The Association Between Sexual Identity, Depression, and Adolescent Substance Use
Springer Science and Business Media LLC - Trang 1-8 - 2023
Tóm tắt
Sexual minority youth (SMY) represent a population vulnerable to several adverse health consequences. Specifically, SMY experience depression and substance use at substantially higher rates than heterosexual peers. Better understanding the relationship between depression and substance use among SMY may help reduce morbidity and mortality. We hypothesize that depression will moderate increased substance use rates seen in SMY. Weighted logistical analyses of covariance, adjusted for race/ethnicity, sex, and age, compared the relationship between sexual identity, depression, and substance use (14 outcomes), using data from the 2019 Youth Risk Behavior Survey (n = 13,677) of high school students. SMY reported depression at rates nearly double than heterosexual peers (63.9% vs 33.0%). Except for vaping and alcohol, SMY had significantly higher odds of all SU (aORs 1.41–2.45, p < 0.001–0.0011). After adjusting for depression, odds of all SMY substance use decreased; most relationships remained significant (aORs 0.73–1.89), though the relationship between SMY and lifetime cannabis use became non-significant. The relationship between SMY and current vaping became significant and the relationship between SMY and alcohol and binge-drinking remained non-significant. SMY are at higher risk for use of most substances and depression compared to heterosexual youth. As depression consistently plays a role in the relationship between sexual minority status and adolescent substance use across a wide variety of substances, it may be a modifiable risk factor for substance use among sexual minority youth that should be screened for and treated. This study additionally provides important information for future studies examining nuances of SMY substance use patterns.
Tài liệu tham khảo
Johnston LD, Miech RA, Patrick ME, O’Malley PM, Schulenberg JE, Bachman JG (2023) Monitoring the future national survey results on drug use 1975–2022: Overview, key findings on adolescent drug use. Institute for Social Research University of Michigan, Ann Arbor
Marshal MP et al (2008) Sexual orientation and adolescent substance use: a meta-analysis and methodological review. Addiction 103(4):546–556
Felner JK et al (2020) Stress, coping, and context: examining substance use among LGBTQ young adults with probable substance use disorders. Psychiatr Serv 71(2):112–120
Saewyc EM (2011) Research on adolescent sexual orientation: development, health disparities stigma and resilience. J Res Adolesc 21(1):256–272
Meyer IH (2003) Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull 129(5):674–697
Lucassen MF et al (2017) Sexual minority youth and depressive symptoms or depressive disorder: A systematic review and meta-analysis of population-based studies. Aust N Z J Psychiatry 51(8):774–787
Swendsen J (2000) The comorbidity of depression and substance use disorders. Clin Psychol Rev 20(2):173–189
Davis L et al (2008) Major depression and comorbid substance use disorders. Curr Opin Psychiatry 21(1):14–18
Calarco CA, Lobo MK (2021) Chapter six: depression and substance use disorders: clinical comorbidity and shared neurobiology. In: Calipari ES, Gilpin NW (eds) International review of neurobiology. Academic Press, Cham, pp 245–309
Sullivan MD et al (2006) Association between mental health disorders, problem drug use, and regular prescription opioid use. JAMA Intern Med 166(19):2087–2093
Samet S et al (2013) Effects of independent and substance-induced major depressive disorder on remission and relapse of alcohol, cocaine and heroin dependence. Addiction 108(1):115–123
Hasin D et al (2002) Effects of major depression on remission and relapse of substance dependence. Arch Gen Psychiatry 59(4):375–380
Centers for Disease C (2020) YRBS Data User’s Guide.
Feinstein BA (2020) The rejection sensitivity model as a framework for understanding sexual minority mental health. Arch Sex Behav 49(7):2247–2258
D’Avanzo PA et al (2017) Personality and its relation to mental and psychosocial health in emerging adult sexual minority men: the P18 cohort study. Behav Med 43(3):191–199
Hatzenbuehler ML (2009) How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychol Bull 135(5):707–730
Schuler MS, Collins RL (2020) Sexual minority substance use disparities: bisexual women at elevated risk relative to other sexual minority groups. Drug Alcohol Depend 206:107755
London-Nadeau K et al (2021) Longitudinal associations of cannabis, depression, and anxiety in heterosexual and LGB adolescents. J Abnorm Psychol 130(4):333–345
Goodenow C et al (2016) Sexual orientation trends and disparities in school bullying and violence-related experiences, 1999–2013. Psychol Sex Orientat Gend Divers 3(4):386–396
Williams T et al (2005) Peer victimization, social support, and psychosocial adjustment of sexual minority adolescents. J Youth Adolesc 34(5):471–482
Saewyc EM et al (2009) Protective factors in the lives of bisexual adolescents in North America. Am J Public Health 99(1):110–117
Bos HM et al (2008) Same-sex attraction, social relationships, psychosocial functioning, and school performance in early adolescence. Dev Psychol 44(1):59–68
Bontempo DE, D’Augelli AR (2002) Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths’ health risk behavior. J Adolesc Health 30(5):364–374
Hatzenbuehler ML et al (2015) Structural stigma and sexual orientation disparities in adolescent drug use. Addict Behav 46:14–18
Busseri MA et al (2008) On the association between sexual attraction and adolescent risk behavior involvement: examining mediation and moderation. Dev Psychol 44(1):69–80
Birkett M, Espelage DL, Koenig B (2009) LGB and questioning students in schools: the moderating effects of homophobic bullying and school climate on negative outcomes. J Youth Adolesc 38(7):989–1000
Eisenberg ME et al (2020) Supportive community resources are associated with lower risk of substance use among lesbian, gay, bisexual, and questioning adolescents in Minnesota. J Youth Adolesc 49(4):836–848
Watson RJ et al (2020) Associations between community-level LGBTQ-supportive factors and substance use among sexual minority adolescents. LGBT Health 7(2):82–89
Craig SL et al (2020) Frequencies and patterns of adverse childhood events in LGBTQ+ youth. Child Abuse Negl 107:104623
Baams L et al (2021) Childhood trauma and bullying-victimization as an explanation for differences in mental disorders by sexual orientation. J Psychiatr Res 137:225–231
Nydegger LA et al (2020) 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. PLoS ONE 15(8):e0236880
Clements-Nolle K et al (2018) Sexual identity, adverse childhood experiences, and suicidal behaviors. J Adolesc Health 62(2):198–204
Russell ST, Fish JN (2016) Mental health in lesbian, gay, bisexual, and transgender (LGBT) Youth. Annu Rev Clin Psychol 12(1):465–487
Ploderl M, Tremblay P (2015) Mental health of sexual minorities. A systematic review. Int Rev Psychiatry 27(5):367–385
Lewis NM (2009) Mental health in sexual minorities: recent indicators, trends, and their relationships to place in North America and Europe. Health Place 15(4):1029–1045
McClain Z, Peebles R (2016) Body image and eating disorders among lesbian, gay, bisexual, and transgender youth. Pediatr Clin N Am 63(6):1079–1090
Roberts AL et al (2012) Elevated risk of posttraumatic stress in sexual minority youths: mediation by childhood abuse and gender nonconformity. Am J Public Health 102(8):1587–1593
Strutz KL, Herring AH, Halpern CT (2015) Health disparities among young adult sexual minorities in the U.S. Am J Prev Med 48(1):76–88
Morgan EMVD, Manfred HM (2021) Sexuality in emerging adulthood. Oxford University Press
Bettinsoli ML, Suppes A, Napier JL (2019) Predictors of attitudes toward gay men and lesbian women in 23 countries. Soc Psychol Personal Sci 11(5):697–708