Developmental trajectories of depression and suicide among LGBTQ people of color: An Integrative Data Analysis of 18 prevention trials. - Project Summary / Abstract
Increased rates of depression and suicidality among LGBTQ people of color (LGBTQ-POC) is a
critically important public health concern. LGBTQ-POC experience the cumulative stress of systemic in-
equality and discrimination, including lower socioeconomic status, higher exposure to neighborhood crime, trau-
matic childhood experiences, and differential access to mental health care and resources. Although critical for
early prevention and clinical practice, essential gaps remain to understand depression and suicide-related behav-
iors among LGBTQ-POC. Reduced samples in individual studies and methodological limitations have restricted
our ability to understand depression and suicidality from a developmental perspective. I propose using a se-
quential cohort design and Integrative Data Analysis (IDA) to examine longitudinal trajectories of
depression and suicidality among LGBTQ-POC adolescents. IDA combines individual-level data from
multiple independent studies into a single dataset. IDA provides increased statistical power, increased frequency
of low base-rate behaviors, and the ability to study an expanded sample of underrepresented subgroups. Further,
I will explore overlapping age cohorts across numerous longitudinal studies using a sequential co-
hort design, which will provide a much broader understanding of development. The proposed study
includes adolescents in 18 randomized prevention trials who identified as LGBTQ-POC (N = 2,029). Researchers
surveyed participants at varying intervals from 1 to 15.25 years. At baseline, youth enrolled in the studies were 7 to
19 years of age (M = 12.7). Given the length of the trials, the proposed study will examine a sizable developmental
period from 7 up to 34 years. In Aim 1, I will use multilevel growth mixture modeling (MGMM) to examine longi-
tudinal trajectories of depression and suicide-related behaviors among LGBTQ-POC. In Aim 2, I will identify early
depression symptoms associated with longitudinal trajectories of suicide ideation and behaviors. Lastly, Aim 3
will examine the impact of early intrapersonal and interpersonal protective factors on longitudinal trajectories of
depression and suicidality. These aims closely align with strategic Goals 2 and 3 of NIMH to “examine mental
illness trajectories throughout the lifespan” and “highlight efforts to improve preventive and therapeutic inter-
ventions.” Further, the aims of this fellowship can support efforts to remediate systemic inequalities in mental
healthcare that disproportionately impact LGBTQ-POC. These insights could offer new evidence and actionable
tools to supplement existing interventions and target prevention efforts to critical periods of development and
groups of high need capitalizing on the strengths and protective factors of LGBTQ-POC. Lastly, this fellowship
will allow me to build a strong background in developmental science, mental health prevention, and quantitative
methodology with a focus on the health and well-being of LGBTQ-POC adolescents.
