Bullying and Suicidality in Sexual Minority Youth: Testing Substance Use As a Mediator

Background and Purpose: Sexual minority youth experience disproportionate rates of bullying and victimization (e.g., Cenat et al., 2015; Jackman et al., 2020). Bullying happens at school, but is also prevalent on social media (Gonzales, 2014). Sexual minority youth often cope with bullying by using substances (e.g, Coulter et al., 2018; Huebner et al., 2014). Although substance use is common in adolescence (Johnson et al., 2014), it increases risk of mental health issues, such as suicidality by lowering inhibitions and increasing the likelihood of suicidal attempts (e.g., Poorolajal et al., 2016). Further, alcohol and marijuana are the most commonly used substances among adolescents and are depressants (Johnson et al., 2014), enhancing the risk of suicidality from ideation to attempted and completed suicide (Zullig et al., 2015). Bullying victimization is also linked to suicide, especially in sexual minority youth (e.g., Ahuja et al., 2015); however, current research has yet to assess whether the link between bullying victimization and suicidality can be explained by substance use in a sample of LGB youth. The purpose of this study is to examine the mediation effects of substance use on the relationship of LGB youth being bullied at school and electronically with considering suicide, planning suicide, attempting suicide, and attempting suicide with injuries.

Methods: This study analyzed data from the 2017 Youth Risk Behavior Survey (Centers for Disease Control and Prevention [2017] Youth Risk Behavior Survey Data). Data were filtered to only include responses of LGB youth. Logistic regression analysis was conducted. Model 1 tested the relationship between experiencing bullying victimization and experiences with suicidality. Model 2 tested substance use as a mediator between bullying victimization and suicidality.

Results: The sample (n=1494) was 60% BIPOC and 76% female, with an average age of 16. Model 1 found being threatened at school, being bullied at school, and being bullied electronically were all positively related to considering suicide (OR=1.15, p=.04; OR=2.63, p<.001; OR=1.90, p<.001), planning suicide (OR=1.16, p=.02; OR=1.96, p<.001; OR=1.99, p<.001), attempting suicide (OR=1.51, p<.001; OR=1.84, p=.001; OR=2.37, p<.001), and attempting suicide with injuries (OR=1.47, p<.001; OR=2.34, p=.003; OR=2.05, p=.01). Model 2 found significant indirect effects of being bullied at school with attempting suicide (total=.269, direct=.016) and attempting suicide with injuries (total=.260, direct=.232) via drinking alcohol We also found significant indirect effects of being bullied electronically with considering suicide (total=.298, direct=.288), planning suicide (total=.244, direct=.236), attempting suicide (total=.207, direct=.191), and attempting suicide with injuries (total=.098, direct=.087) via drinking alcohol. Binge drinking had significant indirect effects on being bullied electronically and planning suicide (total=.274, direct=.265), attempting suicide (total=.242, direct=.226), and attempting suicide with injuries (total=.107, direct=.094). Smoking marijuana had significant indirect effects on being bullied electronically with attempting suicide (total=.228, direct=.219) and attempting suicide with injuries (total=.093, direct=.086).

Implications: These findings raise concerns for sexual minority youth and their engagement with substance use. Understanding that substance use can explain how bullying is related to suicide, practice and program development can focus on substance use prevention and promoting healthy coping for experiences with bullying in attempt to prevent suicidality.