Understanding LGB Adolescent Binge Drinking: A Structural Equation Model of Minority Stress

Purpose: Lesbian, Gay and Bisexual (LGB) adolescents are at disproportionate risk for substance use (Marshal, et al., 2008), including the use alcohol (Moon et al., 2007).  Many studies have found that LGB adolescents are at higher risk for binge drinking than their heterosexual peers (i.e., Eisenberg & Wechsler, 2003b; McCabe, et al., 2003).  Despite a documented need, the mechanisms of use are not well understood (Hatzenbuehler, et al., 2008) and little research exists to explore the minority stress related factors that precipitate use by LGB youth (Goldbach, under review).

Methods: The current study presents a secondary analysis of a national online survey (OutProud, 2000) of 2,237 LGB adolescents (11-17 years old).  Culturally based risk factors for substance use in LGB adolescents identified through previous research (e.g., experiences of discrimination, internalized homophobia, social support) were used as predictors of a composite measure of binge drinking, which accounted for frequency and intensity of alcohol use.  Structural Equation Model (SEM) with latent variables was the overarching approach to analysis (Kline, 2004), beginning with separate confirmatory factor analysis (CFA) to verify indicator variables loaded onto interpretable latent factors.  Regression paths were systematically added between latent and observed variables to explore interrelationships.  Nonsignificant paths were removed until a parsimonious and best-fitting model was reached.

Results: The final model displayed excellent fit (CFI=0.987, TLI=0.985, RMSEA=0.036).  Internalized homophobia (b=0.206, t=4.049, p<0.001) and gay community connectedness (b=0.257, t=4.520, p<0001) were both positively associated with binge drinking. Experiencing violence/victimization (b=0.209, t=6.667, p<0.001) and Outness (b=0.115, t=7.351 p<0.001) were both associated with psychological distress; however psychological distress was not associated with binge drinking.

Implications: Findings suggest that LGB youth experience minority related stressors, which are associated with binge drinking behaviors.  Connection to the gay community was associated with reduced internalized homophobia but also with increased binge drinking, indicating that the gay community provides opportunities for both risk and support.  Further research is needed to elucidate the relationships between the community connection, psychological distress and binge drinking behaviors.