The Role of Alcohol Use in the Relationship between Bullying Victimization and Suicidality: Differences between Gay/Lesbian and Bisexual Youth

Background and Purpose: Sexual minority youth experience disproportionate rates of bullying victimization (e.g., Cenat et al., 2015; Jackman et al., 2020). Bullying happens at school, but is also prevalent electronically (Gonzales, 2014). Youth may cope with bullying by using substances (e.g, Coulter et al., 2018; Huebner et al., 2014), particularly alcohol, which can increase risk of mental health issues, such as suicidality (e.g., Poorolajal et al., 2016). In addition, bullying victimization is linked to suicide, especially in sexual minority youth (e.g., Ahuja et al., 2015). Some studies show that bisexual youth experience worse outcomes than gay/lesbian (monsexual) youth, particularly regarding alcohol use and suicidality (Fish, 2021; Horwitz et al., 2021). The purpose of this study is to examine the mediation effects of alcohol use on the relationship being bullying victimization (in-person and electronically) and attempting suicide. In addition, we tested the equivalence of model paths between gay/lesbian (monosexual) youth and bisexual youth.

Methods: Using data from the 2017 Youth Risk Behavior Survey (Centers for Disease Control and Prevention [CDC], 2017), we: 1) conducted a mediational SEM path analysis to examine the relationship between bullying victimizaton and suicide attempts among 1,494 lesbian, gay, and bisexual young people, 2) tested whether alcohol use mediated that relationship, and 3) examined potential differences in relationship pathways for bisexual youth vs. gay/lesbian youth using multigroup path models.

Results: Over three quarters (76%) of youth identified as bisexual vs. gay/lesbian (24%). Average age of participants was 16 yrs. The majority identified as female (76%) and BIPOC (60%). Thirty-one percent of the sample had experienced bullying in some form. We found significant direct effects of being bullied electronically with alcohol use (b=.52, p<.001). We also found significant direct effects of being bullied in person and electronically with suicide attempts (b=.250, p<.001; b=.334, p<.001) and a direct effect of alcohol use with suicide attempts (b=.095, p<.001). Alcohol use mediated the relationship between being bullied electronically with suicide attempts, but not for being bullied in person. Multigroup models showed that paths differed for gay/lesbian and bisexual youth with alcohol use mediating the relationship between electronic bullying and suicide attempts for bisexual youth, but not for gay/lesbian youth. .

Implications: Prevention interventions that focus on the connections between victimization, suicidality and substance use may be more effective than those centered on preventing one outcome, especially for sexual minority youth who experience disproportionate rates of victimization in adolescence. Additionally, understanding that the risk factors for sexual minority youth may differ based on individual identity is important to promoting positive outcomes and overall wellbeing for sexual minority youth.