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Citation
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Gordon JH, Tran KT, Visoki E, Argabright S, DiDomenico GE, Saiegh E, Hoffman KW, Erez G, Barzilay R. J. Am. Acad. Child Adolesc. Psychiatry 2023; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: Sexual minority (SM) youth experience greater mental health burden compared to their heterosexual peers. The aims of the present study were to (1) characterize mental health disparities among SM compared to non-SM youth, (2) test main and interactive associations of SM identity and stressors targeting SM youth at the individual-level (interpersonal-SM-discrimination) and structural-level (state-level structural-SM-stigma) with youth mental health, and (3) explore the contribution of interpersonal-SM-discrimination to the mental health burden of SM youth.
METHOD: Participants were N=11,622 youth (ages 9-13, 47.6% assigned-female-at-birth) from the Adolescent Brain Cognitive Development (ABCD) Study. Linear mixed-effects models tested main and interactive associations of SM identity, interpersonal-SM-discrimination, and structural-SM-stigma with mental health measures (self-reported overall psychopathology, suicidal ideation, and suicide attempts), adjusting for demographics and other interpersonal stressors not specific to SM (other discrimination types, peer victimization and cyberbullying). Longitudinal mediation models tested whether interpersonal-SM-discrimination mediated the associations between SM identity and mental health measures.
RESULTS: SM youth (n=1,051) experienced more interpersonal-SM-discrimination and overall psychopathology compared to their non-SM peers (n=10,571). There were significant associations (main effects) of interpersonal-SM-discrimination and structural-SM stigma with overall psychopathology adjusting for demographics. When further adjusting for other non-SM related stressors, main effect of structural-SM-stigma was no longer significant. Interpersonal-SM-discrimination was also significantly associated with suicidal ideation and attempt accounting for demographics, while structural-SM-stigma was not. Accounting for both demographics and other non-SM stressors, there was a significant interaction between SM identity and structural-SM-stigma in association with psychopathology (P=0.02), such that, compared to their peers, SM youth showed a greater association between structural-SM-stigma and psychopathology. Longitudinal mediation revealed that interpersonal-SM-discrimination was a significant mediator explaining ∼10-15% of the variance of the pathways between SM identity and all mental health outcomes.
CONCLUSION: Results delineate contributions of interpersonal discrimination and structural stigma targeting SM to their heightened mental health burden in early adolescence.
FINDINGS underscore the need to address microlevel and macrolevel SM-discrimination and structural stigma when caring for this population.
Language: en |