1 - (SYM 39) Identifying Pathways from Childhood Adversity to Suicidal Thoughts and Behaviors Among Sexual Minority Adults: An Exploratory Mediation Analysis

Objective: Sexual minorities are disproportionately affected by adverse childhood experiences (ACEs) compared to their heterosexual peers, marking a critical intersection of vulnerability and adversity. Early exposure to stress has been linked to suicide risk later in life; however, research on the link between ACEs and suicidal outcomes in sexual minority adults remains markedly scarce. Furthermore, existing studies in sexual minority adults have relied primarily on cross-sectional designs, limiting the conclusions that can be drawn from study findings. Therefore, there is a clear need to examine longitudinal pathways through which ACEs contribute to suicidal risk in sexual minorities.

Method: The current study uses a nationally representative longitudinal dataset of sexual minority adults in the US to investigate the pathways from ACEs to adulthood suicidal thoughts and behaviors. ACEs were measured at Wave 1, potential mediators at Wave 2, and suicidal thoughts at Wave 3. We conducted an exploratory mediation analysis to identify potential mediating factors linking ACEs to suicidality. The potential mediators that we examined were social well-being, perceived stigma, experiences of everyday discrimination, social support, psychological distress, alcohol and drug use, importance of sexual identity, community connection, and internalized homophobia. Bootstrap-based selection stability and sensitivity analysis were performed to ensure the robustness of the identified pathways.

Results: Participants were 1518 sexual minorities who identified as lesbian or gay (n = 833; 55%), bisexual (n = 493; 33%), and other sexual minority identity (n = 181; 12%), and were on average 36.48 years (SD = 14.70) of age. Results revealed that psychological distress serves as a common mediator between ACEs and suicidal ideation, intent, plan, and attempt. Additionally, experiences of everyday discrimination emerged as a specific mediator leading to suicidal intent, whereas social support uniquely mediated the relation between ACE and suicide plans. 


Conclusion: The current study identifies shared and unique pathways between ACEs and suicidal thoughts and behaviors among sexual minority individuals. Findings underscore the urgent need for targeted interventions that address the specific mental health needs of sexual minority individuals, particularly focusing on mitigating psychological distress, combating systemic discrimination, and enhancing social support.