LIBRARY
Michigan State
University

 

 

 

This is to certify that the
thesis entitled

THE ASSOCIATIONS BETWEEN SEXUAL ORIENTATION AND
PSYCHOPATHOLOGY, SUBSTANCE USE,
AND EXPERIENCES OF VIOLENCE:
RESULTS FROM A NATIONALLY REPRESENTATIVE
LONGITUDINAL STUDY

presented by

Brooke M. Bluestein

has been accepted towards fulfillment
of the requirements for the

MA. degree in Psychology

 

 

’IW

 

v

V Major Professor’s Signature
8 '3 (a ‘ i a
Date

MSU is an Affirmative Action/Equal Opportunity Employer

.-. A-c-a‘s‘.-o-v-"‘--

 

u.-v-.--.—.---a--.-.-n--.- A--

PLACE IN RETURN BOX to remove this checkout from your record.
TO AVOID FINES return on or before date due.
MAY BE RECALLED with earlier due date if requested.

 

DATE DUE DATE DUE DATE DUE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5/08 K:IProj/Acc&Pres/ClRC/DateDue.rndd

THE ASSOCIATIONS BETWEEN SEXUAL ORIENTATION AND
PSYCHOPATHOLOGY, SUBSTANCE USE, AND EXPERIENCES OF VIOLENCE:
RESULTS FROM A NATIONALLY REPRESENTATIVE LONGITUDINAL STUDY

By

Brooke M. Bluestein

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF ARTS
Psychology

2010

ABSTRACT
THE ASSOCIATIONS BETWEEN SEXUAL ORIENTATION AND
PSYCHOPATHOLOGY, SUBSTANCE USE, AND EXPERIENCES OF VIOLENCE:
RESULTS FROM A NATIONALLY REPRESENTATIVE LONGITUDINAL STUDY
By
Brooke M. Bluestein
Previous research has found that gay, lesbian, and bisexual (GLB) adolescents

exhibit an increased rate of a wide range of psychosocial problems during adolescence.
However, the majority of the research with GLB adolescents has been conducted with
small, non—generalizable, convenience samples. In addition, although it has repeatedly
been suggested that overt social support, particularly from friends, might moderate the
relationship between sexual orientation and a number of the negative outcomes that have
been found in previous research, very few studies have empirically examined the role of
peer support for GLB adolescents. The present study examined the associations between
romantic attraction (exclusively heterosexual, exclusively homosexual, and bisexual) and
psychopathology, substance use, and experiences of violence using data drawn from the
public-use National Longitudinal Study of Adolescent Health (Wave 1: n = 5586; Wave
3: n = 4681). Results indicated that although GLB adolescents are more likely than
heterosexual adolescents to experience a wide range of negative outcomes, these results
generally are not found in young adulthood (with the exceptions of depression and
suicidal ideation). Furthermore, although previous research has suggested that peer
support may serve a protective function for GLB adolescents, results indicated that a high

level of social support was associated with more smoking, negative consequences of

alcohol intoxication, and requiring medical attention following a physical fight.

ACKNOWLEDGEMENTS

This research is based on data from the Add Health project, a program project
designed by J. Richard Urdy (principal investigator) and Peter Bearman and funded by
grant POI-HD31921 from the National Institute of Child Health and Human
Development to the Carolina Population Center, University of North Carolina at Chapel
Hill, with cooperative funding participation by the National Cancer Institute; the National
Institute on Alcohol Abuse and Alcoholism; the National Institute on Deafness and Other
Communication Disorders; the National Institute on Drug Abuse; the National Institute of

General Medical Sciences; the National Institute of Mental Health; the National Institute

" ‘r-rrrcrm

of Nursing Research; the Office of AIDS Research, National Institutes of Health (NIH);
the Office of Behavior and Social Science Research, NIH; the Office of the Director,
NIH; the Office of Research on Women’s Health, NIH; the Office of Populations Affairs,
Department of Health and Human Services (DHHS); the National Center for Health
Statistics, Centers for Disease Control and Prevention, DHHS; the Office of Minority
Health, Centers for Disease Control and Prevention, DHHS; the Office of the Assistant
Secretary for Planning and Evaluation, DHHS; and the National Science Foundation.
Persons interested in obtaining data files from the National Longitudinal Study of
Adolescent Health should contact the Inter-University Consortium for Political and

Social Research (ICPSR).

iii

TABLE OF CONTENTS

LIST OF TABLES ........................................................................................................... v
LIST OF FIGURES ......................................................................................................... vi
INTRODUCTION ............................................... . ........................................................... 1
The Current Study ................................................................................................ 8
METHOD ........................................................................................................................ 8
Participants ........................................................................................................... 10
Measures .............................................................................................................. 11
Sexual Orientation ................................................................................... 11
Race/Ethnicity .......................................................................................... 1 2
Socioeconomic Status (SES) .................................................................... 12
Psychopathology ...................................................................................... l 3
Substance Use and Abuse ........................................................................ 13
Fighting and Violence .............................................................................. 15
Social Support .......................................................................................... 16
RESULTS ........................................................................................................................ 16
Correlations between Sexual Orientation and Outcome Variables ...................... 16
Wave 1 ................................................................................................................. 17
Wave 3 ................................................................................................................. 20
DISCUSSION .................................................................................................................. 21
Negative Psychosocial Outcomes for GLB Adolescents ..................................... 21
Moderating Effect of Social Support ................................................................... 22
Negative Psychosocial Outcomes for GLB Young Adults .................................. 25
Limitations and Future Directions ....................................................................... 27
Conclusion ........................................................................................................... 30
REFERENCES ................................................................................................................ 55

iv

Table 1.

Table 2.

Table 3.

Table 4.

Table 5.

Table 6.

Table 7.

Table 8.

Table 9.

LIST OF TABLES

Means and standard deviations for the included variables ................................ 3]
Correlations and reliability coefficients for the variables included at Wave l..33
Correlations and reliability coefficients for the variables included at Wave 3..36
Regressions for psychopathology outcome variables at Wave 1 ....................... 39
Regressions for substance use outcome variables at Wave 1 ............................ 41
Regressions for experiences of violence outcome variables at Wave 1 ............ 44
Regressions for psychopathology outcome variables at Wave 3 ....................... 47
Regressions for substance use outcome variables at Wave 3 ............................ 48
Regressions for experiences of violence outcome variables at Wave 3 ............ 50

'-""' ‘w‘n in» mun-13m
al

_ _‘_'I

LIST OF FIGURES
Figure 1. Interaction between sexual orientation and peer support on smoking ............. 52

Figure 2. Interaction between sexual orientation and peer support on negative
consequences of alcohol intoxication .............................................................................. 53

Figure 3. Interaction between sexual orientation and peer support on requiring medical
attention afier a physical fight .......................................................................................... 54

vi

The Associations between Sexual Orientation and Psychopathology, Substance Use, and
Experiences of Violence:
Results from a Nationally Representative Longitudinal Study

There is a considerable body of research which suggests that gay, lesbian, and
bisexual (GLB) adolescents regularly fail to reach their full social, psychological, and
academic potential within the modern American education system (Besner & Spungin,
1995; Bontempo & D’Augelli, 2002; D’Augelli, 2002; Gray, 1999; Kosciw, 2004;
Lipkin, 1995; Russell, Seif, & Truong, 2001; Schneider & Owens, 2000; Schneider,
Farberow, & Kruks, 1989; Unks, 1995; van Wormer & McKinney, 2003; Woog, 1995).
For the vast majority of American adolescents, the high school environment is an
extremely important element in the maintenance of a sense of psychosocial well-being.
Specifically, because a large portion of time in an adolescent’s life is consumed by both
school and activities that are related to school (e. g., homework, athletics, extracurricular
activities), the high school environment has the potential to greatly impact the
psychosocial well-being of adolescents (Larson & Richards, 1994).

Furthermore, during the developmental period of adolescence, the peer group
often becomes the most important component of an adolescent’s interpersonal world
(B103, 1962). In other words, the interpersonal dynamic of the adolescent peer group can
greatly influence the psychosocial welfare of adolescents either positively or negatively.
According to Erikson, “Young people can become remarkably clannish, intolerant, and
cruel in their exclusion of others who are ‘different”’ (1968, p. 132). For the unfortunate
adolescents whose primary experiences with the peer group are negative, the long-term

impact on the adolescent’s psychosocial development can be costly. Specifically, the

adolescent is at a greater risk of developing a wide array of negative psychosocial
outcomes, such as a greater sense of loneliness, poor self-esteem, a lack of resiliency, and
poOr academic performance (Larson & Richards, 1994).

In an effort to avoid negative peer group experiences, adolescents often attempt to
assimilate to their group of peers (Erikson, 1968). During the period of adolescence,
conforming to the normative nature of the adolescent peer group is extremely important
for interpersonal success; those individuals who refuse or are unable to conform to the
standards established by the adolescent peer group are consequently at particular risk for
developing undesirable psychosocial outcomes (Larson & Richards, 1994).

In addition, during the period of adolescence, the actual composition of the peer
group is often altered. Specifically, the peer group begins to incorporate members of
both genders, a phenomenon which creates the opportunity for romantic relationships to
flourish. It has been argued that during the period of adolescence, individuals generally
experience their first stirrings of romantic attraction towards other individuals (Savin-
Williams, 1998). However, even in this seemingly personal arena, conforming to the
normative standard of the adolescent peer group is essential to maintaining one’s position
in the group of peers. For those adolescents whose romantic and sexual attractions do not
correspond with the general consensus of the peer group (e. g., GLB adolescents), there
arises yet another reason for being ostracized from one’s established group of peers.

The developmental period of adolescence can be difficult for the majority of
American adolescents, and for some, the tumultuous nature of adolescence is even more

pronounced (Arnett, 1999). For adolescents who do not conform to the normative

standard of the peer group, the developmental period of adolescence may be even more
arduous and uncomfortable.

Consequently, it is not surprising that a number of researchers have found that
GLB adolescents exhibit increased rates of problematic behavior during adolescence.
According to Harbeck (1992):

The experience of acquiring a homosexual or bisexual identity places the

teenager at risk for dysfunction, in part because of the stigma attached to

homosexuality in contemporary American society. Gay, lesbian, and

bisexual adolescents may be at a higher risk of dysfunction because of

their unfulfilled developmental needs for identification with a peer group,

lack of positive role modeling influences and experiences, negative

societal pressures, and their dependence upon parents and educators who

may be unwilling or unable to provide emotional support concerning the

issue of homosexuality. (p. 16)
Previous research has repeatedly found that GLB adolescents demonstrate a greater
incidence of psychosocial problems than do their heterosexual counterparts. However,
this is not to say that GLB adolescents exhibit psychosocial problems that are
categorically different from those of heterosexual adolescents; rather, the research
indicates that GLB adolescents merely demonstrate a significantly higher rate of a
number of common adolescent problems (e. g., psychopathology, substance abuse)
compared to heterosexual adolescents.

For instance, GLB adolescents report more symptoms of psychopathology than do

heterosexual adolescents. Prior studies with GLB adolescents have found that they are

more likely to endorse symptoms of depression (Gonsiorek, 1988; Russell & Joyner,
2001) and suicidality (e. g., suicidal thoughts, plans, or attempts) than are heterosexual
adolescents (D’Augelli, 2002; D’Augelli & Hershberger, 1993; D’Augelli, Hershberger,
& Pilkington, 2001; Grossman & Kemer, 1998; King, 1997; Lewinsohn, Rohde, &
Seeley, 1996; Russell, 2003; Russell & Joyner, 2001). In fact, the Massachusetts
Governor’s Commission on Gay and Lesbian Youth (1993) found that gay and lesbian
youth accounted for approximately one—third of all completed youth suicides;
furthermore, the Commission concluded that gay and lesbian adolescents may actually be
two or three times more likely to attempt suicide than heterosexual adolescents.
According to previous research, poor relationships with family, hostile school and social
environments, and a lack of peer support may be associated with the increased incidence
of suicidality in GLB adolescents (D’Augelli & Hart, 1987; Gonsiorek, 1988;
Radkowsky & Siegel, 1997; Russell et al., 2001b).

In addition to exhibiting an increased risk of psychopathology, a number of
studies have also found that GLB adolescents are more likely to engage in substance use
and substance abuse than are heterosexual adolescents. Specifically, one study reported
that out of the 37 gay and lesbian adolescents that were interviewed for the study, 36
admitted to alcohol and substance abuse (Uribe & Harbeck, 1992). Similarly, a different
study found evidence of significant alcohol and drug abuse among a sample of gay and
lesbian youth (Jordan, 2000). This is especially noteworthy given that a previous study
with a large, racially diverse sample of adolescents reported that 51.5 percent of
adolescents have used alcohol in the past 30 days, but only 30.8 percent have consumed

five or more drinks in a row in the past two weeks (Wallace, Bachman, O’Malley,

Johnston, Schulenberg, & Cooper, 2002). In addition, a study of rural high school
students reported significantly more marijuana and alcohol use among gay and lesbian
adolescents than among heterosexual adolescents (Rostosky, Owens, Zimmerman, &
Riggle, 2003). Finally, when compared to heterosexual adolescents, one study found that
bisexual adolescents were more likely to smoke cigarettes, get drunk, drink alone,
experience problems caused by drinking, use marijuana, and use other drugs (Russell,
Driscoll, & Truong, 2002).

Further, GLB adolescents frequently withstand blatant acts of harassment,
bullying, and violence within the American education system. Kevin Jennings, the
executive director of the Gay, Lesbian, and Straight Education Network (GLSEN),
suggests, “Lesbian, gay, bisexual, and transgendered (LGBT) students face harassment
and violence, and most schools do nothing about it” (2000, p. 285). GLSEN conducts a
national survey of gay and lesbian adolescents every two years (The National School
Climate Survey). In the 2007 National School Climate Survey, 86.2% of GLBT high
school students reported verbal harassment and 44.1% of GLBT high school students
reported physical harassment that was directly in relation to their perceived sexual
orientation. Not surprisingly, 60.8% of GLBT high school students reported feeling
unsafe at school. Similarly, a study of same sex romantic attraction and experiences of
violence during adolescence found that adolescents who reported either same-sex or
both-sex romantic attraction were more likely than adolescents who reported only
opposite-sex romantic attraction to experience extreme forms of violence (e.g., being
involved in a fight that required medical attention; being jumped; being cut, stabbed, or

shot; Russell, Franz, & Driscoll, 2001). While the majority of the literature on sexual

orientation and experiences of violence is focused on acts of violence against GLB
persons, one study examined the relationship between sexual orientation and the
perpetration of violence; this study found that GLB participants were more likely to
perpetrate violence than were heterosexual adolescents (Russell et al., 2001a).

The majority of the research with GLB adolescents has been conducted with
small, non-generalizable, convenience samples. However, there is a small body of
previous research (Russell et al., 2001a; Russell et al., 2001b; Russell et al., 2002; Russell
& Consolacion, 2003; Russell & Joyner, 2001) that has attempted to remedy a number of
the methodological problems that can be found in this field of study. These studies
utilized the National Longitudinal Study of Adolescent Health (Add Health; Udry, 2003)
to examine a variety of outcome variables (e.g., suicide risk, substance use and abuse,
experiences of violence) in a large, nationally representative sample of adolescents. In
the present study, we will attempt to replicate these findings using the public—use Add
Health dataset, which contains only one half of the core sample and one half of the well
educated African-American oversample, chosen at random. Furthermore, we will expand
this body of research in two ways.

First, it is imperative to note that there are a number of factors that may
differentially affect the relationship between sexual orientation and negative psychosocial
outcomes. For instance, it has repeatedly been suggested that overt social support,
particularly from friends, might moderate the relationship between sexual orientation and
a number of the negative outcomes that have been found in previous research (D’Augelli
& Hart, 1987; Gonsiorek, 1988; Radkowsky & Siegel, 1997; Russell et al., 2001b).

Nevertheless, very few studies have empirically examined the role of peer support for

GLB adolescents. Of the studies that have investigated the impact of friendship and peer
support, it has generally been found that GLB adolescents do not feel well supported by
peers (Hershberger & D’Augelli, 1995; Martin & Hetrick, 1988; Radkowsky & Siegel,
1997; Sullivan & Wodarski, 2002). Furthermore, a small number of previous studies
have found a significant relationship between peer support and negative psychosocial
outcomes in GLB adolescents (Garofalo, Wolf, Kessel, Palfrey, & DuRant, 1998;
Williams, Connolly, Pepler, & Craig, 2005). However, to date, no study has examined
the influence of peer support on a wide variety of psychosocial outcomes for GLB
adolescents using a large, nationally representative dataset. Thus, the current study will
augment the existing literature on this understudied population by examining whether or
not peer support is able to moderate the relationship between sexual orientation and
negative outcomes in a nationally representative dataset.

Second, a wide body of literature has indicated that many of the negative
psychosocial outcomes that have been identified in GLB adolescents (e.g., higher rates of
depression, suicidality, and substance use) can also be found in samples of GLB adults
(Herrell et al., 1999; Hughes & Eliason, 2002; Mills et al., 2004). Nevertheless, only a
small number of studies have examined a sample of GLB individuals at more than one
time point. Furthermore, the studies tend to either follow the participants for a maximum
of 12 months (Lackner et al., 1993; Rosario, Schrimshaw, Hunter, & Gwadz, 2002) or are
focused exclusively on a public health issue such as the transmission of HIV (Martin &
Dean, 1993; McKusnick, Coates, Morin, Pollack, & Hoff, 1990). Therefore, the current
study will be able to contribute to the extant literature by investigating the psychosocial

outcomes of a community sample of GLB and heterosexual participants during

adolescence as well as seven years later to determine if a similar pattern of outcomes can
be found at both periods of time.
The Current Study

Using a nationally representative, longitudinal dataset, the present study will
examine the associations between romantic attraction (exclusively heterosexual,
exclusively homosexual, and bisexual) and psychopathology, substance use, and
experiences of violence. In the present study, it is hypothesized that, in general, GLB
adolescents will exhibit significantly worse outcomes than heterosexual adolescents; for
the, purposes of this study, a poor outcome is characterized by increased
psychopathology, greater substance use, and/or more experiences of violence.
Specifically, it is hypothesized that GLB adolescents will exhibit significantly worse
outcomes than heterosexual adolescents at Wave 1 (Hypothesis 1). However, because
much of the literature suggests that the poor outcomes observed in GLB individuals may
be due to a lack of social support (D’Augelli & Hart, 1987; Gonsiorek, 1988; Radkowsky
& Siegel, 1997; Russell et al., 2001b), it is hypothesized that peer support will moderate
the relationship between a homosexual or bisexual romantic attraction and subsequent
psychopathology, substance use, and experiences of violence (Hypothesis 2). Finally, it
is hypothesized that these negative outcomes will also be seen in young adulthood, and
that GLB individuals will once again exhibit significantly worse outcomes than
heterosexual individuals at Wave 3 (Hypothesis 3).

Method
The data for the present study were drawn from the National Longitudinal Study

of Adolescent Health (Add Health; Udry, 2003). This is a nationally representative

l ongitudinal study, which has been collected in four waves between 1994 and 2008; the
present study will use the first and third waves of data collection.

The sampling process for Add Health began by identifying all of the high schools

i m the United States with a minimum of 30 enrolled students (N = 26,666). The schools

were then stratified into 80 clusters by their geographic region (Northeast, Midwest,

South, West), urbanicity (urban, suburban, rural), school size (125 or fewer, 126—350,

3 51-775, 776 or more students), school type (public, private, parochial), percent white (0,
l —66, 67—93, 94—100), percent black (0, 1—6, 7—33, 34—100), grade span (K—12, 7—12, 9—
1 2, 10—12), and curriculum (general, vocational/technical, alternative, special education).
Following the stratification of the schools, a random sample of schools was selected from
each of the clusters; of the schools that were selected for inclusion in the project, 79
percent agreed to participate (N = 134).

Among the participating schools, 96 percent (N = 129) allowed their students to
complete a confidential, in-school survey during the course of the 1994-1995 academic
year (N = 90,118). From the rosters of the participating schools, a randomly selected
subsample of the students participated in a subsequent, 90-minute in-home interview
between April and December 1995 (Wave 1 in-home interview: N = 20,745; 10,480
female, 10,264 male). The participants for the in-home interview ranged in age from 11
to 21 years old (M = 16 years, 25th percentile = 14 years, 75"h percentile = 17 years). The
third wave of data collection, which was designed to investigate a number of factors
i nvolved in the transition from adolescence to young adulthood, was collected during an

iii-home interview conducted between August 2001 and April 2002 (N = 15,197; 8,030

female, 7,167 male). At Wave 3, the participants were between 18 and 28 years of age
(J! = 22 years, 25th percentile = 21 years, 75th percentile = 23 years).
The Add Health interviews measured a wide array of social and health domains,

i mcluding physical, mental, and sexual health; exercise and diet; substance use; family,
peer, and romantic relationships; violent and delinquent activity; school policies; and
access to services in the community. A number of the interview questions were collected
by utilizing an audio computer-aided self-interview (Audio-CASI), including the
questions regarding romantic attraction, substance use, and fighting and violence. For the
Audio-CASI portions of the interview, the participants listened to the interview questions
through headphones and recorded their responses on a laptop. Prior research with
adolescents has revealed that there is a large amount of self-disclosure bias when
questions about sensitive behavior are directly asked by an interviewer; consequently,
methods of interviewing that grant the participant a greater sense of privacy have been
found to increase reporting rates. In particular, previous research with adolescents has
found that the Audio-CASI method of interviewing reduces the impact of both
interviewer and parental influences on the participants’ responses to sensitive questions
( Supple, Aquilino, & Wright, 1999; Turner, Ku, Rogers, Lindberg, Pleck, & Sonenstein,
1 998).

Participants

The present study utilized the public-use Add Health data, a subset of the full,

restricted-use dataset. The public-use dataset contains one half of the core sample and
one half of the well educated African-American oversample, chosen at random. At Wave

1 , there are 6503 total participants in the public-use dataset, and at Wave 3, there are

10

4882. In the present study, a portion of the participants were excluded from the data
analysis because they did not indicate a sexual attraction to either gender (Wave 1: n =
847, 13%; Wave 3: n = 160, 3.3%). In addition, two ethnic subgroups were excluded
because of the small sample size of their group: American Indians (Wave 1: n = 38,
0.6%; Wave 3: n = 41, 0.8%) and “Other” (Wave 1: n = 47, 0.7%; this category was not
i mcluded at Wave 3). The final sample (Wave 1: n = 5586; Wave 3: n = 4681) ranged in
age from 11 to 21 (M= 15.57, SD = 1.72) at Wave 1 and 18 to 28 (M= 21.82, SD = 1.81)
at Wave 3. There were slightly more female participants (Wave 1: n = 2938; Wave 3: n =
2531) than male participants (Wave 1: n = 2648; Wave 3: n = 2150). The participants
Were predominantly white (Wave 1: n = 3315; Wave 3: n = 2822), followed by African-
American/Black (Wave 1: n = 1233; Wave 3: n = 1042), Hispanic/Latino/a (Wave 1: n =
587; Wave 3: n = 480), Asian/Pacific Islander (Wave 1: n = 171; Wave 3: n = 165), and
Multiracial (Wave 1: n = 280; Wave 3: n = 172). The samples were cOmprised of more
heterosexual participants (Wave 1: n = 5277; Wave 3: n = 4299) than GLB participants
(Wave 1: n = 380; Wave 3: n = 423).
Measures

Unless otherwise indicated, scale scores were computed for each of the variables
by summing the item responses. Higher scores indicate a greater amount of the variable
(means and standard deviations for the included variables can be found in Table 1).
Sexual Orientation

There are two questions on the in-home survey that measure romantic attractions;
Specifically, “Have you ever had a romantic attraction to a female?” and “Have you ever

had a romantic attraction to a male?” This allows the distinction among exclusively

11

heterosexual participants, exclusively homosexual participants, and bisexual participants
to be made. Therefore, unlike in a number of previous studies, this system of
c: ]assification has the advantage of being able to classify adolescents even if they do not
yet publicly self-identify as GLB. In the present study, the sexual orientation of the
participants is coded dichotomously (0 = heterosexual, 1 = gay, lesbian, or bisexual) to
ensure large enough cell sizes for statistical analysis.
Race/Ethnicity
A measure of race/ethnicity was entered into the regression equations as a control
variable at both Wave 1 and Wave 3. The five racial categories (i.e., Caucasian/White,
African-American/Black, Asian/Pacific Islander, Latino/a, and Multiracial) were dummy
coded prior to the analyses. Because the majority of the sample was Caucasian, the other
groups were compared to this group when creating the dummy variables (1 = identified
racial group, 0 = all other racial groups).
Socioeconomic Status (SES)
An estimate of SES was used as a control variable in the regression equations. At
Wave 1, SES was assessed by the answer to the following question: “Does [the resident
mother] receive public assistance, such as welfare?” (0 = no, 1 = yes). At Wave 3, SES
Was measured by the participant’s response to the following: “Thinking about your
i hcome and the income of everyone who lives in your household and contributes to the
household budget, what was the total household income before taxes in {2000/2001}?
Include all sources of income received by these household members” (total income range:

$ 1 - $602,500).

12

Psychopathology

Depression. Depression was assessed by the participant’s response to nine
questions about how he or she has felt in the past week, including: “You were bothered
by things that usually don’t bother you,” “You felt that you could not shake off the blues,
even with help from your family and your friends,” “You felt that you were just as good
as other people (reverse scored),” “You had trouble keeping your mind on what you were
doing,” “You felt depressed,” “You felt that you were too tired to do things,” “You
enjoyed life (reverse scored),” “You felt sad,” and “You felt that people disliked you” (0
z never or rarely, 1 = sometimes, 2 = a lot of the time, 3 = most of the time or all of the
time). The items that the questionnaire uses to assess depressive symptoms are drawn
from the CBS-D scale, a 20-item self-report depression measure. For the nine items that
Were included at both Wave 1 and Wave 3, Cronbach’s alpha is 0.78 at Wave 1 and 0.81
at Wave 3.

Suicidality. Suicidal ideation was measured by the response to the following
question: “During the past 12 months, did you ever seriously think about committing
Suicide” (0 = no, 1 = yes).

Substance Use and Abuse

Smoking cigarettes. Smoking was indicated by the number of cigarettes a
participant smoked in past 30 days. This was calculated by multiplying the responses to
the following questions: “During the past 30 days, on how many days did you smoke
Cigarettes” (days range: 0 — 30) and “During the past 30 days, on the days you smoked,

how many cigarettes did you smoke each day?” (cigarettes range: 1 — 100).

13

Alcohol use. Alcohol use was assessed by the number of alcoholic beverages a
participant consumed in past 12 months. This was calculated by multiplying the
responses to the following questions: “During the past 12 months, on how many days did
you drink alcohol” (0 = none, 1 = l or 2 days in the past 12 months, 2 = once a month or
1 ess (3 to 12 times in the past 12 months), 3 = 2 or 3 days per month, 4 = 1 or 2 days per
week, 5 = 3 to 5 days per week, 6 = every day or almost every day) and “Think of all the
times you have had a drink during the past 12 months. How many drinks did you usually
have each time? A ‘drink’ is a glass of wine, a can of beer, a wine cooler, a shot glass of

l iquor, or a mixed drink” (drink range: 1 —— 18).

Alcohol intoxication. Alcohol intoxication was calculated using the following
question: “Over the past 12 months, on how many days have you gotten drunk or ‘very,
Very high’ on alcohol” (0 = none, 1 = 1 or 2 days in the past 12 months, 2 = once a month
or less (3 to 12 times in the past 12 months), 3 = 2 or 3 days a month, 4 = 1 or 2 days a
Vveek, 5 = 3 to 5 days a week, 6 = every day or almost every day).

Consequences of alcohol intoxication. The negative consequences of alcohol
intoxication were assessed by the responses to the following nine questions: “Over the
past 12 months, how many times has each of the following things happened? You got
into trouble with your parents because you had been drinking [. . .] You’ve had problems
at school or work because you had been drinking [. . .] You had problems with your
friends because you had been drinking [. . .] You had problems with someone you were
dating because you had been drinking [. . .] You did something you later regretted because
you had been drinking” and “Over the past 12 months, how many times were you hung

over [. . .] were you sick to your stomach or threw up after drinking [. . .] did you get into a

14

sexual situation that you later regretted because you had been drinking [. . .] did you get
into a physical fight because you had been drinking?” (0 = never, 1 = once, 2 = twice, 3 =
3 or 4 times, 4 = 5 or more times; Cronbach’s (1: Wave 1 = 0.79; Wave 3 = 0.73).
Fighting and Violence

The information about experiences of violence includes questions about fighting,
Victimization, witnessing violent behavior, and perpetrating violence; all of the questions
i 11 this section refer to the number of times each event occurred in the past 12 months.

Fighting. Fighting is assessed by the response to the following question: “During
the past 12 months, how many times were you in a physical fight in which you. were
i mjured and had to be treated by a doctor or nurse?” (range: 1 to 56 times).

Victimization. The measure of victimization includes four items: “Someone pulled
a knife or gun on you,” “Someone shot you,” “Someone cut or stabbed you,” and “You
Were jumped” (Wave 1: 0 = never, 1 = once, 2 = more thanonce; Wave 3: 0 = not
marked, 1 = marked; Cronbach’s 0t: Wave 1 = 0.60; Wave 3 = 0.64).

Witnessing violence. The measure of witnessing violent behavior includes the
following item: “You saw someone shoot or stab another person” (Wave 1: 0 = never, 1 =
Once, 2 = more than once; Wave 3: 0 = not marked, 1 = marked)

Perpetrating violence. Measures of perpetrating violence include the following
two items: “You pulled a knife or gun on someone” and “You shot or stabbed someone”

(Wave 1: 0 = never, 1 = once, 2 = more than once; Wave 3: 0 = not marked, 1 = marked;

Cronbach’s 0t: Wave 1 = 0.69; Wave 3 = 0.53).

15

Social Support

The effect of social support was only examined at Wave 1. At Wave 3, there
were only two questions per identified friend because the questions were designed to
traCk the friends who were originally identified at Wave 1, rather than assess the
respondent’s current level of peer support. Consequently, because there was not an
adequate measure of social support at Wave 3, peer support was not included as a
Variable at Wave 3.

Peer support. The participants were asked to describe their relationships with up
to five male friends and up to five female friends. The level of peer support is derived by
taking the sum across the friends for the participant’s response to five questions: “Did
you go to [your fiiend’s] house during the past seven days,” “Did you meet [your friend]
after school to hang out or go somewhere during the past seven days,” “Did you spend
time with [your friend] during the past weekend,” “Did you talk to [your friend] about a
problem during the past seven days,” and “Did you talk to [your friend] on the telephone
during the past seven days” (0 = no, 1 = yes; Cronbach’s or = 0.89).

Results
Correlations between sexual orientation and outcome variables
At Wave 1, sexual orientation was significantly correlated with all of the outcome
Variables. Furthermore, all of the correlations at Wave 1 were in the expected direction
(Table 2). At Wave 3, sexual orientation was positively correlated with depression,
suicidal ideation, alcohol intoxication, consequences of alcohol intoxication, and being

injured during a physical fight. However, at Wave 3, smoking, alcohol use,

16

v ictimization, witnessing violence, and perpetrating violence were not significantly
correlated with sexual orientation (Table 3).

Wave 1

In order to determine if GLB adolescents exhibited significantly worse outcomes

1; Iran heterosexual adolescents (Hypothesis 1) and if peer support would moderate the
_relationship between sexual orientation and the outcome variables (Hypothesis 2), a series
of hierarchical, moderated regressions were performed. For suicidal ideation, which is
the only dichotomous outcome variable, a moderated logistic regression was conducted.
PriOr to being entered into the regression analyses, the moderator (peer support) was
mean centered in order to reduce multicollinearity (Aiken & West, 1991). For each of
the regression equations, a number of control variables were entered as Step 1: age,
gender, race/ethnicity, and an estimate of socioeconomic status. In Step 2, sexual
orientation and the peer support variable were entered. Finally, the interaction between
sexual orientation and peer support was entered in Step 3 of the regression. The results
of the regression analyses can be found in Tables 4, 5, and 6.

Hypothesis 1. Hypothesis 1 proposed that at Wave 1, GLB adolescents would
exhibit more psychopathology, more substance use, and more experiences of violence
than would heterosexual adolescents (Tables 4, 5, and 6). Consistent with our
hypothesis, the results indicated that a GLB sexual orientation was associated with more
depression, suicidal ideation, alcohol use, alcohol intoxication, victimization, witnessing
Violence, and perpetrating violence. There were no significant differences between GLB
and heterosexual adolescents on the smoking, negative consequences of alcohol

intoxication, or being in a physical fight that resulted in an injury measures.

17

Hypothesis 2. Hypothesis 2 posited that peer support would moderate the
relationship between sexual orientation and the outcome variables at Wave 1. The results
indicated that there was a significant interaction between sexual orientation and peer
support for three of the outcome variables: smoking, consequences of alcohol
i ntoxication, and requiring medical attention after a fight. For each of the significant
interactions, the MODPROBE pick-a-point approach was used to probe the interaction
( Hayes & Matthes, 2009). In order to determine whether the impact of the predictor

variable is significantly different from zero, the MODPROBE macro estimates the effect
Of the predictor variable at low, moderate, and high values of the moderator; in other
\words, the MODPROBE macro was used to conduct an analysis of the simple slopes. In
addition, the MODPROBE macro provides several values of Y as a function of the
moderator and the predictor variable in order to create a graphical representation of the

i nteraction. The results of the hierarchical, moderated regressions can be found in Tables

4, 5, and 6 and the significant interactions are displayed graphically in Figures 1, 2, and

3.

For the smoking outcome variable, GLB adolescents had smoked significantly
more cigarettes in the previous 30 days than did heterosexual adolescents at high levels of
Social support (b = 68.14; t(2073) = 3.29, p < 0.01). There was no significant difference
in smoking between GLB and heterosexual adolescents at low (b = -14.27; t(2073) = -
0.67, p > 0.05) and moderate (b = 26.93; t(2073) = 1.80, p > 0.05) levels of social
Support. This suggests that for both GLB and heterosexual adolescents, as the amount of

SOcial support increases, the number of cigarettes smoked in the past 30 days also

18

 

 

 

increases. However, the slope of the regression line for the GLB respondents is steeper
than the slope of the regression line for the heterosexual participants (Figure 1).

A similar pattern was found for the negative consequences of alcohol intoxication
and being involved in a fight that required medical attention. Specifically, there was no
significant difference in the negative consequences of alcohol intoxication between GLB
and heterosexual adolescents at low (b = -0.42; t(2313) = -0.89, p > 0.05) and moderate
(b = 0.48; t(2313) = 1.44, p > 0.05) levels of peer support. However, GLB adolescents
experienced significantly more negative consequences related to alcohol intoxication in
the previous 12 months than did heterosexual adolescents at high levels of peer support (b
= 1.38; t(2313) = 3.12,p < 0.01). An examination of Figure 2 reveals that while the
number of negative consequences of alcohol intoxication remains relatively steady for
heterosexual adolescents across the levels of peer support (increasing by less than 1
between low support and high support), the number of negative consequences related to
alcohol intoxication increases at a steeper rate for GLB adolescents.

Likewise, at high levels of peer support, GLB adolescents were significantly more
1 ikely to have been involved in a fight that required medical attention than were
heterosexual adolescents (b = 4.32; t(2624) = 3.87, p < 0.001). There was no significant
difference in the likelihood of having been involved in a fight that required medical
attention between GLB and heterosexual adolescents at low (b = -1.37; t(2624) = -1.13, p
> 0.05) and moderate (b = 1.47; t(2624) = 1.76, p > 0.05) levels of peer support. Figure 3
Suggests that for heterosexual adolescents, the frequency of needing medical assistance
following a fight remains below one time on average in the past 12 months, regardless of

the amount of social support. However, as the level of peer support increases for GLB

19

adolescents, the average number of times medical attention is required after a fight jumps
from less than one time at low peer support to nearly five times in the last 12 months at
high levels of peer support.

Wave 3

In order to determine if GLB individuals would also exhibit significantly worse
outcomes than heterosexual individuals in young adulthood (Hypothesis 3), a series of
hierarchical regressions were conducted. For suicidal ideation, which is the only
dichotomous outcome variable, a logistic regression was performed. In Step 1, the same
four control variables that were identified at Wave 1 were entered into the regression
equations. In Step 2, the sexual orientation variable was entered. Because the level of
peer support was not adequately assessed at Wave 3, the moderation analyses (Step 3 at
Wave 1) were not conducted at Wave 3. The results of the regression analyses can be
found in Tables 7, 8, and 9.

Hypothesis 3. Hypothesis 3 proposed that at Wave 3, GLB individuals would
exhibit more psychopathology, more substance use, and more experiences of violence
than would heterosexual individuals (Tables 7, 8, and 9). The results indicated that while
there was not a significant difference between GLB and heterosexual young adults on the
measures of alcohol use, alcohol intoxication, smoking, victimization, witnessing
violence, perpetrating violence, and being in a physical fight that resulted in an injury, a
GLB sexual orientation was associated with more depression, suicidal ideation, and
negative consequences of alcohol intoxication. Consistent with our hypothesis, a number
of the outcomes were the same at both time points; specifically, at both Waves 1 and 3,

GLB participants were more depressed and reported more suicidal ideation than

20

heterosexual participants. However, at Wave 3, a number of the outcomes (e. g., alcohol
use, alcohol intoxication, victimization, witnessing violence, and perpetrating violence)
were not significantly different for GLB and heterosexual young adults.
Discussion

The current study was designed to address three primary questions. First, during
the developmental period of adolescence, will GLB individuals exhibit more negative
outcomes than will heterosexual individuals? Second, is peer support able to moderate
the relationship between sexual orientation and negative outcomes? Third, will a GLB
sexual orientation also be associated with a more negative outcome at Wave 3, when the
participants are young adults?
Negative Psychosocial Outcomes for GLB Adolescents

Our results indicated that during the period of adolescence, GLB persons
experienced more negative outcomes than did heterosexual persons across a number of
psychosocial domains, a finding that has been well documented in previous research
(Besner & Spungin, 1995; Bontempo & D’Augelli, 2002; D’Augelli, 2002; Gray, 1999;
Kosciw, 2004; Lipkin, 1995; Russell, Seif, & Truong, 2001; Schneider & Owens, 2000;
Unks, 1995; van Wormer & McKinney, 2003; Woog, 1995). Specifically, the prevalence
of psychopathology (i.e., depression and suicidal ideation) was significantly higher for
GLB adolescents than for heterosexual adolescents. Our results are consistent with a
wide body of prior research (D’Augelli, 2002; D’Augelli & Hershberger, 1993;
D’Augelli, Hershberger, & Pilkington, 2001; Gonsiorek, 1988; Grossman & Kemer,
1998; King, 1997; Lewinsohn, Rohde, & Seeley, 1996; Remafedi, Farrow, & Deisher,

1991; Russell, 2003; Russell & Joyner, 2001), but it is important to recognize that the

21

current study utilized a large, nationally representative, community sample, which has not
often been done in the previous work with the GLB population. In addition, in the
present study, we found that in the 12 months that preceded the survey, GLB adolescents
' had consumed significantly more alcohol and been intoxicated more frequently than
heterosexual adolescents, which is consistent with previous research that has found that
GLB adolescents are more likely to use and abuse substances than are heterosexual
adolescents (Jordan, 2000; Rostosky et al., 2003; Russell et al., 2002; Uribe & Harbeck,
1992). Furthermore, in accordance with previous research (Jennings, 2000; Russell et al.,
2001a), GLB adolescents were significantly more likely to have experienced fighting and
violence than were heterosexual adolescents. In particular, our study found in the prior
12 months, GLB adolescents were more likely to have been victimized, to have witnessed
violence, and to have perpetrated violence. It is particularly noteworthy that the results of
the current study found that GLB adolescents were more likely to perpetrate violence
than were heterosexual adolescents as only one previous study has investigated the
relationship between sexual orientation and the perpetration of violence (Russell et al.,
2001a)
Moderating Effect of Social Support

Much of the literature suggests that the poor outcomes observed in GLB
individuals may be due to a lack of social support (D’Augelli & Hart, 1987; Gonsiorek,
1988; Radkowsky & Siegel, 1997; Russell et al., 2001b). Nonetheless, very few of the
studies with GLB adolescents have empirically investigated this relationship. The current
study was able to address this gap in the extant literature by examining the interaction

between sexual orientation and the level of peer support on a number of outcomes. In

22

particular, the current study hypothesized that peer support would moderate the
relationship between a homosexual or bisexual romantic attraction and subsequent
psychopathology, substance use, and experiences of violence. However, we were unable
to support our hypothesis. Rather, the results indicated that while the interaction between
sexual orientation and peer support was significant for three of the ten outcome variables
(i.e., smoking, consequences of alcohol intoxication, and requiring medical attention after
a fight), a high level of peer support was actually associated with a more negative
outcome for the GLB adolescents.

For the three significant interactions (i.e., smoking, negative consequences of
alcohol intoxication, and requiring medical attention following a physical fight), the
results indicated that although there was not a significant difference between GLB
adolescents and heterosexual adolescents at low and moderate levels of peer support, the
GLB adolescents were significantly more likely to exhibit negative outcomes at high
levels of peer support. Specifically, when peer support was high, GLB adolescents
smoked more cigarettes, experienced more negative outcomes of alcohol intoxication,
and were more likely to seek medical attention after a physical fight than heterosexual
adolescents. This pattern of findings is contrary to what we expected to find. In other
words, because previous research (D’Augelli & Hart, 1987; Gonsiorek, 1988;
Radkowsky & Siegel, 1997; Russell et al., 2001b) has suggested that social support may
serve a protective function for GLB adolescents, it was initially surprising to find more
negative outcomes as social support increased. However, it is important to recognize that
rather than gauging peer support, it is possible that we were actually measuring peer

involvement. In other words, because the majority of the questions asked about the

23

respondents’ identified friends assessed the amount of time spent together outside of
school, it may be more accurate to conceptualize this as a measure of peer involvement,
or popularity. This distinction may be important because there is a body of research on
the correlates of popularity in mainstream adolescents that indicates that popular
adolescents may be more inclined to engage in mild delinquent behavior (Santor,
Messervey, & Kusumakar, 2000). Accordingly, these results may reflect a tendency for
popular GLB adolescents to engage in more mildly delinquent behavior in an attempt to
maintain their high level of social support.

Previous research (Alexander, Piazza, Mekos, & Valente, 2001; Kristjanssona,
Sigfusdottira, Jamesa, Allegrantea, & Helgasona, 2010; Nichter, Nichter, Vuckovic,
Quintero, & Ritenbaugh, 1997) has repeatedly found a relationship between popularity
and cigarette smoking in adolescence. Specifically, Kobus (2003) suggested that
adolescents often experience an internal pressure to smoke cigarettes in an attempt to
gain social approval and avoid being excluded by peers. Thus, because GLB adolescents
often find it difficult to assimilate to the peer group because of their sexual orientation,
GLB adolescents may feel an increased internal pressure to smoke cigarettes in order to
gain social standing. Further, because the nicotine in cigarettes is highly addictive, it
may result in a situation in which the number of cigarettes smoked increases greatly over
time.

In addition, it is important to note that although GLB adolescents did not consume
significantly more alcohol than did heterosexual adolescents with a high level of peer
involvement, GLB adolescents experienced more negative consequences of alcohol

intoxication than did heterosexual adolescents. This may suggest that while GLB

24

adolescents do not consume a larger amount of alcohol at high levels of peer
involvement, they may be more likely to consume alcohol in a way (e.g., binge drinking,
becoming intoxicated) that leaves them more vulnerable to experiencing negative
consequence of alcohol intoxication. For example, previous research (Kristjanssona et
al., 2010) has found that getting drunk is related to perceptions of peer pressure, the
desire to conform to the social group, and the belief that consuming alcohol may help one
gain the respect of their peers. Thus, it is possible that GLB adolescents may use the
excessive consumption of alcohol in order to better assimilate to their peer group, which
may leave them more likely to experience the detrimental side effects that often
accompany alcohol intoxication.

Furthermore, an increase in peer involvement may simply provide GLB
adolescents with more Opportunities to engage in physical altercations that escalate to
such a degree that the individual must seek medical attention. In other words, because a
physical fight that occurs within the confines of the middle school or high school setting
is often stopped by the school’s staff before it can reach the point where someone is
seriously injured, it is possible that an increased social connection with one’s peers will
place an adolescent in more unsupervised situations in which a serious fight can erupt.
Because aggression has been found to be positively related to social status by middle
school (Rose, Swenson, & Waller, 2004), it is possible that GLB adolescents may utilize
more overt aggression in an attempt to cement their social status.

Negative Psychosocial Outcomes for GLB Young Adults
We hypothesized that the increased prevalence of negative outcomes would also

be found in young adulthood, and that GLB individuals would once again exhibit

25

significantly worse outcomes than heterosexual individuals at Wave 3. However, this
hypothesis was only supported for a small number of the outcome variables.

At Wave 3, GLB young adults reported significantly more psychopathology than
did heterosexual young adults. Specifically, in accordance with previous research
(Cochran & Mays, 2000; Cochran, Sullivan, & Mays, 2003; Sandfort, de Graaf, Bijl, &
Schnabel, 2001), GLB participants reported significantly more depressive symptoms than
did heterosexual participants. In addition, GLB young adults reported more suicidal
ideation than did heterosexual young adults. This finding is consistent with a wide body
of literature that has found a higher rate of suicidal ideation, suicide attempts, and
completed suicides in GLB youth (D’Augelli, 2002; D’Augelli & Hershberger, 1993;
D’Augelli, Hershberger, & Pilkington, 2001; Grossman & Kemer, 1998; King, 1997;
Lewinsohn, Rohde, & Seeley, 1996; Paul et al., 2002).

While GLB young adults experience significantly more negative consequences of
alcohol intoxication than heterosexual young adults, there is no significant difference
between GLB participants and heterosexual participants on measures of smoking, alcohol
use, and alcohol intoxication. Previous research with GLB college students has found
mixed results on the prevalence of substance use among GLB individuals. However, the
majority of the research has suggested that gay, lesbian, and bisexual male college
students do not smoke (Eisenberg & Wechsler, 2003a; Eisenberg & Wechsler, 2003b),
binge drink (Eisenberg & Wechsler, 2003a; Eisenberg & Wechsler, 2003b), or consume
alcohol (McCabe, Boyd, Hughes, & d’Arcy, 2003) significantly more than do
heterosexual college students. In the current study, we are unable to determine why GLB

young adults endorse significantly more negative consequences of alcohol intoxication

26

compared to heterosexual young adults. However, this tendency for GLB young adults to
experience significantly more negative consequences of alcohol intoxication than
heterosexual young adults warrants more attention by researchers.

Finally, at Wave 3, there were no significant differences between the GLB and
heterosexual participants on any of the fighting or experiences of violence outcome
measures. It is possible that the lack of significant differences between GLB and
heterosexual young adults is an artifact of no longer being restricted by the confines of
the high school environment. In other words, once the participants are no longer within
the high school setting, there is more freedom to select one’s surroundings as well as the
individuals with whom one elects to associate. It is possible, therefore, that by young
adulthood, GLB individuals less frequently find themselves in situations in which they
are. targeted because of their sexual orientation. Further, this may be an artifact of age.
As individuals progress from adolescence to young adulthood, acts of overt aggression
are perceived less favorably by one’s peers (Brown & Larson, 2009). Thus, there may no
longer be a social advantage for GLB young adults to use overt forms of aggression.
Limitations and Future Directions

The current study utilizes a large nationally representative longitudinal dataset to
examine both the effect of peer support on a number of psychosocial outcomes for GLB
adolescents as well as to explore the differences in the outcome variables when the
participants are adolescents and young adults. However, despite the current study’s
contribution to the extant literature, there are a few limitations to note.

First and foremost, there is no direct measure of sexual orientation in the Add

Health Wave 1 questionnaire. In other words, romantic attraction to the same gender,

27

opposite gender, or both genders was used as a proxy for self-identified sexual
orientation. This can be viewed as a limitation of the current research because it limits
the ability to compare the results of the current study with previous research that uses
self-identified sexual orientation to classify its participants. However, more recent
research with GLB populations is often choosing to use measures of same, opposite, or
both gender desire, attraction, and relationships as indicators of sexual orientation due in
part to the influence of the previous research with sexual orientation using the Add
Health data (Russell, 2006). Because this system of classification has the advantage of
being able to identify adolescents even if they do not yet publicly self-identify as GLB,
future research with sexually diverse youth should consider utilizing a combination of
self-identification and desire, attraction, and relationships to classify participants.

Second, across the ten outcome variables, the effect sizes were generally small
(particularly given the size of our dataset). However, this finding does not necessarily
imply that the results of the present study do not have meaningful real world
implications. In other words, because the outcomes included in this study can have
dramatic and long-lasting consequences (e.g., lifelong struggles with mental health and
problematic substance use), even a small difference may be consequential. Furthermore,
our effect sizes are comparable to those found in previous research with community
samples of this understudied population (Caldwell, Kivel, Smith, & Hays, 1998; Reis &
Saewyc, 1999; Robin, Brener, Donahue, Hack, Hale, & Goodenow, 2004; Rostosky et
aL,2003)

In addition, conducting secondary data analysis with an existing dataset can make

it difficult to examine a particular research question because it may not be possible to

28

directly measure all of the variables. For example, the Add Health questionnaire bases its
depression questions on the CES-D scale; however, because not all of the items from the
scale are included on the questionnaire, it is not possible to use the criteria for the CES-D
to label the participants as “depressed” or “not depressed.” Furthermore, the questions
that are included on the questionnaire limit the research questions that can be asked. For
instance, while the data indicated that GLB adolescents were more likely to experience
victimization, witness violence, and perpetrate violence than were heterosexual
adolescents, it was not possible to determine if this difference was due to the impact of
being bullied or targeted due to one’s sexual orientation. Thus, future research is needed
to examine the potential reasons for the increased experiences of fighting and violence
that were found in this study as well as previous research (DuRant, Krowchuck, & Sinal,
1998; Russell et al., 2001a).

Finally, there is a concern with all self-report survey research of a response bias.
However, prior research investigating the response patterns of adolescents suggests that
even when they are being asked sensitive questions (e.g., about substance use),
adolescents generally answer in an open and truthful manner (Akers, Massey, & Clarke,
1983; Winters, Stinchfield, Henly, & Schwartz, 1990). Furthermore, Add Health utilized
an audio computer—aided self-interview (Audio-CASI) to ask the participants about
sensitive topics, which grants the participant a greater sense of privacy and has been
forind to increase reporting rates in adolescents (Supple et al., 1999; Turner et al., 1998).
However, it is important to note that adolescents may not be entirely truthful in their
response to the questions about romantic attraction, particularly if they have been

attracted to someone of the same gender. It is therefore possible that our findings may be

29

attenuated by the propensity for adolescents to underreport same-sex romantic attraction.
Consequently, future research should consider using more complex research designs that
utilize multiple methods of collecting data or multiple reporters in order to more
completely investigate the experiences of GLB youth.
Conclusion

The current study is one of the first to investigate the experiences of GLB
adolescents at more than one time point using a nationally representative longitudinal
dataset. Our results indicate that although GLB adolescents are more likely than
heterosexual adolescents to experience a wide range of negative outcomes (i.e.,
depression, suicidal ideation, alcohol use, alcohol intoxication, victimization, witnessing
violence, and perpetrating violence), these results generally are not found in young
adulthood (with the exceptions of depression and suicidal ideation). Furthermore,
although previous research has suggested that peer support may serve a protective
function for GLB adolescents, our results indicated that a high level of social support was
associated with more smoking, negative consequences of alcohol intoxication, and
requiring medical attention following a physical fight. This study highlights the need for
firture research that is explicitly designed to directly investigate the experiences of GLB

youth.

30

 

 

31

modem vmdhm 3.8m m _. Sm wodmm coda Qm
mfimfi m 2.3m mmdfi m o~.mo_ no.9: mmda 3 wEonm
mod one Ed mmé cmd Ken QM
:osmoiowfi mo
mm.m NSC 5N6. mm.m Se wm.m 3 Boson—USED
2V.— Omg S: cm; Q; E: QM.
20:898.:
mm; mm; om; em; E4 34 E 6582
one: 3.: 3.9 2.0m woem wmwm 9m.
max,”— 3.2 3.2 8.2 m9: em.m_ 3 33 3:82
mad ovd mmd emd :3 emd QM.
SUEDE
cod omd mod 26 ad .26 3 32015
woe «We 35 vmé eve mmé 9m.
91» £6 36 end med :6 3 commmoaom
30,—. mac 336856: gob mqo 335856:
m 26>? _ o>m3

 

833.8; hmBSoE 2: noszotcEmB REES»? N35 v.58:

fl Bash

 

nod
mod
Mao
Nod
mmd
mod
omd
m _ .o

$.N
mad
End
86
mmd
ocd
3.0
one

omd
ood
m ~ .o
Nod
mmd
mod
36
mac

mme
wed
$6
$6
mend
Mod
Med
26
Ed
two

med
mod
MNMN
mm;
50.0
3.9
mmd
vmd
5N;
cod

3.0
we.»
:3.
3.0
$6
Mod
Sad
36
wwd
emd

QM.

QM.

QM.

QM.

QM.

tomasm Doom

Ema
80¢ M545

8565
wEHmboBom

8565
$5355»

cozmmmficog

3.253 _ 0:5

32

S. v a .1. MC. V Q ... genomic 2: mac? 82m: E 8255 08 356580 5:3“..on 2: 633293 0855 682

 

as $2 tag :26 :NS :26 13d :86 ted 3:5 .e>we§aeaa E
- .32 1:5 to; :36 1de :36 ted the sleeve; a
as 1N3 tog 385 ...._.:.o 1:5 12d :35 8:835 w
- :86 :25 :36 So 8d cod Emcee: has 5
as £2 £2 :53 £3 32.0 2353388 a
- :33 :86 38d ted Seaweed? m
- ted ES :39 83282 a
- 3.86 3.25 waeoem m
- 1.2.0 aeaoaaeasm N
on d commoaoo g
2 a w A a m a m N _

Q 98;.“ E bmhéofi $33.29, 3: kgfitflommxooo RENEE? BS» ESBQELOU

N 2an

33

E. v a. .1. E. v Q * ”anwflw 2: mac? 8:“: E 32>on 03 $222-$000 525$? 05 638:9? 20:3 682

 

 

.Ibdd IEd *._.wd.d .Ibdd **m d d 12d .Imdd 13d :Ed :Vdd teamsm Son 2
.Ibdd imdd IEd *Ed **md.d **wd.d Imdd .Ibdd ibdd :Ed 22332.5 $2.8m wd
mod :mdd *mdd Ed- Ed Ed- Ed Ed- *mdd *mdd 368252 :
Ivod iwdd .Ibdd ddd Ed Ed- *mdd **md.d- Ed ibdd oats-H 2
Ed- ddd Ed- Ed- *Vdd- **md.d- mdd- *Ed- mod imdd aflm< 2
:odd :3 d iodd Ed :Ed- ibdd firmed- 11d- Icod- Ivod Mom—m 3
Iddd 13d iwdd Ed IEd .Ibdd- Nod ddd :Ed 12d ma 2
i. _ fid- imdd- .1 Ed- *Ed- :odd- .3; ~d- Iddd- 33d- iddd imfld 5980 Nd
*mdd **mdd “Imdd mdd- 32d 13d **N_d 13d 38d 32d ow< :
d_ d w n o m w m N E

5:53 m 2,3

34

E. v Q .2. md. v Q .._ xmcowflc 05 mac—m mom—ax E 32>on 95 356508 Nam—32:: 05 633:9? 80:3 .682

 

 

5o cod 1.2.? :3. ES :26 toaasmsom a
mod 8d- cod :3 18d- *2; coceficoasxom M:
38d- :35- :25- :3d So so. 3622:: t
- 185. $2.? :25 86 5o 253 2
- :25- :3. :3. mod 33 2
- :85 cod :3 Vega 3
- :3 *mod- mmm 2
- :35- 5200 S
- ow< :

2 2 E 2 Q :

5:53 N 033

35

E. v Q .3 3. v A .._ ”3:0me 05 mac—m 82m: 5 32>th 03 358508 $5322 05 633:QO 20:3 .632

 

MB :26 :36 £de :86 Nod $3 Nod :86 zed .oSwégoefi S
- :30 :85 :85 So 185 So- :35 33¢ .05 wages; a
as :36 :25 £3 IN; 23 :86 :26 SufieES w
- :25 8d :3 :3 85 :25 35 EE EPE N
MN 6 .252 :Nvo 86 1:5 1:5 2953388 c
- £2 85 .2; 3 15¢ 83935 .02 m
- :85 :85 So a: 3:82 v
- 3d 8.0 mcsoam N
- :mNd 8:82 .833 N
Ed commmoaon— d
S o m N o m v m N d

 

m. SEN: B Bufifiufi $33.29 2: .NQQNBBRES $235ng 38 25:53.50

m @33-

36

E. V K .2, E. v Q * :wcommsu 2: mac? 8%: E 32>on 03 356508 5:33? 05 .o_nmo=&a 82;? $82

 

 

:mdd Nod- Ed- 12d 32d nosfifito :3me ad
ddd mod- mod Ed Nod 368232 2
mod. Ed 13d- Nod .Ibdd 0523 @—
mod- 33.? 13d- *mdd- Nod Sfim< 2
1K. _ d- .12 d- **w ~ d- Nod- imdd xofim v—
..imod Ed Ed- odd *Ed- mmm 2
*iumd- *KNd- iodd- Ed *1 dd 8986 NM
Ended- 18d- vod .IEd- mod- ow< :
w v m N _

 

V €253 m 25

37

E. v Q 1. E. v m * xmcowflw on“ mac? 8%: E 32>on 8w 358508 5233?: 2: «289.23% 22:5 532

 

Ed mod Ed. Edd. mod ISd *mod- couficoto 338m M:

 

- :85- :55. 1:5- 36 So *3? 38.332 2
- :85- tad- *3? So- So 253 E
- 12d- 36 So- *2; 923 2
- :25- go 8.0 fism E
- So- 85. mmm 2
- $8.0- 5250 S
- a? :
t 2 a E 2 m. :

 

8253 m 23

38

Table 4

Regressions for psychopathology outcome variables at Wave 1

 

 

 

Depression Suicidal Ideation
B B B Lower ()qu Upper
Ratio

Ste . 2

1. p 8315?“: Model x2 = 6685*“
Age 0.23 0.09* ** 0.02 0.97 1.02 1.07
Gender 1.43 0.17*** 0.55*** 1.46 1.74 2.08
SES 1.67 0.11*** 0.46** 1.21 1.58 2.07
Black 0.26 0.02 -0.38** 0.54 0.68 0.86
Asian 1.59 0.06*** 0.22 0.78 1.25 2.00
Latino 1.04 0.07* ** 0.08 0.82 1.08 1.43
Multiracial 0.70 0.04* 0.19 0.84 1.20 1.72

Step Adjz R2 = 0.059 Step )3: 16.91 ***

A R = 0003*” Model x = 83.76***

Age 0.22 0.09*** 0.01 0.96 1.01 1.06
Gender 1.45 0.17*** 0.57*** 1.49 1.77 2.12
SES 1.65 0.11*** 0.45** 1.19 1.56 2.04
Black 0.28 0.03 -0.36** 0.55 0.70 0.88
Asian 1.62 0.06* * * 0.25 0.80 1.28 2.04
Latino 1.03 0.07"‘ ** 0.07 0.81 1.07 1.41
Multiracial 0.72 0.04* 0.20 0.85 1.22 1.75
Sexual Orientation 0.98 0.06*** 0.63*** 1.39 1.88 2.52
Peer Support 0.01 0.01 0.01 0.99 1.01 1.02

39

 

Table 4 (cont’d)

:‘C‘P Adj 1:2 = 0.060 Step 3‘2 = 0.67
A R = 0.001 Model x = 84.43***
Age 0.22 0.09*** 0.01 0.96 1.01 1.07
Gender 1.46 0.17*** 0.58*** 1.49 1.78 2.13
SES 1.65 0.1 l*** 0.45** 1.19 1.56 2.04
Black 0.28 0.03 -0.36** 0.55 0.70 0.88
Asian 1.62 0.06*** 0.24 0.80 1.28 2.04
Latino 1.03 0.07*** 0.07 0.81 1.07 1.41
Multiracial 0.72 0.04* 0.20 0.85 1.22 1.75
Sexual Orientation 1.02 0.06*** 0.64* * * 1.41 1.90 2.56
Peer Support 0.01 0.02 0.01 1.00 1.01 1.02

Orientation x

-0.07 -0.03 -0.02 0.94 0.98 1.03
Support

 

Note: *p < .05 **p < .01 ***p < .001

40

Nod- wo.v_- Nod- and- *mod- Kud- Ndd- VON.- RENE—=2
iced- ENV- Nod- de- vod- o~d- Sd dwd GEE-H
*mod- wadd- mod- vwd- *mdd- ovd- mod- cod- Gammxx
frugd- wmdd- .12.; _.0- mm. 7 ***o_d- Nvd- ***hdd- :d- 0.35
8d Ed :...2d mm._ ***ood wvd *mod omé mmm
:ood- md._m- *mod- Sud- Sid—d- de- ***oo.o- and. 5980
..:.:..©—d 2.2 ***N~d mmd *igd 2d ***N~d do; ow<

41

tamed “mm .a< 3.385 ”mm .€< tamed “mm .a< .133 n ma .3

 

 

.2 dam
m. m a m a m a m
couwomxoufi 3:82 :oumocASE
wfixofim do moocosvomcou 3:82 83 3:82

 

N 9.3: B $33.23» 2:830 93 8:835. aQEEEEMmM

m 033-

:hed- No.9“-
*med- endo-
tIh—d- defie-
~ed emd
ibed- madm-
*..:._:d em.:
*...mee.e H NM <
33 "mm .3
.Iie—d meN
ved hNdN
_ed- we.“ -
**©ed- NNNV-
*med- Ewe-
***m_d- mofiw-
_ed ewd
.Ibed- hmdm-
***V~d mm.:

***N—ed H NM 4
$3 ”mm €<

 

Ned- hmd-
med- end-
.Iieed- e~._-
***e—.e mm;
*med- mvd-
1: fid emd
**meed H mm <
Sod ”mm €<
***e_.e oed
med mmd
Ned- omd-
Ned- hmd-
med- ewd-
*._:_.eed- 0e;-
***e~d mm;
*med- vvd-
*zmfid emd

***e~ed H mm <
«:3 ”mm pa

fied- 3d-
...ved- wmd-
*fweed- emd-
.Iieed wvd
***e~.e- eNd-
***m_d did
eeed H mm 4
Bod “mm .3
"I": "d Ned
finned ewd
*ved- emd-
ved- e—d-
*ved- wmd-
***e_.e- emd-
***eed wvd
..:.:..e—d- eNd-
***m~d 3d
fiefied “NM
Sod ”mm .3

:3 So
8.? 3%.
£85. «3-
*2; Se
:39? 3+-
***N~d 3;
83 n mm 4
on; ”mm :5
86 3o
god o3
8d- 8a-
:3 :3
mod- 9%.
..:.:.&.ed- 5.?-
._.8.o 2+
:33. a3-
***N_.e ed;
Sod n ma <
om; ”mm .a<

253
523‘
v.85

mmm
$250
ow<

tongsm Bum
couficoto Esxom
E62232

25.3

cflm<

xofim

wmm

53:00

ow<

5:53 m 23 ,

.maem

.N 3%

42

_ee. v Quiz." —e. V Q. ** we. V an." 632

 

. . . . . . 5&6
:85 8 c :8 o 2 o a o- S o- 8 o- one- x 8:385
:33 mi 38¢ 86 :1 3 So 85 2.0 5&3 :2
85 8.8 85 and $86 as *2; $4- 8355 13me
:3- 3: _- So. «no- *3? one- .86. EN. 38532

5:53 m 23

43

 

 

Ed. 3d- *mdd odd ***wdd 2d :vod id 368252
8d NNd imod 8d 1:3 dd 2d itdd VNd 253
5d. mvd- 3d vod Nod cod 5d odd adv-xx
Nod- 3d- ..nthd nod 1*:d w_d *3..de Ed xoflm
5d- MNd- *idfid 2d Iaod Ed iadd oNd mMm
vod- de- *idfid- odd- 133d- udd- ***NNd- wmd- Bus-.5
Sd- 3d- 5d ddd Nod 5d 5d ddd ow<
83 u ~13 :amod n m 3 1.386 n a mi $83 n m .€<
N N N N .
_ 3%
a m a m a m a m
Ema Rumba 8:205 8535
8on >53 wquwboE-ni mammmofirfi gouging;

 

N 33: B mmEExg 2:828 8:383? 892m???» SKwfiEfi-mxwmx

o 23

44

8d
3d-
3d-
5d-
vod-
Ndd-

de
wmd-
mmd-
de-
wad-
Ed-

.Iimood H NM <

83 ”mm :5.
8.0 2.9
...3.o m:
:3. as-
:3 m2
:3. ”no-
So- one-
:3. 23.
23. $5.
86. MS.
as: n mm <
33 ”mm .3

:mod no.0
Nod vod
***wo.o mod
***o~.o m—d
***o—.o- mod-
ood cod
Good “NM <
33 "mm .e<

tamed cod
3:006 ood
*mod cod
**mo.o nod
Nod vod
***wo.o mod
tic—d m—d
***o~.o- ood-
ood cod

***moo.o H NM 4
«86 ”mm .a<

.1826 o—d
Nod wod
.Iiw—d afio
*taod .36
***wo.o- hod-
Sd cod
Good H NM <
63 ”mm .3
“winced cod
*Luod bed
..:.:..wo.o :6
***m—.o afio
No.0 wed
fix—d ofid
***oo.o vfio
***wo.o- nod-
56 cod

***voo.o H NM 4
God “mm .€<

***wo.o VNd
Ed wed
.12..de w_.o
*fwaod and
***NN.O- wmd-
cod cod
Good H NM <
ES ”am my.
*._:..©o.o ~06
**mo.o ©_.o
fumed wad
***wo.o vmd
~od cad
fiwod 2.0
“timed omd
***NN.O- wmd-
cod cod

--moo.o H am <
ES "mm .3

953
58¢.
gum—m

mmm
$950
ow<

toqasm Sum
cozficoto 388m
368252

oats-H

Sam/x

xoflm

mmm

$950

ow<

5:53 0 22¢

.m 3%

.N 8%

45

So. V523." 5. V Q3. mo. V R... .632

 

. . . . . . . . Edna
1.2 o 3 o s o oo o S o 8 o S o S o x 8:985
5.0 So :35 8d 585 cod 5.85 So 2255 sum
85 o: ._.._....8.o 3o .33 :3 13° 2d 8:955 333
So- as- *2; 3o 2&3 Ed .136 w; 3682::

5:53 o 23$

46

Table 7

Regressions for psychopathology outcome variables at Wave 3

 

 

 

Depression Suicidal Ideation
B B B Lower ()qu Upper
Ratio

Step 2 2

1. Adj R = 0009* Model x = 1696*
Age 003 -0.01 -0.15* 0.76 0.86 0.98
Gender 0.65 008* -035 0.45 0.70 1.09
SES 0.00 -0.06 0.00 1.00 1.00 1.00
Black 0.32 0.03 -O.69* 0.26 0.50 0.96
Asian 0.97 0.05 -0.42 0.20 0.66 2.21
Latino 0.49 0.04 -0.02 0.53 0.98 1.82
Multiracial 0.86 0.04 0.22 0.42 1.25 3.73

Step Adj R2 = 0.029 Step x2 = 27.81 ***

' ARZ = 0.021 *** Model 112 = 44.77***

Age -003 -0.01 -O.l6* 0.75 0.85 0.97
Gender 0.52 0.06* -0.57* 0.35 0.56 0.90
SES 0.00 -0.07* 0.00 1.00 1.00 1.00
Black 0.36 0.04 -0.68* 0.26 0.51 0.98
Asian 0.95 0.05 -054 0.17 0.59 2.04
Latino 0.49 0.04 -0.06 0.50 0.94 1.77
Multiracial 0.75 0.03 0.12 0.37 1.12 3.46
se’.‘“al . 2.26 0.15*** 1.72*** 3.10 5.58 10.07
Orientation

 

Note: *p < .05 **p < .01 ***p < .001

47

mod
26-
mod-
€1.86-
mod-
1.2.0-
cod

Bud:
0mg: T
wdeT
NwddN-
ddd
3di-
NN.N~

1.886 1 Na .43..

hod-
mod-
vod-
._:..N_ .o-
“Inmfid
* * *h — .o-
mod-

._....._.Neo.o 1 mm .34

ow. T
wmd-
:d-
NN. T
ddd
Nm. 7
Ed-

*mod-

ood-
vod-

* * .5 fl .o-
.306
***mm.o-
ood-

***vofi.o H NM 93%

Ed-
NNd-
mmd-
Ed-
ddd
:d-
mod-

*hod-
cod
aided-
*dod-
cod
***NN.O-
vod-

._....._.ao.on mm .36....

wad-
2d-
5.5-
mw.m-
ddd
NNd-
Sud-

38:st
05:3
§Mm<
xoflm

mmm
8250
ow<

._ dam

 

m

m

 

48

:ofiwaSE 3:82
no 3053350

cosawomxowfi

w 08
a: m 6:82

a: 3:82

 

m. 98% B $33.29, 2:828 mm: 8:333 LQEoBmmemx

w 033-

So. v3.2.3." 5. v Q1. mo. V B. 632

 

So 2.3
86 0;:
85. 2.2 _-
wed- @32-
21. 8o- magm-
wod- 8o
:25- NE:-
ood 3.:
53 n $2
83 n ma .a<

“I. _ _.o mm;
.39? om._-
mod- mmd-
vod- £6-
scum—d- MN. T
.126 cod
*fLME-o 3&7
mod- :6.
EL 56 H add
~85 H mm .3

So 5o
.53. Rd-
cod- Rd-
3o- @2-

..ied- mg-
86 86
***VN.O- Mud-
mod. 86.
Sad n $2
83 H mm m?-

Sd 23
ES- 8.0-
85 2;-
185- m?-
.53. m3.
ood 86
3:85. «$-
3.? as-
83 n $2

83 n ma :2-

:ouficoto 338m
308232

2554

55¢.

Jon—m

mmm

8980

ow<

.N 85

9.33 w 03$

49

 

 

56 mod . mod Nod vod cod Rod vmd 308232
mod- 86. Ed cod mod Nod cod 86 95m:—
86. Bd- Sd 5d cod cod mod- ood- 564x
vod mod 3d mod * .1. 55 N _ .o vod mod xoflm
8d cod mod cod mod- cod Ed- cod mmm
1*mfio- :6- Rod. mod- *126- cod- ..::.2 .o- m fl .o- 8950
Nod- cod vod- ood 1:6- Sd- Iwod- mod- ow<
L So u m .€< Sod u m .3 1.385 n m €< 385 n m .€<
N N m N .
fl 35
a m a m a m a m
3me Rom-Em 8:205 8:205
Eat ban: graham-5m wEmmoSS/ soumumEc-og

 

M. 983 3 $33.29» 2:830 8533-? umutmtmmxm xoxu-tot-mmgmmx

o 033-

50

:5. v 33.2.“ fio. V Q3." mo. V Q..- 632

 

5d- 5d-
86 mod
Nod- 86.
mod- 36.
vod mod
56 cod
***N_.ou :6.
mod- cod
coed H mad
29o "mm .3

cod cod
So So
So cod
:3 :3
3o 85
:3 8.9
ES- So-
36. 8.0
256 n $2
53 "mm .€<

mod vod
vod cod
mod Nod
cod cod
.12." ~N.o N—d
vo-ou cod
“3.1.2.0- ood-
**~ To- _o.o-
moo-o H Md
”3o “Na :5.

mod . S-o
*hod vmd
cod 86
mod- @od-
vod mod
Ed- cod
*zzdu 02V-
fume-o.- mod-
moo-o H my?
33 "mm .3

£535th 73me
308532

05:5

§_m<

xoflm

mmm

$950

ow<

.N 8%

558V ¢ 283

51

Figure 1

Interaction between sexual orientation and peer support on smoking

 

Number of Cigarettes Smoked

 

200

in 30 Days

180

160 -

140
120
100
80
6O
4O
20
O

 

 

 

I
I
I
I
I
I
I
I
I
I
Low Peer Moderate Peer High Peer
Support Support

— Heterosexual
- - GLB

 

 

52

Figure 2

Interaction between sexual orientation and peer support on negative consequences of
alcohol intoxication

 

Heterosexual
- - GLB

Number of Negatrve Consequences
of Alcohol Intox1catlon 1n 12 Months
DJ

\
\
\
\

 

 

 

Low Peer Moderate Peer High Peer
Support Support Support

F”“"‘"“ M-“

 

 

53

Figure 3

Interaction between sexual orientation and peer support on requiring medical attention
after a physical fight

 

 

 

 

. 6 " -
i a
3 ..
.5? 5 ,
% fig I
i 33 I
i <52! 4 I
- ":6 c: ,
i .2':
i B ‘50 3 I,
F E I: ’ —Heterosexual

‘1’ I

E B i I - - GLB

F 25 2 ,

u-t -..

O .C: ’

a... DD

2 a 1 I

S m I

/ !_
Z I
o I
Low Peer Moderate Peer High Peer
Support SuPport Support

 

 

 

54

REFERENCES

Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting
interactions. Newbury Park: Sage Publications.

Akers, R. L., Massey, J ., & Clarke, W. (1983). Are self-reports of adolescent deviance
valid? Biochemical measures, randomized response, and the bogus pipeline in
smoking behavior. Social Forces, 62, 234-251.

Alexander, C., Piazza, M., Mekos, D., & Valente, T. (2001). Peers, schools, and
adolescent cigarette smoking. Journal of Adolescent Health, 29, 22-30.

Amett, J. J. (1999). Adolescent storm and stress, reconsidered. American Psychologist,
54, 317-326.

Besner, H. F ., & Spungin, C. I. (1995). Gay and lesbian students: Understanding their
needs. Washington, D. C.: Taylor and Francis.

Blos, P. (1962). On adolescence: A psychoanalytic interpretation. New York: Free Press.

Bontempo, D. E., & D’Augelli, A. R. (2002). Effects of at-school victimization and
sexual orientation on lesbian, gay, or bisexual youths’ health risk behavior.
Journal of Adolescent Health, 30, 364-374.

Brown, B. B., & Larson, J. (2009). Peer relationships in adolescence. In R. M. Lerner, &
L. Steinberg (Eds), Handbook of adolescent psychology (3” ed.) (pp. 74-103).
Hoboken, NJ: John Wiley & Sons.

Caldwell, L. L., Kivel, B. D., Smith, E. A., & Hays, D. (1998). The leisure context of
adolescents who are lesbian, gay male, bisexual, and questioning their sexual
identities: An exploratory study. Journal of Leisure Research, 30, 341-355.

Cochran, S.D., & Mays, V.M. (2000). Lifetime prevalence of suicidal symptoms and
affective disorders among men reporting same-sex sexual partners: Results from
the NHANES 111. American Journal of Public Health, 90, 573-578.

Cochran, S.D., Sullivan, J .G., & Mays, V.M. (2003). Prevalence of mental disorders,
psychological distress, and mental health services use among LGB adults in the
United States. Journal of Consulting & Clinical Psychology, 71, 53-61.

D’Augelli, A. R. (2002). Mental health problems among lesbian, gay, and bisexual
youths ages 14 to 21. Clinical Child Psychology and Psychiatry, 7, 433-456.

D’Augelli, A. R., & Hart, M. M. (1987). Gay women, men and families in rural settings:

Toward the development of helping communities. American Journal of
Community Psychology, 21, 421-448.

55

D’Augelli, A. R., & Hershberger, S. L. (1993). Lesbian, gay, and bisexual youth in
community settings: Personal challenges and mental health problems. American
Journal of Community Psychology, 21, 421-448.

D’Augelli, A. R., Hershberger, S. L., & Pilkington, S. L. (2001). Suicidality patterns and
sexual orientation-related factors among lesbian, gay, and bisexual youths.
Suicide and Life, 3, 250-264.

DuRant, R. H., Krowchuck, D. P., & Sinal, S. H. (1998). Victimization, use of violence,
and drug use at school among male adolescents who engage in same-sex
behavior. Journal of Pediatrics, 132, 113-118.

Eisenberg, M.E., & Wechsler, H. (2003a). Social influences on substance-use behaviors
of gay, lesbian, and bisexual college students: Findings from a national study.
Social Science & Medicine, 57, 1913-1923.

Eisenberg, M.E., & Wechsler, H. (2003b). Substance use behaviors among college
students with same-sex and opposite-sex experience: Results from a national
study. Addictive Behaviors, 28, 899-913.

Erikson, E. H. (1968). Identity: Youth and crisis. New York: W. W. Norton & Co.

Garofalo, R.,Wolf, R.,Kessel, S., Palfrey, J ., and DuRant, R. (1998). The association
between health risk behaviours and sexual orientation among a school-based
sample of adolescents. Pediatrics, 101, 895—902.

Gonsiorek, J. C. (1988). Mental health issues of gay and lesbian adolescents. Journal of
Adolescent Health Care, 9, 114-122.

Gray, M. L. (1999). In your face: Stories from the lives of queer youth. New York:
Harrington Park Press.

Grossman, A. H., & Kemer, M. S. (1998). Support networks of gay male and lesbian
youth. Journal of Gay, Lesbian, and Bisexual Identity, 3, 27-46.

Harbeck, K. M. (Ed.). (1992). Coming out of the classroom closet: Gay and lesbian
students, teachers, and curricula. New York: Haworth.

Harris, K. M., & Udry, J. R. (2010). National Longitudinal Study of Adolescent Health
(Add Health), 1994-2002 [Computer file]. Available from ICPSR21600-v3. Ann
Arbor, MI: Inter-university Consortium for Political and Social Research
[distributor]. ‘

Hayes, A. F., & Matthes, J. (2009). Computational procedures for probing interactions in

OLS and logistic regression: SPSS and SAS implementations. Behavior Research
Methods, 41, 924-936.

56

Herrell, R., Goldberg, J ., True, W. R., Ramakrishnan, V., Lyons, M., Eisen, S., &
Tsuang, M. T. (1999). Sexual orientation and suicidality: A co-twin control study
in adult men. Archives of General Psychiatry, 56, 867-874.

Hershberger, S., and D’Augelli, A. (1995). The impact of victimization on the mental
health and suicidality of lesbian, gay, and bisexual youths. Developmental
Psychology, 31, 65—74.

Hughes, T. L., & Eliason, M. (2002). Substance use and abuse in lesbian, gay, bisexual
and transgender populations. Journal of Primary Prevention, 22, 263-298.

Jennings, K. (2000). Foreword. Education and Urban Society, 32, 285-286.

Jordan, K. M. (2000). Substance abuse among gay, lesbian, bisexual, transgender, and
question adolescents. School Psychology Review, 29, 201-206.

King, C. A. (1997). Suicidal behavior in adolescence. In R. W. Maris, M. M. Silverman,
& S. S. Canatto (Eds.), Review of Suicidality, 1997 (pp. 61-95). New York:
Guilford Press.

Kobus, K. (2003). Peers and adolescent smoking. Addiction, 98(1), 37—55.

Kosciw, J. (2004). The 2003 National School Climate Survey: The school-related
experiences of our nation’s lesbian, gay, bisexual and transgender youth. New
York: GLSEN.

Kosciw, J. G., Diaz, E. M., & Greytak, E. A. (2008). The 2007 National School Climate
Survey: The experiences of lesbian, gay, bisexual and transgender youth in our
nation’s schools. New York: GLSEN.

Kristjansson, A. L., Sigfusdottir, I. D., James, J. E., Allegrante, J. P., & Helgason, A. R.
(2010). Perceived parental reactions and peer respect as predictors of adolescent
cigarette smoking and alcohol use. Addictive Behaviors, 35, 256-259.

Lackner, J. 3., Joseph, J. G., Ostrow, D. G., Kessler, R. C., Eshleman, S., Wortman, C.
B., et al. (1993). A longitudinal study of psychological distress in a cohort of gay
men: Effects of social support and coping strategies. Journal of Nervous &
Mental Disease, 181, 4-12.

Larson, R. W., & Richards, M. H. (1994). Divergent realities: The emotional lives of
mothers, fathers, and adolescents. New York: Basic Books.

Lewinsohn, P. M., Rohde, P., & Seeley, J. R. (1996). Adolescent suicide ideation and

attempts: Prevalence, risk factors, and clinical implications. Clinical Psychology:
Science & Practice, 3, 25-46.

57

Lipkin, A. (1995). The case for a gay and lesbian curriculum. In G. Unks (Ed), The gay
teen: Educational practice and theory for lesbian, gay, and bisexual adolescents
(pp. 31-52). New York: Routledge.

Martin, A. D., and Hetrick, E. S. (1988). The stigmatization of the gay and lesbian
adolescent. Journal of Homosexuality, 15, 515—518.

Martin, J. L., & Dean, L. (1993). Effects of AIDS-related bereavement and HIV-related
illness on psychological distress among gay men: A 7-year longitudinal study,
1985—1 991. Journal of Consulting and Clinical Psychology, 61, 94-103.

Massachusetts Governor’s Commission on Gay and Lesbian Youth. (1993). Making
schools safe for gay and lesbian youth: Breaking the silence in schools and in
families. Boston: The Commission on Gay and Lesbian Youth.

McCabe, S. E., Boyd, C, Hughes, T. L., & d'Arcy, H. (2003). Sexual identity and
substance use among undergraduate students. Substance Abuse, 24(2), 77-91.

McKusick, L., Coates, T. J ., Morin, S. G., Pollack, L., & Hoff, C. (1990). Longitudinal
predictors of reductions in unprotected anal intercourse among gay men in San
Francisco: The AIDS Behavioral Research Project. American Journal of Public
Health, 80, 978-983.

Mills, T. C., Paul, J ., Stall, R., Pollack, L., Canchola, J ., Chang, Y. S., Moskowitz, J. T.,
& Catania, J. A. (2004). Distress and depression in men who have sex with men:
The urban men’s health study. American Journal of Psychiatry, 161, 278-285.

Nichter, M., Nichter, M., Vuckovic, N., Quintero, G. & Ritenbaugh, C. (1997) Smoking
experimentation and initiation among adolescent girls: Qualitative and
quantitative findings. Tobacco Control, 6, 285—295.

Paul, J .P., Catania, J ., Pollack, L., Moskowitz, J ., Canchola, J ., Mills, T., Binson, D., &
Stall, R. (2002). Suicide attempts among gay and bisexual men: Lifetime
prevalence and antecedents. American Journal of Public Health, 92, 1338-1345.

Radkowsky, M. & Siegel, L. J. (1997). The gay adolescent: Stressors, adaptations, and
psychosocial interventions. Clinical Psychology Review, 17, 191-216.

Reis, E., & Saewyc, E. (1999). 83 000 youth: Select findings of eight population-based
studies as they pertain to anti-gay harassment and the safety and well-being of
sexual minority students. Seattle, WA: Safe Schools Coalition of Washington.

Remafedi, G., Farrow, J. A., & Deisher, R. W. (1991). Risk factors for attempted suicide
in gay and bisexual youth. Pediatrics, 87, 869-875.

58

Robin, L., Brener, N. D., Donahue, S. F., Hack, T., Hale, K., & Goodenow, C. (2004).
Associations between health risk behaviors and opposite-, same-, and both-sex
sexual partners in representative samples of Vermont and Massachusetts high
school students. Archives of Pediatrics & Adolescent Medicine, 15 6, 349—355.

Rosario, M., Schrimshaw, E. W., Hunter, J ., & Gwadz, M. (2002). Gay-related stress and
emotional distress among gay, lesbian, and bisexual youths: A longitudinal
examination. Journal of Consulting and Clinical Psychology, 70, 967-975.

Rose, A. J ., Swenson, L. P., & Waller, E. M. (2004). Overt and relational aggression and
perceived popularity: Developmental differences in concurrent and prospective
relations. Developmental Psychology, 40, 378-387.

Rotosky, S. S., Owens, G. P., Zimmerman, R. S., & Riggle, E. D. B. (2003). Associations
among sexual attraction status, school belonging, and alcohol and marijuana use
in rural high school students. Journal of Adolescence, 26, 741-751.

Russell, S. T. (2003). Sexual minority youth and suicide risk. American Behavioral
Scientist, 46, 1241-1257.

Russell, S. T. (2006). Substance use and abuse and mental health among sexual minority
youth: Evidence from Add Health. In A. Omoto, & H. Kurtzman (Eds), Sexual
Orientation and Mental Health: Examining Identity and Development in Lesbian,
Gay, and Bisexual People. (pp.13-35). Washington, DC: APA Books.

Russell, S. T., & Consolacion, T. B. (2003). Adolescent romance and emotional health in
the United States: Beyond binaries. Journal of Clinical Child and Adolescent
Psychology, 32, 499-508.

Russell, S. T., Driscoll, A. K., & Truong, N. (2002). Adolescent same-sex romantic
attractions and relationships: Implications for substance use and abuse. American
Journal of Public Health, 92, 198-202.

Russell, S. T., Franz, B. T., & Driscoll, A. K. (2001a). Same-sex romantic attraction and
experiences of violence in adolescence. American Journal of Public Health, 91,
903-906.

Russell, S. T., & Joyner, K. (2001). Adolescent sexual orientation and suicide risk:
Evidence from a national study. American Journal of Public Health, 91, 1276-
1281.

Russell, S. T., Seif, H., & Truong, N. L. (2001b). School outcomes of sexual minority

youth in the United States: Evidence from a national study. Journal of
Adolescence, 24, 1 1 1-127.

59

Sandfort, T.G., de Graaf, R., Bijl, R.V., & Schnabel, P. (2001). Same-sex sexual behavior
and psychiatric disorders: Findings from the Netherlands Mental Health Survey
and Incidence Study (N EMESIS). Archives of General Psychiatry, 58, 85-91.

Santor , D. A., Messervey, D., & Kusumakar, V. (2000). Measuring peer pressure,
popularity, and conformity in young adolescent boys and girls: Predicting school
performance, sexual attitudes, and substance use. Journal of Youth and
Adolescence, 29, 163-182.

Savin-Williams, R. C. (1998). “...And then I became gay”: Young men’s stories. New
York: Routledge.

Schneider, S. G., F arberow, N. L., & Kruks, G. N. (1989). Suicidal behavior in
adolescent and young adult gay men. Suicide and Life- Threatening Behavior, 19,
381-394.

Schneider, M. E., & Owens, R. E. (2000). Concern for lesbian, gay, and bisexual kinds:
The benefits for all children. Education and Urban Society, 32, 349-367.

Sullivan, M., & Wodarski, J .S. (2002). Social alienation in gay youth. Journal of Human
Behavior in the Social Environment, 5, 1-17.

Supple, A. J ., Aquilino, W. S., & Wright, D. L. (1999). Collecting sensitive self-report
data with laptop computers: Impact on the response tendencies of adolescents in a
home interview. Journal of Research on Adolescence, 9, 467-488.

Turner, C. F., Ku, L., Rogers, S. M., Lindberg, L. D., Pleck, J. H., & Sonenstein, F. L.
(1998). Adolescent sexual behavior, drug use, and violence: Increased reporting
with computer survey technology. Science, 280, 867-873.

Udry, J. R. (2003). The National Longitudinal Study of Adolescent Health (Add Health),
Waves 1 & 11, [994-1996; Wave 111, 2001-2002 [machine-readable data file and
documentation]. Chapel Hill, NC: Carolina Population Center, University of
North Carolina at Chapel Hill.

Unks, G. (Ed.). (1995). The gay teen: Educational practice and theory for lesbian, gay,
and bisexual adolescents. New York: Routledge.

Uribe, V. & Harbeck, K. M. (1992). Addressing the needs of lesbian, gay, and bisexual
youth: The origins of PROJECT 10 and school-based intervention. In K. Harbeck
(Ed.), Coming out of the classroom closet: Gay and lesbian students, teachers,
and curricula (pp. 9-28). New York: Harrington Park Press.

van Wormer, K., & McKinney, R. (2003). What schools can do to help

gay/lesbian/bisexual youth: A harm reduction approach. Adolescence, 38, 409-
420.

60

Wallace, J. M., Bachman, J. G., O’Malley, P. M., Johnston, L. D., Schulenberg, J. E., &
Cooper, S. M. (2002). Tobacco, alcohol, and illicit drug use: Racial and ethnic
differences among US. high school seniors, 1976-2000. Public Health Reports,
11 7, S67-S75.

Williams, T., Connolly, J., Pepler, D., & Craig, W. (2005). Peer victimization, social
support, and psychosocial adjustment of sexual minority adolescents. Journal of
Youth and Adolescence, 34, 471-482.

Winters, K. C., Stinchfield, R. D., Henly, G. A., & Schwartz, R. H. (1990). Validity of
adolescent self-report of alcohol and other drug involvement. Substance Use &

Misuse, 25, 1379-1395.

Woog, D. (1995). School ’s out: The impact of gay and lesbian issues on America’s
schools. Boston: Alyson Publications.

61

MICHI N STATE UNIVERSITY LIBRARIES

lllllllll I II II I II III! II
3 1293 ([316! 7253