title: Cross-sectional evidence for a stress-negative affect pathway to substance use among sexual minority girls.
abstract: Sexual minority girls (SMGs) are four times more likely to engage in substance use than are heterosexual girls. A better understanding of the explanatory mechanisms of this disparity is needed to inform prevention and intervention programs. The goal of this study was to conduct a preliminary test of a "stress-negative affect" pathway by examining gay-related victimization and depression as mediators of substance use among SMGs. Adolescent girls (N = 156, 41% SMGs) were recruited from two urban adolescent medicine clinics to participate in an NIH-funded study of adolescent substance use. The average age was 17.0 years old and 57% were nonwhite. Mediation analyses were conducted in a multiple regression framework using SPSS and a mediation macro utilizing bias-corrected bootstrapping. Four models were estimated to test mediated pathways from sexual orientation to gay-related victimization (Mediator 1), to depression symptoms (Mediator 2), and then to each of four substance use variables: cigarettes, marijuana, alcohol, and heavy alcohol use. Significant mediated pathways (mediation tests with 95% CIs) were found for cigarette, alcohol and heavy alcohol use outcome variables. Results provide preliminary support for the minority stress hypothesis and the stress-negative affect pathway, and may inform the development of future prevention and intervention programs.
authors.affiliation: Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. marshalmp@upmc.edu
authors.forename: Michael P
authors.initials: MP
authors.lastname: Marshal
authors.forename: Chad M
authors.initials: CM
authors.lastname: Burton
authors.forename: Deena J
authors.initials: DJ
authors.lastname: Chisolm
authors.forename: Gina S
authors.initials: GS
authors.lastname: Sucato
authors.forename: Mark S
authors.initials: MS
authors.lastname: Friedman
mesh_terms: D000293:Adolescent; D019548:Crime Victims / Q000523:psychology; D005260:Female; D018451:Homosexuality, Male / Q000523:psychology; D006801:Humans; D008297:Male; D008913:Minority Groups / Q000523:psychology*; D012725:Sexual Behavior / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology*; D055815:Young Adult
keywords: adolescence; alcohol; bisexual; gay; lesbian; pediatrics; psychology; sexual orientation
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