that disproportionately impacts sexual and gender minority identified students. Objective: This study explores how circumstances of the crime, disclosure to informal sources, training and campus climate are associated with reporting sexual assault to college officials by these students. Participants: A total of 409 lesbian, gay, bisexual, transgender and queer/questioning college students who experienced sexual assault while attending their current four-year college. Results: Chi-square and t-test analysis found that reporting to college officials was significantly associated with the type of assault experienced, disclosure to a campus advocates, disclosure to a parent/guardian, and the campus climate for LGBTQ students. Conclusion: These findings suggest that practitioners and college officials may support reporting behavior amongst sexual and gender minority identified students through enhanced campus support systems and strategic educational efforts.

Universal Sexual Violence Intervention Effects in a Cluster-Randomized Trial: Moderation by Sexual Orientation

Sexual minority (e.g., gay/lesbian, bisexual, and queer) students are more likely than their heterosexual peers to experience sexual violence (SV) during college. Interventions that prevent SV and improve SV care-seeking behaviors for sexual minority students are lacking. Giving Information for Trauma Support and Safety (GIFTSS) is an evidence-based universal SV intervention implemented by providers during college health and counseling visits. Compared to controls, GIFTSS participants reported greater self-efficacy to use SV harm reduction strategies and SV disclosure during clinical visits. However, GIFTSS' effectiveness for sexual minority participants is unknown. The current study examines whether sexual orientation moderates GIFTSS' effects on numerous SV-related outcomes (i.e., to test whether intervention effects at 4 and 12 months differed based on sexual orientation). Across 28 college campuses in Pennsylvania and West Virginia, 2,291 students participated in a two-arm cluster-randomized controlled trial. We used mixed models with two- and three-way interaction terms to test whether sexual orientation modified GIFTSS' effects at 4- and 12-month follow-up on participants': SV recognition; knowledge of and self-efficacy to enact SV harm reduction strategies; intentions to intervene; knowledge of and self-efficacy to use SV-related services; SV disclosure during visits; and recent SV exposure. Overall, 22.1% of participants were sexual minorities (n = 507). Sexual orientation moderated GIFTSS effectiveness as indicated by significant three-way interaction (p = .01) at 12-month follow-up, and knowledge of SV services decreased for heterosexual participants (β = -.23) but increased for sexual minority participants (β = .23). Our study indicates that universal provider-based education may promote greater knowledge of SV services among sexual minority than heterosexual participants, and population-specific interventions are needed that reduce sexual minority students' SV exposure, service utilization, and other critical aspects of SV prevention on university campuses.Clinical Trial Registration: Registry name: College Health Center-based Alcohol and Sexual Violence Intervention (GIFTSS), Registration number: NCT02355470, Web link: https://clinicaltrials.gov/ct2/show/NCT02355470, Deidentified individual participant data will not be made available.

Sexual Attraction and Non-Suicidal Self-Harm: The Role of Stressors and Psychological Mediators

Non-suicidal self-harm (NSSH) is a serious concern for the well-being of youth. Stressors relate to greater NSSH risk, such as being non-heterosexual in a heteronormative society. Other stressors may include traumatic experiences. These relationships may be mediated by psychological factors (depressed mood, anxiety, anger, and self-esteem) as well as contextual factors (support from parents and peers). The purpose of this study was to examine NSHH ideation and behavior among Icelandic youth, as well as relationships with stressors and mediators. Students in Icelandic high schools (N = 8921, 50.8% female) completed an in-class survey in the year 2016. Results showed an elevated risk of NSSH ideation and behavior among bisexual and homosexual youth. Mediation analyses showed that, for girls, being bisexual related to greater NSSH ideation and behavior, and these relationships were mediated by depressed mood, anger, and self-esteem, as well as by support from parents and peers. For boys, however, both homosexual and bisexual attraction related to greater risk for NSSH ideation and behavior, which was mediated by depressed mood, anger, and self-esteem. These results suggest that NSSH risk factors vary by gender and, therefore, they may benefit from different interventions to stop and prevent this behavior. This is the first study of its kind in Iceland, where sexual minority stress may need further study within the Nordic context.

Examining developmental assets of young Black sexual gender minority males in preventing suicidal behaviors

Black gay and bisexual male adolescents and young adults (BGBMA/YA) are at higher risk for suicidal outcomes given their minoritized and stigmatized identities at the intersection of race and sexual orientation. This study explores key developmental assets, including family support and family communication, and their role in preventing depression symptoms and suicidal outcomes among BGBMA/YA. A cross-sectional survey was administered to participants (N = 400, Mage = 23.46, SD = 2.59) recruited through Amazon M-Turk, community-based organizations, and social media sites. A path analysis was conducted to examine associations among external assets (family support, communication about sex and drugs with parents, open family communication), depression symptoms, and suicidal attempts and plan to die by suicide. About 28 % of respondents reported a suicide attempt in the past 12 months. Depression symptoms and communication about sex and drugs with parents were positively associated with plan to die by suicide. Family support was negatively associated with depression symptoms. Depression symptoms were positively associated with suicide attempts. Family support was indirectly and negatively associated with suicide attempts. Suggestions for future research and policy implications are discussed.

Sexual and Relationship Violence Among LGBTQ+ College Students: A Scoping Review

Although there has been increased attention to campus sexual and relationship violence (SRV) because of Title IX and the #MeToo movement, much of that attention has focused on victimization of cisgender heterosexual women. This scoping review uncovers information from empirical studies on what is known about LGBTQ+ (e.g., lesbian, gay, bisexual, transgender, queer, and nonbinary) students' experiences of campus SRV. Using rigorous scoping review methods (i.e., searches of 15 databases, searches of expert websites, hand searching, reference harvesting, and forward citation chaining), we identified 60 documents published since 2000 that contained findings from empirical studies related to LGBTQ+ students and SRV on U.S. college and university campuses. Through content analysis, we summarized findings around five key themes: (1) extent and types of victimization, (2) negative outcomes, (3) knowledge of and attitudes about SRV, (4) perspectives on SRV services and prevention education programs, and (5) recommendations from study authors based on their findings. Implications for research, practice, and policy based on these findings are discussed.

Does Athlete Status Explain Sexual Violence Victimization and Perpetration on College Campuses? A Socio-Ecological Study

In the United States, college students have been identified as a high-risk group for sexual violence (SV) victimization and perpetration, with one in three women and one in four men experiencing SV in their lifetimes. Therefore, studies investigating both perpetration and victimization across genders are pertinent. Additionally, in the context of higher education, athletics is often viewed as a high-risk environment for SV. Despite established relationships between SV and intercollegiate athletics, research on this topic is not conclusive due to the heterogeneous nature of college sports, as well as a dearth of research on recreational athletes. The primary purpose of this study was to examine the differences in SV victimization and perpetration among intercollegiate, recreational, and non-athlete populations. Additional context was provided by exploring variables at multiple levels of the socio-ecological model for violence prevention, as these factors can be important aspects of a person's development and may inform behavior. Utilizing a sample of 62,996 students from 199 institutions of higher education in the United States, multilevel logistic regression analyses were conducted to assess individual- (i.e., personal demographics), relationship- (i.e., athlete status), and community-level (i.e., institutional characteristics) predictors of SV victimization and perpetration. The results indicated that recreational athletes are the most at-risk group, experiencing and perpetrating SV at higher rates than non-athletes. Results on institutional status and individual characteristics, as well as implications for practitioners and future research is discussed.

NCHA variable combination as a method to undertake LGBTQ + student subpopulation analyses

ObjectiveCombine National Collegiate Health Assessment (NCHA) measures indicating LGBTQ + membership into a single variable in order to analyze health responses of this group as compared to their cisgender, heterosexual (cis-het) peers. Participants: Students at a liberal arts university who completed the Spring 2019 NCHA-II study (n = 1107). Methods: Four different NCHA sexual orientation and gender identification variables were combined, creating a new variable to examine the campus LGBTQ + student sub-sample as a single, complete group. That group was then compared to cis-het students across multiple variables. Results: LGBTQ + students reported statistically significant differences for key variables such as suicide attempts, suicidal ideation, and self-harm, as well as for stressors that impact academic success such as discrimination. Conclusions: This analysis indicates that the challenges campus LGBTQ + students face are much different than their cis-het peers. Support from campus community members is suggested to reduce negative impacts for these students.

A daily diary study of minority stressors, suicidal ideation, nonsuicidal self-injury ideation, and affective mechanisms among sexual and gender minority youth

Sexual and gender minority youth (SGMY) are at greater risk than their heterosexual and cisgender counterparts for suicidal thoughts and behaviors (STB) and nonsuicidal self-injury (NSSI). Unique stressors (i.e., minority stressors) specific to SGMY's stigmatized identities such as discrimination or concealment of one's identity are posited to explain these disparities. However, there is limited research examining the associations among minority stressors, affective mediating processes, and STB and NSSI in SGMY's daily lives. We conducted a 28-day daily diary study to test the mediating effects of daily negative and positive affect and emotion dysregulation between minority stressors and STB and NSSI among SGMY who were recruited from clinical and community settings. Participants were 92 SGMY, aged 12-19 years old (M = 16.45; SD = 1.81; 64% cisgender; 69% White). Results indicated that on days SGMY experienced external and internalized minority stressors, they reported greater intensity of suicidal and nonsuicidal self-injurious ideation and affective distress (i.e., greater negative affect, lower positive affect, and more emotion dysregulation). Greater affective reactivity processes were associated with greater suicidal and nonsuicidal self-injurious ideation intensity on the same day. Most of the within-person associations between external and internalized minority stressors and ideation intensity were mediated by heightened negative affect and emotion dysregulation but not lower positive affect. Our results provide the first evidence of these associations among SGMY, advance the minority stress model, and have implications for clinical interventions as we identified modifiable affective mechanisms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effects of sexual orientation and NSSI severity on suicide risk

INTRODUCTION

People who identify as sexual minorities are at increased risk for suicide. Non-suicidal self-injury (NSSI) is also a risk factor for suicide and NSSI severity may contribute to development of capability for lethal self-injury. Further research is needed to understand how NSSI severity increases suicide risk, specifically in high-risk populations like sexual minorities. The current study seeks to examine whether sexual minority adults exhibit greater NSSI severity and suicide risk than heterosexuals, and if NSSI severity moderates the relationship between sexual orientation and suicide risk.

METHODS

Undergraduate students (N = 1,994) who reported five or more acts of NSSI in their lifetime completed online self-report questionnaires including sexual orientation, NSSI severity, and suicide risk.

RESULTS

A factorial ANOVA demonstrated main effects of sexual orientation and NSSI severity on suicide risk.

DISCUSSION

The lack of significant interaction effect indicates NSSI severity does not amplify the effect of on sexual orientation on suicide risk; rather, it predicts the same level of increased risk across orientations. Therefore, suicidality related to both sexual orientation and NSSI severity are equally important treatment targets.

Minority stressors and suicidal ideation in sexual and gender minority youth assigned female at birth: Prospective associations and racial differences

INTRODUCTION

Suicidal ideation (SI) disproportionately affects sexual and gender minority (SGM) versus cisgender/heterosexual youth, likely due to the minority stressors (MS) they face. Research has shown cross-sectional associations between SGM MS and suicidality; however, few studies have used longitudinal data or examined racial differences in the effects of MS on SI. The current study tested whether MS prospectively predict next-year SI and whether race moderates these prospective associations.

METHOD

Three hundred and sixty-nine Black, Latinx, and White SGM youth completed baseline measures of MS, SI, and demographics, and SI 6 and 12 months later.

RESULTS

Internalized stigma, microaggressions, and low support from family and from significant others demonstrated associations with next-year SI. When controlling for baseline SI, however, only low significant other support predicted next-year SI. Moderation analyses indicated that internalized stigma predicted SI for White, but not Black or Latinx, individuals and that lower friend support was associated with SI for Latinx, but not White or Black, individuals.

CONCLUSIONS

Though minority stressors appear to raise risk for SI among SGM, effects may differ by race. Internalized stigma may be particularly influential for SI among White SGM whereas lack of support from friends may be most influential for SI among Latinx SGM youth.

Campus Climate and the Sexual Assault Victimization of LGBQ College Students

Sexual minority college students are disproportionately impacted by sexual assault in college, however, there is a paucity of research exploring the role of the college environment in victimization. This study explores the relationship of campus climate with sexual assault victimization for these students. This sample included 1,110 current college students in the United States who identified as a sexual minority. Logistic regression results indicated that the more observations of harassment and discrimination of sexual minority students by participants, the more likely they were to experience sexual assault victimization in college. Also, the more out a participant was on campus, and the stronger sense of belonging they had to their college, the less likely they were to experience sexual assault victimization. Sexual assault prevention efforts on college campuses would benefit from programming and policies that support belonging and address discrimination and harassment.

Prevalence and correlates of mental health symptoms and disorders among US international college students

Objective: This study assessed the prevalence and correlates of mental health (MH) symptoms and diagnoses in international college students in the United States. Participants: The sample included 44,851 degree-seeking undergraduate students (42,428 domestic students and 2,423 international students). Methods: Logistic regression analyses were conducted using international student status to predict MH symptoms and diagnoses from the Spring 2017 administration of the ACHA-National College Health Assessment (ACHA-NCHA). Results: International students were less likely than domestic students to report a diagnosis of anxiety, comorbid depression and anxiety, or other psychiatric diagnoses. International students were more likely to report suicide attempts and feeling overwhelmingly depressed. Conclusions: Among international students studying in the US, lower rates of MH diagnoses despite higher rates of depressive symptoms and suicide attempts mirror similar trends seen in American-born minority students. University campuses should consider culturally sensitive and targeted psychoeducation, mental health services, and outreach programming.

Sexual Minority Status, Affect Lability, and Suicide Ideation: Buffering Role of Trait Mindfulness

OBJECTIVE

Emotion regulation has been proposed as a mechanism driving sexual orientation disparities in suicide ideation (SI), but little research has examined the role of affect lability in the association of sexual minority identity and SI. As prior research has found trait mindfulness to be associated with lower SI, the objective of the present study was to examine the buffering role of mindfulness in the associations of sexual orientation, affect lability, and SI.

METHOD

The present study used a moderated mediation model to examine a cross-sectional dataset consisting of heterosexual (n = 1511) and sexual minority (n = 355) U.S. college students (N = 1866), to examine whether five facets of mindfulness moderated the indirect association of sexual minority identity on SI via affect lability.

RESULTS

As predicted, sexual minority identity was associated with higher affect lability, which in turn was associated with higher SI. Acting with awareness (i.e., attending to the present activities), describing (i.e., the ability to verbalize inner experiences), and non-judging (i.e., refraining from judging inner experiences) buffered the indirect association of sexual minority identity on SI via affect lability, such that the indirect association weakened at higher levels of those mindfulness facets.

CONCLUSIONS

Our results provide a better understanding of the emotion regulation mechanisms underlying the higher risk of SI among sexual minorities. Future research is needed to examine mindfulness facets as buffers against SI among other communities, and to examine the efficacy of emotion regulation and mindfulness interventions in reducing suicide ideation and other aspects of suicidality (i.e., plans/attempts).HighlightsSexual orientation disparities in suicide ideation (SI) and affect lability.Sexual minority identity linked to higher SI via higher affect lability.Three mindfulness facets attenuated indirect association of identity on SI.

Suicidality among bisexual youths: the role of parental sexual orientation support and concealment

Compared with the heterosexual population, the prevalence of mental health outcomes such as suicidality (suicidal ideation, suicide plans, and suicide attempts) is higher among sexual minority youth, particularly those who identify themselves as bisexuals. Bisexuals are at an even elevated risk within the LGB populations due to biphobia, monosexism, bisexual invisibility or erasure, and lack of support resources. These experiences may bring about issues regarding concealment of their sexual orientation linked to suicidality. Studies have also identified that parental support is a protective factor against suicidality among the youth, particularly their sexual orientation. The present study used a cross-sectional, predictive research design to examine parental sexual orientation support and concealment and their associations and predictive abilities in the suicidality of 151 Filipino bisexual youths aged 18-24 years old. The participants were recruited online within six months, from July 2021 to December 2021. As measured by the Parental Support for Sexual Orientation Scale, Sexual Orientation Concealment Scale, and Suicide Behaviors Questionnaire-Revised, results showed that among our bisexual participants, parental sexual orientation support and concealment did not have a significant relationship with and could not predict their risk for suicidality. Limitations and suggestions for further research were discussed, considering our findings.

The Associations Between Sexual Victimization and Health Outcomes Among LGBQA College Students: Examining the Moderating Role of Social Support

Prior studies have demonstrated that sexual minority college students are two to four times more likely to experience sexual victimization (e.g., sexual assault and/or unwanted or uncomfortable sexual experiences) compared to their heterosexual counterparts. However, research that has focused on the detrimental effects of sexual victimization on health outcomes has paid more attention to heterosexual college samples and community-based adults. Understanding how sexual victimization influences mental health and substance use outcomes among lesbian, gay, bisexual, queer, and asexual (LGBQA) emerging adults in college is warranted given that this developmental period represents a critical risk period for trauma exposure, risk behavior, and psychological distress. Thus, the current study tested how sexual victimization was associated with depressive symptoms, post-traumatic stress disorder (PTSD) symptoms, and alcohol use disorder (AUD) symptoms among 234 diverse college students who self-identified as LGBQA. Additionally, social support was tested as a moderator. Findings indicated that sexual victimization was related to greater depressive symptoms, PTSD symptoms, and AUD symptoms. In addition, perceived social support moderated the relation between sexual victimization and depressive symptoms, however, in a direction contrary to hypotheses. In particular, higher sexual victimization was associated with greater depressive symptoms among LGBQA students with higher levels of social support (b = .29, p = .00), and was not significant among LGBQA students with lower levels of social support (b = .13, p = .26). The current study highlights the need to consider the detrimental effects of sexual victimization on health outcomes among LGBQA college students, as well as the mechanisms through which social support may be influencing these relations.

Suicide Risk and Association With the Different Trauma During the COVID-19 Pandemic Period: A Cross-Sectional Study on Adolescent With Different Learning Stage in Chongqing, China

This study aimed to examine the current suicidal risk and whether the suicidal risk was associated with a wide range of trauma. The self-administered online questionnaire was adopted to collect suicide risk (SR) such as suicidal ideation, self-harm, suicide attempts, and different trauma information of the adolescents by cluster sampling in Chongqing, China. Multivariable linear regression was presented to assess the association between different risks of trauma and SR scores. Approximately 14.7% of adolescents enrolled reported suicide ideation and more than 10% of adolescents have experienced one kind of trauma during the Coronavirus disease 2019 (COVID-19) pandemic period. After adjusting for confounding variables, adolescents who suffered family hurt had a higher risk score of SR (beta coefficients (β) = 0.289, 95% confidence interval (CI) = 0.115-0.463). A positive association was found among participants from junior and senior school (β = 0.415, 95% CI = 0.152, 0.768), and the SR score was positively associated with sexism among participants from the university/college (β = 0.238, 95% CI = 0.042, 0.434). The most potentially obvious trauma that contributed to SR in junior and senior school adolescents might be cyberbullying. Family neglect or abuse might be a detrimental factor in SR for adolescents whether those in junior school or those in university school in China. More interventions, like education related to cyberbullying and family abuse, should be prioritized to reduce the risk of suicide.

An Integrative Psychological Model of Risk Factors for Suicidal Ideation and Behavior Among Israeli LGBT Individuals

Lesbians, gays, bisexuals, and transgender individuals (LGBT) are at high risk for suicide. This study aimed to examine an integrative psychological model of risk factors among LGBT individuals and explore the psychological pathways connecting social stigma, mental pain, and interpersonal characteristics to suicidal ideation and behavior (SIB) in this population. LGBT adults (N = 473) responded to an online questionnaire about stigma, mental pain, interpersonal characteristics, as well as suicidal ideation and behaviors. We found group differences between LGBT respondents in the study variables: Transgender people reported the highest levels of SIB and depression, closely followed by bisexuals. The association between stigma-related variables and SIB was mediated by depression, entrapment, and perceived burdensomeness. These results highlight the role of entrapment and burdensomeness in facilitating suicide risk among LGBT adults, as they may increase the damaging effect of negative societal stigma against LGBTs and thus, elevate the suicide risk in this population.

Longitudinal Transitions in Intimate Partner Violence among Female Assigned at Birth Sexual and Gender Minority Youth

Female-assigned at birth sexual and gender minorities (FAB SGM) are at elevated risk of experiencing intimate partner violence (IPV), yet little longitudinal research has been conducted with this population. In the current study, we attempted to understand how patterns of IPV victimization and perpetration, measured across a wide range of IPV behaviors (psychological, physical, sexual, cyber, and SGM-specific), changed over time for FAB SGM youth. Participants came from a longitudinal cohort study of FAB SGM late adolescents and young adults (FAB400; N = 488) and included anyone who reported a romantic partner at one of the first three waves (six months apart; N = 433). Latent class analysis (LCA) was run at each wave to determine the best-fitting class structure across IPV experiences. These were followed up with latent transition analyses (LTAs) to determine patterns of movement between classes over the course of the three waves. Lastly, we looked at the effects of staying with the same romantic partner on transitions. We found that the same three-class structure replicated across all three waves of the study. That class structure identified no/low, psychological, and high IPV classes at each wave. In the LTA, when transitions occurred for FAB SGM, they were much more likely to transition to a class defined by lower likelihoods of experiencing IPV (i.e., psychological to no/low) than they were to a class defined by higher likelihoods of IPV (i.e., psychological to high). However, we found that FAB SGM youth were less likely to transition to a less severe IPV class if they maintained the same serious romantic partner across waves. This finding, in particular, suggests that IPV is often relationship specific for FAB SGM and that efforts to reduce IPV in SGM communities must consider intervening at the relationship level to effect meaningful change.

Minority Stress and Suicidal Ideation and Suicide Attempts Among LGBT Adolescents and Young Adults: A Meta-Analysis

Purpose: This meta-analytic study examined associations between minority stressors and suicidal ideation and suicide attempts among LGBT adolescents and young adults (aged 12-25 years). Methods: Identified studies were screened using the inclusion and exclusion criteria. Studies had to include an association between a minority stressor and a suicidality outcome and were categorized into 10 meta-analyses. Overall effect sizes were calculated using three-level meta-analyses. In addition, moderation by sampling strategy was examined. Results: A total of 44 studies were included. Overall, LGBT bias-based victimization, general victimization, bullying, and negative family treatment were significantly associated with suicidal ideation and/or suicide attempts. Associations of discrimination and internalized homophobia and transphobia with suicidal ideation and/or suicide attempts were not significant. No moderation effects were found for sampling strategy. Conclusion: Although overall effect sizes were small, our meta-analytic study shows a clear link between various types of minority stressors and suicidal ideation and suicide attempts among LGBT adolescents and young adults.

Syndemic Profiles and Sexual Minority Men's HIV-Risk Behavior: A Latent Class Analysis

Syndemic theory posits that "syndemic conditions" (e.g., alcohol misuse, polydrug use, suicidality) co-occur among sexual minority men and influence HIV-risk behavior, namely HIV acquisition and transmission risk. To examine how four syndemic conditions cluster among sexual minority men and contribute to HIV-risk behavior, we conducted latent class analysis (LCA) to: (1) classify sexual minority men (n = 937) into subgroups based on their probability of experiencing each syndemic condition; (2) examine the demographic (e.g., race/ethnicity) and social status (e.g., level of socioeconomic distress) characteristics of the most optimally fitting four syndemic classes; (3) examine between-group differences in HIV-risk behavior across classes; and (4) use syndemic class membership to predict HIV-risk behavior with sexual minority men reporting no syndemic conditions as the reference group. The four classes were: (1) no syndemic, (2) alcohol misuse and polydrug use syndemic, (3) polydrug use and HIV syndemic, and (4) alcohol misuse. HIV-risk behavior differed across these latent classes. Demographic and social status characteristics predicted class membership, suggesting that syndemic conditions disproportionately co-occur in vulnerable subpopulations of sexual minority men, such as those experiencing high socioeconomic distress. When predicting HIV-risk behavior, men in the polydrug use and HIV syndemic class were more likely (Adjusted Risk Ratio [ARR] = 2.93, 95% CI: 1.05, 8.21) and men in the alcohol misuse class were less likely (ARR = 0.17, 95% CI: 0.07, 0.44) to report HIV-risk behavior than were men in the no syndemic class. LCA represents a promising methodology to inform the development and delivery of tailored interventions targeting distinct combinations of syndemic conditions to reduce sexual minority men's HIV-risk behavior.

Student Stories: Microaggressions in Communication Sciences and Disorders

Purpose Microaggressions and how they affect underrepresented college students have been frequently documented. However, there is a lack of literature on the experiences of underrepresented communication sciences and disorders (CSD) students. The purpose of this study is to understand how underrepresented post baccalaureate, undergraduate, and graduate students in CSD experience microaggressions in their academic programs. Method A 19-item electronic survey was developed by American Speech-Language-Hearing Association's Multicultural Issues Board and distributed via multiple online platforms. A diverse group of 155 underrepresented CSD students completed the survey. A multistage qualitative thematic analysis was used to analyze students' experiences. Results Students (64.51%) who completed the survey have experienced microaggressions in their academic programs. Prominent themes of students' descriptions of microaggressions included feelings of otherness, damaging generalization, maltreatment from faculty, and maltreatment from peers. Students reported various responses to microaggressions including identity management strategies, disengaging, and working hard to exceed expectations and to prove themselves. Conclusions This study illustrates the ways that underrepresented CSD students experience symbolic violence from clients, peers, and faculty. It has implications for the need to cultivate more inclusive learning and social environments in CSD programs. Further research is needed to explore the ramifications of microaggressions and ways to effectively reduce and eventually eradicate them. Supplemental Material https://doi.org/10.23641/asha.15240723.

Experiences of Intimate Partner Violence Among Lesbian, Gay, Bisexual, and Transgender College Students: The Intersection of Gender, Race, and Sexual Orientation

Lesbian, gay, bisexual, and transgender (LGBT) college students experience disproportionate rates of intimate partner violence (IPV) compared with their heterosexual and cisgender counterparts. Some studies report rates of IPV among lesbian, gay, and bisexual college students as high as 50%, and 9 times greater among transgender students compared with their cisgender peers. Few studies have investigated the impact of intersectional identity on experiencing different types of IPV, such as emotional, physical, and sexual IPV. The present study utilized the National College Health Assessment-II from 2011 to 2013 (n = 88,975) to examine the differences in types of IPV among college students based on sexual orientation, gender identity, and the intersection of these two identities. Bivariate Rao-Scott chi-square and multilevel logistic regression was used to test the associations between sexual orientation, gender identity, and the intersection of these identities on multiple types of IPV. Adjusting for covariates and school clustering, LGBT college students had higher odds of reporting emotional IPV (adjusted odds ratios [AORs] = 1.34-1.99), physical IPV (AOR = 1.58-2.93), and sexual IPV (AOR = 1.41-6.18). Bisexual and transgender college students demonstrated the highest odds of reporting IPV based on sexual orientation and gender identity, respectively. Intersectional identities were not significantly associated with IPV. These findings demonstrate a need for clinicians working with college students to be aware of the disproportionate prevalence of IPV among LGBT individuals, particularly for those clients those who identify as bisexual and/or transgender and participate in continuing education related to these populations. Furthermore, these findings illustrate the need for additional intersectional research with LGBT college students.

Sexual assault, sense of belonging, depression and suicidality among LGBQ and heterosexual college students

To compare the effect of sexual orientation, history of sexual assault and sense of belonging on depression and suicidality among lesbian, gay, bisexual, queer and questioning (LGBQ) and heterosexual students. Participants: A total of 60,194 students from 60 US campuses who participated in the 2017-2018 Healthy Minds Study. Methods: Three-way interaction effects were analyzed using PROCESS macro models in SPSS. Results: Significant three-way interaction effects were found for sexual orientation, sexual assault and sense of belonging predicting depressive symptoms (b = -0.06, p= 0.042, CI: -0.12 to -0.00), and suicidality (b = -0.10, p= 0.004, CI: -0.01 to -0.003). The effect of sexual assault on mental health differed depending on sexual orientation and sense of belonging. Particularly among LGBQ students, high sense of belonging was protective in the presence of sexual assault, and its absence had a deleterious effect on mental health. Conclusion: Enhancing sense of belonging may represent a strategy to mitigate depression and promote suicide prevention, particularly among LGBQ students.

A systematic review and meta-analysis of victimisation and mental health prevalence among LGBTQ+ young people with experiences of self-harm and suicide

BACKGROUND

LGBTQ+ youth have higher rates of self-harm and suicide than cisgender, heterosexual peers. Less is known about prevalence of risks within these populations.

OBJECTIVES

The first systematic review and meta-analysis to investigate the prevalence of risks among young people throughout the LGBTQ+ umbrella with experiences across the dimension of self-harm, suicidal ideation and suicide behaviour; and how they may differ between LGBTQ+ umbrella groups.

DATA SOURCES

MEDLINE, Scopus, EMBASE, PsycINFO, and Web of Science searches were run to identify quantitative research papers (database inception to 31st January, 2020).

STUDY ELIGIBILITY CRITERIA

Articles included were empirical quantitative studies, which examined risks associated with self-harm, suicidal ideation or suicidal behaviour in LGBTQ+ young people (12-25 years).

SYNTHESIS METHODS

2457 articles were identified for screening which was completed by two independent reviewers. 104 studies met inclusion criteria of which 40 had data which could be meta-analysed in a meaningful way. This analysis represents victimisation and mental health difficulties as risks among LGBTQ+ youth with self-harm and suicide experiences. Random-effects modelling was used for the main analyses with planned subgroup analyses.

RESULTS

Victimisation and mental health were key risk factors across the dimension self-harm and suicide identified through all analyses. A pooled prevalence of 0.36 was indicated for victimisation and 0.39 for mental health difficulties within LGBTQ+ young people with experiences of self-harm or suicide. Odds ratios were calculated which demonstrated particularly high levels of victimisation (3.74) and mental health difficulties (2.67) when compared to cisgender, heterosexual counterparts who also had these experiences.

CONCLUSIONS

Victimisation and mental health difficulties are highly prevalent among LGBTQ+ youth with experiences of self-harm and suicide. Due to inconsistency of reporting, further risk synthesis is limited. Given the global inclusion of studies, these results can be considered across countries and inform policy and suicide prevention initiatives.

PROSPERO REGISTRATION NUMBER

CRD42019130037.

Suicidal Thoughts and Behaviors Among LGBTQ Youth: Meta-Analyses and a Systematic Review

Suicide continues to be the second-leading cause of death for all youths aged 15-24. Lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth are at a significantly higher risk for suicidal thoughts or behaviors (STB). Establishing and understanding correlates of STB among LGBTQ youth is one important step toward enhancing prevention, intervention, and research efforts. To synthesize current knowledge on suicide among LGBTQ youth, the present meta-analyses offer results from 44 studies over the past 20 years. Two-hundred and thirty-four correlation coefficient effect sizes were calculated and categorized. To be included, the study had to quantitatively examine correlates of STB among LGBTQ youth. A number of social-science databases were used to examine the existing published research. Results illustrated the variability among correlates of STB as well as substantial limitations in the extant literature. There was a heterogeneity of effect sizes, a lack of novel correlates, a focus on risk, a dearth of theoretically driven designs, moderate publication bias, a paucity of developmentally driven analyses, and a dearth of research with transgender youth.

Impact of the COVID-19 pandemic on students at elevated risk of self-injury: The importance of virtual and online resources

Non-suicidal self-injury (NSSI), which involves deliberate damage to body tissue without suicidal intent, has long been a concern for schools and school staff. Secondary schools are an ideal setting in which to identify, and appropriately refer, students who self-injure as well as implement evidence-based prevention and early intervention programs. However, in the context of the global COVID-19 pandemic, schools have been closed and students sent home to learn online. This may result in the exacerbation of existing anxieties and pose several new stressors that cumulatively may increase risk of NSSI. In this article, we draw on recent research and our collective experience working with schools, as well as digital mental health, to outline some of these potential stressors and offer resources for school staff to help students who are engaging in or at risk of NSSI.

Questions of faith: Religious affiliations and suicidal ideation among sexual minority young adults

OBJECTIVE

To examine how the associations of specific religious affiliations with recent suicidal ideation vary by sexual orientation among young adults.

METHOD

This project was a cross-sectional secondary analysis of data from the 2006 and 2011 surveys of the National Research Consortium of Counseling Centers in Higher Education. The analytic sample was restricted to persons between the ages of 18-29 (n = 40,150). Multiple logistic regression analyses were used to examine associations of religious affiliations with recent suicidal ideation between heterosexual and sexual minority (e.g., gay, lesbian, bisexual, questioning) young adults.

RESULTS

Approximately 6.7% of the sample self-identified as sexual minority. Compared to heterosexuals, sexual minorities were more likely to report recent suicidal ideation (aOR = 4.52, 95% CI = 3.97-5.16). Among heterosexuals, Unspecified Christian and Catholic denominations were associated with 24% and 37% reduced odds of recent suicidal ideation compared to agnostic/atheist heterosexuals. However, among sexual minorities, Unspecified Christian and Catholic denominations were associated with 68% and 77% increased odds of recent suicidal ideation compared to agnostic/atheist sexual minorities. Unspecified Christian and Catholic sexual minorities had 184% and 198% increased odds of recent suicidal ideation compared to Unitarian/Universalist sexual minorities.

CONCLUSIONS

Although protective for heterosexuals, religious affiliation may not be globally protective against suicidal ideation among sexual minorities.

Teen Dating Violence and Suicide Risk Among Bisexual Adolescents

PURPOSE

Suicide is a public health problem that disproportionately affects bisexual youth more than heterosexual, lesbian/gay, and other sexual minority youth. Teen dating violence (TDV) consists of physically, emotionally, and/or psychologically aggressive behavior in adolescent relationships and has been linked to increased suicidality among sexual minority youth. Although biological sex differences in suicide and TDV have been noted, limited research currently exists regarding the importance of these differences in bisexual youth.

METHODS

This study employed a cross-sectional descriptive design to investigate the relationship between biological sex, TDV, and suicide risk among bisexual youth in grades 9-12. This study used structural equation modeling to conduct a secondary analysis of pooled 2015 and 2017 national Youth Risk Behavior Surveillance Survey data that examined whether TDV mediated the relationship between biological sex and suicide risk among bisexual youth.

RESULTS

Results indicated that TDV did not mediate the relationship between biological sex and suicide risk among bisexual youth. Biological sex was a significant predictor of suicide risk with male youth reporting lower suicide risk than female youth, when controlling for dating history, TDV, age, and race. TDV predicted suicide risk, with youth reporting TDV having higher suicide risk, when controlling for dating history, biological sex, age, and race. In addition, black and Hispanic youth reported lower suicide risk compared to white youth.

CONCLUSION

There is a dire need for research that addresses issues of TDV and suicide among bisexual youth. Understanding factors influencing suicide risk following TDV experiences among bisexual youth will inform interventions to mitigate negative mental health outcomes.

Bisexuality and Non-Suicidal Self-Injury (NSSI): A narrative synthesis of associated variables and a meta-analysis of risk

BACKGROUND

Bisexual people have been found to be at increased risk of non-suicidal self-injury (NSSI) when compared to heterosexual and gay or lesbian people. The purpose of this review was to update the estimated risk of NSSI for bisexual people and to examine variables that have been associated with NSSI in this population.

METHODS

The protocol for this paper was pre-registered (CRD42019145299). An electronic search of PsycINFO, CINAHL Plus, PubMed, Ovid Online and Web of Science was undertaken from earliest available date to October 2019. Twenty-four eligible papers were identified. Meta-analyses, including moderator analysis, were conducted to ascertain NSSI risk and a narrative synthesis was undertaken of predictors and correlates. All studies were assessed for risk of bias.

RESULTS

Bisexual people had up to six times the odds of engaging in NSSI compared to other sexualities. Mental health variables of anxiety and depression symptoms were found to be most commonly associated with NSSI for this population. The majority of studies had moderate risk of bias. This review demonstrates that bisexual people have an elevated risk of engaging in NSSI. Increased incidence of anxiety and depression and exposure to negative life events may explain this increased risk.

LIMITATIONS

Studies were found to be consistently cross-sectional in design and limited to western cultures. A limitation of this review was that only English language papers were included.

CONCLUSIONS

Results are clinically relevant as they suggest early identification and prevention of NSSI can be achieved. Future research should examine bisexual people independently of others.

Disparities in Prescription Opioid Misuse Affecting Sexual Minority Adults Are Attenuated by Depression and Suicidal Ideation

Purpose: Heightened rates of prescription opioid misuse have been observed among sexual minority (SM) compared with heterosexual populations. In addition, depression and suicidal ideation are risk factors for misuse, and they are also elevated among SM populations. The purpose of this analysis was to examine whether depression and suicidal ideation attenuate disparities in prescription opioid misuse among SM adults. Methods: Data came from a publicly available, nationally representative data set, the National Survey on Drug Use and Health, 2015-2018. Among adults, survey-weighted logistic regression was used to assess the relationship between sexual orientation and past-year opioid misuse adjusting for demographics and either past-year major depressive episode or suicidal ideation. Probabilities of prescription opioid misuse were also assessed under counterfactual rates of depression and suicidal ideation. Analyses were stratified by sex. Results: Among participants in the analytic sample (N = 169,759; SM = 11,268), 9254 (5.5%) reported past-year prescription opioid misuse. The overall rate of opioid misuse decreased from 6.2% in 2015 to 4.6% in 2018. The association between sexual orientation and opioid misuse was attenuated downward for gay men, lesbian women, and bisexual individuals (men and women) after adjusting for either major depressive episode or suicidal ideation, but opioid misuse remained higher among most SM groups. In addition, rates of opioid misuse were found to be lower in counterfactual analyses with a nearly 2.5- and 4-fold decrease in depression and suicidal ideation among gay men and bisexual women, respectively. Conclusion: Efforts to reduce disparities in depression and suicidal ideation affecting SM individuals may reduce disparities in prescription opioid misuse affecting this population.

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.

Inward- and Outward-Directed Violence in the Lives of Urban Minority Adults Followed from Middle School into Their Thirties

This study explores connections between inward-directed violence and outward-directed violence using data from the Reach for Health sample, which was originally recruited in the 1990s from three middle schools in economically distressed, predominantly African American neighborhoods of New York City. Now in their thirties, participants (N = 595) completed surveys assessing current suicidal thoughts and behaviors as well as other violence involvements, including intimate partner violence victimization and perpetration. About 10% of males and females reported any suicidal ideation or attempt in the past 12 months. In logistic regression analyses adjusting for sociodemographics, prior reports of feeling blue in middle school (OR: 1.12, CI: 1.02-4.39) and young adult suicidality (OR: 2.54, CI: 1.30-4.95) are significantly related to later suicidality. So are concurrent aggressive behaviors, including reports of physical fighting outside the home (OR: 2.70, CI: 1.29-5.67) and IPV perpetration (OR: 2.09, CI: 1.11-3.94). Neither IPV victimization nor witnessing neighborhood violence is correlated. Findings shed light on the persistence of suicidality in the lives of those who come of age, and often remain, in communities with high levels of poverty, and confirm linkages of suicidality with externally directed aggression. Life-stage interventions are needed to counter the interwoven causes and consequences of multiple forms of violence.

Sexual Minority Status and Psychological Risk for Suicide Attempt: A Serial Multiple Mediation Model of Social Support and Emotion Regulation

The current study examined the relation between sexual minority status, social support, emotion dysregulation, and suicide attempt in a community sample. A total of 388 community and college adults completed a one-time survey examining self-injury and suicidality. Findings demonstrated that that social support and emotion regulation, independently and in sequence, mediated the relation between sexual minority status and suicide attempt. The reverse mediation model with emotion regulation as the first mediator and social support as the second mediator was also significant. Social support and emotion regulation may both be related and may explain the relation between sexual minority status and suicide attempt. If replicated longitudinally, these findings shed light on specific risk factors and their interrelations, which may have important implications for preventing suicide in sexual minorities.

#selfharn on Instagram: understanding online communities surrounding non-suicidal self-injury through conversations and common properties among authors

Objectives

#selfharm has been blocked by Instagram, but manoeuvring hashtags (e.g. #selfharn) are beginning to appear in order for secret non-suicidal self-injury (NSSI) communities to communicate. The purpose of this study was to (a) determine the nature of the #selfharn conversation on Instagram, (b) analyze common properties of the visual content (i.e. images and videos; n = 93) tagged with #selfharn, and (c) discover what kind of environment the authors (n = 50) of #selfharn were creating.

Methods

A multi-method approach was utilized for this study. Netlytic was used to generate a text and content analysis to examine the authors’ captions and comments (n = 8772) associated with #selfharn (collected over a seven-day period).

Results

After removing #selfharn from the dataset, the text analysis revealed that #depression (n = 3081) and #suicide (n = 2270) were the most commonly used terms associated with #selfharn. Overall, 52% (n = 4386) of the popular words/phrases related with #selfharn posts were categorized as ‘bad feelings’. Through manual coding, it was determined that the majority of #selfharn visual content (n = 92; 99%) did not generate an advisory warning but did contain a wound (n = 70; 75%). The #selfharn author analysis suggests that most were women (n = 18; 36%) with a dark-coloured profile aesthetic (n = 37; 74%) determined by an overwhelming amount of grey, black, blue, red, or purple colours.

Conclusion

According to the text and content analyses, #selfharn on Instagram may be contributing negatively to an online community of mental-health issues. More resources should be provided by Instagram to those who are involved in the NSSI Instagram community.

Suicidal Behaviors and Help-Seeking Attitudes Among Deaf and Hard-of-Hearing College Students

OBJECTIVE

The objective of this study was to examine the prevalence of suicidal ideation, suicide attempts, and help-seeking attitudes among D/HH and hearing college students.

METHOD

A total of 500,860 students completed the ACHA-NCHA-IIb (Fall 2011-Spring 2015). Survey administration and sampling methods differed across institutions. We randomly selected hearing students to have a 1:1 ratio of D/HH and hearing students (analytic N = 12,056). The mean age was 20.3 years, and the sample was predominantly white (68%) and female (65%). Multinomial and binary logistic regressions determined the relation between hearing status, suicide ideation and attempt, and help-seeking.

RESULTS

D/HH college students were more likely than hearing college students to have seriously considered suicide or attempted suicide in their lifetime. [Correction added on November 26, 2019, after first online publication: The phrase "but not in the past year" was deleted in the previous sentence.] In adjusted analyses, D/HH college students were more likely than hearing college students to have attempted suicide in the past year (OR 2.42, 95% CI 1.85, 3.17). There were no differences between D/HH and hearing groups in help-seeking attitudes.

CONCLUSIONS

Findings from this national data set indicate that D/HH college students are more likely to consider or attempt suicide. These results underscore the need for focused suicide risk prevention interventions with this population.

College Sexual Assault and Campus Climate for Sexual- and Gender-Minority Undergraduate Students

Sexual- and gender-minority (e.g., lesbian, gay, bisexual, and transgender) undergraduate students are at greater risk for sexual assault victimization than their cisgender (i.e., nontransgender) heterosexual peers. However, few studies have examined how social environments affect sexual assault victimization among sexual- and gender-minority undergraduate students. Nevertheless, this research area was identified as a priority by the Institute of Medicine as well as President Barack Obama's White House Task Force to Protect Students From Sexual Assault. Therefore, we tested the association between college campuses' inclusion of sexual- and gender-minority people and experiences of sexual assault victimization. Cross-sectional surveys were completed by sexual- and gender-minority undergraduate students (N = 1,925) from higher education institutions in all 50 U.S. states in 2010. Our dependent variable was experiencing sexual assault victimization at college. Our primary independent variable was campus climate, measured with items assessing perceived inclusion of sexual- and gender-minority people and witnessing sexual- or gender-minority harassment. We used multivariable logistic regression with generalized estimating equations (accounting for the clustering of students within schools) to estimate the association between campus climate and experiencing sexual assault victimization. Overall, 5.2% of the sample reported ever being victims of sexual assault at college. Controlling for sexual orientation, gender identity, race/ethnicity, and year in school, greater perceived inclusion of sexual- and gender-minority people on campus was associated with significantly lower odds of experiencing sexual assault victimization. Our study suggests that improving campus climate for sexual- and gender-minority individuals may reduce their prevalence of college sexual assault, which has potential implications for college practitioners and administrators as well as sexual assault prevention programs and policies.

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

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.

Suicide risk among gender and sexual minority college students: The roles of victimization, discrimination, connectedness, and identity affirmation

BACKGROUND

Little is known about how victimization and discrimination relate to suicide risk among sexual and gender minority (SGM) college students, or what is protective for these students. The current study will: 1.) determine the extent to which interpersonal victimization, discrimination, identity affirmation, and social connectedness are associated with suicide risk characteristics, and if race and/or ethnicity moderates this association; 2.) examine whether identity affirmation and social connectedness are protective against associations between victimization or discrimination and suicide risk characteristics.

METHOD

Participants were 868 students (63.6% female) from four United States universities who completed an online screening survey and met the following study inclusion criteria: self-identification as gender and/or sexual minority, endorsement of at least one suicide risk characteristic and no current use of mental health services. Participants also completed measures that assessed demographics, non-suicidal self-injury (NSSI), victimization, discrimination, connectedness, and LGBTQ identity affirmation.

RESULTS

Victimization was positively associated with depression severity, suicidal ideation, alcohol misuse, suicide attempt history, and NSSI. Discrimination was positively associated with depression severity, suicide attempt history, and NSSI. Connectedness was inversely associated with depression severity, suicidal ideation severity, suicide attempt history, and NSSI, and moderated the association between victimization and suicide attempt history. LGBTQ identity affirmation moderated the link between victimization and depression.

CONCLUSIONS

Results suggest efforts to decrease victimization and discrimination and increase connectedness may decrease depressive morbidity and risks for self-harm among SGM college students. Further, increasing LGBTQ identity affirmation may buffer the impact of victimization on depression.

Intimate Partner Violence Experiences of Sexual and Gender Minority Adolescents and Young Adults Assigned Female at Birth

Sexual and gender minority youth, especially those assigned female at birth, are at risk for intimate partner violence (IPV) due to minority stressors. With a sample of 352 sexual and gender minority youth assigned female at birth (age 16-32), we aimed to describe IPV in this population, including the prevalence, directionality, frequency, co-occurrence, and demographic correlates of various IPV types. Rates of past-6-month IPV were high, with victimization and perpetration of minor psychological IPV most common (64-70%); followed by severe psychological, minor physical, and coercive control (20-33%); and severe physical and sexual IPV (10-15%). For cyber abuse and IPV tactics leveraging anti-sexual minority stigma, victimization (12.5% and 15%, respectively) was more common than perpetration (8% and 6%, respectively). Most IPV was bidirectional and occurred 1-2 times in 6 months, although frequency varied considerably. Latent class analyses revealed that half of participants reported no or minimal IPV; one-third experienced multiple forms of psychological IPV (including coercive control); and 10-15% reported psychological, physical, sexual, and cyber abuse. Racial minority youth had higher rates of most IPV types than White participants. We hope study findings will inform policies and interventions to prevent IPV among gender and sexual minority youth assigned female at birth.

A Longitudinal Study of IPV Victimization Among Sexual Minority Youth

Although intimate partner violence (IPV) is highly prevalent among lesbian, gay, bisexual, and transgender (LGBT) youth, little is known regarding its developmental patterns, risk factors, or health-related consequences. We examined IPV victimization in an ethnically diverse community-based convenience sample of 248 LGBT youth (aged 16-20 at study outset) who provided six waves of data across a 5-year period. Results from multilevel models indicated high, stable rates of IPV victimization across this developmental period (ages 16-25 years) that differed between demographic groups. Overall, 45.2% of LGBT youth were physically abused and 16.9% were sexually victimized by a dating partner during the study. Odds of physical victimization were 76% higher for female than for male LGBT youth, 2.46 times higher for transgender than for cisgender youth, and 2 to 4 times higher for racial-ethnic minorities than for White youth. The prevalence of physical IPV declined with age for White youth but remained stable for racial-ethnic minorities. Odds of sexual victimization were 3.42 times higher for transgender than for cisgender youth, 75% higher for bisexual or questioning than for gay or lesbian youth, and increased more with age for male than female participants. Within-person analyses indicated that odds of physical IPV were higher at times when youth reported more sexual partners, more marijuana use, and lower social support; odds of sexual IPV were higher at times when youth reported more sexual partners and more LGBT-related victimization. In prospective analyses, sexual IPV predicted increased psychological distress; both IPV types marginally predicted increased marijuana use.

Intimate partner violence, health, sexuality, and academic performance among a national sample of undergraduates

OBJECTIVE

To determine the association between intimate partner violence (IPV) and academic performance among heterosexual and sexual minority undergraduates, including whether health mediates this relationship.

PARTICIPANTS

A national sample of undergraduate students aged 18-24 years old who completed the 2011-2014 National College Health Assessment IIb (N = 85,071).

METHODS

We used structural equation modeling to create a latent variable of IPV victimization (stalking, physical, sexual, and emotional violence) in order to test its relationship with health (physical and mental) and two indicators of academic performance (GPA and perceived academic difficulties), according to participants' sexual identity (heterosexual, lesbian, gay, bisexual, and unsure).

RESULTS

Regardless of sexual identity, undergraduates who reported IPV were more likely to have lower GPA and increased academic difficulties. Health mediates this relationship, such that IPV reduces health, which negatively affects performance.

CONCLUSIONS

IPV poses a serious threat to undergraduates' health and educational success. Findings warrant universal prevention and intervention.

LGBTQ College Students' Experiences With University Health Services: An Exploratory Study

Access to inclusive, equitable health care is central to the wellbeing of all college students yet little is known about LGBTQ students' experiences with university health services. In this article, individual interviews with a convenience sample of 14 LGBTQ students at a large public university were analyzed to explore their perceptions of and experiences with the university's health center and its services. Our findings demonstrate that the university is not adequately meeting their health care needs. Participants' narratives offer insights into how to improve campus-based health services for LGBTQ students.

Violência física contra lésbicas, gays, bissexuais, travestis e transexuais no interior do nordeste brasileiro

Objetivo Determinar o perfil de violência física perpetrada contra integrantes lésbicas, gays, bissexuais, travestis e transexuais (LGBTT).Método Estudo descritivo, de abordagem quantitativa, realizado com minorias sexuais nos municípios de Juazeiro do Norte e Crato, Ceará, Brasil. Utilizou-se um formulário estruturado para coleta de dados. O estudo teve aprovação prévia de Comitê de Ética em Pesquisa.Resultados Um total de 316 integrantes LGBTT, em sua maioria gays, solteiros, pardos e com idade média de 24,3 anos, participaram do estudo. Dentre as violências sofridas ao longo da vida, as físicas ocuparam a segunda colocação (31,3%). Frente a estas, prevaleceram os empurrões (21,8%) e socos (17,4%). O local preferencial para os ataques foi a face (84,4%) e a maioria dos agressores são pessoas desconhecidas (13,6%).Discussão A vitimização LGBTT constitui-se em grave violação aos direitos humanos, com repercussões negativas à saúde. Os resultados apontam para um quadro de homofobia social, semelhante ao observado em todo o território brasileiro mediante relatórios produzidos pela Secretaria de Direitos Humanos da Presidência da República. Minorias sexuais são vítimas de agressões cotidianas que resultam em sequelas temporárias e/ou permanentes a exemplo de torções e fraturas. A ameaça de agressão é constante, visto os maiores agressores serem pessoas transeuntes desconhecidas.Conclusão Integrantes LGBTT são vítimas de violência física e suas repercussões negativas. O enfrentamento desta realidade implica em elaboração de estratégias políticas e sociais, de setores governamentais e não governamentais, para o combate e a redução deste tipo de violência dirigida ao grupo.

Sexual Violence on Campus: Differences Across Gender and Sexual Minority Status

PURPOSE

Sexual violence is a pervasive problem on university campuses. Although previous work has documented greater vulnerability for sexual violence among sexual and gender minority students, little is known about contextual variation in vulnerability to this kind of violence. The goals of the current study were (1) to identify vulnerability among sexual and gender minority students with regard to sexual violence, and (2) to explore if the context of this violence differs across sexual and gender minority status.

METHODS

Undergraduate students (ages 18-24) from six francophone universities in Quebec, Canada (N = 4,264) completed online questionnaires regarding their experience of sexual violence, as well as the context of these acts (e.g., the gender of the perpetrator, the status of the perpetrator, and the location of the violence). They also provided information regarding their sexual and gender minority status. Binary logistic regressions were conducted to assess for variation in experiencing sexual violence across sexual and gender minority status.

RESULTS

Transgender/nonbinary students generally reported higher levels of sexual violence than their cisgender peers, while variation occurred with regard to vulnerability across sexual identity subgroups. Few differences in context were observed across sexual minority identity. Transgender/nonbinary students were significantly more likely to report sexual violence in athletic contexts and during volunteering activities compared to their cisgender peers.

CONCLUSIONS

Findings highlight the higher levels of vulnerability for sexual violence among gender minority and some sexual minority university students. They also point to the contexts in which such violence occurs, suggesting specific strategies for prevention.

Prevalence of Past-Year Sexual Assault Victimization Among Undergraduate Students: Exploring Differences by and Intersections of Gender Identity, Sexual Identity, and Race/Ethnicity

A critical step in developing sexual assault prevention and treatment is identifying groups at high risk for sexual assault. We explored the independent and interaction effects of sexual identity, gender identity, and race/ethnicity on past-year sexual assault among college students. From 2011 to 2013, 71,421 undergraduate students from 120 US post-secondary education institutions completed cross-sectional surveys. We fit multilevel logistic regression models to examine differences in past-year sexual assault. Compared to cisgender (i.e., non-transgender) men, cisgender women (adjusted odds ratios [AOR] = 2.47; 95% confidence interval [CI] 2.29, 2.68) and transgender people (AOR = 3.93; 95% CI 2.68, 5.76) had higher odds of sexual assault. Among cisgender people, gays/lesbians had higher odds of sexual assault than heterosexuals for men (AOR = 3.50; 95% CI 2.81, 4.35) but not for women (AOR = 1.13; 95% CI 0.87, 1.46). People unsure of their sexual identity had higher odds of sexual assault than heterosexuals, but effects were larger among cisgender men (AOR = 2.92; 95% CI 2.10, 4.08) than cisgender women (AOR = 1.68; 95% CI 1.40, 2.02). Bisexuals had higher odds of sexual assault than heterosexuals with similar magnitude among cisgender men (AOR = 3.19; 95% CI 2.37, 4.27) and women (AOR = 2.31; 95% CI 2.05, 2.60). Among transgender people, Blacks had higher odds of sexual assault than Whites (AOR = 8.26; 95% CI 1.09, 62.82). Predicted probabilities of sexual assault ranged from 2.6 (API cisgender men) to 57.7% (Black transgender people). Epidemiologic research and interventions should consider intersections of gender identity, sexual identity, and race/ethnicity to better tailor sexual assault prevention and treatment for college students.

Trends in suicidality among sexual minority and heterosexual students in a Canadian population-based cohort study

Objectives

Despite evidence from numerous studies that document disparities in suicidality for sexual minorities, few have investigated whether or not these trends have improved over time, which is the objective of the current study.

Methods

Using school-based population data over a 15-year period (1998 to 2013), multivariate logistic regressions were used to calculate age-adjusted odds ratios separately by gender. Interactions were included to test widening or narrowing disparities within orientation groups, which makes this one of the first studies to test whether gaps in disparities between heterosexual and sexual minorities have widened or narrowed over time.

Results

Results show that sexual minority youth are persistently at a greater risk for suicidal behaviour, a trend that has continued particularly for bisexual youth of both sexes. Results also suggest that the gap in suicidal behaviour is widening among some female sexual orientation groups, yet narrowing for other male sexual orientation groups.

Conclusions

These findings have important public health implications, especially since we see decreases in suicidal behaviour for heterosexual adolescents, but not in the same way for many sexual minority youth, despite advances in social acceptance of gay, lesbian, and bisexual issues in North America.

Nonsuicidal self-injury, suicidal thoughts and suicide attempts among sexual minority youth in Ireland during their emerging adult years

AIM

This study aimed to examine whether or not sexual minority youth constitute an at-risk group for nonsuicidal self-injury, suicidal ideation or suicide attempts during their emerging adult years.

METHODS

Using data from the Challenging Times Study, a population-based study of psychopathology and suicide in Ireland, analyses were conducted to test the associations between sexual minority status and the odds of any lifetime experience of nonsuicidal self-injury, suicidal thoughts or suicide attempts among Irish youth aged 19-24 years.

RESULTS

Sexual minority youth had 6.6-fold (95% CI 1.7-24.7) increased risk of nonsuicidal self-injury, a 5.0-fold (95% CI 1.3-18.3) increased risk of suicidal ideation, a 7.7-fold (95% CI 1.8-32.0) increased risk of suicide intent and a 6.8-fold (95% CI 1.6-27.6) increased risk of a suicide attempt during their lifetime compared to their heterosexual peers.

CONCLUSIONS

This study shows that emerging adulthood is a period of risk for suicide and nonsuicidal self-injurious behaviour among sexual minority youth.