Peer Victimization and Risky Alcohol Use among Sexual Minority Youth: Understanding Mechanisms and Contexts

摘要 女同性恋者、男同性恋者、双性恋者、酷儿或质疑者，以及具有其他性少数身份的青少年 (LGBQ+）报告的饮酒模式比异性恋同龄人风险更高。这引起了人们的担忧， 在一般人群中发现的模式-早期，危险的酒精使用可能强烈预测以后的酒精问题 以及相关的有害健康后果（例如，其他药物滥用、受害、身体状况不佳和 心理健康），导致性少数成年人之间的健康差距。同伴的有害影响 受害（PV;即欺凌和性骚扰）对青少年心理社会功能的影响可能是其中之一 LGBQ+青年参与高风险酒精使用的途径。在青春期， 通过欺凌和仇视同性恋的性骚扰，社会规范得到强有力的执行。高得惊人 LGBQ+青年经历同性恋同伴攻击的人数。这种经历可能会导致内化 异性恋和性少数压力。性少数压力与增加的 性少数人群的整个生命周期中的酒精使用。横断面研究表明，PV是 与LGBQ+青少年的酒精和其他物质使用呈正相关。但 PV导致不良结局的机制和改善不良结局的保护因素 LGBTQ+青年的这些结果还没有得到很好的理解。了解PV影响的进展 对LGBQ+青少年的研究受到缺乏纵向和混合方法研究的阻碍， 包括这些年轻人。使用混合方法设计，拟议的研究将调查 PV对LGBQ+青少年危险酒精使用的急性每日和纵向影响，以及确定潜在的 这些结果的缓冲区和风险因素。数据来自500名青少年（年龄15-17岁，50%为女性） 身份，不同种族组成）将使用四个纵向调查（基线，6，12和18- 月随访）、两次每日报告（每次4周）和定性访谈。性知识 少数民族压力和心理中介理论，本研究旨在：（1）确定心理社会 LGBQ+青少年中PV与酒精和其他物质使用的联系机制;（2）了解日常生活 PV与酒精和物质使用之间的关联;（3）检查LGBQ+青年 体验PV并深入了解与PV和物质使用相关的心理社会因素。拟议 本研究采用了一种新的综合概念模型，该模型结合了光伏研究的现有知识 和物质使用与异性恋青年进行沿着与LGBQ+文献中确定的因素， 包括性少数压力和心理调解框架，以澄清所涉及的过程 LGBQ+青少年使用的药物。这项研究的结果对于理解这些途径至关重要， LGBQ+青少年参与高风险酒精使用的过程和背景， 制定一级预防计划，改善和保护LGBQ+青年的健康。

Abstract Lesbian, gay, bisexual, queer or questioning, and those youth with other sexual minority identities (LGBQ+) report riskier alcohol use patterns than their heterosexual peers. This raises concerns that—like patterns found in the general population—early, risky alcohol use may strongly predict later alcohol problems and related deleterious health consequences (e.g., other substance abuse, victimization, poor physical and mental health) that contribute to health disparities among sexual minority adults. The harmful effects of peer victimization (PV; i.e. bullying and sexual harassment) on adolescent psychosocial functioning may be one pathway through which LGBQ+ youth become involved in high-risk alcohol use. In adolescence, heterosexist social norms are strongly enforced through bullying and homophobic sexual harassment. Alarmingly high numbers of LGBQ+ youth experience homophobic peer aggression. Such experiences can lead to internalized heterosexism and sexual minority stress. Sexual minority stress has been strongly associated with increased alcohol use across the lifespan in sexual minority populations. Cross-sectional studies have shown that PV is positively associated with alcohol and other substance use among LGBQ+ adolescents. However, the mechanisms through which PV contributes to negative outcomes and the protective factors that ameliorate those outcomes among LGBTQ+ youth are not well understood. Advances in understanding the effects of PV on LGBQ+ adolescents have been hampered by a dearth of longitudinal and mixed methods studies that include these youth in their samples. Using a mixed methods design, the proposed study will investigate the acute daily and longitudinal effects of PV on LGBQ+ adolescent risky alcohol use, as well as identify potential buffers and risk factors for these outcomes. Data from 500 adolescents (ages 15-17 years, 50% female gender identity, diverse racial composition) will be collected using four longitudinal surveys (baseline, 6-, 12, and 18- month follow-ups), two bursts of daily reports (4-weeks each), and qualitative interviews. Informed by sexual minority stress and psychological mediation theories, the proposed study aims to: (1) identify the psychosocial mechanisms linking PV with alcohol and other substance use among LGBQ+ youth; (2) understand the daily associations between PV and alcohol and substance use; and (3) examine the contexts in which LGBQ+ youth experience PV and gain insight into the psychosocial factors related to PV and substance use. The proposed study utilizes a novel integrative conceptual model that incorporates extant knowledge from research on PV and substance use conducted with heterosexual youth along with factors identified in the LGBQ+ literature, including sexual minority stress and the psychological mediation framework, to clarify the processes implicated in substance use by LGBQ+ youth. Results from this study are critically needed to understand the pathways, processes and contexts through which LGBQ+ adolescents become involved in high-risk alcohol use to inform the development of primary prevention programs that improve and preserve the health of LGBQ+ youth.