Minority stress is longitudinally associated with alcohol-related problems among sexual minority women

doi:10.1016/j.addbeh.2016.05.017

Addictive Behaviors

Volume 61, October 2016, Pages 80-83

https://doi.org/10.1016/j.addbeh.2016.05.017 Get rights and content

Highlights

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For young adult lesbian/bisexual women, minority stress is linked to problem drinking
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Sexual minority stress predicted the severity of drinking consequences one year later
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Minority stress was not associated with quantity of alcohol consumed the next year

Abstract

Compared to sexual minority men and heterosexual women, sexual minority women report elevated alcohol use in young adulthood. Heavy alcohol use and alcohol use disorders disproportionately affect sexual minority women across the lifespan, yet there is limited research investigating reasons for such associations. The present study investigates longitudinal associations between minority stress and both alcohol use as well as self-rated drinking consequences. Participants (N = 1057) were self-identified lesbian (40.5%) and bisexual (59.5%) women between the ages of 18 to 25 recruited from across the U.S. using online advertisements. Participants completed four annual surveys. Hurdle mixed effects models were used to assess associations between minority stress and typical weekly drinking and drinking consequences one year later. Minority stress was not significantly associated with subsequent typical drinking. However, minority stress was significantly associated with having any alcohol consequences as well as the count of alcohol consequences one year later after controlling for covariates. Consistent with extant literature, this study provides evidence for a prospective association between minority stress experienced by sexual minority women and drinking consequences. This study also provides support for the potential impact of efforts to reduce minority stress faced by sexual minority women.

Section snippets

Current study

We examined the prospective association between minority stress and alcohol use as well as negative drinking consequences in young adult SMW to extend previous cross-sectional research. As drinking risk is highest during young adulthood, it is of particular import to examine alcohol use during this critical developmental phase. We hypothesized minority stress would be prospectively associated with increased alcohol use and consequences.

Participants and procedures

Participants were recruited nationally via Craigslist and Facebook online advertisements, and upon recruitment were routed to a website showing an informational statement. Those who consented received an online screening assessment (n = 4119). Eligibility criteria were met by 1877 participants and included: 1) U.S. residence, 2) valid e-mail address, 3) age 18 to 25, and 4) self-identified as lesbian or bisexual. Participants were retained in the study if they changed or omitted their reported

Results

As shown in Table 1, baseline typical drinks per week and drinking consequences were highly correlated (ρ = 0.68). Minority stress was weakly correlated with typical drinking (ρ = 0.07) and moderately correlated with drinking consequences (ρ = 0.16). At baseline, 26.5% of women reported no drinking and 25.0% reported no drinking consequences. Over the 3 follow-up waves, the proportion of women reporting no drinking was similar compared to baseline (25.6%), but the likelihood of reporting no

Discussion

The current study extends research regarding the association between minority stress and drinking among SMW by focusing on a critical developmental phase for both drinking behavior and sexual identity formation. Previous research has linked minority stress experiences with increased drinking consequences in sexual minorities (Meyer, 2013). This study supported these previous findings by revealing a prospective relationship between SMW's minority stress and later drinking consequences. Contrary

Role of funding sources

Funding for this study was provided by NIAAA grant R01AA018292 (PI: Kaysen, D. L.). Manuscript preparation was partially supported by NIMH grant T32 MH18869 (PIs Kilpatrick, D. G., & Danielson, C. K.) and the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment (Dr. Wilson). NIAAA, NIMH, and the Department of Veterans Affairs had no role in the study design, collection, analysis or interpretation of the data, writing

Contributors

Dr. Kaysen designed the study and wrote the protocol. Drs. Kaysen and Wilson conducted literature searches and provided summaries of previous research studies. Dr. Rhew conducted the statistical analysis. Drs. Wilson, Gilmore, Rhew, and Ms. Hodge collaboratively wrote the original submission of the manuscript and all authors contributed to and have approved the revised manuscript.

Conflict of interest

All authors declare that they have no conflicts of interest.

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The majority of this work has been informed by Meyer's (2003) sexual minority stress framework, which posits that higher rates of substance use among sexual minorities are consequences of possessing a stigmatized, socially disadvantaged sexual minority identity. Among the many forms of stigma explored in relation to alcohol use among SMW, numerous studies have documented robust, direct links between drinking and experience of negative alcohol-related consequences and exposure to distal sexual minority stressors including prejudice, violence, and harassment, which operate at the interpersonal level (e.g., Lehavot & Simoni, 2011; Lewis et al., 2017; McNair et al., 2016; Slater et al., 2017; Wilson et al., 2016). As encounters with these interpersonal forms of stigma are most prevalent among SMW who openly identify as LBQ (e.g., Meyer, 2003) and these sexual identities also describe the types of SMW most likely to take part in alcohol interventions advertised in LBQ community settings, it is critical to understand the potential impact of such stigma experiences on evidence-based, intervention strategies developed for non-stigmatized populations (Layland et al., 2020).
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^☆: This research was supported by the National Institute on Alcohol Abuse and Alcoholism (R01AA018292; PI: Kaysen, D. L.). Manuscript preparation was partially supported by T32 MH18869 (PIs Kilpatrick, D. G., & Danielson, C. K.) and the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment (Dr. Wilson). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the VA or the United States government or any of the institutions with which the authors are affiliated.

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Short CommunicationMinority stress is longitudinally associated with alcohol-related problems among sexual minority women☆

Highlights

Abstract

Section snippets

Current study

Participants and procedures

Results

Discussion

Role of funding sources

Contributors

Conflict of interest

Addictive Behaviors

Emotional distress among LGBT youth: The influence of perceived discrimination based on sexual orientation

Journal of Youth and Adolescence

A longitudinal study of the effects of coping motives, negative affect and drinking level on drinking problems among college students

Anxiety, Stress, and Coping

A tutorial on count regression and zero-altered count models for longitudinal substance use data

Psychology of Addictive Behaviors

The Daily Heterosexist Experiences Questionnaire: Measuring minority stress among lesbian, gay, bisexual, and transgender adults

Measurement and Evaluation in Counseling and Development

Interventions to reduce sexual prejudice: A study-space analysis and meta-analytic review

Journal of Sex Research

Social determinants of alcohol consumption: the effects of social interaction and model status on the self‐administration of alcohol

Journal of Consulting and Clinical Psychology

Research funded by the National Institutes of Health on the health of lesbian, gay, bisexual, and transgender populations

American Journal of Public Health

Longitudinal disparities of hazardous drinking between sexual minority and heterosexual individuals from adolescence to young adulthood

Journal of Youth and Adolescence

Risk of substance abuse and dependence among young adult sexual minority groups using a multidimensional measure of sexual orientation

Public Health Reports

Missing data analysis: Making it work in the real world

Annual Review of Psychology

Patterns of cigarette smoking and alcohol use among lesbians and bisexual women enrolled in a large health maintenance organization

American Journal of Public Health

State-level policies and psychiatric morbidity in lesbian, gay, and bisexual populations

American Journal of Public Health

The impact of institutional discrimination on psychiatric disorders in lesbian, gay, and bisexual populations: A prospective study

American Journal of Public Health

Short Communication
Minority stress is longitudinally associated with alcohol-related problems among sexual minority women☆