Is stress about being LGBTQ different from ordinary teen stress?
A new questionnaire measuring stress tied to being a sexual-minority teenager tracked depression, problem behaviour and drug use, overlapped only modestly with general teen stress, and explained extra variation in outcomes beyond it.
Source
Criterion and Divergent Validity of the Sexual Minority Adolescent Stress Inventory
Study at a glance
- Design
- Cross-sectional — One-time online/in-person survey; SMASI scores correlated with depression, suicidality, problem behaviours and substance use, and compared with a general adolescent stress measure in latent-variable models
- N
- N=346 · 346 gay, lesbian or bisexual adolescents aged 14-17; the optional work subscale was answered only by the roughly 30% with an employment history
- Population
- US sexual-minority adolescents aged 14-17, recruited in person, via social media and through respondent-driven (peer referral) sampling
- Outcome
- Correlations of Sexual Minority Adolescent Stress Inventory (SMASI) scores with CESD-4 depressive symptoms, 12-month suicidality and self-harm, Youth Self Report problem behaviours and substance use; overlap with the Adolescent Stress Questionnaire (ASQ)
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What they did
The researchers surveyed 346 gay, lesbian and bisexual adolescents aged 14 to 17, recruited in person, online and by having participants refer their peers. Teens completed the new Sexual Minority Adolescent Stress Inventory (SMASI), which covers ten kinds of minority stress such as family rejection, social marginalization, internalized homonegativity and a hostile school climate, rated both for their lifetime and for the past 30 days. They also completed a general adolescent stress questionnaire and measures of depressive symptoms, suicidality, self-harm, problem behaviours and substance use. The team checked whether SMASI scores related to these outcomes (criterion validity), whether they overlapped only partly with general stress (divergent validity), and whether adding minority stress to statistical models improved prediction beyond general stress.
What they found
Lifetime minority stress correlated with depressive symptoms (r = 0.32) and more strongly with externalizing problem behaviour (r = 0.60) and illicit drug use (r = 0.47), but not with marijuana use. Recent (30-day) minority stress was linked to suicidal ideation, suicide attempts and self-harm, whereas lifetime scores were not. Correlations between the minority-stress and general-stress measures were only small to moderate, and the two latent stress factors correlated at just 0.27. Adding minority stress to models that already contained general stress increased the variance explained for most outcomes, especially problem behaviours and tobacco, prescription drug and illicit drug use.
The limits
What it doesn't show
All data were collected at a single time point, so the study cannot show that minority stress causes depression or drug use; distressed teens might also report more stress. Every measure was self-reported, and the sample was reached through social media and peer referral, so teens who are not out to anyone are probably under-represented. The questionnaire was validated using a 102-item candidate pool, so the final 64-item version might behave slightly differently when given on its own. Subgroups by race, ethnicity and sexual identity were too small to compare properly.
Key terms
- Minority stress theory
- The idea that people from stigmatized groups face extra, chronic stressors linked to that identity, such as discrimination or fear of rejection, which help explain their poorer health.
- Criterion validity
- Evidence that scores on a measure relate to outcomes they theoretically should relate to, such as a stress scale correlating with depression.
- Divergent validity
- Evidence that a measure is not simply a copy of a different construct, shown by only modest correlations with a measure of that other construct.
- Distal vs proximal stressors
- Distal stressors are external events like harassment or family rejection; proximal stressors are internal, such as expecting rejection or negative feelings about one's own identity.
- Respondent-driven sampling
- A recruitment method in which participants pass referral codes to peers, used to reach hidden or hard-to-find populations.
- Latent variable
- An unobserved construct, such as 'minority stress', estimated statistically from several observed subscale scores.
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Quiz yourself
What did the researchers conclude from the small-to-moderate correlations between the SMASI and the general stress questionnaire?
Common questions
Why not just use an ordinary stress questionnaire with LGBTQ teens?
General stress measures miss experiences tied specifically to sexual identity, such as being forced to come out or hearing anti-gay jokes from friends. This study found that minority-stress scores explained extra variation in outcomes even after general stress was already in the model.
Does this prove that minority stress causes mental-health problems?
No. The survey measured everything at the same moment, so the links are correlations. Longitudinal studies that measure stress first and outcomes later are needed to test causation.
Why might recent stress relate to suicidality but lifetime stress relate to drug use?
The authors suggest that acute distress like suicidal thoughts may track what is happening right now, while outcomes like drug use may take time to develop after stressful experiences, for example through changes in peer groups.
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