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AFSP-funded LGBTQ research studies and publications

AFSP encourages research on suicide, suicide risk, and suicide prevention in the LGBTQ community. A better understanding of this increased suicidal ideation and behavior is needed across a wider range of samples and data collection methods.

Survey data suggest that individuals who identify as LGBT are at greater risk for suicide attempts. Confirmation and a better understanding of this increased suicidal ideation and behavior is needed across a wider range of samples and using a wider range of data collection methods. In an effort to learn more about this issue, we require that all AFSP-funded researchers who are collecting original data systematically assess research participants for the full spectrum of sexual orientation and gender identity using appropriate measures of demographics such as those provided by The Williams Institute.

AFSP-funded LGBTQ research studies

ABFT for LGBTQ Suicidal Youth: Feasibility, Acceptability and Transportability

Jody Russon, Ph.D., Drexel University
2016 Postdoctoral Fellowship
Findings pending publication

Strengths and Supports in the Lives of LGBT Youth: An Examination of Suicide Attempts and Thriving

Russell Toomey, Ph.D., Kent State University
2015 Standard Research Grant

Main Findings

There are notable differences between those who attempt suicide and those who do not, based on age, gender identity, sexual orientation, race, and ethnicity. Sexual minority and gender minority adolescents may be more likely to attempt suicide than heterosexual or cisgender adolescents. In terms of skills and traits that may protect from suicide risk, most sexual minority youth in this study reported fewer internal and external developmental assets (i.e. positive qualities or skills an individual may possess or that may be offered by their community, respectively). However, only decision-making skills and planning skills were found to be associated with risk for suicidal behavior with better skills related to lower risk. Therefore, when developing interventions, it is important to take gender identity and sexual orientation into account and include a focus on improving problem-solving and planning skills

Grant-Related References

Syvertsen, A.K., Scales, P.C., & Toomey, R.B. (2019). Developmental Assets framework revisited: Confirmatory analysis and invariance testing to create a new generation of assets measures for applied research, Applied Developmental Science, doi: 10.1080/10888691.2019.1613155

Toomey, R.B., Syvertsen, A.K., & Flores, M. (2019). Are Developmental Assets Protective Against Suicidal Behavior? Differential Associations by Sexual Orientation. Journal of Youth and Adolescence, 48:788–801. https://doi.org/10.1007/s10964-018-0954-y

Toomey, R. B., Syvertsen, A. K., & Shramko, M. (2018). Transgender Adolescent Suicide Behavior. Pediatrics, 142(4). https://doi.org/10.1542/peds.2017-4218.

Read more about Dr. Toomey’s findings on the risk and protective factors for suicide among LGBTQ adolescents in the Research Connection newsletter and learn three ways to support LGBTQ youth and protect against suicidal behavior.

Using Text Messages to Predict Depression and Suicidal Behavior among LGBT Individuals

Megan Lytle, Ph.D., University of Rochester Medical Center
2014 Young Investigator Grant
Findings pending publication

Explaining the Sexual Orientation Disparity in Adolescent Suicide Risk

Stephen Russell, Ph.D., University of Arizona

2008 Distinguished Investigator Grant

Main Findings

The increased risk for suicidal ideation and attempts among same-sex attracted men is mainly limited to the teenage years. Although the risk and protective factors for suicide among sexual minority adolescents are similar to those of heterosexual adolescents, there are certain risk factors and predictors for suicidal thoughts after adolescence in sexual minorities, including “personal and friends’ school connections and friendship activities.” More specifically, in this study, sexual minority youth who experienced thoughts of suicide reported feeling less connected to their schools and others within their schools and feeling less happy at school as compared to heterosexual youth with and without suicidal thoughts. These sexual minority youth also were more likely to report that their mother cares about them. For youth who did not experience suicidal thoughts, school connectedness and social connectedness at school were similar for sexual minority youth and heterosexual youth. Further, sexual minority youth who did not experience suicidal thoughts were found to participate in more activities with their friends than sexual minority youth who experienced thoughts of suicide.

Grant-Related References

Russell, S. T., Toomey, R. B. (2012). Men’s sexual orientation and suicide: Evidence for adolescent-specific risk. Social Science & Medicine. doi:10.1016/j.socscimed.2010.07.038

Russell, S. T., & Toomey, R. B. (2013). Risk and protective factors for suicidal thoughts among sexual minority youth: Evidence from the add health study. Journal of Gay & Lesbian Mental Health, 17(2), 132–149. https://doi.org/10.1080/19359705.2012.753398

Attachment-based Family Therapy for Suicidal and Depressed, Lesbian, Gay and Bisexual Adolescents: A Treatment Development Study

Gary Diamond, Ph.D., Children’s Hospital of Philadelphia
2007 Standard Research Grant

Main Findings

Attachment-based family therapy (ABFT) is an intervention that was adapted in structure and content to specifically treat adolescents who are gay, lesbian, and bisexual, and have suicidal thoughts. A specific adaptation included greater amounts of time spent delivering the intervention to parents alone in order to help parents integrate their religious beliefs with their child’s sexual orientation, and address fears about family or community rejection and concerns about their child’s safety and wellbeing. Greater attention to resolving parents’ fear, anger, and shame often led to increases in parents’ empathy and support for their children and the ability for parents to attend ABFT sessions with their children. Additional adaptations of ABFT included the promotion of adolescents’ awareness of and engagement in LGB-affirmative services, parental education on positive LGB lifestyles and community support groups, and conversations about parents’ acceptance of their children and children’s acceptance of their parents. For many of the parents, it was important to distinguish between tolerance and approval whereas for many adolescents, it was important to reframe acceptance as an ongoing process. A major goal of the treatment was to facilitate parental understanding that critical and aggressive rejection causes emotional damage and negatively impacts attachment with children. Additionally, for parents, the intervention included the identification and elimination of subtle invalidating behaviors, or microaggressions (e.g. disapproving facial expressions). Most of the 10 LGB adolescents who received this treatment in a pilot study experienced a significant reduction in suicidal ideation, depressive symptoms, and anxiety and avoidance related to maternal attachment.

Grant-Related Reference

Diamond, G. M., Diamond, G. S., Levy, S., Closs, C., Ladipo, T., & Siqueland, L. (2012). Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: A treatment development study and open trial with preliminary findings. Psychotherapy, 49(1), 62-71. doi:10.1037/a0026247

Prevalence and Predictors of Suicidality among GLB Youth

Brian Mustanski, Ph.D., University of Illinois at Chicago
2007 Young Investigator Grant

Main Findings

Almost a third of this sample of 250 adolescents who identified as LGB reported having ever attempted suicide with seven percent reporting an attempt in the past 12 months. Significant risk factors for suicidal ideation in this sample included a previous suicide attempt, impulsivity, low social support and victimization. As has been found in samples of youth who do not identify as LGBT, a history of suicide attempt was associated most with depressive symptoms and hopelessness and the strongest predictor of a future suicide attempt was a previous suicide attempt. 

Grant-Related References

Liu, R. T., & Mustanski, B. (2012). Suicidal Ideation and Self-Harm in Lesbian, Gay, Bisexual, and Transgender Youth. American Journal of Preventive Medicine, 42(3), 221-228. doi: http://dx.doi.org/10.1016/j.amepre.2011.10.023

Mustanski, B., & Liu, R. T. (2013). A longitudinal study of predictors of suicide attempts among lesbian, gay, bisexual, and transgender youth. Archives of sexual behavior, 42(3), 437-448.

Sexual Orientation and Risk for Adolescent Suicide

Michael Feldman, M.D., Columbia University
1997 Institutional Research Grant

Suicide in Gay Men

Ilan Meyer, Ph.D., Columbia University
1994 Institutional Research Grant

Main Findings

Through his research, Dr. Meyer found that an important risk factor for suicide among individuals who are gay, lesbian, and bisexual is minority stress, or stress that an LGBTQ individual can experience as a result of being in a minority group because of their sexual orientation and/or gender identity. This stress is often caused by prejudice, discrimination, and stigma, each of which make it more difficult for the individual to engage in social situations and ultimately has a negative impact on the individuals’ mental health.

Grant-Related References

Meyer I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychological bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674

Publications from AFSP-funded LGBTQ research

Syvertsen, A.K., Scales, P.C., & Toomey, R.B. (2019). Developmental Assets framework revisited: Confirmatory analysis and invariance testing to create a new generation of assets measures for applied research, Applied Developmental Science, DOI: 10.1080/10888691.2019.1613155

Toomey, R.B., Syvertsen, A.K., & Flores, M. (2019). Are Developmental Assets Protective Against Suicidal Behavior? Differential Associations by Sexual Orientation. Journal of Youth and Adolescence, 48:788–801. https://doi.org/10.1007/s10964-018-0954-y

Toomey, R. B., Syvertsen, A. K., & Shramko, M. (2018). Transgender Adolescent Suicide Behavior. Pediatrics, 142(4). https://doi.org/10.1542/peds.2017-4218

Ibrahim, M., Russon, J., Levy, S., & Diamond, G. (2018). Promoting parental acceptance of bisexuality: A case study of attachment-based family therapy. Journal of Family Psychotherapy, 29(3), 223-251. doi:10.1080/08975353.2018.1427401

Shearer, A., Russon, J., Herres, J., Wong, A., Jacobs, C., Diamond, G. M., & Diamond, G. S. (2017). Religion, Sexual Orientation, and Suicide Attempts among a Sample of Suicidal Adolescents. Suicide & Life-Threatening Behavior. doi:10.1111/sltb.12372

Russon, J., Levy, S. A., & Diamond, G. M. (2016). Attachment-Based Family Therapy for Suicidal Lesbian, Gay, and Bisexual Adolescents: A Case Study. Australian and New Zealand Journal of Family Therapy, 37(2), 190-206. doi:10.1002/anzf.1151

Rutter, T. M., Flentje, A., Dilley, J. W., Barakat, S., Liu, N. H., Gross, M. S., & Leykin, Y. (2016). Sexual orientation and treatment-seeking for depression in a multilingual worldwide sample. Journal of Affective Disorders, 206, 87-93. doi:http://doi.org/10.1016/j.jad.2016.07.003

Mustanski, B., & Liu, R. T. (2013). A longitudinal study of predictors of suicide attempts among lesbian, gay, bisexual, and transgender youth. Archives of sexual behavior, 42(3), 437-448.

Russell, S. T., & Toomey, R. B. (2013). Risk and Protective Factors for Suicidal Thoughts Among Sexual Minority Youth: Evidence from the Add Health Study. Journal of Gay & Lesbian Mental Health, 17(2), 132-149. doi:10.1080/19359705.2012.753398

Beidas, R. S., Birkett, M., Newcomb, M. E., & Mustanski, B. (2012). Do psychiatric disorders moderate the relationship between psychological distress and sexual risk-taking behaviors in young men who have sex with men? A longitudinal perspective. AIDS Patient Care And Stds, 26(6), 366-374. doi:10.1089/apc.2011.0418

Diamond, G. M., Diamond, G. S., Levy, S., Closs, C., Ladipo, T., & Siqueland, L. (2012). Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: A treatment development study and open trial with preliminary findings. Psychotherapy, 49(1), 62-71. doi:10.1037/a0026247

Liu, R. T., & Mustanski, B. (2012). Suicidal Ideation and Self-Harm in Lesbian, Gay, Bisexual, and Transgender Youth. American Journal of Preventive Medicine, 42(3), 221-228. doi:http://dx.doi.org/10.1016/j.amepre.2011.10.023

Newcomb, M. E., Heinz, A. J., & Mustanski, B. (2012). Examining Risk and Protective Factors for Alcohol Use in Lesbian, Gay, Bisexual, and Transgender Youth: A Longitudinal Multilevel Analysis. Journal of Studies on Alcohol and Drugs, 73(5), 783-793. doi:10.15288/jsad.2012.73.783

Russell, S. T., & Toomey, R. B. (2012). Men’s sexual orientation and suicide: Evidence for U.S. adolescent-specific risk. Social Science & Medicine, 74(4), 523-529. doi:http://dx.doi.org/10.1016/j.socscimed.2010.07.038

Clerkin, E. M., Newcomb, M. E., & Mustanski, B. (2011). Unpacking the racial disparity in HIV rates: the effect of race on risky sexual behavior among Black young men who have sex with men (YMSM). Journal of Behavioral Medicine, 34(4), 237-243. doi:10.1007/s10865-010-9306-4

Diamond, G. M., Shilo, G., Jurgensen, E., D’Augelli, A., Samarova, V., & White, K. (2011). How Depressed and Suicidal Sexual Minority Adolescents Understand the Causes of Their Distress. Journal of Gay & Lesbian Mental Health, 15(2), 130-151. doi:10.1080/19359705.2010.532668

Du Bois, S. N., Emerson, E., & Mustanski, B. (2011). Condom-Related Problems Among a Racially Diverse Sample of Young Men Who Have Sex with Men. AIDS and Behavior, 15(7), 1342-1346. doi:10.1007/s10461-010-9862-1

Mustanski, B., Newcomb, M. E., & Clerkin, E. M. (2011). Relationship characteristics and sexual risk-taking in young men who have sex with men. Health Psychology, 30(5), 597-605. doi:10.1037/a0023858

Mustanski, B. S., Garofalo, R., & Emerson, E. M. (2010). Mental Health Disorders, Psychological Distress, and Suicidality in a Diverse Sample of Lesbian, Gay, Bisexual, and Transgender Youths. American Journal of Public Health, 100(12), 2426-2432. doi:10.2105/ajph.2009.178319

Additional publications

Haas, A. P., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., D'Augelli, A. R., ... & Russell, S. T. (2010). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendations. Journal of homosexuality58(1), 10-51.

Haas, A. P., Lane, A., & Working Group for Postmortem Identification of SO/GI. (2015). Collecting sexual orientation and gender identity data in suicide and other violent deaths: A step towards identifying and addressing LGBT mortality disparities. LGBT health2(1), 84-87.

Haas, A. P., Lane, A. D., Blosnich, J. R., Butcher, B. A., & Mortali, M. G. (2019). Collecting sexual orientation and gender identity information at death. American journal of public health109(2), 255-259.

Haas, A. P., & Mortali, M. G. (2020). 14 Suicidal Behavior among Sexual and Gender Minority Populations. The Oxford Handbook of Sexual and Gender Minority Mental Health, 159.

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