Daily Experiences of Minority Stress, Social Media Use, and Suicidality in LGBTQ+ Emerging Adults

Suicide remains a leading cause of death among LGBTQ+ emerging adults. There is limited research on the daily dynamics of minority stress, social media use, and suicide ideation and behavior among LGBTQ+ individuals. The proposed community-engaged, embedded mixed methods study aims to address this critical gap by conducting 21 days of ecological momentary assessment (EMA) capturing quantitative and qualitative data assessed within the framework of the Interpersonal–Psychological Theory of Suicide (IPTS). The study protocol and resulting data will be designed and analyzed in collaboration with a youth advisory team with lived experience to ensure the acceptability and relevance of the study. Study aims include (1) examining same-day and next-day associations between minority stress experiences, suicide ideation severity, and suicidal behavior 3 times daily over a 21-day period; (2) identifying themes related to minority stress, social media use, and suicidality using data from daily digital diaries and semi-structured interviews; (3) integrating quantitative EMA data with qualitative interview data to develop a comprehensive understanding of how LGBTQ+ emerging adults’ online minority stress experiences impact suicide ideation severity and social media use as a coping mechanism; and (4) assessing the acceptability, feasibility, and safety of the proposed methodology, as measured by retention, survey completion rates, adverse events, and participant feedback during the semi-structured interview. A minimum of 30 and maximum of 50 LGBTQ+ emerging adult study participants (ages 18–24) will be recruited from local hospitals and clinics, community organizations, and online social networks. We anticipate that (1) higher levels of minority stress will be associated with increased same-day and next-day suicide ideation severity (i.e., controllability, duration) and suicidal behavior (i.e., preparatory behavior, attempts); (2) the association between minority stress and suicide ideation severity will be mediated by IPTS suicidal desire constructs (i.e., unmet interpersonal needs); (3) the association between minority stress and suicide ideation severity will be mediated by interpersonally motivated social media use; and (4) the protocol will be acceptable, feasible, and safe. Findings from this study will inform evidence-based interventions (e.g., Just-in-Time Adaptive Interventions) that leverage digital health tools to reduce suicide risk among LGBTQ+ youth. By integrating EMA, mixed methods, and lived experience advisory board input, this project will contribute valuable insights into the real-time dynamics and social contexts of minority stress, social media use, and suicidality to guide future suicide prevention efforts for marginalized populations.