Sexual Violence, Posttraumatic Stress, and Heterosexism in Relation to Suicide and Self-Harm Risk in Bisexual + College Students

OBJECTIVE: Bisexual + people experience higher rates of suicidality and self-harm compared to heterosexual and lesbian/gay people. We examined the association between sexual violence (SV) and suicidality, current urges to self-harm, and current suicidal intent among bisexual + college students. We tested whether posttraumatic stress disorder (PTSD) symptoms would explain these links and whether discrimination due to sexual minority identity (i.e., heterosexism) would exacerbate the association between SV severity and PTSD symptoms. METHOD: Students were recruited from two large, public minority-serving universities. A subsample of 454 bisexual + students (ages 18-25; 73.6% cisgender women, 15.4% gender minority, 10.8% cisgender men; 50.2% White, 22.2% Black, 15.9% Asian; 21.8% Hispanic/Latino/a/x) were selected for the current study. Two indirect effects models were tested examining: (1) suicidality in the full sample, and (2) current urges to self-harm and suicidal intent in a subsample of 244 bisexual + students who screened positive for suicide risk. RESULTS: There was no interaction between SV severity and heterosexism. Both SV severity and heterosexism had direct associations with greater PTSD symptoms. In turn, greater PTSD symptoms explained the associations of SV severity and heterosexism with greater suicidality and likelihood to report current urges to self-harm and current suicidal intent. CONCLUSIONS: SV severity and heterosexism appear to be important risk factors for suicidality and self-harm via PTSD symptoms among bisexual + young adults. Results suggest the need for prevention and public health intervention efforts to reduce risk for SV and discrimination due to sexual identity in addition to individual-level interventions to reduce PTSD symptoms.