Sexual Assault and Co-Occurrence of Mental Health Outcomes Among Cisgender Female, Cisgender Male, and Gender Minority U.S. College Students.

PURPOSE: The aim of this study was to examine the co-occurrence of mental health (depression, anxiety, nonsuicidal self-injury, and suicide ideation) and substance use outcomes among cisgender female, cisgender male, and gender minority college students exposed to sexual assault (SA). METHODS: Data were drawn from a 2018 U.S. national survey of college student well-being (N = 50,438). Inverse propensity-weighted three-step latent class analysis was used to examine co-occurrence of outcomes while adjusting for 31 potential confounders of the relation between SA and outcome classes. RESULTS: Four latent classes were identified for cisgender female and male participants and two for gender minority participants, reflecting a range from low to high risk of co-occurring outcomes. SA was associated with significantly and substantially increased odds (odds ratio: 2.03-3.64) of membership to the highest-risk outcome class compared with the lowest-risk class across gender identity subgroups. CONCLUSIONS: SA in the college setting is associated with substantially increased odds of co-occurring depression, anxiety, nonsuicidal self-injury, and suicide ideation, regardless of gender identity.