Sexual orientation and mental health in a US cohort of children: a longitudinal mediation study.

BACKGROUND: Sexual minorities, including children, are at increased risk for adverse mental health outcomes compared to their heterosexual peers, but longitudinal studies are needed to determine the factors that explain the associations between sexual minority identification and adverse mental health outcomes during this developmental period. We examined longitudinal associations between sexual orientation and mental health over 2 years in a US cohort of children (aged 9-10 at baseline) and two explanatory factors (increased social problems such as getting teased and decreased perceived school safety). We hypothesized that beginning to identify as gay/bisexual and consistently identifying as gay/bisexual would be associated with increases in internalizing (e.g. depression, anxiety) and externalizing (e.g. aggression) problems compared to consistently identifying as heterosexual, and these associations would be partially explained by increased social problems and decreased perceived school safety. METHODS: We used data from Waves 1-3 of the Adolescent Brain Cognitive Development study. The analytic sample included 5,574 children (46.0% female; 55.1% non-Hispanic White). RESULTS: Beginning to identify as gay/bisexual was associated with increased internalizing/externalizing problems, and consistently identifying as gay/bisexual was associated with increased internalizing problems, compared to consistently identifying as heterosexual. For those who consistently identified as gay/bisexual, increased disparities in internalizing problems were partially explained by increased social problems and decreased perceived school safety, and increased disparities in externalizing problems were partially explained by increased social problems. CONCLUSIONS: These findings suggest the health disparities affecting sexual minority children include both internalizing and externalizing problems, and social problems and feeling unsafe at school may be contributing factors.

Differences in clinical presentations of patients seeking care for treatment-resistant depression across sexual orientations and gender identities.

BACKGROUND: Sexual and/or gender minority (SGM) individuals experience higher rates and greater severity of depressive disorders than non-SGM persons. SGM individuals are more likely than non-SGM individuals to seek mental health treatment and to present to treatment with unique characteristics that should be accounted for when considering treatment recommendations. Patients seeking care for treatment-resistant depression (TRD) are offered a variety of evidence-based interventions ranging in modality and invasiveness (eg, psychotherapy and neuromodulation). METHODS: The current study used data from a TRD clinical research program to examine whether SGM (N = 52) and non-SGM (N = 202) patients differed in their clinical presentations and the treatment recommendations offered to them. RESULTS: We found that SGM patients were younger, had a more severe history of childhood trauma, and reported greater current suicidality than non-SGM patients. There were no significant differences in treatment recommendations between groups. CONCLUSIONS: This study adds to nascent literature investigating clinical characteristics of SGM populations seeking mental health care and provides foundational evidence for the unique treatment considerations necessary for SGM individuals seeking treatment for TRD. Research into whether treatment outcomes differ for SGM and non-SGM individuals with TRD is encouraged, given clinical differences in trauma history and suicidality.

Testing the interpersonal theory of suicide in a sample of sexual minority young adults: Attention to within-group differences.

INTRODUCTION: This study investigated demographic differences in interpersonal theory of suicide factors and their associations with suicide attempts among sexual minority young adults. METHODS: 784 sexual minority young adults ages 18-29 (42.7% cisgender men, 42.2% cisgender women, 15.1% transgender/gender diverse; 62.2% non-Hispanic White; 50.5% gay/lesbian, 49.5% bisexual+) completed an online survey assessing lifetime suicide attempts and interpersonal theory of suicide factors. RESULTS: Demographic differences included (1) greater perceived burdensomeness among transgender/gender diverse participants compared to other gender groups; (2) greater acquired capability for suicide and suicide attempts among cisgender men compared to cisgender women; (3) greater acquired capability for suicide among bisexual+ compared to gay/lesbian participants; and (4) a lower number of suicide attempts among Asian/Asian American sexual minority participants compared to most other sexual minority participants. All interpersonal theory of suicide factors were significantly associated with a higher number of suicide attempts, though only perceived burdensomeness and acquired capability for suicide remained significant when examining all three simultaneously. No two- or three-way interactions between interpersonal theory of suicide factors were significant. CONCLUSION: The interpersonal theory of suicide may be useful for understanding suicide attempts in this population, with perceived burdensomeness and acquired capability being particularly relevant to consider.

Aspects of positive identity buffer the longitudinal associations between discrimination and suicidal ideation among bi+ young adults.

OBJECTIVE: Prior research has demonstrated that discrimination is associated with suicidal ideation among bi + individuals, but little is known about resilience factors (both general and bi + specific) that may buffer these associations. This prospective study examined the main and interactive effects of antibisexual discrimination and resilience factors, including general resilience and positive bi + identity factors (community, authenticity, and intimacy), in predicting suicidal ideation at 1- and 2-month follow-up. METHOD: Participants were bi + young adults (N = 396; ages 18-29; 42.7% cisgender men, 42.2% cisgender women, 15.2% transgender/gender diverse individuals; 37.9% racial and ethnic minority individuals) who completed measures of antibisexual discrimination (Brief Antibisexual Experiences Scale), positive bi + identity (Lesbian, Gay, and Bisexual Positive Identity Measure), general resilience (Brief Resilience Scale), and suicidal ideation (Beck Scale for Suicide Ideation) at baseline, and suicidal ideation again at 1- and 2-month follow-up. RESULTS: Greater antibisexual discrimination was significantly associated with increases in suicidal ideation at 1-month follow-up at low levels of community, authenticity, and intimacy, and increases in suicidal ideation at 2-month follow-up at low levels of authenticity. In addition, at high levels of authenticity, greater antibisexual discrimination was significantly associated with decreases in suicidal ideation at 1-month follow-up. In contrast, general resilience did not moderate the associations between antibisexual discrimination and suicidal ideation at 1- or 2-month follow-up. CONCLUSIONS: Results suggest that promoting positive aspects of bi + identity (community, authenticity, and intimacy), but not general resilience, may help attenuate the effects of antibisexual discrimination on suicidal ideation over time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).