The Impact of Bully Victimization and Substance Use on Suicidal Behavior in Sexual Minority Youth

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Estoup, Ashley Christine
suicidality; bully victimization; sexual orientation; substance use; adolescents; Clinical Psychology
thesis / dissertation description
Bully victimization has been shown to be associated with a variety of problems in adolescence. Adolescent bully victims endorse higher rates of substance use, suicidal ideation, and suicide attempts. One possible explanation is that adolescents who are bullied use substances to cope with victimization and turn to suicidal behaviors when this coping mechanism proves ineffective. Sexual orientation is one variable that is believed to moderate these relationships. Non-heterosexual youth are more likely to be victimized by peers, engage in substance use, and experience suicidality. The purpose of this study was to explore the relationships between bully victimization, substance use, suicidality, and sexual orientation in a national sample of adolescents. I hypothesized that bully victimization will be positively associated with suicidality and substance use will mediate this relationship. I also predicted sexual orientation would moderate all relationships. Data was drawn from the Youth Risk Behavior Surveillance System survey, a large-scale survey measuring health-risk behaviors contributing to death and disability in youth. The survey contains questions about frequency of bully victimization, engagement in substance use, and prevalence of suicidal behaviors. Participants are also asked about a variety of demographic variables, including sexual orientation. Adolescents in this study completed the survey in 2015. Half of the participants were male, with a mean age of 16. The sample was representative of the U.S. population, with 45.0% identifying as non-Hispanic White, 33.5% as Hispanic, 10.9% as non-Hispanic Black, and 10.7% identifying as Other. A moderated mediation model revealed that the indirect effect of bully victimization through substance use to suicidality was significant for heterosexual (b = .029, SE = .003, CI99 = .022, .038) and sexual minority (b = .040, SE = .009, CI99 = .020, .066) adolescents. Sexual orientation moderated the relationships between bully victimization and substance use and bully victimization and suicidality. It did not moderate the relationship between substance use and suicidality. Results suggest that sexual minority youth are at an increased risk for substance use and suicidality when victimized. Results also highlight the importance of addressing bully victimization when providing mental health and substance use services to adolescents.