Relationships Between Suicide Attempts and Sexual Orientation Among Lesbian, Gay and Bisexual Youths

1
Relationships Between Suicide Attempts and Sexual
Orientation Among Lesbian, Gay and Bisexual
Youths

• Arnold H. Grossman, PhD, MSW
• New York University
• Anthony R. DAugelli, PhD
• Penn State University
• Daniel E. Bontempo, M.A.
• Penn State University
• APHA Convention, Boston, MA
• October 24, 2001
• Research supported by grant MH58155 from National
  Institute of Mental Health

2
The Q Project An Overview

• investigating the mental health consequences of
  victimization in a large sample (500) lgb youths
• obtaining a diverse (e.g., SES, ethnicity) sample
  of youths from community-based organizations
• using a longitudinal design, each youth is being
  interviewed 3 times over a two-year period
• measuring different forms of victimization (e.g.,
  sexual orientation, ethnic identity)
• measuring resilience (e.g., support, coping)
• making a direct linkage of sexual identity issues
  to mental health outcomes

3
Goals

• to determine the kinds of victimization
  experienced by lgb youth ages 15 to 21
• to determine the frequency of mental health
  problems among lgb youth
• to examine the relationship between verbal
  harassment and physical violence on mental health
  problems of lgb youth
• to identify characteristics of youth who cope
  successfully with victimization from those who
  show mental health problems
• to identify characteristics of lgb youths that
  predict suicidal thinking and suicide attempts

4
Research Sites

• selecting sites 1 urban and 2 suburban agencies
  providing services to lgb youth
• developing partnerships with agencies
• learning culture of agencies
• learning experiences of agencies with previous
  research collaborations, i.e., resulting likes
  and dislikes

5
Recruiting Youth

• first wave self-identified lgb youth, 15-19,
  commitment to three interviews
• monetary incentives for 3-hour structured
  interviews
• drop-in/lounge programs and special events
• snowball and respondent-driven sampling using
  youths networks
• appointment cards and reminder calls

6
Protecting Youth

• waiving of parental consent
• creating role of Youth Advocate
• obtaining federal certificate of confidentiality
• developing protocols for addressing mental health
  crises and referring youth
• developing protocols for reporting abuse and
  neglect and referring youth
• establishing a toll free telephone number
• separating youths identity from research data

7
Protecting Youth (continued)

• recruiting masters-level clinicians
  (certification/license preferred) with previous
  experience with adolescents (lgb preferred)
• assigning same interviewers (when possible) for
  all 3 interviews

8
Tracking and Retaining Youth

• tracking information
• check-in system and raffle every 3 months
• awarding prizes at youths programs
• Youth Coordinators Project Aides roles
• Youth Advocates role

9
Assessment of Suicidality

• Past and present ideation
• Relationship of ideation to sexual orientation
• Past suicide attempts (, relationship to S.O)
• Clinician judgment of severity of attempt
• Suicidal ideation in the last year

10
Differences between Suicide Attempters and
Non-attempters

• Demographic characteristics
• Sexual orientation development milestones
• Self-esteem (Rosenberg)
• Internalized homophobia (Shidlo)
• Mental health symptoms
• General (Brief Symptom Inventory)
• Trauma-related (Trauma Checklist 40)
• Psychological Physical Maltreatment Scale

11
Differences between Suicide Attempters and
Non-attempters

• Victimization History
• Sexual-Orientation Related
• Verbal Victimization (abuse, threats)
• Physical Victimization (hit, punched)
• Sexual Victimization (assault, rape)

12
This presentation is based on Wave 1 interviews
the first 361 youths (187 males and 174
females)Data collected from June 1999 to March
200132 reported suicide attempts39 of
females and 26 of males
13
Suicide Attempt Patterns

• More females than males have sometimes or often
  thought about suicide in their lives (28 vs.
  19)
• More males than females lifetime suicidal
  ideation relates to sexual orientation (23 vs.
  4)
• More females (39) than males (26) make attempts
• Of the attempters, 25 make potentially lethal
  attempts 29 make serious life-threatening
  attempts

14
Suicide Attempt Patterns

• One sexual orientation milestone difference
  Attempters were called sissy/tomboy at earlier
  ages
• Attempters reported significantly more
  psychological and physical abuse as children from
  the person who raised them (highly significant
  differences)
• Attempters have heard more negative comments
  about being lgbt from family based on religious
  views

15
Mental Health DifferencesAttempters

• Had lower self-esteem
• Reported less personal mastery
• Reported more perceived stress in their lives
• Had higher overall symptomatology (BSI)
• Had higher trauma symptom scores (TSC 40)
• Did NOT use more drugs of any kind
• Had higher personal homonegativity scores

16
Mental Health DifferencesAttempters

• Reported more overall fears that led to their
  hiding their sexual orientation
• Reported more fears related to being in school
• Reported more fears of rejection and abuse from
  parents and siblings at home
• Reported higher overall levels of verbal abuse
  based on their sexual orientation
• Reported higher percentages of posttraumatic
  stress disorder

17
Victimization Differences

• More physical abuse reported by attempters (55)
  vs. non-attempters (36)
• More overall sexual abuse reported by attempters
  (51) vs. non-attempters (24)
• Attempters reported more physical abuse based on
  sexual orientation (15) than non-attempters (8)
• Attempters reported more sexual abuse based on
  their sexual orientation (13) vs. non-attempters
  (4)

18
Suicidality Issues

• Attempters report more lifetime suicidal ideation
• No differences were found between attempters and
  non-attempters in the degree to which their
  suicidal ideation was about their SO
• Within the last year, 15 of the females reported
  suicidal ideation compared to 13 of the males
• Within the last year, 15 of the males reported
  suicidal ideation related to their SO compared to
  6 of the females

19
Past Mental Health Services

• More attempters (86) than non-attempters (69)
  have ever talked to a professional about personal
  problems related to suicidal ideation or attempts
• More attempters (32) than non-attempters (11)
  had been in psychiatric hospitals for suicidal
  ideation or attempts

20
Research Limitations

• Convenience sample in a greater metropolitan area
• Self-reported data
• Youth self-identified as lesbian, gay or bisexual
• Youth had access to and attended agencies
  providing services to lesbian, gay and bisexual
  adolescents and young adults
• Cross-sectional data from the first Wave of a
  longitudinal study