The trauma-suicide connection among racial and ethnically diverse lesbian, gay, and bisexual adults: Examining the roles of intersectional discrimination and complex posttraumatic stress disorder

Abstract

Aim

We sought: (a) to explore the roles of complex posttraumatic stress disorder (CPTSD), racism, and heterosexist discrimination in linking exposure to traumatic events and lifetime suicide attempt among sexually diverse racial and ethnic minority adults; and (b) to explore differences by race/ethnicity.

Methods

We used structural equation modeling methods (moderated mediation analysis) to analyze a sample of sexually diverse racial and ethnic minority adults from the National Epidemiological Study of Alcohol and Related Conditions (NESARC-III) dataset (n = 632). Descriptive results are included for underpowered subgroups.

Results

We found significant differences by racial/ethnic identity, with CPTSD mediating associations between trauma exposure and suicide attempt status among Hispanic respondents, but not Black respondents. Furthermore, racism and heterosexist discrimination amplified the effects of trauma exposure on CPTSD symptoms among Hispanic respondents.

Conclusion

CPTSD may be an important mechanism in the trauma-suicide connection among some sexually diverse racial and ethnic minority people. These findings have important implications for suicide prevention work among sexually diverse populations, including the need for interventions that integrate traumatic stress treatment and employ an intersectional approach, addressing the influence of racism and heterosexism, particularly for Latinx and Hispanic groups.

Keywords:

• Racial and ethnic minorities
• LGBTQ
• suicide
• complex posttraumatic stress disorder

Acknowledgements

This article was prepared using a limited access dataset obtained from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). This article has not been reviewed or endorsed by NIAAA and does not necessarily represent the opinions of NIAAA, who is not responsible for the contents. Dr. Ellis was funded by the SAMHSA and AAMFT Minority Fellowship Program to complete this original project.

Disclosure statement

The authors have no conflicts of interest to declare.

Data availability

Data are available from the National Institute on Alcohol Abuse and Alcoholism.

Additional information

Funding

Substance Abuse and Mental Health Services Administration Minority Fellowship Program.