Criterion and Divergent Validity of the Sexual Minority Adolescent Stress Inventory

Jeremy T Goldbach,Mary R Mamey,Sheree M Schrager

doi:10.3389/fpsyg.2017.02057

Abstract

Sexual minority adolescents (SMA) consistently report health disparities compared to their heterosexual counterparts, yet the underlying mechanisms of these negative health outcomes remain unclear. The predominant explanatory model is the minority stress theory; however, this model was developed largely with adults, and no valid and comprehensive measure of minority stress has been developed for adolescents. The present study validated a newly developed instrument to measure minority stress among racially and ethnically diverse SMA. A sample of 346 SMA aged 14–17 was recruited and surveyed between February 2015 and July 2016. The focal measure of interest was the 64-item, 11-factor Sexual Minority Adolescent Stress Inventory (SMASI) developed in the initial phase of this study. Criterion validation measures included measures of depressive symptoms, suicidality and self-harm, youth problem behaviors, and substance use; the general Adolescent Stress Questionnaire (ASQ) was included as a measure of divergent validity. Analyses included Pearson and tetrachoric correlations to establish criterion and divergent validity and structural equation modeling to assess the explanatory utility of the SMASI relative to the ASQ. SMASI scores were significantly associated with all outcomes but only moderately associated with the ASQ (r = −0.13 to 0.51). Analyses revealed significant associations of a latent minority stress variable with both proximal and distal health outcomes beyond the variation explained by general stress. Results show that the SMASI is the first instrument to validly measure minority stress among SMA.

Highlights

Recent analyses of the National Longitudinal Study of Adolescent to Adult Health (Add Health) suggested that upward of 10% of youth do not identify as exclusively heterosexual and all sexual minority adolescent (SMA) subgroups report health disparities (Marshal et al, 2013)
In an effort to improve generalizability, youth were provided a referral code that they could share with their peers using respondent driven sampling (RDS; Heckathorn, 1997). 63.6% of youth in our sample were recruited through the RDS process
Numerous studies, including meta-analyses, have established evidence of significant health disparities for SMA as compared to their peers (Marshal et al, 2008, 2011; Friedman et al, 2011) and dozens of studies have attributed these outcomes to the presence of minority stress

Summary

Introduction

Recent analyses of the National Longitudinal Study of Adolescent to Adult Health (Add Health) suggested that upward of 10% of youth do not identify as exclusively heterosexual and all sexual minority adolescent (SMA) subgroups (gay, lesbian, bisexual, mostly heterosexual) report health disparities (Marshal et al, 2013). 3 times more likely to report a history of suicidality and 5 times more likely to make an attempt than their peers (Marshal et al, 2011) These youth more frequently report lower academic achievement (D’Augelli et al, 2002; Kosciw et al, 2012; Poteat et al, 2014) and higher rates of eating disorders and obesity (Austin et al, 2013) than their heterosexual peers. When these disparities occur in adolescence, they can negatively influence a lifelong trajectory of health (Baer, 1993)

Methods

Results

Conclusion