(PS1-25) Prospective Risk Associations with Multiple Minority Identities

Abstract Text: Adolescent substance (i.e., alcohol and cannabis) use occurs in a reciprocal relationship with sleep and mood disturbances. The minority stress model posits that the compounded effects of environmental stressors (e.g., discrimination experiences) with minoritized identities may be associated with deleterious mental health outcomes; individuals with intersecting marginalized identities (e.g., race, gender, sexual identity, low socioeconomic status) may experience discrimination associated with one or more of their identities. Despite findings that individuals frequently have difficulty in identifying a single identity for their experienced discrimination, the majority of research investigating discrimination and associated outcomes (e.g., alcohol use frequency, sleep disturbances) among adolescents has focused on racial discrimination. The current study examined the prospective associations among multiple minority identities, internalizing symptoms (i.e., anxiety, depression) and health-risk behaviors (i.e., sleep disturbance, alcohol use, cannabis use, sexual activity). Secondary analyses utilized data from a two-wave (Years 1 and 2; Y1 and Y2) online survey study of 414 high school students (Mage = 15.07 [SD = 1.19]; 57% female; 41% Black; 22% White; 18% Asian; 17% Multiracial; 75% living in neighborhoods where at least 20% of residents fall below the poverty line). A mediation path model was constructed to assess the risk pathway from Y1 multiple minority identity to Y2 health-risk outcomes via Y1 internalizing symptoms. Results showed that Y1 multiple minority identity status was positively associated with concurrent internalizing symptoms (B = 0.13; SE = 0.06; p = .03; 95% bootstrapped CI = [0.01, 0.25]). In turn, Y1 internalizing symptoms were positively associated with Y2 health-risk outcomes (B = 0.23; SE = 0.11; p = .03; 95% bootstrapped CI = [0.01, 0.45]). Despite these significant indirect paths, however, the indirect effect from Y1 multiple minority identity to Y2 health-risk outcomes via Y1 internalizing symptoms was not statistically significant (B = 0.03; SE = 0.02; p = 0.14; 95% bootstrapped CI = [-0.00, 0.08]). Further, there was a significant direct association of Y1 multiple minority identity with Y2 health-risk outcomes (B= -0.31; SE = 0.09; p = .001; 95% bootstrapped CI = [-0.49, -0.11]), such that higher multiple minority identity status at Y1 was negatively associated with prospective health risk outcomes. Findings suggest that multiple pathways may operate in the association of multiple minority identities with prospective health-risk outcomes. Future research may explore factors which differentially confer risk and/or protection within this risk pathway across different minority identities to better understand nuanced associations among minority status, internalizing symptoms and health risk behaviors over time.