University of Waterloo, Waterloo, Ontario, Canada.
Health Educ Behav. 2021 Feb;48(1):82-92. doi: 10.1177/1090198120965509. Epub 2020 Oct 26.
BACKGROUND/AIMS: Adolescents who identify as nonbinary gender or as not heterosexual report higher levels of mental illness than their counterparts. Cannabis use is a commonly employed strategy to cope with mental illness symptoms among adolescents; however, cannabis use can have many deleterious health consequences for youth. Within the frame of minority stress theory, this study investigates the relationships between gender identity and sexual orientation, internalizing disorder symptoms, and cannabis use among adolescents.
A national cross-sectional survey of a generalizable sample of high school students in Canada from the 2017 wave ( = 15,191) of the Cancer Risk Assessment in Youth Survey was analyzed in spring 2019. Mediation analyses were completed to examine risk of internalizing disorder symptoms as a potential mediator of the association between (1) gender identity and (2) sexual orientation, and cannabis use.
Indirect effects in all models show significantly higher levels of reported internalizing disorder symptoms for female (OR = 3.44, 95% CI [2.84, 4.18]) and nonbinary gender (OR = 3.75, 95% CI [2.16, 6.51]) compared with male students. Sexual minority adolescents had higher odds of internalizing disorder risk relative to non-sexual minority adolescents (OR = 3.13, 95% CI [2.63, 3.74]). Students who reported higher rates of internalizing disorder symptoms were more likely to have ever used cannabis. Patterns of partial mediation are also present among all groups.
DISCUSSION/CONCLUSIONS: Findings can be used to better inform mental health interventions for adolescents. Future study should explore specific mental health stressors of vulnerable adolescent groups with respect to cannabis use as a coping mechanism.
背景/目的：认同非二元性别或非异性恋的青少年比同龄人报告更高水平的精神疾病。青少年常采用大麻使用来应对精神疾病症状；然而，大麻使用会给年轻人带来许多不良的健康后果。在少数群体应激理论框架内，本研究调查了青少年的性别认同和性取向、内化障碍症状和大麻使用之间的关系。
2019 年春季对来自加拿大青少年癌症风险评估调查 2017 波（n = 15191）的具有代表性的高中生进行了全国性的横断面调查。完成中介分析以检验内化障碍症状作为（1）性别认同和（2）性取向与大麻使用之间关联的潜在中介的风险。
所有模型中的间接效应均显示，与男性学生相比，女性（OR = 3.44，95%CI [2.84, 4.18]）和非二元性别（OR = 3.75，95%CI [2.16, 6.51]）的学生报告的内化障碍症状水平明显更高。与非性少数青少年相比，性少数青少年内化障碍风险的可能性更高（OR = 3.13，95%CI [2.63, 3.74]）。报告内化障碍症状发生率较高的学生更有可能曾经使用过大麻。所有群体也存在部分中介模式。
讨论/结论：研究结果可用于更好地为青少年提供心理健康干预。未来的研究应该探索特定的心理健康压力源与大麻使用作为应对机制的弱势青少年群体。
