Weight Discrimination and Self-Injurious Thoughts and Behaviors Among Sexual and Gender Minority Adolescents and their Peers

PROJECT SUMMARY/ABSTRACT Suicide is the second leading cause of death among early adolescents (i.e., ages 10-14), and adolescent suicide rates have nearly tripled in recent years. Self-injurious thoughts and behaviors (SITBs), such as non- suicidal self-injury, suicidal ideation, and suicidal behavior, commonly first occur during this period. Completed suicide is often preceded by SITBs, making understanding risk factors for SITBs in early adolescence a research priority. Experiences of discrimination are identified by Healthy People 2030 as a key social determinant of health. Various types of discrimination, including due to sexual identity and race/ethnicity, are known to be associated with higher risk of SITBs in early adolescence. Weight discrimination, among the most common types of discrimination in early adolescence, may also be associated with SITBs, but the existing evidence is limited. Sexual and gender minority (SGM) early adolescents, an NIH health disparities population, are about four times as likely as non-SGM early adolescents to experience SITBs, and they are also more likely to report weight discrimination. Thus, weight discrimination may be a particularly important risk factor for SITBs among SGM individuals, but this has yet to be studied among early adolescents. I propose to address these important gaps in the literature through a secondary analysis of data from the Adolescent Brain and Cognitive Development Study, a study of a large national sample of adolescents that is among the first to include measures of weight discrimination, SITBs, SGM identity, and other pertinent variables. Guided by an adaptation of Meyer’s Minority Stress Model, my specific aims are to (1) examine the association between weight discrimination and SITBs in adolescents ages 11-12 and (2) determine whether the association between weight discrimination and SITBs differs for SGM adolescents and heterosexual, cisgender adolescents. Additionally, in an exploratory aim I will explore potential differences in the association between weight discrimination, SGM identity, and SITBs based on SGM-related stress, racial/ethnic discrimination, and sex assigned at birth. Findings will inform future interventions to prevent suicide and promote mental health among adolescents (especially SGM adolescents) by addressing social determinants of health such as discrimination. The proposed aims align with the NINR’s Research Lenses of Prevention and Health Promotion, Social Determinants of Health, and Health Equity. To facilitate the proposed research, I will build my knowledge and skills in adolescent mental health, SGM health, data science, multilevel modelling, and moderation analysis. With the mentorship of a dedicated and NIH-funded interdisciplinary sponsorship team, and the resource-rich environment of Columbia University, I will build a strong foundation from which to move toward my long-term goal of becoming an independent, interdisciplinary nurse scientist with expertise in promoting adolescent mental health, particularly among SGM adolescents.