Depression and Anxiety in Sexual Minority Youth: What Role Does Bullying Play?

Background and Purpose

              Sexual minority youth (SMY) are at disproportionate risk of developing depression and anxiety than their sexual majority peers. SMY are also more likely to experience bullying, which has been identified as a risk factor for depression and anxiety in adolescents. Although bullying has been identified as a risk factor for both depression and anxiety, and SMY have higher rates of being bullied, the potential mediating effects of being bullied on subsequent development of depression and anxiety has not been well studied in this population, the primary focus of this study.

Methods

              The present study was a secondary analysis of data collected in the most recent wave (2014-2017) of the Fragile Families and Child Wellbeing Study (FFCWS). FFCWS is a national longitudinal study that first interviewed primary caregivers when their children were born (1998-2000). We utilized interviews with 3,189 now adolescent (approximately age 15) participants in FFCWS. SMY were identified as those who indicated having “ever liked a person of the same sex as more than a friend”. Depression was measured using a five-item scale drawn from the CES-D. Anxiety was measured using a six-item scale based on the BSI-18. Frequency of being bullied in the past month was measured using a five-point Likert scale with response options ranging from 0 (“Never”) to 4 (“About every day”). Ordinary least squares (OLS) regression was used to separately model the outcomes of depression and anxiety and included covariates adjusting for the effects of age, race/ethnicity, and poverty level. Parameter variances were estimated using jackknife replicate weights to control for survey design effects. Mediation effects were assessed using a Sobel-Goodman test with bootstrapped standard errors.

Results

Bullying partially mediated the associations among elevated levels of anxiety and depression for SMY. SMY had a higher mean level (b=.54, p<.001) of depression compared with sexual majority youth that decomposed into a direct effect of being in a sexual minority (b=.48, p<.001) with an indirect (mediated) effect of experiencing bullying (b=.07, p<.001). Similarly, SMY had a higher mean level of anxiety (b=.31, p<.001) that was mediated through the indirect effect of having been bullied (b=.07, p<.05). Hence, being bullied accounted for 22% of the variance in depression and 12% of the variance in anxiety attributable to sexual minority status.

Conclusions and Implications

              While SMY are more likely than their sexual majority peers to experience depression and anxiety, bullying appears to significantly mediate the relationship between SMY and mental health. This suggests that developing policies and programs directed at reducing bullying could positively impact the mental health of youth who are at disproportionate risk for depression, anxiety, and suicide. Programs that have been shown to have a positive impact on bullying experienced by these youth include Gay-Straight Alliance (GSA) and others which foster a supportive climate for SMY. Future research should explore the broader effects of school climate on the prevalence of bullying and the mental health of SMY to more effectively support SMY and prevent depression, anxiety, and suicide.