Resilience Through Social Support: An Intersectional Analysis of Sexual Minority Women's Social Resources for Wellbeing.

Sexual minority women (SMW) are at higher risk for a range of health conditions (e.g. depression, anxiety, and alcohol use disorder) than heterosexual women. However, poor health outcomes do not occur for all SMW. Resilience provides a lens for understanding why some SMW maintain good mental and behavioral health despite the presence of multiple risk factors. Few studies have examined the resilience-promoting factor of social support in relation to depression, anxiety, and alcohol use disorder in SMW. There is a need for further research clarifying sources of social support (e.g. family, significant others, friends, LGBTQ+ community) associated with resilient outcomes for SMW. This study used data from a telephone-based survey of 520 SMW to examine the relationships between resilience and social support. We used multiple regression and tested for interactions with ethnoracial identity and sexual identity. Greater levels of overall social support were associated with greater resilience, as was social support from the LGBTQ+ community in particular. There were few differences in these relationships by ethnoracial identity, sexual identity, or their intersections. Interventions that increase social support across any of four support sources appear to have the potential to increase resilience and decrease mental and behavioral health risks for SMW.

Ethnoracial Differences in Past Year Victimization Rates for a National Sample of Gender and Sexual Minority Adolescents.

Little research exists on victimization for gender and sexual minority adolescents (GSMA) of color. This study identifies differences in past year rates across six victimization types for GSMA by ethnoracial identification. Descriptive analyses were conducted on 1,177 GSMA (14-19 years old), with victimization types stratified by ethnoracial identification and multiple logit regression was used to identify differences. Compared to White (non-Hispanic) peers, Black (non-Hispanic) GSMA reported lower victimization rates across multiple categories with two exceptions. Higher rates of racially biased physical assault were noted among Black (non-Hispanic) and bi/multi-ethnoracial GSMA. Higher rates of witnessing community violence were reported by Black (non-Hispanic), bi/multi-ethnoracial, and Latinx GSMA. To address GSMA's needs, we need to understand the differential risk so that our interventions are responsive to the diversity within this community.

Trans adolescents' perceptions and experiences of their parents' supportive and rejecting behaviors.

Transgender (trans) adolescents consistently report higher rates of adverse mental health outcomes compared to their cisgender peers. Parental support is a recognized adolescent protective factor; however, little is known about the specific parental behaviors that trans adolescents perceive as most or least supportive. To address this gap, we analyzed data from qualitative interviews conducted with an ethnically diverse, urban-based sample of trans adolescents (N = 24; 16-20 years old) to describe (a) the spectrum of specific parental behaviors across 3 categories-rejecting, supportive, and mixed (i.e., simultaneous supportive and rejecting behaviors)-and (b) the perceived psychosocial consequences across these 3 categories of parental behaviors. Qualitative data were gathered through lifeline interviews (i.e., visual representations from birth to present) and photo elicitation (i.e., photographs representing parental support and/or rejection). Supportive behaviors included instances where parents made independent efforts to learn about trans issues or help their child obtain gender-affirming health care. Rejecting behaviors included instances when parents refused to use their child's name or pronouns or failed to show empathy when their child struggled with gender-identity-related challenges. Mixed behaviors included examples when parents expressed support of their child's gender identity, but not of their sexual orientation (or vice versa). Overall, participants reported that rejecting and mixed parental behaviors contributed to a range of psychosocial problems (e.g., depression and suicidal ideation), while supportive behaviors increased positive wellbeing. These findings expand upon descriptions of parental support and rejection within the trans adolescent literature and can help practitioners target specific behaviors for interventions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

LGBTQ Microaggressions and Microaffirmations in Families: Scale Development and Validation Study.

Subtle experiences of both invalidation and support are common for LGBTQ adolescents within their family systems. LGBTQ microaggressions increase the risk for negative health outcomes, while small acts of support and affirmation can bolster adolescent wellbeing. Research on family-level microaggressions and microaffirmations is limited, due to the absence of a theoretically informed and psychometrically tested measure of these constructs. To address this gap, we designed the LGBTQ Microaggressions and Microaffirmations in Families Scale. Using a large national sample of LGBTQ adolescents (N = 952, 14-19 years old), the current article presents the (1) process of item generation, (2) descriptives of scale items, (3) scale's confirmatory factor structure, and (4) indicators of scale reliability and validity. The scale's four-factor structure was confirmed, while demonstrating good reliability and predictive validity. The scale provides researchers with a psychometrically valid measure to assess the lifetime frequency and correlates of LGBTQ microaggressions and microaffirmations.

Exploring Bullying Perpetration and Victimization Among Adolescent Girls in the Child Welfare System: Bully-Only, Victim-Only, Bully-Victim, and Noninvolved Roles.

Childhood abuse is a common experience for youth in the child welfare system, increasing their risk of bullying perpetration and victimization. Little research exists that has examined the rates of bullying perpetration and victimization for child welfare-involved adolescent girls. The study addressed the following aims: (a) to generate frequency estimates of physical, nonphysical, and relational forms of bullying perpetration and victimization; (b) to identify the frequency of bully-only, victim-only, bully-victim, and noninvolved roles; and (c) to identify risk and protective factors that correlate with these bullying role types. Participants were 236 girls (12-19 years) in the child welfare system from a Midwestern urban area. Participants were referred to the study to join a trauma-focused group program. Seventy-five percent of the total sample were youth of color, with the remaining 25% identifying as White, non-Hispanic. Data were collected through baseline surveys that assessed childhood abuse, bullying perpetration and victimization, posttraumatic stress, substance misuse, aggression-related beliefs and self-efficacy, placement type, placement instability, and mental health service use. Child welfare-involved adolescent girls were found to assume all four major role types: bully-only (6.4%, n = 15), victim-only (20.3%, n = 48), bully-victim (44.1%, n = 104), and nonvictims (29.2%, n = 69). The bully-victim rate was approximately 7 times higher than the rate found in a nationally representative sample of non-child welfare-involved youth. The current study identified posttraumatic stress disorder (PTSD) symptoms, anger self-efficacy, and alcohol use as significant correlates of bullying roles. The identification of a substantially higher rate of bully-victims has important practice implications, suggesting child welfare and school systems adopt trauma-informed systems of care. Bully-victims are very likely traumatized children who are in need of effective trauma treatment rather than punitive sanctions.

Advancing Research on LGBTQ Microaggressions: A Psychometric Scoping Review of Measures.

Understanding the nature and consequences of LGBTQ microaggressions is critical to fostering equity and wellbeing among sexual and gender minorities. Yet little guidance is available for researchers seeking psychometrically robust measures of subtle LGBTQ slights, invalidations, and insults. To address this gap, we conducted a scoping review of multi-item quantitative measures that included at least one question addressing LGBTQ microaggressions. This article reports the study characteristics and psychometric properties of 27 original measures we identified and their subsequent adaptations. The article concludes with an assessment of strengths and limitations of LGBTQ microaggression measurement, highlighting aspects of measurement innovation on which future researchers can build. As microaggressions remain a powerful and underexplored mechanism of sexual and gender minority oppression, this review will help to both advance methodological quality in this critical research area and enhance our understanding of how microaggressions manifest in the lives of LGBTQ individuals.

A Systematic Review of Family Victimization Experiences Among Sexual Minority Youth.

Sexual minority youth experience substantially higher rates of family victimization than their heterosexual peers. No systematic review has yet identified the predictors and consequences in this vulnerable population of childhood abuse, exposure to sibling abuse and domestic violence, and sibling aggression. This systematic review aims to (a) describe differences in these family victimization rates by sexual orientation, gender, and race/ethnicity; (b) identify potential sexual minority and non-sexual minority-specific risk factors; and (c) identify physical, mental, and behavioral health and extrafamilial victimization correlates. The systematic review, which followed PRISMA guidelines, yielded 32 articles that met study inclusion criteria. Rates of childhood physical, sexual, and emotional abuse were consistently higher for sexual minority youth than for their heterosexual peers. Bisexual youth appear to be at greater risk for physical abuse than their gay and lesbian peers. Younger age at sexual minority milestones (first awareness, disclosure, and same-sex sexual contact) and higher levels of sexual minority-specific (sexuality disclosure, gender non-conformity) and non-sexual minority-specific (delinquent behaviors, parental drinking) risk factors were associated with higher rates of family victimization. Sexual minorities who experienced some form of childhood abuse reported more frequent physical (higher rates of HIV, higher BMIs, lower levels of perceived health), mental (higher rates of depression, PTSD symptoms, experiential avoidance, internalized homophobia), and behavioral (higher rates of suicidality, substance misuse, earlier sexual debut, unprotected anal sex) health problems relative to heterosexual or non-abused sexual minority peers. Sexual minority females who experienced childhood physical or sexual abuse were at greater risk than abused sexual minority males for sexual assault later in life. We conclude this systematic review with recommendations for future research, including the necessity for longitudinal research that utilizes a poly-victimization conceptual framework to identify the developmental pathways connecting risk factors, different types of family victimization, and health and extrafamilial victimization consequences.

Conducting Anonymous, Incentivized, Online Surveys With Sexual and Gender Minority Adolescents: Lessons Learned From a National Polyvictimization Study.

Sexual and gender minority adolescents represent an understudied and hard-to-reach population who experience higher rates of mental and behavioral health problems in comparison to their cisgender, heterosexual peers. Online surveys and the proliferation of Internet-connected devices among adolescents offer an exciting opportunity for researchers to begin addressing research gaps and past methodological limitations with these hard-to-reach populations. The purpose of this article is to provide guidance to researchers who are designing and implementing anonymous, incentivized, online surveys by examining the following critical domains-(a) recruitment and engagement: means of leveraging social media and videos to recruit and engage a more nationally representative sample; (b) safety and protection: strategies for administering informed consent and protecting participant anonymity and well-being; and (c) data integrity: mechanisms to detect dishonest and repeat responders. To facilitate discussion of these aims, concrete examples are used from SpeakOut-a 3-year, national study funded by the National Institute of Justice that utilized an anonymous, incentivized, online survey with a large sample of sexual and gender minority adolescents ( N = 1,177) to identify the prevalence, incidence, and correlates of polyvictimization. The article concludes with lessons learned from this national study and recommendations for technological innovations and future research that will strengthen the utility of anonymous, incentivized, online surveys to study sexual and gender minority adolescents and other hard-to-reach populations.

Bullying Victimization Trajectories for Sexual Minority Adolescents: Stable Victims, Desisters, and Late-Onset Victims.

Sexual minority adolescents are bullied more frequently than heterosexual peers. Research is lacking on their rates of general and sexual orientation bullying victimization. The present study identified (1) the rate, onset, and desistance of general and sexual orientation bullying victimization, (2) the rate of bullying victimization trajectories, and (3) risk and protective factors across trajectories. A life history calendar method and thematic analysis were employed with a sexual minority adolescent sample (N = 52, 14-20 y/o). General bullying began at age 5 and declined after age 12, with sexual orientation bullying increasing throughout adolescence. Late-onset victim (34.6%) was the most common trajectory, followed by stable victim (28.9%), desister (23.1%), and nonvictim (13.5%). Differences in risk and protective factors were found across trajectories.

Challenging Conventions of Bullying Thresholds: Exploring Differences between Low and High Levels of Bully-Only, Victim-Only, and Bully-Victim Roles.

Using a commonly accepted threshold of 2 to 3 times per month as a marker of bullying-involvement from noninvolvement, approximately 30% of U.S. students report being a bully, victim, or both. Although variation in the frequency of involvement exists, infrequent engagement (less than 2 to 3 times a month) is generally considered noninvolved. However, the question remains: Do these differences have implications for behavioral health patterns, including substance use, depression and school connectedness? The present study used a district-wide random cluster sample of 66 middle and high schools in a mid-size city. The study population consisted of 3,221 middle school (53.4%) and high school (45.6%) students, with 48.7% females, 44.6 males, and 6.7% youth identifying with another gender category. These youth were racially diverse, with the modal category being Black (36.0%). Based on student survey response, we report, (a) the frequency and intensity of bullying behaviors, (b) common patterns of involvement, and (c) demographic and individual-level risk factors associated with these patterns. Analyses resulted in nine bully types, with substantial differences in bullying-involvement intensity based on gender, race, school connectedness, and mental health. Perhaps most striking, the majority of youth (70.9%) were involved in some level of bullying perpetration, victimization, or both, when accounting for the accumulation of low frequency involvement (e.g., once, twice, or a few times) across multiple bullying behaviors. Implications for adolescent development and prevention are described.

Social Ecological Correlates of Family-Level Interpersonal and Environmental Microaggressions Toward Sexual and Gender Minority Adolescents.

Microaggressions are associated with mental and behavioral health problems and are common experiences for sexual and gender minority adolescents (SGMA). Little is known about the social ecological correlates of family-level interpersonal and environmental microaggressions for SGMA. Utilizing a national sample of SGMA (N = 1,177), this study (a) identified the frequencies of family-level interpersonal and environmental microaggressions by participant demographics and (b) examined individual-, family-, and structural-level factors associated with interpersonal and environmental microaggressions. Outness to parents, a transgender or genderqueer identity, and higher levels of gender role non-conformity were associated with higher frequencies of interpersonal microaggressions. Higher levels of family-level child maltreatment and religiosity were associated with higher frequencies of interpersonal and environmental microaggressions. State-level non-discrimination protections were associated with lower frequencies of environmental microaggressions. Suggestions for increased individual-level support for gender non-binary adolescents as well as family targeted preventive strategies are discussed. Areas for future research are highlighted.

Social Ecological Correlates of Polyvictimization among a National Sample of Transgender, Genderqueer, and Cisgender Sexual Minority Adolescents.

Polyvictimization is a common experience for youth in the United States, with 20% nationally experiencing five or more different forms of victimization in the last year. Utilizing a large, national convenience sample of sexual and gender minority adolescents (N = 1177, 14-19 years old), the current study aimed to (a) generate the first estimates of last year polyvictimization (including nine victimization subtypes) for transgender, genderqueer, and cisgender (i.e., assigned birth sex aligns with gender identity) sexual minority adolescents and (b) identify social ecological correlates of last year polyvictimization. The study utilized an online survey advertised through Facebook and community organizations across the United States. Approximately, 40% of participants experienced ten or more different forms of victimization in the last year and were classified as polyvictims. A significantly higher percentage of transgender female (63.4%), transgender male (48.9%), genderqueer assigned male at birth (71.5%) and genderqueer assigned female at birth (49.5%) were polyvictimized in comparison to cisgender sexual minority males (33.0%). Polyvictimization rates for cisgender sexual minority females (35.1%) were not significantly different from male counterparts (33.0%). Several significant risk factors for polyvictimization were identified: genderqueer identity for participants assigned male at birth and higher-levels of posttraumatic stress, family-level microaggressions, and peer rejection. The manuscript concludes with recommendations for future research including the exploration of factors (e.g., lack of community support, gender-role policing) associated with higher polyvictimization rates for genderqueer adolescents. Additionally, professionals (e.g., foster care, homeless shelters, schools) require new tools to assess for polyvictimization among sexual and gender minority adolescents.

Pathways From Bullying Perpetration, Victimization, and Bully Victimization to Suicidality Among School-Aged Youth: A Review of the Potential Mediators and a Call for Further Investigation.

In the wake of several highly publicized adolescent suicides attributed to bullying victimization, national attention has been brought to bear on the profound public health problem of bullying. This article reviews the extant literature on the associations between bullying perpetration, victimization, and thoughts of or attempts at suicide and proposes five potential mediators, namely depression, anxiety, low self-esteem, loneliness, and hopelessness, that may explain this relationship. Numerous studies have found empirical support for the interrelations between internalizing behaviors and both bullying perpetration and victimization and suicide. We find that further longitudinal research needs to be conducted to more conclusively determine the role and causal ordering these various psychosocial factors may play in bullying perpetration, victimization, and suicide. Although the research literature implies causal directions among all these potential mediators, untangling the unique influence of bullying perpetration, victimization, and bully victimization on suicide and its mechanisms of action has major research and practice implications.

A conceptual framework for understanding the association between school bullying victimization and substance misuse.

This article reviews current research findings and presents a conceptual framework for better understanding the relationship between bullying victimization (hereafter referred to as victimization) and substance misuse (hereafter referred to as SM) among adolescents. Although victimization and SM may appear to be separate problems, research suggests an intriguing relationship between the 2. We present a brief, empirical overview of the direct association between victimization and adolescent SM, followed by a proposed conceptual framework that includes co-occurring risk factors for victimization and SM within family, peer, and school and community contexts. Next, we discuss potential mediators linking victimization and SM, such as internalizing problems, traumatic stress, low academic performance, and school truancy and absence. We then identify potential moderating influences of age, gender and sex, social supports, and school connectedness that could amplify or abate the association between victimization and SM. Finally, we discuss practice and policy implications.

Social participation among young adults with an autism spectrum disorder.

Investigating social participation of young adults with an autism spectrum disorder (ASD) is important given the increasing number of youth aging into young adulthood. Social participation is an indicator of life quality and overall functioning. Using data from the National Longitudinal Transition Study 2, we examined rates of participation in social activities among young adults who received special education services for autism (ASD group), compared to young adults who received special education for intellectual disability, emotional/behavioral disability, or a learning disability. Young adults with an ASD were significantly more likely to never see friends, never get called by friends, never be invited to activities, and be socially isolated. Among those with an ASD, lower conversation ability, lower functional skills, and living with a parent were predictors of less social participation.

Bullying involvement and autism spectrum disorders: prevalence and correlates of bullying involvement among adolescents with an autism spectrum disorder.

OBJECTIVES: To produce nationally representative estimates for rates of bullying involvement among adolescents with an autism spectrum disorder (ASD), to compare population estimates with adolescents who have other developmental disabilities, and to identify social ecological correlates of bullying involvement. DESIGN: Nationally representative surveys from 2001. SETTING: United States. PARTICIPANTS: Parents of adolescents with an ASD, principals of the schools they attended, and staff members most familiar with their school programs. MAIN EXPOSURE: Autism spectrum disorders. MAIN OUTCOME MEASURES: Parent report of victimization, perpetration, and victimization/perpetration within the past school year. RESULTS: The prevalence rates of bullying involvement for adolescents with an ASD were 46.3% for victimization, 14.8% for perpetration, and 8.9% for victimization/perpetration. Victimization was related to having a non-Hispanic ethnicity, attention-deficit/hyperactivity disorder, lower social skills, some form of conversational ability, and more classes in general education. Correlates of perpetration included being white, having attention-deficit/hyperactivity disorder, and getting together with friends at least once a week. Victimization/perpetration was associated with being white non-Hispanic, having attention-deficit/hyperactivity disorder, and getting together with friends at least once a week. CONCLUSIONS: School-based bullying interventions need to target the core deficits of ASD (conversational ability and social skills) and comorbid conditions (eg, attention-deficit/hyperactivity disorder). Future bullying interventions also need to address the higher rates of victimization that occur in general education settings by increasing social integration into protective peer groups and increasing the empathy and social skills of typically developing students toward their peers with an ASD.

Postsecondary education and employment among youth with an autism spectrum disorder.

OBJECTIVES: We examined the prevalence and correlates of postsecondary education and employment among youth with an autism spectrum disorder (ASD). METHODS: Data were from a nationally representative survey of parents, guardians, and young adults with an ASD. Participation in postsecondary employment, college, or vocational education and lack of participation in any of these activities were examined. Rates were compared with those of youth in 3 other eligibility categories: speech/language impairment, learning disability, and mental retardation. Logistic regression was used to examine correlates of each outcome. RESULTS: For youth with an ASD, 34.7% had attended college and 55.1% had held paid employment during the first 6 years after high school. More than 50% of youth who had left high school in the past 2 years had no participation in employment or education. Youth with an ASD had the lowest rates of participation in employment and the highest rates of no participation compared with youth in other disability categories. Higher income and higher functional ability were associated with higher adjusted odds of participation in postsecondary employment and education. CONCLUSIONS: Youth with an ASD have poor postsecondary employment and education outcomes, especially in the first 2 years after high school. Those from lower-income families and those with greater functional impairments are at heightened risk for poor outcomes. Further research is needed to understand how transition planning before high school exit can facilitate a better connection to productive postsecondary activities.

Mental health service use among adolescents with an autism spectrum disorder.

OBJECTIVE: This study examined prevalence and correlates of mental health service use among adolescents with an autism spectrum disorder. METHODS: Data from the National Longitudinal Transition Study-2 were used to examine mental health service use among 920 youths with this disorder. Estimates are nationally representative of students enrolled in the special education autism category. Regression models examined the association of predisposing, enabling, and need factors with service use overall and with a focus on receiving these services at school. RESULTS: Overall, 46% (weighted) of the youths had used a mental health service in the past year. Of those who had, 49% (weighted) had received it at school. Need variables were the strongest correlates of service use. African-American youths and youths from lower-income families were more likely to receive school-based services. CONCLUSIONS: Schools played a key role in providing services, especially for vulnerable populations. Focused attention on youths with an autism spectrum disorder is needed to ensure continuity of care as youths leave high school.

Psychosocial resources and barriers to self-management in African American adolescents with type 2 diabetes: a qualitative analysis.

PURPOSE: The purpose of this qualitative study was to identify psychosocial resources and barriers to self-management among African American adolescents with type 2 diabetes and their mothers. METHODS: African American adolescents (n = 10) aged 14 to 19 years old with type 2 diabetes for >1 year and their mothers (n = 10) were recruited from the pediatric diabetes clinic of a large medical center practice. Participants were independently interviewed and responded to a series of open-ended questions concerning illness experiences and resources and barriers to diabetes self-management. This study used a modified grounded theory approach to data coding and analysis. RESULTS: Adolescents and mothers shared similar perceptions of resources and barriers to self-management. Resources included mother's role as the primary support person, emergence of greater self-efficacy and coping over time, family recognition of the seriousness of diabetes, and the presence of supportive peers. Barriers included comorbidity, dietary and other regimen challenges, negative peer influences, and financial problems. CONCLUSIONS: Resources and barriers identified in this study represent the multiple contexts that influence type 2 diabetes (eg, individual, family, peer, economic, and cultural).