Mental Health Issues Related to Sexual Orientation in a High School Setting

Abstract

High school students are maturing physically, psychosocially, and sexually. Some may be unsure of their sexual orientation. The purpose of the study was to determine whether students who self-identified as homosexual-lesbian/gay, bisexual (LGB), and unsure of sexual orientation had more stressful life events (SLEs), perceived stress, bullying victimization, and depressive symptoms as compared to heterosexual peers. Cortisol was examined to determine whether levels were within normal range for age and followed a normal diurnal rhythm. This correlational design included five surveys to assess n = 143 ninth graders. LGB and unsure students had more SLEs, perceived stress, bullying victimization, and depressive symptoms than heterosexual peers. All participants had normal cortisol levels, with the majority having normal diurnal rhythms. School nurses should consider more training about LGB and unsure students. Additional outreach, support, screening, or referrals for LGB and unsure students are warranted if the school nurse suspects depressive symptoms.

Who attempts suicide among medical students?

“…Although we believe that this positive relation may be related to the fact that this population suffers more discrimination and difficulty of acceptance, often isolating themselves and presenting a higher prevalence of depressive symptoms, we were unable to identify a significant interaction between history of bullying and sexuality. As described in the literature, homosexual‐lesbian/gay, bisexual, and questioning students had more stressful life events, perceived stress, bullying victimization, functional limitations, and depressive symptoms than heterosexual peers . Future work should assess suicide attempts in other groups of students and compare their findings with our findings.…”

“…symptoms, we were unable to identify a significant interaction between history of bullying and sexuality. As described in the literature, homosexual-lesbian/gay, bisexual, and questioning students had more stressful life events, perceived stress, bullying victimization, functional limitations, and depressive symptoms than heterosexual peers (37,38). Future work should assess suicide attempts in other groups of students and compare their findings with our findings.…”

Peer victimization and cortisol production in children and adolescents: A systematic review

“…In contrast, cybervictims in González‐Cabrera et al () showed heightened cortisol levels and a less steep decline in cortisol relative to cyberbullies or cyberbystanders. Three studies (Vaillancourt et al, ; Williams, ; Williams, Turner‐Henson, Davis, & Soistmann, ) reported no association between peer victimization and diurnal slope or levels of morning or evening cortisol. Additionally, Peters et al () did not find an association between overt peer victimization and diurnal cortisol.…”

“…González‐Cabrera et al () collected five samples following the same general timeline on 1 day. Williams () and Williams et al () collected two samples on 1 day only: one in the morning, and one in the evening. Collecting cortisol samples on more than 1 day and aggregating the data is recommended to increase the stability and validity of the cortisol estimates (Adam & Gunnar, ; Nicolson, ).…”

“…González‐Cabrera et al () focused exclusively on cybervictimization and cyberbullying; Peters et al asked students’ classmates to nominate students who were excluded (relational victimization) or bullied (overt victimization). Other researchers used measures that combined overt and relational forms of victimization in one measure (e.g., verbal, physical, relational, cyber; Williams, ; Williams et al, ). To the extent that different forms of victimization may produce different HPA axis responses, as evidenced in the Peters et al () study, using the total victimization scores from these measures may obscure differences in cortisol responses.…”