Reducing substance use and negative mental health outcomes of interpersonal victimization among sexual and gender minority youth (SGMY) represents a critical public health priority. Victimized individuals often develop cognitive schemas, or organized knowledge structures consisting of traits, values, and memories about the self, such as self-concept factors, in response to interpersonal victimization. Prior studies demonstrate the role of self-concept factors (e.g., mastery, control, and self-esteem) in explaining the relationship between victimization and substance use and mental health. However, mastery, control, and self-esteem have not been explored as mediators of interpersonal victimization and health among SGMY. This study is among the first to apply cognitive schema models of trauma-related health symptoms using a large sample of SGMY to examine (a) whether interpersonal victimization is associated with substance use (i.e., alcohol use, cannabis use, and cigarette use) and mental health problems (i.e., depressive symptoms, self-perceived stress, self-rated health issues) and (b) whether diminished sense of mastery and control and lower self-esteem can partially explain elevated rates of substance use and mental health problems in this population. We used the U.S.-based 2017 LGBTQ National Teen Survey (n = 17,112; M_age = 15.57, SD = 1.27); 6,401 (37.4%) identified as gay or lesbian, 7,396 (43.2%) as cisgender women, and 10,245 (59.9%) as White. Substance use and mental health variables were positively associated with interpersonal victimization variables and negatively associated with self-concept factors. Self-concept factors partially mediated the relationship between interpersonal victimization and mental health. This model explained 74.2% of the variance in mental health and 28.4% of the variance in substance use. Cognitive coping may represent an important modifiable factor that can be targeted by trauma-focused interventions in efforts to improve victimized SGMY’s mental health. Findings call for the development of identity-affirmative, evidence-based, and trauma-focused interventions for SGMY to improve this populations’ overall health.

减少性少数和性别少数青少年 (SGMY) 中的药物使用和人际受害造成的负面心理健康后果是一项重要的公共卫生优先事项。受害人通常会形成认知图式，或由自我特征、价值观和记忆组成的有组织的知识结构，例如自我概念因素，以应对人际受害。先前的研究证明了自我概念因素（例如，掌握、控制和自尊）在解释受害与物质使用和心理健康之间的关系中的作用。然而，掌控、控制和自尊尚未被探索为 SGMY 中人际受害和健康的中介因素。这项研究是第一个应用创伤相关健康症状的认知图式模型的研究，使用大量 SGMY 样本来检查（a）人际受害是否与物质使用（即酒精使用、大麻使用和香烟使用）有关，以及心理健康问题（即抑郁症状、自我感知的压力、自评健康问题）以及（b）掌控感和控制感的减弱以及自尊心的降低是否可以部分解释这一群体中物质使用率和心理健康问题的增加人口。我们使用了美国 2017 年 LGBTQ 全国青少年调查（ n = 17,112； M_年龄= 15.57， SD = 1.27）； 6,401 人 (37.4%) 被认定为男同性恋或女同性恋，7,396 人 (43.2%) 被认定为顺性别女性，10,245 人 (59.9%) 被认定为白人。药物使用和心理健康变量与人际受害变量呈正相关，与自我概念因素呈负相关。 自我概念因素部分调节了人际受害与心理健康之间的关系。该模型解释了 74.2% 的心理健康差异和 28.4% 的物质使用差异。认知应对可能是一个重要的可改变因素，可以通过以创伤为重点的干预措施来改善受害SGMY的心理健康。研究结果呼吁为 SGMY 制定身份肯定、基于证据和以创伤为重点的干预措施，以改善该人群的整体健康状况。