Sexual minority mental health: investigating the association between sexual identity, depressive symptoms and suicide attempts in a community sample of adolescents

Abstract

Background: Previous studies have highlighted the elevated risk of depression and suicidality among sexual minority youth (SMY). However, few studies have investigated effect modifiers of the association between sexual identity and depressive symptomology. Methods: We used data from a community sample of adolescents (n = 465) to describe differences between heterosexual and SMY in depression symptom counts assessed over the adolescent period and lifetime history of suicide attempts by late adolescence. We used negative binomial regression to adjust for relevant confounders of the association between sexual identity and depressive symptoms. We used logistic regression to investigate the association between sexual identity and lifetime odds of suicide attempt, while adjusting for relevant confounders. We conducted a stratified analysis to investigate the role bullying plays in depressive symptoms among heterosexual and SMY. We also examined whether maternal connection, social support, or emotion dysregulation modified the association between sexual identity and depressive symptomology. Results: We found that SMY experienced higher levels of depressive symptomology (Symptom Count Ratio: 1.36; 95% CI: 1.15, 1.61; p < 0.001) and higher odds of lifetime suicide attempt (OR: 6.65; 95% CI: 2.72, 16.27, p<0.0001). We also found that SMY were more likely to report being bullied; and among both heterosexual and SMY, those who experienced more bullying reported higher depressive symptoms. We found that maternal connection was an effect modifier of the association between sexual identity and depressive symptomology. Conclusion: SMY reported more depressive symptoms and were more likely than heterosexual youth to have experienced a suicide attempt. The association between SMY and depressive symptoms was weaker among youth who reported stronger connection with their mothers. Interventions to strengthen parent-child relationships could contribute towards reducing mental health disparities for SMY.