Current Studies
Intersectional Minority Stress, Structural Oppression, and Alcohol Use and Misuse among Sexual and Gender Minority Adolescents of Color (NIAAA R01 AA029989; PI Mereish)
The lab's current 5-year project examines the impact of intersectional minority stress (e.g., discrimination) and structural oppression (e.g., structural racism and heterosexism) on substance use and mental health outcomes of sexual and gender minority youth of color. Funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA; R01 AA029989), using a measurement-burst design, a combination of longitudinal and daily diary methods, our aims are to: 1) test the prospective associations between intersectional stress and structural oppression and alcohol and other drug (AOD) use and misuse among a national sample of sexual and gender minority adolescents (SGMA) of color over 2.5 years with 6-month time-points; 2) test the daily associations between intersectional stress and AOD outcomes among the sample over 10-days at each 6- month time point; 3) test protective and risk factors that attenuate or exacerbate the associations between intersectional stress and AOD use outcomes over adolescence across the 2.5 years and in daily life. The results will allow for more precise understanding of minority stress, structural oppression, and AOD use outcomes in this population and inform clinical assessment and the development of culturally sensitive interventions for SGMA of color.
Check back here soon for more information on how you can become involved as a participant!
Testing the Effects of a Self-Affirmation Writing Intervention for LGBTQ+ Adolescents
(PI: Diana Cox)
LGBTQ+ adolescents are often at higher risk for adverse psychological health outcomes compared to their heterosexual and cisgender peers. Effective, low-cost, and brief interventions are needed to address this disparity, yet there are few interventions that are empirically supported, tailored to adolescents, and accessible to this population. Researchers have emphasized the importance of affirming LGBTQ+ teens and their identities, but no adolescent interventions to date have focused solely on a self-affirmation approach. Self-affirmation facilitates a sense of worthiness through reflections on personal values and strengths, and it is often studied through expressive writing tasks. This pilot study will investigate the feasibility and efficacy of a self-affirmation writing intervention on improving mental health outcomes of LGBTQ+ adolescents.
Project COMIC – COMmunity, Identity, and Culture
(PI: Ethan Mereish)
Queer and transgender adolescents who are Black Indigenous, and People of Color (QTBIPOC) experience multiple and intersectional forms of oppression-based stressors, which negatively impact their wellbeing. This study aims to test the acceptability, feasibility, and preliminary effectiveness of a culturally affirming online comic intervention specifically designed to help QTBIPOC cope and resist oppression-based stressors.
Mental health and healthcare utilization among sexual and gender minority youth by race and ethnicity
(PI: Hyemin Lee)
Sexual and gender minority adolescents often face substantial mental health disparities, indicating greater mental health needs compared to their cisgender, heterosexual peers. Relatedly, sexual and gender minority adolescents are more likely to use mental healthcare services, such as psychotherapy and prescribed medication. However, despite increased service use, many still face unmet mental healthcare needs, receiving insufficient or no care when support is needed. Given that this population comprises a heterogeneous group with multiple, intersecting identities, and considering the lack of research on racial and ethnic disparities within this community, our study investigates racial and ethnic disparities in both mental health outcomes and mental healthcare utilization among sexual and gender minority adolescents.
Structural cissexism, psychological distress, and unmet healthcare needs among gender diverse adolescents
(PI: Hyemin Lee)
Gender diverse adolescents report disproportionately higher risks of psychological distress and poor mental health outcomes compared to their cisgender peers, leading to an increased need for and utilization of mental healthcare services. Mental health disparities among gender diverse adolescents have predominantly been attributed to individual-level experiences of oppression including both interpersonal (e.g., discrimination and victimization) and intrapersonal (e.g., internalized stigma, identity concealment) forms of cissexism. Despite increasing anti-transgender legislation across U.S. states, the impact of structural forms of cissexism on mental health and mental healthcare utilization remains understudied among gender diverse adolescents. To address these limitations, this study examines the associations between state-level structural cissexism, psychological distress, and unmet mental healthcare needs in a large national sample of gender diverse adolescents.
Intersecting impact of state-level structural anti-Asian racism and cisheterosexism on Asian American sexual and gender minority youths' mental health and substance use in post-COVID-19 era
(PI: Hyemin Lee)
Since the COVID-19 pandemic began, an alarming increase in anti-Asian stigma has been observed in the United States. Recent studies showed that anti-Asian harassment, violence, and hate crimes can negatively affect the mental health of Asian Americans during the COVID-19 pandemic. Moreover, there has been a surge in anti-LGBTQ legislation, particularly targeting youth. Significant findings from recent literature have highlighted the detrimental impact of structural cisheterosexism on the health and well-being of sexual and gender minority individuals. The intersection of these two forms of structural oppression—anti-Asian racism and cisheterosexism—presents a unique and understudied challenge for Asian American sexual and gender minority adolescents. However, to our knowledge, no study has investigated the intersectional effects of structural anti-Asian racism and cisheterosexism among Asian American sexual and gender minority adolescents. This study aims to address this critical gap by examining the intersecting impact of state-level structural anti-Asian racism and cisheterosexism on Asian American sexual and gender minority adolescents' psychological distress, sleep trouble, and substance use in the post-COVID-19 era.
Completed Studies
Minority Stress Reactivity and Hazardous Drinking among Sexual Minority Heavy Drinkers
(NIAAA K08 AA025011; PI: Mereish)
Sexual minority (SM; i.e., lesbian, gay, or bisexual) adults are at increased risk for hazardous drinking as compared to heterosexual adults. SMs experience minority stressors and these are associated with hazardous drinking. Funded by NIH’s National Institute on Alcohol Abuse and Alcoholism (NIAAA; K08 AA025011), this study: 1) examined the effects of psychophysiological mechanisms underpinning minority stress and alcohol craving in a lab experiment of sexual minorities who are at most risk for developing AUD (i.e., heavy drinkers); and 2) used experience sampling methods (i.e., EMA) over a 30-day period, to examine: a) the effects of psychophysiological stress reactivity from the lab on minority stress reactivity and drinking in the natural environment and b) the prospective effects of minority stress on proximal changes in affect and drinking and its consequences in real time.
Suicidal and Nonsuicidal Self-Injurious Behavior in Sexual and Gender Minority Youth
(NIMH R21 MH1131183; PIs: Mereish & Yen)
Lesbian, gay, bisexual, transgender, and queer and other sexual and gender minority youth (SGMY) are at greater risk than their heterosexual counterparts for suicidal thoughts and behaviors (STB), nonsuicidal self-injury (NSSI), and myriad health problems. This study addressed gaps in the field by examining potential mechanisms that may account for the relationship between MS and STB/NSSI in SGMY. We investigated mechanisms across four areas: affective, cognitive, interpersonal, and SGMY-group specific factors. Funded by NIH’s National Institute of Mental Health (NIMH; R21MH1131183), we conducted an innovative exploratory study, administering subjective self-report measures and objective behavioral tasks to high risk SGMY, recruited from various clinical settings. Using a daily diary approach, we examined whether minority stress was associated with specific affective, cognitive, interpersonal, and group-specific mechanisms, and whether these are in turn associated with STB/NSSI in SGMY. We also conducted in-depth qualitative interviews with SGMY to understand their experiences with minority stress, STB/NSSI, and mental treatment to inform the development of future interventions for SGMY.
Minority Stress and Nicotine Use among Sexual Minority Youth
(NIMHD R21-MD010761; PIs: Mereish & Miranda)
Health disparities in tobacco and other substance use are well documented between sexual minorities (e.g., lesbian, gay, bisexual, or queer) and heterosexual individuals across the lifespan. In particular, sexual minority youth (SMY) initiate tobacco use at younger ages and smoke cigarettes at higher rates than their heterosexual counterparts. Stigma and discrimination-related stressors specific to their minority sexual orientation (i.e., minority stressors) contribute to our understanding of health disparities among SMY. Funded by the NIH’s National Institute on Minority Health and Health Disparities (NIMHD; R21 MD010761), this study examined: a) the relationship between minority stressors and proximal changes in nicotine use in real time in the natural environment among SMY nicotine using ecological momentary assessment (EMA) over a 30-day period; b) the effects of minority stressors on proximal changes in affect and craving; and, c) the mediating effects of affect and craving on the relationship between minority stressors and nicotine use. Secondary aims examined the effects of minority stressors on proximal changes in other substance use as well as to test resilience resources and contextual risk factors that might be associated with smoking. Findings from this exploratory study have important theoretical implications for minority stress theory and inform the development of culturally sensitive smoking prevention and cessation interventions for SMY, targeting specific within-individual mechanisms as well as contextual factors.
Association between Victimization and Substance Use Among Sexual and Gender Minority College Students of Color
(PI: Yajna Jowaheer)
This study seeks to investigate the associations among intimate partner victimization, non-intimate partner victimization, and substance use (alcohol, tobacco, and cannabis) among sexual and gender minority BIPOC college students. Furthermore, this study will explore the moderating effects of loneliness as a risk factor as well as resilience as a protective factor on the associations between victimization and substance use.
Minority Stress and Alcohol-Related Outcomes Among Transgender and Gender Diverse College Students: The Moderating Effects of Resilience and Flourishing
(PI: Steven Smathers)
Cissexism-specific minority stress is associated with greater negative alcohol-related outcomes (e.g., binge drinking, negative drinking-related consequences) among transgender and gender diverse (TGD) college students. The aim of this study is to examine the associations between minority stressors and alcohol-related outcomes among TGD college students and test the role of protective factors (e.g., resilience, flourishing) that may attenuate the negative impact of minority stress on alcohol-related outcomes.
Associations among Intimate Partner Violence, Suicidality, Non-Suicidal Self-Injury, and Psychological Well-Being in Black American Emerging Adults
(PI: Diamonde McCollum)
The goals of the current study are to examine the associations among intimate partner violence (IPV), suicidality, and nonsuicidal self-injury (NSSI) and test the moderating effect of psychological well-being on these associations in Black American emerging adults. This study is an essential contribution to current literature as IPV disproportionately affects Black Americans and suicide rates have alarmingly increased over the last decade within Black communities. Results from this study will inform intervention and prevention methods specifically for Black communities to combat rising rates of suicidality and engagement in NSSI.