Journal of Youth and Adolescence

, Volume 42, Issue 8, pp 1243–1256 | Cite as

Trajectories of Depressive Symptoms and Suicidality Among Heterosexual and Sexual Minority Youth

  • Michael P. Marshal
  • Sarah S. Dermody
  • JeeWon Cheong
  • Chad M. Burton
  • Mark S. Friedman
  • Frances Aranda
  • Tonda L. Hughes
Empirical Research


Sexual minority youth report higher rates of depression and suicidality than do heterosexual youth. Little is known, however, about whether these disparities continue as youth transition into young adulthood. The primary goals of this study were to describe and compare trajectories of adolescent depressive symptoms and suicidality among sexual minority and heterosexual youth, examine differences in depressive symptoms and suicidality trajectories across sexual orientation subgroups, and determine whether there are gender differences in these longitudinal disparities. Four waves of data from the National Longitudinal Study of Adolescent Health were analyzed using latent curve modeling (N = 12,379; 53 % female). Results showed that the rates of depressive symptoms and suicidality in early adolescence were higher among sexual minority youth than among heterosexual youth, and that these disparities persisted over time as participants transitioned into young adulthood. Consistent with previous cross-sectional studies, the observed longitudinal disparities were largest for females and for bisexually-identified youth. Sexual minority youth may benefit from childhood and early adolescent prevention and intervention programs.


Sexual minority youth Lesbian, gay, and bisexual youth Sexual orientation Depressive symptoms Suicidality Trajectories Latent growth curve modeling 



The production of this manuscript was supported by grants awarded to the first author from the National Institute of Drug Abuse (DA030385 and DA026312). We would like to thank Stephanie Miller for her help with manuscript preparation. This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by Grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website ( No direct support was received from Grant P01-HD31921 for this analysis.

Author contributions

MPM conceived of the study, participated in its design and coordination and drafted the manuscript; SSD participated in the design of the study, conducted all of the analyses, drafted the Method and Results sections, JWC participated in the design of the study, supervised the data analysis and interpretation, and assisted with drafting the Results section, CMB participated in its design and coordination and helped to draft the manuscript, MSF, FA, and TH participated in the design of the study and assisted with drafting components of the Introduction and Discussion. All authors read, edited, and approved the final manuscript.


  1. Almeida, J., Johnson, R. M., Corliss, H. L., Molnar, B. E., & Azrael, D. (2009). Emotional distress among LGBT youth: The influence of perceived discrimination based on sexual orientation. Journal of Youth and Adolescence, 38, 1001–1014.PubMedCrossRefGoogle Scholar
  2. Austin, S. B., Ziyadeh, N., Fisher, L. B., Kahn, J. A., Colditz, G. A., & Frazier, A. L. (2004). Sexual orientation and tobacco use in a cohort study of US adolescent girls and boys. Archives of Pediatric and Adolescent Medicine, 158, 317–322.CrossRefGoogle Scholar
  3. Bertolote, J. M., & Fleischmann, A. (2002). A global perspective in the epidemiology of suicide. Suicidology, 7, 6–8.Google Scholar
  4. Bollen, K. A., & Curran, P. J. (2006). Latent curve models: A structural equation approach. Hoboken, NJ: Wiley Series in Probability and Mathematical Statistics.Google Scholar
  5. Bostwick, W. B., Boyd, C. J., Hughes, T. L., & McCabe, S. E. (2010). Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. American Journal of Public Health, 100, 468–475.PubMedCrossRefGoogle Scholar
  6. Brent, D. A., Poling, K. D., & Goldstein, T. R. (2011). Treating depressed and suicidal adolescents: A clinician’s guide. New York: Guilford.Google Scholar
  7. Burton, C. M., Marshal, M. P., Chisolm, D. J., Sucato, G. S., & Friedman, M. S. (2013). Sexual minority-related victimization as a mediator of mental health disparities in sexual minority youth: A longitudinal analysis. Journal of Youth and Adolescence, 42, 394–402.PubMedCrossRefGoogle Scholar
  8. Chantala, K. (2003). Introduction to analyzing add health data. Prepared for the add health users workshop, National Institutes of health. Retrieved June 10, 2011, from
  9. Cicchetti, D., & Cohen, D. J. (Eds.). (2006). Developmental psychopathology: Theory and method (2nd ed., Vol. 1). Hoboken, NJ: Wiley.Google Scholar
  10. Cochran, S. D., Sullivan, J. G., & Mays, V. M. (2003). Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. Journal of Consulting and Clinical Psychology, 71, 53–61.PubMedCrossRefGoogle Scholar
  11. Collins, P., Patel, V., Joestl, S., March, D., Insel, T., & Daar, A. (2011). Grand challenges in global mental health. Nature, 475(7354), 27–30.PubMedCrossRefGoogle Scholar
  12. Corliss, H. L., Rosario, M., Wypij, D., Fisher, L. B., & Austin, S. B. (2008). Sexual orientation disparities in longitudinal alcohol use patterns among adolescents: findings from the growing up today study. Archives of Pediatrics and Adolescent Medicine, 162, 1071–1078.PubMedCrossRefGoogle Scholar
  13. Corliss, H. L., Wadler, B. M., Jun, H. J., Rosario, M., Wypij, D., Frazier, A. L., et al. (2013). Sexual-orientation disparities in cigarette smoking in a longitudinal cohort study of adolescents. Nicotine & Tobacco Research, 15, 213–222.CrossRefGoogle Scholar
  14. Cyranowski, J. M., Frank, E., Young, E., & Shear, K. (2000). Adolescent onset of the gender difference in lifetime rates of major depression: A theoretical model. Archives of General Psychiatry, 57, 21–27.PubMedCrossRefGoogle Scholar
  15. Dekker, M. C., Ferdinand, R. F., Van Lang, N. D., Bongers, I. L., Van Der Ende, J., & Verhulst, F. C. (2007). Developmental trajectories of depressive symptoms from early childhood to late adolescence: Gender differences and adult outcome. Journal of Child Psychology and Psychiatry, 48, 657–666.PubMedCrossRefGoogle Scholar
  16. Dermody, S. S., Marshal, M. P., Cheong, J. W., Burton, C. M., Friedman, M. S., Aranda, F., & Hughes, T. (2013). Longitudinal disparities of hazardous drinking between sexual minority and heterosexual individuals from adolescence to young adulthood. Journal of Youth and Adolescence. doi: 10.1007/s10964-013-9905-9.
  17. Friedman, M. S., Marshal, M. P., Guadamuz, T. E., Wei, C., Wong, C. F., Saewyc, E. M., et al. (2011). A meta-analysis of disparities in childhood sexual abuse, parental physical abuse, and peer victimization among sexual minority and sexual nonminority individuals. American Journal of Public Health, 101, 1481–1494.PubMedCrossRefGoogle Scholar
  18. Friedman, M. S., Marshal, M. P., Stall, R., Cheong, J., & Wright, E. R. (2008). Gay-related development, early abuse and adult health outcomes among gay males. AIDS and Behavior, 12, 891–902.PubMedCrossRefGoogle Scholar
  19. Galliher, R. V., Rostosky, S. S., & Hughes, H. K. (2004). School belonging, self-esteem, and depressive symptoms in adolescents: An examination of sex, sexual attraction status, and urbanicity. Journal of Youth and Adolescence, 33, 235–245.CrossRefGoogle Scholar
  20. Garber, J., Keiley, M. K., & Martin, N. C. (2002). Developmental trajectories of adolescents depressive symptoms: Predictors of change. Journal of Consulting and Clinical Psychology, 70, 79–95.PubMedCrossRefGoogle Scholar
  21. Ge, X., Conger, R. D., & Elder, G. H. (2001). Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms. Developmental Psychology, 37, 404–416.PubMedCrossRefGoogle Scholar
  22. Ge, X., Lorenz, F. O., Conger, R. D., Elder, G. H., & Simons, R. L. (1994). Trajectories of stressful life events and depressive symptoms during adolescence. Developmental Psychology, 30, 467–483.CrossRefGoogle Scholar
  23. Haas, A., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., D’Augelli, A. R., et al. (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendations. Journal of Homosexuality, 58, 10–51.PubMedCrossRefGoogle Scholar
  24. Hankin, B. L., Abramson, L. Y., Moffitt, T. E., Silva, P. A., McGee, R., & Angell, K. E. (1998). Development of depression from preadolescence to young adulthood: Emerging gender differences in a 10-year longitudinal study. Journal of Abnormal Psychology, 107, 128–140.PubMedCrossRefGoogle Scholar
  25. Harris, K. M. (2009). The national longitudinal study of adolescent health (Add Health), Waves I & II, 1994–1996; Wave III, 2001–2002; Wave IV, 2007–2009 [machine-readable data file and documentation]. Chapel Hill, NC: Carolina Population Center, University of North Carolina at Chapel Hill.Google Scholar
  26. Heck, J. E., Sell, R. L., & Gorin, S. S. (2006). Health care access among individuals involved in same-sex relationships. American Journal of Public Health, 96, 1111–1118.PubMedCrossRefGoogle Scholar
  27. Hughes, T., Szalacha, L. A., & McNair, R. (2010). Substance abuse and mental health disparities: Comparisons across sexual identity groups in a national sample of young Australian women. Social Science and Medicine, 71, 824–831.PubMedCrossRefGoogle Scholar
  28. Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, DC: The National Academic Press.Google Scholar
  29. King, M., Semlyen, J., Tai, S. S., Killaspy, H., Osborn, D., Popelyuk, D., et al. (2008). A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry, 8, 70–87.PubMedCrossRefGoogle Scholar
  30. Marshal, M. P., Dietz, L. J., Friedman, M. S., Stall, R., Smith, H. A., McGinley, J., et al. (2011). Suicidality and depression disparities between sexual minority and heterosexual youth: A meta-analytic review. Journal of Adolescent Health, 49, 115–123.PubMedCrossRefGoogle Scholar
  31. Marshal, M. P., Friedman, M. S., Stall, R., King, K. M., Miles, J., Gold, M. A., et al. (2008). Sexual orientation and adolescent substance use: A meta-analysis and methodological review. Addiction, 103, 546–556.PubMedCrossRefGoogle Scholar
  32. Marshal, M. P., Friedman, M. S., Stall, R., & Thompson, A. L. (2009). Individual trajectories of substance use in lesbian, gay, and bisexual youth and heterosexual youth. Addiction, 104, 974–981.PubMedCrossRefGoogle Scholar
  33. Marshal, M. P., King, K. M., Stepp, S. D., Hipwell, A., Smith, H. A., Chung, T., et al. (2012). Trajectories of alcohol and cigarette use among sexual minority and heterosexual girls. Journal of Adolescent Health, 50, 97–99.PubMedCrossRefGoogle Scholar
  34. McCabe, S. E., Hughes, T. L., Bostwick, W., & Boyd, C. J. (2005). Assessment of difference in dimensions of sexual orientation: Implications for substance use research in a college-age population. Journal of Studies on Alcohol, 66, 620–629.PubMedGoogle Scholar
  35. Meadows, S. O., Brown, J. S., & Elder, G. H., Jr. (2006). Depressive symptoms, stress, and support: Gendered trajectories from adolescence to young adulthood. Journal of Youth and Adolescence, 35, 89–99.CrossRefGoogle Scholar
  36. Mehta, P. D., & West, S. G. (2000). Putting the individual back into individual growth curves. Psychological Methods, 5, 23–43.PubMedCrossRefGoogle Scholar
  37. Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697.PubMedCrossRefGoogle Scholar
  38. Muthén, L. K., & Muthén, B. O. (1998–2010). Mplus 6.0 [Computer Software]. Los Angeles, CA: Muthén & Muthén.Google Scholar
  39. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
  40. Remafedi, G., French, S., Story, M., Resnick, M. D., & Blum, R. (1998). The relationship between suicide risk and sexual orientation: Results of a population-based study. American Journal of Public Health, 88, 57–60.PubMedCrossRefGoogle Scholar
  41. Russell, S. T., & Joyner, K. (2001). Adolescent sexual orientation and suicide risk: Evidence from a national study. American Journal of Public Health, 91, 1276–1281.PubMedCrossRefGoogle Scholar
  42. Ryan, C. (2010). Engaging families to support lesbian, gay, bisexual, and transgender youth: The family acceptance project. Prevention Researcher, 17, 11–13.Google Scholar
  43. Satorra, A., & Bentler, P. M. (2001). A scaled difference Chi square test statistic for moment structure analysis. Psychometrika, 66, 507–514.CrossRefGoogle Scholar
  44. Stapleton, L. M. (2006). An assessment of practical solutions for structural equation modeling with complex sample data. Structural Equation Modeling, 13, 28–58.CrossRefGoogle Scholar
  45. Tourangeau, R., & Shin, H. C. (1999). Grand sample weight. Retrieved June 10, 2011, from
  46. Williams, T., Connolly, J., Pepler, D., & Craig, W. (2005). Peer victimization, social support, and psychosocial adjustment of sexual minority adolescents. Journal of Youth and Adolescence, 34, 471–482.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Michael P. Marshal
    • 1
  • Sarah S. Dermody
    • 2
  • JeeWon Cheong
    • 3
  • Chad M. Burton
    • 4
  • Mark S. Friedman
    • 5
  • Frances Aranda
    • 6
  • Tonda L. Hughes
    • 7
  1. 1.Department of Psychiatry and PediatricsUniversity of PittsburghPittsburghUSA
  2. 2.Department of PsychologyUniversity of PittsburghPittsburghUSA
  3. 3.Department of Health Behavior, School of Public HealthUniversity of Alabama at BirminghamBirminghamUSA
  4. 4.Department of Psychiatry, Western Psychiatric Institute and ClinicUniversity of PittsburghPittsburghUSA
  5. 5.Department of Behavioral and Community Health Sciences, Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  6. 6.College of Nursing-Health Systems ScienceUniversity of Illinois at ChicagoChicagoUSA
  7. 7.UIC National Center of Excellence in Women’s Health, College of NursingUniversity of Illinois at ChicagoChicagoUSA

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