Sarah S Dermody1, Michael P Marshal2,3, Chad M Burton2, Deena J Chisolm4. 1. Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA. 2. Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. 3. Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. 4. Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, OH, USA.
Abstract
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 (6 months apart) of a longitudinal adolescent health risk study (2011-14). 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: A total of 290 adolescents (ages 14-19 years, mean: 17.08) who were 71.0% female, 33.4% non-Hispanic white and 34.5% 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% confidence interval (CI) = 0.01, 0.07], after accounting for the indirect effect of sexual-orientation related victimization (wave 2; indirect effect = 0.10, 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 = - 0.04, P = 0.66). Sex differences in the indirect effects were not detected (Ps > 0.10). CONCLUSIONS: Sexual minority adolescents in the United States 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.
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 (6 months apart) of a longitudinal adolescent health risk study (2011-14). 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: A total of 290 adolescents (ages 14-19 years, mean: 17.08) who were 71.0% female, 33.4% non-Hispanic white and 34.5% 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% confidence interval (CI) = 0.01, 0.07], after accounting for the indirect effect of sexual-orientation related victimization (wave 2; indirect effect = 0.10, 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 = - 0.04, P = 0.66). Sex differences in the indirect effects were not detected (Ps > 0.10). CONCLUSIONS: Sexual minority adolescents in the United States 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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