Criterion and Divergent Validity of the Sexual Minority Adolescent Stress Inventory

Abstract

Sexual minority adolescents (SMA) consistently report health disparities compared to their heterosexual counterparts, yet the underlying mechanisms of these negative health outcomes remain unclear. The predominant explanatory model is the minority stress theory; however, this model was developed largely with adults, and no valid and comprehensive measure of minority stress has been developed for adolescents. The present study validated a newly developed instrument to measure minority stress among racially and ethnically diverse SMA. A sample of 346 SMA aged 14–17 was recruited and surveyed between February 2015 and July 2016. The focal measure of interest was the 64-item, 11-factor Sexual Minority Adolescent Stress Inventory (SMASI) developed in the initial phase of this study. Criterion validation measures included measures of depressive symptoms, suicidality and self-harm, youth problem behaviors, and substance use; the general Adolescent Stress Questionnaire (ASQ) was included as a measure of divergent validity. Analyses included Pearson and tetrachoric correlations to establish criterion and divergent validity and structural equation modeling to assess the explanatory utility of the SMASI relative to the ASQ. SMASI scores were significantly associated with all outcomes but only moderately associated with the ASQ (r = −0.13 to 0.51). Analyses revealed significant associations of a latent minority stress variable with both proximal and distal health outcomes beyond the variation explained by general stress. Results show that the SMASI is the first instrument to validly measure minority stress among SMA.

Social and Non-social Reward Processing and Depressive Symptoms Among Sexual Minority Adolescents

“…While this is one component of victimization is experienced by SMA, more specific scales have been developed to measure additional aspects of sexual minority-related stress (Newcomb and Mustanski, 2010; Goldbach et al, 2017). These scales, which include questions such as “There are times when I do not want to be LGBTQ” and “I expect people to reject me when they find out that I am LGBTQ,” measure a wider variety of victimization and negative interpersonal experiences not present in the YRBS (Goldbach et al, 2017). Further studies examining the impact of orientation-related stress on social reward circuits and depressive symptoms are necessary.…”

Development of the Sexual Minority Adolescent Stress Inventory

“…First, we did not present evidence that the new measure predicts health outcomes in line with the expectations of MST. Given the breadth of decisions and data that led to the production of the final SMASI measure, the equally comprehensive analyses to validate the measure are presented in an accompanying work (Goldbach et al, 2017 ). As described in the accompanying manuscript, both the lifetime and 30 day SMASI measures were indeed found to be significantly associated with concurrent measures of depressive symptoms, suicidality, self-harm, youth problem behaviors, and use of alcohol, tobacco, prescription drug, and illicit drug use, but were only moderately associated with a measure of general adolescent stress and had explanatory utility for those outcomes above and beyond general stress (Goldbach et al, 2017 ).…”

“…Given the breadth of decisions and data that led to the production of the final SMASI measure, the equally comprehensive analyses to validate the measure are presented in an accompanying work (Goldbach et al, 2017 ). As described in the accompanying manuscript, both the lifetime and 30 day SMASI measures were indeed found to be significantly associated with concurrent measures of depressive symptoms, suicidality, self-harm, youth problem behaviors, and use of alcohol, tobacco, prescription drug, and illicit drug use, but were only moderately associated with a measure of general adolescent stress and had explanatory utility for those outcomes above and beyond general stress (Goldbach et al, 2017 ). Second, although the majority of the measure performed well across demographic subgroups and the overall measure of the 54 required items demonstrated excellent reliability in the entire sample and by subgroup, the SMASI's performance is less than ideal in some areas (e.g., subgroup internal consistency scores for negative expectancies, and homonegative communications).…”

“…Because a secondary aim of the study was to test the validity of the emerging measure (Goldbach et al, 2017 ), researchers were also interested in collecting information related to other sources of stress and mental and behavioral health. For this reason, the survey also included the Adolescent Stress Questionnaire (Byrne et al, 2007 ), the abbreviated (56-item) Revised Youth Self Report (Ivanova et al, 2007 ), the four-item version of the Center for Epidemiologic Studies Depression Scale (Melchior et al, 1993 ), an additional three items probing suicidality and self-harm, and 18 items assessing lifetime and past-30 day substance use from the Youth Risk Behavior Survey (CDC, 2010 ).…”

Methodological Considerations for Advancing Research on the Health and Wellbeing of Sexual and Gender Minority Youth

“…Across population characteristics and outcomes, the dearth of available research on representative samples of SGM youth broadly and disaggregated subgroups has resulted in the proliferation of unvalidated measures with poor psychometric performance, 79 particularly related to victimization, homophobic attitudes, and other aspects of gender and sexual minority stress. 80 Although some validated measures are emerging, 81,82 we caution researchers that qualitative research, cognitive testing, and validity and reliability studies may still be required 83 -especially when a measure is directly relevant to gender or sexual identity, as the terminology used in older measures may not be sufficiently sensitive or reflective of modern youth experience. 48 Of course, measure selection for research with SGM youth should also be informed by measurement considerations relevant to the general population of adolescents, such as literacy, developmental appropriateness, and survey fatigue.…”