Risk of Heavy Drinking among Sexual Minority Adolescents: Indirect Pathways through Sexual Orientation-Related Victimization & Affiliation with Substance-Using Peers
AIMS:
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.
DESIGN:
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.
SETTING:
Two large
urban adolescent health clinics in Pennsylvania and Ohio, USA.
PARTICIPANTS:
290
adolescents (ages 14-19, mean: 17) who were 71% female, 33% non-Hispanic White,
and 34% SMAs.
MEASUREMENTS:
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.
FINDINGS:
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).
CONCLUSIONS:
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.
- 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.
- Addiction. 2016 Mar 28. doi: 10.1111/add.13409.
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