The Prevalence Of Depression,Anxiety,and Stress Symptoms And Their Related Factors Among LGB College Students In China

Objective: The study aims to understand the prevalence of depression,anxiety and stress symptoms among Lesbian,Gay,and Bisexual(LGB)college students in China and analyze their influencing factors.Based on the theory of sexual minority pression,the relationship between sexual minority stress(school bullying and internalized homophobia),social support,and symptoms of depression,anxiety,and stress was examined to provide a scientific basis for mental health interventions among LGB college students.Methods: From May 2021 to September 2021,the snowball and targeted sampling methods were used to recruit LGB college students on platforms such as the Rainbow Wall,the Blued,and the Confession Wall in universities nationwide.Participants who agreed to participate then completed the questionnaire online using “wenjuanxing”.The survey included demographics,behavioral characteristics,school bullying,internalized homophobia,social support,and affective disorder symptoms(depression,anxiety and stress).Ordinal logistic regression analysis was used to analyze the influencing factors of the symptoms of depression,anxiety,and stress.Structural equation modeling(SEM)was employed to analyze the relationship between sexual minority stress,social support,and its effects on affective disorder symptoms,and test the model’s stability.Results:A total of 1393 valid questionnaires were collected in this study,with 55.99% of those aged ≤20 years,92.89% of Han Chinese,48.46% identified as gay,20.39% as lesbian,and 31.16% as bisexual(37.79% assigned male at birth,62.21% assigned female at birth).29.15% of LGB college students reported perceiving low levels of social support,77.24% reported low-level school bullying,and 76.88% reported lowlevel internalized homophobia.48.10% of the LGB students had depression symptoms;anxiety and stress symptoms were 57.07% and 37.47%,respectively.The univariate analysis showed that social support,school bullying,and internalized homophobia were associated with depression,anxiety,and stress.Ordinal logistic regression analysis showed that the lower the score of social support(OR=0.96,95% CI=0.95～0.96),the higher the score of school bullying(OR=1.07,95%CI=1.04～1.10),and the higher the score of internalized homophobia(OR=1.03,95%CI:1.01～1.04),the higher the degree of depression.The lower the score of social support(OR=0.97,95%CI: 0.96～0.98),the higher the score of school bullying(OR=1.07,95%CI: 1.04～1.10),and the higher the score of internalized homophobia(OR=1.04,95%CI: 1.02～1.05),the higher the degree of anxiety.The lower the score of social support(OR=0.97,95%CI: 0.96～0.98),the higher the score of school bullying(OR=1.03,95%CI: 1.00～1.06),and the higher the score of internalized homophobia(OR=1.03,95%CI: 1.01～1.04),the higher the degree of stress.The results of the structural equation modeling showed that school bullying,internalized homophobia,and social support have a direct effect on affective disorder symptoms,and the effect values were 0.151(P<0.001),0.096(P<0.01)and-0.324(P<0.001),respectively.Social support mediated the effect of school bullying and internalized homophobia on affective disorder symptoms.the mediating effect value was 0.038(P<0.001)and 0.036(P<0.001),which accounted for 20.11% and 27.27% of the total effect,respectively.The verification of the stability of the model indicates that the model has multi-group invariance.Conclusions: Affective disorder symptoms(depression,anxiety,and stress symptoms)are common among LGB college students in China.The lower the social support score,the more severe the affective disorder symptoms;the higher the school bullying score,the more severe the affective disorder symptoms;and the higher the internalized homophobia score,the more severe the affective disorder symptoms.Moreover,the effect of school bullying and internalized homophobia on affective disorder symptoms can be mediated by social support.