(PS11-49) Exploring the Link Between Rejection Sensitivity and Suicide Ideation in Sexual Minority, Gender Minority and Cisgender Heterosexual Youth at High Risk for Suicide

Self-injurious thoughts and behaviors (SITBs) are more frequent and severe among sexual minority (SM) and gender minority (GM) youth than cisgender and heterosexual (non-SGM) youth. The rejection sensitivity (RS) model was proposed as a complement to the better-known minority stress theory to explain health disparities between SGM and non-SGM individuals, postulating that exposure to mistreatment, stigma, or discrimination related to SM and GM identities fosters an anxious fear and expectation of future rejection for sexual minorities. RS is a risk factor for suicidal behaviors in sexual minority adults, but research on RS in SM and GM youth is lacking. This study aims to examine differences in RS between SM, GM, and non-SGM youth, in a high-risk sample recently hospitalized for suicide risk. Specifically, SM, GM and non-SGM youth were compared in RS, recent suicidal ideation (SI) severity, and associations between RS and SI severity. 

Adolescents ages 12-18 (n = 96; 50% White, 28% Black, 15% Multiracial; 18% Hispanic) were recruited following discharge from acute psychiatric care for suicide risk. Sexual orientation, gender identity, rejection sensitivity, and ratings of recent suicidal ideation were measured at baseline (within 3 months of discharge from acute psychiatric care). The SM group included cisgender adolescents who identified their sexual orientation as anything other than heterosexual. This group was independent from the GM group, which included adolescents who identified as transgender or gender diverse; of note, 30 (94%) also identified their sexual orientation as something other than heterosexual. RS was assessed using a validated self-report questionnaire, and SI was assessed using a novel self-report measure which asks about passive and active suicidal ideation in the past week. These data are from an ongoing study and results will be updated as recruitment continues.

Age did not differ between the SM (n=29), GM (n=32) and non-SGM participants (n=31), F(2,89)=1.31, p=.276. There was a significant difference between the three groups on RS (F(2,76)=5.071, p=.009, η=.118). Tukey’s post-hoc analyses indicated that RS was significantly higher in GM (M=48.93, SD= 10.16) than non-SGM youth (M=36.54, SD=18.56), p=.006. The SM group (M=44.35, SD=13.00) did not significantly differ from the GM (p=.477) or non-SGM (p=.127) groups. There was no significant difference in mean SI between non-SGM, SM, and GM youth, F(2,74)=0.37, p=.696, η=.010). When examining how RS relates to SI, RS was related to SI in non-SGM youth (r(23)=.58, p=.003) but not in SM (r(24)=-.08, p=.715) or GM youth (r=.15, p=.472). 

Preliminary results suggest that GM youth have higher levels of RS than their non-SGM peers. Differences between SM and non-SGM youth were not significant, but may be underpowered in the current sample (data collection is ongoing). Notably, while GM, SM and non-SGM youth did not differ on recent SI severity in this high risk sample, SI was related to RS for non-SGM youth, but not for SM or GM youth. These findings point to the need to identify other potential relationships that may relate to the greater RS experienced by SGM youth.