Risk factors for internalizing and externalizing problems among gay, lesbian, and bisexual adolescents

This study investigated the risk factors associated with internalizing and externalizing problems among 169 gay, lesbian, and bisexual adolescents, ages 13 to 18, in northern New England, who were recruited through multiple methods. Data were gathered on individual, family, and community risk factors and youths' mental health and behavioral functioning. The youths did not differ on internalizing or externalizing problems by gender or by sexual orientation. Multivariate analyses demonstrated that risk factors unrelated to sexual orientation explained 18 percent and 19 percent of the variance in internalizing and externalizing problems, respectively. Risk factors related to sexual orientation explained an additional 4 percent of the variance in youths' internalizing problems and 1 percent in youths' externalizing problems. The results suggest that adolescent service providers should carefully assess gay, lesbian, and bisexual adolescents for concerns related and not directly related to their sexual orientation, as well as concerns specific to their identity. Even youths with positive feelings about their sexual orientation may be at risk. Key words: adolescents; bisexual youths; gay youths; lesbian youths, mental health; risk factors ********** Research with gay, lesbian, and bisexual adolescents suggests high risk of emotional distress, such as symptoms of depression and anxiety (D'Augelli & Hershberger, 1993; Rosario, Rotheram-Borus, & Reid, 1996), suicidality (Rotheram-Borus, Hunter, & Rosario, 1994), and problem behaviors (Rosario et al.). Adolescents' growing awareness of romantic or sexual feelings for individuals of the same sex often occurs in family and community environments marked by stigmatization, victimization, and a lack of support (D'Augelli, Hershberger, & Pilkington, 1998). Gay, lesbian, and bisexual adolescents are coming out at younger ages (Herdt & Boxer, 1993), raising critical questions about how best to ensure their health and well-being, particularly because evidence suggests that early self-identification is associated with greater morbidity (Remafedi, Farrow, & Deisher, 1991). Little is known, however, about potential risk factors, or whether the risk factors are unique to their experience as gay, lesbian, and bisexual adolescents or shared with other vulnerable adolescents. Research with gay, lesbian, and bisexual adolescents has tended to focus on risk factors specific to their sexual orientation (for example, age at self-labeling) rather than account for risk factors that have been implicated in child and adolescent psychopathology (for example, socioeconomic status or family mental health problems). Few studies have developed multivariate models to predict mental health and behavior problems that incorporate risks specifically related to sexual orientation and risks shared with other vulnerable youths. RISK FACTORS FOR MENTAL HEALTH AND BEHAVIOR PROBLEMS Risk factors for adolescent mental health and behavior problems that are frequently cited in the literature include low socioeconomic status, marital discord, and family mental health problems (for example, Rae-Grant, Thomas, Offord, & Boyle, 1989), with the risk increasing as the risk factors increase (Rutter, 1979). Other studies point to gender (Reinherz et al., 1993), poor family functioning (Fleming & Offord, 1990), and a lack of family support (Lewinsohn et al., 1994). Many studies have linked chronic life stressors (for example, Masten, Best, & Garmezy, 1990) and stressful life events with depression, suicidality, and delinquency in adolescents (for example, Compas, Orosan, & Grant, 1993; Garrison, Jackson, Marsteller, McKeown, & Addy, 1990; Reinherz et al.; Tiet et al., 1998). Few studies have examined an array of risk factors experienced by gay, lesbian, and bisexual adolescents, and even fewer have included young lesbians or bisexual females. …