Sunday, April 3, 2016

Risk of Heavy Drinking among Sexual Minority Adolescents: Indirect Pathways through Sexual Orientation-Related Victimization & Affiliation with Substance-Using Peers

To test two indirect pathways through which sexual minority adolescents (SMAs) may be at risk for heavy episodic drinking (HED) including a socialization pathway via substance-using peer affiliations and social marginalization pathway via sexual minority-specific victimization and subsequent substance-using peer affiliations.

Analysis of the first three waves (six-months apart) of a longitudinal adolescent health risk study (2011-2014). Participants were referred by medical providers or a screening system in providers' waiting rooms.

Two large urban adolescent health clinics in Pennsylvania and Ohio, USA.

290 adolescents (ages 14-19, mean: 17) who were 71% female, 33% non-Hispanic White, and 34% SMAs.

Self-reported sexual minority status (wave 1) and affiliation with substance-using peers (waves 1 and 2), and latent sexual-minority specific victimization (waves 1 and 2) and HED (waves 1 and 3) variables.

Using mediation analyses in a structural equation modeling framework, there was a significant indirect effect of sexual minority status (wave 1) on HED (wave 3) via affiliation with substance-using peers (wave 2; indirect effect = 0.03, 95%CI: 0.01, 0.07), after accounting for the indirect effect of sexual-orientation related victimization (wave 2; indirect effect = .10, 95%CI: 0.02-0.19). The social marginalization pathway was not supported as victimization (wave 1) was not associated with affiliation with substance-using peers (wave 2; β = -.04, p = .66). Sex differences in the indirect effects were not detected (ps > .10).

Sexual minority adolescents in the US appear to exhibit increased heavy episodic drinking via an indirect socialization pathway including affiliations with substance-using peers and a concurrent indirect pathway involving sexual minority-related victimization. The pathways appear to operate similarly for boys and girls.

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  • 1Department of Psychology, University of Pittsburgh.
  • 2Department of Psychiatry, School of Medicine, University of Pittsburgh.
  • 3Department of Pediatrics, School of Medicine, University of Pittsburgh.
  • 4Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital. 
  •  2016 Mar 28. doi: 10.1111/add.13409. 

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