Confirming the Reliability and Validity of the Sexual Minority Adolescent Stress Inventory in a National Sample of Sexual Minority Adolescents

Abstract

Objective: Sexual minority adolescents (SMA) experience numerous behavioral health disparities, including depression, anxiety, substance use, non-suicidal self-injury, and suicidality. The primary framework to understand these disparities is minority stress theory, which frames this disproportionate burden as the result of discrimination, violence, and victimization in a homophobic culture. Empirical examinations of minority stress among SMA have been limited by lack of diverse samples or validated measures. This study engaged a national community sample of SMA to confirm reliability and validity of the Sexual Minority Adolescent Stress Inventory (SMASI).Method: A national sample of 2,310 SMA aged 14–17 was recruited in the United States through a hybrid social media and respondent-driven sampling approach. Item response theory and confirmatory factor analysis established the psychometric properties of the SMASI in this sample; minority stress was modeled as a latent variable in several regression models to verify criterion and divergent validity.Results: In this national sample (M age = 15.9; 64% female and 60% White), the factor structure of the SMASI and its 11 subscales was confirmed and shown to be invariant by demographic characteristics. Minority stress as measured by the SMASI was significantly associated with all mental and behavioral health outcomes.Conclusions: This study provides evidence that SMASI is a reliable, valid, and important tool for better understanding minority stress and subsequent health and mental health consequences among SMA.

Validating the Structure of Proximal and Distal Factors within the Sexual Minority Adolescent Stress Inventory

“…Items included in the SMASI are based on key minority stress theory frameworks (Goldbach et al, 2014;Hatzenbuehler, 2011;Meyer, 2003) and qualitative information obtained via interviews with sexual minority cisgender adolescents ages 13-19 years. Schrager et al ( 2018) and Goldbach et al's (2017) initial validation studies as well as Goldbach et al's (2021) follow-up validation study with a diverse sample demonstrated the SMASI scales had strong internal consistency reliability and good divergent and convergent validity with other mental health measures. Additionally, Burgess (2017) and Fulginiti et al (2020) found the SAMSI to be psychometrically sound in their respective studies.…”

Explaining behavioral health differences in urban and rural sexual minority adolescents

“…Lifetime experiences of adolescent minority stress were assessed with 10 subscales of the SMASI. 56 Subscales included items like "I have been physically assaulted in the neighborhood where I live because I am LGBTQ," "A religious leader tried to change my sexual orientation," and "My parents are uncomfortable with LGBTQ people," with binary response options (0 = no, 1 = yes). Higher percentages reflected more lifetime experiences of minority stress.…”