Discrepant Alcohol Use, Intimate Partner Violence, and Relationship Adjustment among Lesbian Women and their Relationship Partners

The impacts of violence among women in intimate relationships: an integrative literature review

The aim is to identify cultural, social and health impacts caused by intimate partner violence (IPV) in homoaffective (MOH) and biaffective (MOB) women. This is an integrative literature review that sought and analyzed studies indexed in the PubMed and Lilacs databases, considering the following languages. The study sought to answer the following research question: "What impacts does IPV bring to MOB and MOH?". Forty two studies were found and after applying the exclusion criteria, 19 went into the final sample. Data were analyzed using the content analysis methodology, Bardin's thematic analysis modality (2009). The full analysis of the articles revealed two categories: 1) Intimate partner violence and sociocultural impacts; and 2) Intimate partner violence and health impacts. The experience of situations of violence in intimate partnerships between homo and/or biaffective women affect their sociocultural and health dimensions, since they are under the bias of double vulnerability: women in homo/biaffective relationships. There is also an invisibility of the phenomenon in health services, since professionals are not trained to address the different sexual orientations among women and even less the situations of violence resulting from these relationships.

Intimate Partner Violence Among Sexual Minority Women: A Scoping Review

Intimate partner violence (IPV) is prevalent among sexual minority women (SMW). However, compared to IPV research with heterosexual women and other LGBTQ+ population groups, SMW are understudied. We conducted a scoping review to examine the current state of knowledge about IPV among SMW, and to identify gaps and directions for future research. A search of Medline, Embase, CINAHL, and PsycINFO databases returned 1,807 papers published between January 2000 and December 2021. After independent reviewers screened these papers for relevance, 99 were included in the final review. Papers were included if they used quantitative methods and reported IPV data on adult SMW separately from other groups. Findings confirmed high rates of IPV among SMW and highlighted groups with particular vulnerabilities, including non-monosexual women and SMW of color. Risk factors for IPV in this population include prior trauma and victimization, psychological and emotional concerns, substance use, and minority stressors. Outcomes include poor mental and physical health. Findings related to the effects of minority stressors on IPV and comparisons across sexual minority groups were inconsistent. Future research should focus on IPV perpetration; mechanisms underlying risk for IPV, including structural-level risk factors; and understanding differences among SMW subgroups.

Alday A, Jay J. Aurellano A, Raven R. Escala S, Ermelo V. Hernandez P, Esrom P. Matienzo J, Marian R. Panaguiton K, Charmaine C. Tan A, Zsila Á. Minority Stressors and Attitudes Toward Intimate Partner Violence Among Lesbian and Gay Individuals

Sexual minority individuals experience more intimate partner violence (IPV) than those in heterosexual relationships. Issues of mistrust, stigma, and anticipation of abuse contribute to these rates. Lesbian and gay IPV victims have distinct experiences from their abuses with exposure to homophobia, heterosexism, discrimination, and threats of sexual disclosure, among others. These unique and additive minority stressors can lead to adverse health concerns, increase vulnerability to victimization, and elevate abuse perpetration. This study aimed to investigate whether experiences of minority stressors are associated with attitudes toward intimate partner violence among a sample of 240 lesbian and gay Filipinos (155 lesbian and 85 gay participants) aged 20 to 40. Through convenience sampling, lesbian and gay Filipinos completed the Sexual Minority Stress Scale (SMSS) and Intimate Partner Violence Attitude Scale-Revised (IPVAS-Revised). Comparing the minority stressors levels among the participants, lesbians expressed higher expectations of rejection, while gay men experienced more sexual minority adverse events. Lesbians also reported higher satisfaction with outness. Regarding IPV, gay men expressed slightly more favorable attitudes toward abuse, which could make them at risk of becoming victims or perpetrators. Internalized homophobia was associated with more favorable attitudes toward abuse and control, indicating its contribution to more favorable IPV attitudes, although the explanatory power was modest.

Social Abuse in Intimate Partner Relationships: A Hybrid Concept Analysis

Belongingness is a basic human need. The violation of this need has been described in numerous studies on intimate partner violence (IPV). However, it has not been conceptually defined. Therefore, this study aimed to develop and analyze the concept of social abuse in intimate partner relationships. A hybrid model of concept analysis was used for this study consisting of three phases: theoretical, fieldwork, and analytic. In the theoretical phase, a systematic literature review was performed to obtain a working definition of social abuse. In total, 20 articles that met the inclusion criteria were included in the analysis. The findings from the theoretical phase were refined and confirmed by qualitative data collected from the fieldwork phase. In the analytical phase, four attributes of social abuse emerged: cutting off the victim's social relations, limiting the victim's social engagement, interfering with the victim's social relations, and closely watching the victim's social interactions. Possessiveness, escalating suspicion, allegations of infidelity, and fear that the victim will leave were identified as antecedents of social abuse in perpetrators. Additionally, the experience of social abuse had negative consequences on victims' social relationships, mental health, and help-seeking behaviors. This study extends the theoretical framework of IPV and implies a strong need to educate victims and their social acquaintances on social abuse.

Sexual Minority Stressors and Intimate Partner Violence Among Same-Sex Couples: Commitment as a Resource

Accumulating evidence has been found for the associations from sexual minority stressors to intimate partner violence (IPV) among same-sex couples. Yet key gaps still exist, including the rare utilization of couple dyadic data, the understudied moderating and mediating mechanisms, and the few studies conducted during the transitional period of same-sex marriage legalization. To address these gaps, we used cross-sectional, dyadic data collected from 144 US same-sex couples during the 2014-2015 national campaign for the legalization of same-sex marriage. Guided by the systemic transactional model (STM), we examined associations from sexual minority stressors (including both internalized homophobia and discrimination) to same-sex IPV and tested whether commitment moderated or mediated these associations. Overall, we found evidence supporting the STM: (1) High internalized homophobia and discrimination were related to high prevalence and/or frequency of IPV perpetration; (2) high commitment attenuated positive associations between high discrimination and high prevalence and/or frequency of IPV perpetration; and (3) high internalized homophobia was related to low commitment, which in turn was related to high prevalence and/or frequency of IPV perpetration. Collectively, our study identified commitment as both a moderator and mediator in associations from sexual minority stressors to same-sex IPV. Further, the roles of commitment (i.e., moderator or mediator) depend on whether the focal sexual minority stressors are distal and more intermittent (i.e., heterosexist discrimination) or proximal and more constant (i.e., internalized homophobia).

The Chicago Health and Life Experiences of Women Couples Study: Protocol for a Study of Stress, Hazardous Drinking, and Intimate Partner Aggression Among Sexual Minority Women and Their Partners

BACKGROUND

Large gaps exist in research on alcohol use and intimate partner aggression (IPA) among sexual minority women (SMW; eg, lesbian, bisexual). Dyadic research with SMW and their partners can illuminate how couple-level factors operate in conjunction with individual-level factors to shape well-being in this understudied and vulnerable population. Given the traditionally gendered lens with which women are primarily viewed as victims and men as perpetrators, understanding the dynamics of IPA in same-sex female couples can also advance research and practice related to IPA more generally.

OBJECTIVE

Guided by a recent extension of the minority stress model that includes relational (couple-level) sexual minority stress and the I-cubed theoretical perspective on IPA, we will collect individual and dyadic data to better characterize the links between hazardous drinking and IPA among SMW and their partners. First, this study aims to examine the associations among minority stress, hazardous drinking, and IPA in SMW and their partners. Minority stressors will be assessed as both individual and couple-level constructs, thus further extending the minority stress model. Second, we aim to examine potential mediators and moderators of the associations among minority stress, hazardous drinking, and IPA. Finally, we aim to test models guided by the I-cubed theoretical perspective that includes instigating (eg, relationship conflict), impelling (eg, negative affect and trait anger), and inhibiting (eg, relationship commitment and emotion regulation) or disinhibiting (eg, hazardous drinking) influences on IPA perpetration.

METHODS

This United States National Institutes of Health-funded project will draw from a large and diverse cohort of SMW currently enrolled in the Chicago Health and Life Experiences of Women (CHLEW) study-a 21-year longitudinal study of risk factors and consequences associated with SMW hazardous drinking. SMW currently enrolled in the CHLEW and their partners will be invited to participate in the CHLEW Couples Study. By analyzing dyadic data using actor-partner interdependence models, we will examine how each partner's minority stress, hazardous drinking, and IPA experiences are associated with both her own and her partner's minority stress, hazardous drinking, and IPA perpetration.

RESULTS

Data collection began in February 2021 and will likely continue through 2023. Initial results should be available by mid-2024.

CONCLUSIONS

The CHLEW Couples Study will fill important gaps in knowledge and provide the basis for future research aimed at clarifying the causal pathways linking hazardous drinking and IPA among SMW. This will support the development of culturally appropriate targeted individual and dyadic prevention and intervention strategies.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/28080.

Experiences of Minority Stress and Intimate Partner Violence Among Homosexual Women in Turkey

Intimate partner violence (IPV) has been recognized as an important public health problem over the past two decades, and increased attention to violence in intimate relationships has been given to heterosexual couples. Although the vast majority of literature has determined the rate of IPV among lesbian, gay, bisexual couples, and relationship quality, few studies investigated how stress specific to living as a lesbian or bisexual woman might correlate with IPV in these relationships. For this reason, the purpose of this descriptive study was to determine the experiences of minority stress and IPV among homosexual women (n = 149) in Turkey. Data were collected using convenience and snowball sampling. Participants completed an interviewer-administered survey. Results indicated that victimization and perpetration of all the forms of IPV occur but the most prevalent was perpetration (66.4%) and victimization (63.1%) of psychological violence. The mean score of participants' total level of outness was found 4.78 ± 2.15 (0-10). Most participants (74.5%) reported being often exposed to discrimination in the public area and reported moderate level of internalized homophobia (2.72 ± 0.87). Participants' level of outness associated with psychological (Victimization r = .319, p = .00; Perpetration r = .421, p = .00), physical (Victimization r = .184, p = .025; Perpetration r = .209, p = .010), and sexual (Victimization r = .263, p = .001; Perpetration r = .372, p = .00) violence perpetration and victimization. It is also founded that there was relation between internalized homophobia level and sexual violence perpetration (r = .164, p = .045)/victimization (r = .189, p = .021). These findings demonstrate a need for health care staff to be aware of the prevalence of IPV and minority stress that affected this population. Mental health of homosexual individuals is under the risk due to minority stress and IPV experiences. Furthermore, this finding illustrated that need for additional empirical research improved interpersonal relationship among these women. Also, policies need to be developed to reduce the minority stress experienced by these individuals and provide integration with the society.

Assessment of Research on Intimate Partner Violence (IPV) Among Sexual Minorities in the United States

Although sexual minority couples experience intimate partner violence (IPV) similar to or higher than heterosexual couples, not much attention has been given to LGBTQ couples. Using content analysis, this integrative review seeks to examine the state of scholarly literature regarding IPV among LGBTQ+ communities in the United States. For studies to be eligible for inclusion in this review, studies were required to focus on LGBTQ+ populations within the United States, published in English, involved violence between intimate partners, were the result of peer-reviewed, original research, and were published between years 2008 and 2018. Using SocIndex as the search database, a total of 46 peer-reviewed journal articles met the inclusion criteria. This study found that most studies employed quantitative research designs aiming to examine the statistical relationship between IPV and other variables by using surveys. Demographic information of the participants was mostly used as predictors of IPV, whereas health-related risky behaviors were mostly used as outcomes variables that were associated with IPV. Theoretical frameworks, methodology, and policy suggestions used in each study were examined in depth. A discussion of future studies and policy implications follows the findings of this study.

Internalized Homophobia and Relationship Quality among Same-Sex Couples: The Mediating Role of Intimate Partner Violence

Based on a geographically and socioeconomically diverse sample of 144 same-sex couples and using a dyadic approach (i.e., the Actor-Partner Interdependence Mediation Model [APIMeM] with interchangeable dyads), this study examined the association between internalized homophobia and same-sex relationship quality, and also tested the potential mediating role of intimate partner violence perpetration in this association. Results indicated that individuals' own and their partners' psychological violence perpetration mediated the negative associations from individuals' own internalized homophobia to individuals' own and their partner's relationship quality. Such findings contribute to the understanding of mechanisms underlying the harmful effects of sexual minority stressors for same-sex relationship well-being. Implications for interventions were also discussed.

The Role of the Family in Alcohol Use Disorder Recovery for Adults

Alcohol use disorder (AUD) and family functioning are inextricably bound, and families are impacted negatively by AUD, but families show substantial improvements with AUD recovery. Family members can successfully motivate a person with AUD to initiate changes in drinking or to seek AUD treatment. During recovery, family members can provide active support for recovery. Several couple- or family-involved treatments for AUD have been developed and tested in rigorous efficacy trials. Efficacious treatments based in family systems theory or cognitive behavioral approaches focus on the concerned family member alone, or they engage the couple or family as a unit in the treatment. However, most treatments have been studied in fairly homogeneous, heterosexual, White, non-Hispanic populations, limiting the potential generalizability of these treatments. Substantial gaps remain in our understanding of family processes associated with the initiation and maintenance of AUD recovery among adults. This review outlines the existing literature and describes opportunities for future research to address knowledge gaps in understanding the mechanisms by which these treatments are efficacious, use of family-based treatments with diverse populations, integration of pharmacotherapies with family-involved treatment, role of families in recovery-oriented systems of care, and how to improve treatment development and dissemination.

Pathological personality, relationship satisfaction, and intimate partner aggression: Analyses using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, alternative model of personality disorder traits

Personality disorders (PDs) have been linked to lower levels of marital satisfaction and the perpetration of intimate partner aggression (IPA). Much of this work has used self-reports of PD symptoms conceptualized via the Diagnostic and Statistical Manual of Mental Disorder's (DSM) categorical approach. The current study adds to the literature by examining how marital satisfaction and IPA are associated with a dimensional assessment of PDs, specifically by conceptualizing PDs using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Section III alternative model of personality disorder. By collecting data from both partners in a sample of newlywed couples, we also leverage PD trait agreement between (a) both partner's own self-reports (similarity), (b) self- and spouse report (accuracy), and (c) self and ratings of partner (perceptual similarity), to examine couple-level predictors of relationship well-being (i.e., satisfaction and psychological/physical IPA). Data were drawn from a sample of 101 newly married couples who participated in baseline and follow-up data collection over a period of 12 months. Actor-partner interdependence analyses revealed significant self-report actor and partner effects on marital satisfaction and psychological and physical IPA; for spouse report, actor effects were more consistent than partner reports. Agreement was moderate for both similarity and accuracy, but greater agreement was related to greater relationship satisfaction, particularly at later time points. Thus, although reports of elevated personality pathology are detrimental to marital functioning, spousal agreement may protect against these effects. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Research on alcohol and other drug (AOD) use among sexual minority women: A global scoping review

Until the 1980s, the limited research on alcohol and other drug (AOD) use among sexual minority women (SMW) focused on alcohol and used samples recruited from gay bars, resulting in inflated estimates of hazardous drinking. Over the past several decades the number of AOD studies with SMW has increased dramatically. To characterize this literature, we conducted a scoping review to answer the following questions: What do we know, and what are the gaps in research about AOD use among SMW? We searched multiple electronic databases (Medline [PubMed], CINAHL, PsycInfo, and Web of Science) for peer-reviewed research articles about AOD use among adult SMW published between January 1, 2000 and May 31, 2017. After duplicates were removed the search identified 4,204 articles. We reviewed the titles and abstracts and removed articles that did not meet inclusion criteria. We used full-text review of the remaining 229 articles to make a final determination regarding inclusion and we retained 181 articles for review. Although the quantity of AOD research with SMW has grown substantially, the great majority of studies have been conducted in the United States (US) and most focus on hazardous drinking; relatively little research has focused on other drugs. In addition, although there has been marked improvement in theories and methods used in this research, many gaps and limitations remain. Examples are the lack of longitudinal research; reliance on samples that tend to over-represent white, well-educated, and relatively young women; sparse attention to mechanisms underlying the disproportionately high rates of AOD use among SMW; and the absence of intervention research. In general, more high-quality research on SMW's use of AODs is needed, but gaps and limitations are particularly large in non-western countries. Addressing these research gaps and limitations is essential for providing information that can be used to develop more effective prevention and early intervention strategies, as well as for informing policies that can help to reduce risky drinking and drug misuse among SMW.

Effects of Alcohol Consumption on Pair Bond Maintenance and Potential Neural Substrates in Female Prairie Voles

AIMS

Discordant heavy alcohol use is a risk factor for disruption of intimate partner relationships. Modeling these relationships in prairie voles indicates that biological effects of alcohol can contribute to this risk. In particular, alcohol consumption disrupted an established preference for a female partner in male prairie voles if the partner was drinking water, but not if the partner was drinking alcohol. The current study investigated the effects of alcohol consumption on pair bonds in female prairie voles.

METHODS

Female and male prairie voles established pair bonds during 1 week of cohabitation. Following cohabitation, females and their partners were put into mesh-divided cages where they were given access to 10% ethanol and water or only water for 1 week. Pair bonds in female prairie voles were tested using the partner preference test (PPT). Following the PPT, we examined oxytocin, vasopressin and FosB immunoreactivity across several brain regions.

RESULTS

Female prairie voles consumed more alcohol if their male partner was also drinking alcohol, but not if their partner was drinking water. During PPT, females preferred their partner over a stranger, regardless of their partner's drinking status. Alcohol consumption decreased oxytocin immunoreactivity in the paraventricular nucleus of the hypothalamus and increased FosB immunoreactivity in the centrally projecting Edinger-Westphal nucleus.

CONCLUSIONS

Established partner preference in female prairie voles is resistant to alcohol consumption. This finding suggests that the risk for disruption of intimate partner relationships in females is not mediated by a decreased motivation to be with their partners.

Rationale and Design of a Remote Web-Based Daily Diary Study Examining Sexual Minority Stress, Relationship Factors, and Alcohol Use in Same-Sex Female Couples Across the United States: Study Protocol of Project Relate

Background

The Healthy People 2020 initiative aims to reduce health disparities, including alcohol use, among sexual minority women (SMW; eg, lesbian, bisexual, queer, and pansexual). Compared with heterosexual women, SMW engage in more hazardous drinking and report more alcohol-related problems. Sexual minority stress (ie, the unique experiences associated with stigmatization and marginalization) has been associated with alcohol use among SMW. Among heterosexuals, relationship factors (eg, partner violence and drinking apart vs together) have also been associated with alcohol use. Negative affect has also been identified as a contributor to alcohol use. To date, most studies examining alcohol use among SMW have used cross-sectional or longitudinal designs.

Objective

Project Relate was designed to increase our understanding of alcohol use among young SMW who are at risk for alcohol problems. The primary objectives of this study are to identify daily factors, as well as potential person-level risk and protective factors, which may contribute to alcohol use in SMW. Secondary objectives include examining other physical and mental concerns in this sample (eg, other substance use, eating, physical activity, and stress).

Methods

Both partners of a female same-sex couple (aged 18-35 years; n=150 couples) are being enrolled in the study following preliminary screening by a market research firm that specializes in recruiting sexual minority individuals. Web-based surveys are being used to collect information about the primary constructs of interest (daily experiences of alcohol use, sexual minority stress, relationship interactions, and mood) as well as secondary measures of other physical and mental health constructs. Data are collected entirely remotely from women across the United States. Each member of eligible couples completes a baseline survey and then 14 days of daily surveys each morning. Data will be analyzed using multilevel structural equation modeling.

Results

To date, 208 women (ie, 104 couples) were successfully screened and enrolled into the study. In total, 164 women have completed the 14-day daily protocol. Compliance with completing the daily diaries has been excellent, with participants on average completing 92% of the daily diaries. Data collection will be completed in fall 2018, with results published as early as 2019 or 2020.

Conclusions

Project Relate is designed to increase our understanding of between- and within-person processes underlying hazardous drinking in understudied, at-risk SMW. The study includes a remote daily diary methodology to provide insight into variables that may be associated with daily hazardous alcohol use. Before the development of programs that address hazardous alcohol use among young SMW, there is a need for better understanding of individual and dyadic variables that contribute to risk in this population. The unique challenges of recruiting and enrolling SMW from across the United States in a daily diary study are discussed.

International Registered Report Identifier (IRRID)

DERR1-10.2196/11718

Health and Health Behavior Concordance between Spouses in Same-Sex and Different-Sex Marriages

Research shows that heterosexual spouses are concordant on a variety of health and health behavior outcomes. Yet, little is known about patterns of concordance between spouses in same-sex marriages, or whether concordance patterns differ for spouses in same- and different-sex marriages. Using descriptive techniques, we analyze survey data from both spouses in 121 gay, 168 lesbian, and 122 heterosexual married couples to examine health and health behavior concordance. We find that gay and lesbian couples are more concordant than heterosexual couples on several health and health behavior outcomes. Differences in concordance between gay and lesbian couples are also found. Findings suggest that the pathways through which concordance occurs may differ in important ways for same-sex and different-sex unions.

Discrepant Drinking and Partner Violence Perpetration Over Time in Lesbians' Relationships

Discrepant drinking (i.e., differences in alcohol use) and perpetration of intimate partner violence in same-sex female couples were examined. Self-identified lesbian participants were recruited from market research firms and reported on their own and their partner's alcohol use and their own perpetration of psychological aggression and physical violence at baseline, then 6 and 12 months later. Cross-lagged panel analyses revealed that discrepant drinking predicted participants' subsequent perpetration of psychological aggression but not physical violence. Both psychological aggression and physical aggression predicted subsequent discrepant drinking. Consistent with findings in heterosexual couples, differences in alcohol use appear to be a risk factor for relationship aggression.

The role of perceptions of partner's alcohol use in heavy alcohol use and alcohol reduction intervention preferences among LGBQ adults in primary, romantic relationships

Correlates of heavy episodic alcohol and alcohol reduction intervention preferences were examined among LGBQ adults in romantic relationships. Anonymous data were collected online; analyses included logistic and multinomial regression models. One-fourth of participants reported recent heavy episodic alcohol use. Perceptions of partners' engaging in heavy alcohol use was associated with an incsreased odds of engaging in heavy alcohol use. Perceptions of partners' heavy alcohol use was associated an increased odds of preferring a couples-based alcohol intervention compared to preferring no intervention. Findings highlight the need to consider partners in alcohol interventions for LGBQ couples.

Breakthroughs in understanding addiction and close relationships

Substance use is one aspect of life that can serve to bring couples together or tear them apart. Evidence has accumulated for both substance use affecting relationship distress (e.g., partners of substance users report poorer individual and relational outcomes) as well as relationship conflict affecting subsequent substance use (e.g., individuals use substances as a way to cope with interpersonal conflict and distress). We discuss several determinants of each association, including individual difference and relationship-specific constructs. We conclude by considering how conceptualizing addiction as an interdependent-rather than independent-process is critical for future theory refinement and intervention development.

Relationship satisfaction in lesbian couples: Review, methodological critique, and research agenda

There has been increased interest in and attention to understanding the characteristics associated with relationship satisfaction among same-sex couples. This review examines the individual, couple, and external factors associated with relationship satisfaction among contemporary lesbian couples, highlighting domains such as internalized homophobia, personality, communication, conflict, sex, stress, and social support. I discuss methodological concerns and future directions to advance research in this area.

Empirical Investigation of a Model of Sexual Minority Specific and General Risk Factors for Intimate Partner Violence among Lesbian Women

OBJECTIVE

This study proposed and tested the first conceptual model of sexual minority specific (discrimination, internalized homophobia) and more general risk factors (perpetrator and partner alcohol use, anger, relationship satisfaction) for intimate partner violence among partnered lesbian women.

METHOD

Self-identified lesbian women (N=1048) were recruited from online market research panels. Participants completed an online survey that included measures of minority stress, anger, alcohol use and alcohol-related problems, relationship satisfaction, psychological aggression, and physical violence.

RESULTS

The model demonstrated good fit and significant links from sexual minority discrimination to internalized homophobia and anger, from internalized homophobia to anger and alcohol problems, and from alcohol problems to intimate partner violence. Partner alcohol use predicted partner physical violence. Relationship dissatisfaction was associated with physical violence via psychological aggression. Physical violence was bidirectional.

CONCLUSIONS

Minority stress, anger, alcohol use and alcohol-related problems play an important role in perpetration of psychological aggression and physical violence in lesbian women's intimate partner relationships. The results of this study provide evidence of potentially modifiable sexual minority specific and more general risk factors for lesbian women's partner violence.

Pathways to Hazardous Drinking Among Racially and Socioeconomically Diverse Lesbian Women: Sexual Minority Stress, Rumination, Social Isolation, and Drinking to Cope

Lesbian women engage in more hazardous drinking than heterosexual women yet we know relatively little about what explains this disparity. In the present study, race, socioeconomic status, minority stress, general psychological processes and distress were examined as pathways to hazardous drinking among young (18-35 years) Black and non-Hispanic White lesbian women. We used the psychological mediation framework adaptation of minority stress theory and the reserve capacity model as theoretical underpinnings of the conceptual model in the current study. Self-identified lesbian participants (N= 867) completed a one-time online survey that assessed race, socioeconomic status, perceived sexual minority discrimination, proximal minority stress (concealment, internalized homophobia, lack of connection to lesbian community), rumination, social isolation, psychological distress, drinking to cope, and hazardous drinking. Cross-sectional results demonstrated that being Black was associated with hazardous drinking via sequential mediators of rumination, psychological distress, and drinking to cope. Socioeconomic status was associated with hazardous drinking via sequential mediators of sexual minority discrimination, proximal minority stress, rumination, social isolation, psychological distress, and drinking to cope. Understanding these pathways can aid researchers and clinicians studying and working with lesbians who are at risk for hazardous drinking.