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Scheer JR, Wall MM, Veldhuis CB, Ford JV, Cascalheira CJ, Helminen EC, Shaw TJ, Jaipuriyar V, Zaso MJ, Hughes TL. Associations Between Latent Classes of Trauma Exposure and Minority Stressors and Substance Use Among Cisgender Sexual Minority Women. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:8286-8315. [PMID: 36843440 DOI: 10.1177/08862605231153886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Psychosocial stressors (e.g., minority stressors, trauma exposure) profoundly impact sexual minority women's (SMW's) risk of alcohol and other drug (AOD) use. However, research has not examined whether there are distinct typologies (i.e., patterns) of psychosocial stressors and whether these vary based on sociodemographic characteristics or are differentially associated with AOD outcomes (e.g., alcohol dependence) among SMW. This study aimed to identify latent classes of SMW reporting distinct typologies of psychosocial stressors and examine predictors and outcomes of latent classes of psychosocial stressors among SMW. Participants included a community sample of 602 SMW (Mage = 39.9, SD = 14.0; 74.0% lesbian; 37.4% White, 36.6% Black, 22.3% Latinx; 26.6% annual income ≤$14,999). Latent class analysis was used to identify typologies of psychosocial stressors. Regression analyses were employed to examine sociodemographic predictors and AOD outcomes of class membership. Three classes of psychosocial stressors emerged. Participants in Class 1 were likely to report relatively low adversity. SMW in Class 2, who reported childhood physical abuse (CPA), severe childhood sexual abuse, and adult physical assault, were vulnerable to discrimination and stigma consciousness. A distinct subgroup of SMW (Class 3) was at heightened risk of CPA, adult sexual assault (ASA), and stigma consciousness. Older SMW, Black SMW, and SMW with lower social support were more likely to be in classes characterized by higher adversity. Older SMW were at disproportionate risk of CPA and ASA. Different combinations of psychosocial stressors were uniquely associated with AOD outcomes. Findings underscore the importance of considering within-group heterogeneity in SMW's differential risk of psychosocial stressors and AOD outcomes. Routine screening of psychosocial stressors across several dimensions, brief interventions targeting AOD outcomes, and policies mitigating structural drivers of SMW's increased risk of trauma and minority stressors may be especially important for older SMW, Black SMW, and SMW who lack social support.
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Affiliation(s)
| | - Melanie M Wall
- New York State Psychiatric Institute, New York, NY, USA
- Columbia University School of Nursing, Center for Sexual and Gender Minority Health Research, New York, NY, USA
| | - Cindy B Veldhuis
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Cory J Cascalheira
- Syracuse University, Syracuse, NY, USA
- New Mexico State University, Las Cruces, NM, USA
| | - Emily C Helminen
- Syracuse University, Syracuse, NY, USA
- Rochester Institute of Technology, Rochester, NY, USA
| | - Thomas J Shaw
- Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | | | | | - Tonda L Hughes
- Columbia University, New York, NY, USA
- Columbia University School of Nursing, Center for Sexual and Gender Minority Health Research, New York, NY, USA
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Talley AE, Veldhuis C, Wall MM, Wilsnack SC, Everett BG, Hughes TL. Associations of adult roles and minority stressors with trajectories of alcohol dependence symptoms throughout adulthood among sexual minority women. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:559-570. [PMID: 35849352 PMCID: PMC9845428 DOI: 10.1037/adb0000869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE In the present study, we sought to identify trajectories of symptoms of potential alcohol dependence (AD) among adult sexual minority women (SMW). Theoretical correlates were examined in relation to the empirically identified trajectories. METHOD Data were collected at three time points between 2000 and 2012 from SMW drinkers (n = 434) enrolled in a longitudinal study (M Age = 37.49 at baseline, SD = 11.55). Using an accelerated-cohort longitudinal design, latent growth curve mixture models identified homogeneous patterns of any past-year symptoms of potential AD. Correlates of trajectories included alcohol-related developmental risk factors, adult roles, and exposure to minority stressors. RESULTS Three trajectories were identified that captured risk of symptoms of potential AD over time, reflecting: (a) relatively consistent, low risk over time; (b) deceleration in risk throughout adulthood; (c) relatively persistent, high risk over time. Consistent with prior work, SMW drinkers who reported higher levels of perceived stigma or masculinity showed persistently high risk of reporting at least one past-year symptom of potential AD. CONCLUSIONS Most SMW drinkers report deceleration in risk of AD symptoms over time. Findings have implications for prevention and intervention efforts tailored to SMW drinkers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | - Melanie M. Wall
- Research Foundation for Mental Hygiene
- Columbia University Department of Psychiatry
- New York State Psychiatric Institute
| | | | | | - Tonda L. Hughes
- Columbia University School of Nursing
- Columbia University Department of Psychiatry
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Mueller J. Data Visualization and Advocacy for Sexual and Gender Minority Health. JOURNAL OF MAP & GEOGRAPHY LIBRARIES 2022. [DOI: 10.1080/15420353.2022.2139329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Janina Mueller
- Massachusetts College of Pharmacy and Health Sciences, Boston, Massachusetts, USA
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Disparities in alcohol use and heavy episodic drinking among bisexual people: A systematic review, meta-analysis, and meta-regression. Drug Alcohol Depend 2022; 235:109433. [PMID: 35395502 DOI: 10.1016/j.drugalcdep.2022.109433] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 03/18/2022] [Accepted: 03/24/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Alcohol consumption is more prevalent among sexual minorities than among heterosexuals; however, differences between minority sexual orientation groups are understudied. This systematic review and meta-analysis aimed to summarize existing evidence on the prevalence of alcohol use among bisexual people compared to their lesbian/gay and heterosexual counterparts. METHODS A systematic review of literature from 1995 to May 2020 was performed using Medline, PsycInfo, and Embase (OVID), Scopus, CINHAL and LGBT Life (EBSCO), combining keywords for bisexuality and alcohol use. Peer-reviewed publications that reported quantitative data on alcohol use among bisexual people were included. A random-effects model was used to pool the prevalence of two outcomes: any alcohol use and heavy episodic drinking (HED). Subgroup analysis and random-effects meta-regression were used to explore heterogeneity. RESULTS Of 105 studies eligible for data extraction, the overall prevalence of alcohol use was higher among bisexuals compared to lesbian/gay and heterosexual people. For example, the prevalence of past-month HED was 30.0% (28.2, 31.8) among bisexual people versus 25.5% (23.8, 27.2) among lesbian/gay and 21.3% (19.6, 23.0) among heterosexual individuals. Pooled odds ratio estimates showed that bisexual people were more likely to report alcohol use and HED compared to their counterparts. Gender was a significant effect modifier in meta-regression analysis, with greater disparities among women than among men. CONCLUSIONS These results highlight the need for additional research to understand factors underlying bisexual people's greater risk, and particularly bisexual women, as well as alcohol use interventions that are targeted towards the specific needs of bisexual people.
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Trocki KF, Mericle AA, Drabble LA, Klinger JL, Veldhuis CB, Hughes TL, Karriker-Jaffe KJ. Investigating differential protective effects of marriage on substance use by sexual identity status. INTERNATIONAL JOURNAL OF ALCOHOL AND DRUG RESEARCH 2020; 8:69-80. [PMID: 33510823 PMCID: PMC7837608 DOI: 10.7895/ijadr.267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Research suggests that marriage is protective against substance use. However, few studies have examined whether this protective effect differs for sexual minorities, a population at increased risk for substance use. Using data from four waves of the cross-sectional U.S. National Alcohol Survey (NAS; 2000, 2005, 2010, and 2015), we investigated whether the protective effects of marriage varied by sexual identity. METHODS Sex-stratified logistic regression models were used to examine independent and interactive effects of current marital status (being married vs. not) and sexual minority status (lesbian/gay/bisexual vs. heterosexual) on high-intensity drinking, alcohol use disorder, and marijuana use in the past year. RESULTS Among both women and men, sexual minority status was generally associated with higher odds of these outcomes and marriage was consistently associated with lower odds. Differential effects of marriage by sexual identity with respect to marijuana use were found only among men; marriage was significantly associated with decreased odds of marijuana use among heterosexual men but increased odds among sexual minority men. CONCLUSIONS Marriage may be less consistently protective against hazardous drinking and marijuana use among sexual minorities than heterosexuals. Findings underscore the importance of both quantitative and qualitative studies designed to better understand disparities in substance use across both sexual identity and relationship statuses.
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Affiliation(s)
- Karen F. Trocki
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Amy A. Mericle
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Laurie A. Drabble
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
- San José State University College of Health and Human Sciences, One Washington Square, San Jose, CA 95192-0049, USA
| | - Jamie L. Klinger
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Cindy B. Veldhuis
- School of Nursing, Columbia University, 630 West 168 Street, Mail Box Code 6, New York, NY 10032, USA
| | - Tonda L. Hughes
- School of Nursing, Columbia University, 630 West 168 Street, Mail Box Code 6, New York, NY 10032, USA
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McCann E, Brown MJ. The views and experiences of lesbians regarding their mental health needs and concerns: Qualitative findings from a mixed-methods study. Perspect Psychiatr Care 2020; 56:827-836. [PMID: 32175605 DOI: 10.1111/ppc.12498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/26/2020] [Accepted: 03/07/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The aim of this paper is to report the specific views and experiences of lesbians and identify their distinct mental health issues and concerns. DESIGN AND METHODS A mixed-methods design with surveys and individual interviews was utilized. The data were thematically analyzed. FINDINGS The key themes were (a) enabling service access, (b) person-centered support, (c) models of care, (d) community presence and participation, and (e) future aspirations for mental health services. PRACTICE IMPLICATIONS The study results inform and develops the understanding of the issues that impact upon the mental health and well-being of lesbians. The implications for mental health practice are discussed.
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Affiliation(s)
- Edward McCann
- Faculty of Health Sciences, School of Nursing and Midwifery, Dublin, Republic of Ireland
| | - Michael J Brown
- Faculty of Medicine, Health and Life Sciences, School of Nursing and Midwifery, Belfast, Northern Ireland
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Veldhuis CB, Hughes TL, Drabble L, Wilsnack S, Matthews A. Do relationships provide the same levels of protection against heavy drinking for lesbian and bisexual women? An intersectional approach. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2020; 7:337-352. [PMID: 34485591 PMCID: PMC8411928 DOI: 10.1037/sgd0000383] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE Sexual minority women (SMW; e.g., lesbian, bisexual) are more likely than heterosexual women to be heavy drinkers, with bisexual women showing the highest risk. There is ample literature demonstrating that intimate relationships protect against stress-related health risk behaviors in the general population. However, very little research has focused on SMW's relationships and far less is known about the relationships of SMW of color. Using intersectionality theory as our framework, we tested two competing models to determine whether the effects of minority sexual identity (lesbian, bisexual) and race/ethnicity (African American, Latinx, White) are: 1) additive, or 2) multiplicative in the associations between relationship status and heavy drinking. METHODS Data are from a diverse sample of cisgender sexual minority women (N = 641) interviewed in Wave 3 of the CHLEW study, a 20-year longitudinal study of SMW's health. RESULTS Findings from two- and three-way interactions provide mixed evidence for both the additive and multiplicative hypotheses; support for each varied by sexual identity and race/ethnicity. Overall, we found that Latinx SMW, particularly single and bisexual Latinx SMW report the highest rates of heavy drinking compared to their cohabiting and lesbian counterparts, respectively. African American single SMW reported significantly higher rates of heavy drinking compared to their cohabiting counterparts. CONCLUSION Our findings suggest that the protective qualities of SMW's intimate relationships vary based on sexual identity and race/ethnicity-and the intersections between them. These results highlight that research among SMW that does not take into account multiple marginalized identities may obscure differences. PUBLIC SIGNIFICANCE Little research has focused on health within sexual minority women's relationships, particularly among sexual minority women of color. Given the potential additive or multiplicative effects of multiple sources of oppression such as heterosexism, racism, and sexism, understanding the potential protective effects of relationships is important. Our findings demonstrate that the protective qualities of intimate relationships among SMW vary based on sexual identity and race/ethnicity - and the intersections between them.
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Affiliation(s)
| | - Tonda L Hughes
- School of Nursing, Columbia University
- College of Nursing, University of Illinois at Chicago
| | | | - Sharon Wilsnack
- School of Medicine & Health Sciences, University of North Dakota
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Nadaleti NP, Ribeiro JF, Ferreira PM, Santos SVMD, Terra FDS. Self-esteem and consumption of alcohol, tobacco, and other substances in outsourced workers. Rev Lat Am Enfermagem 2019; 27:e3199. [PMID: 31618392 PMCID: PMC6792343 DOI: 10.1590/1518-8345.3401.3199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/29/2019] [Indexed: 01/20/2023] Open
Abstract
Objective to evaluate self-esteem, the consumption of alcohol, tobacco and other
substances in outsourced workers of a public university. Method a descriptive-analytical, cross-sectional, quantitative study developed with
316 outsourced workers from a municipality in the Southeast of Brazil. Data
was collected through a characterization tool, the Rosenberg Self-Esteem
Scale and the Alcohol, Smoking and Substance Involvement Screening Test. For
data analysis, we used descriptive statistics, Pearson’s chi-square test,
Fisher’s exact test, odds ratio and logistic regression. Results the majority of workers had high self-esteem and some used alcohol, tobacco,
marijuana and inhalants. A significant association between gender, age group
and work shift with self-esteem; between the risk of developing problems
related to alcohol consumption with sex, age group, marital status,
religious belief and number of children; between the practice of physical
activity and the risk of developing problems related to the consumption of
tobacco products was found. Conclusion this study contributes to the increase of knowledge due to the small number
of researches involving this subject and to contribute to the nurses to have
subsidies to work with this population using strategies to combat the
triggers of psychic disorders.
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Affiliation(s)
- Nayara Pires Nadaleti
- Universidade Federal de Alfenas, Escola de Enfermagem, Alfenas, MG, Brasil.,Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Jefferson Felipe Ribeiro
- Universidade Federal de Alfenas, Escola de Enfermagem, Alfenas, MG, Brasil.,Bolsista do MEC/SESu/PET, Brasil
| | - Poliana Martins Ferreira
- Universidade Federal de Alfenas, Escola de Enfermagem, Alfenas, MG, Brasil.,Bolsista do MEC/SESu/PET, Brasil
| | - Sérgio Valverde Marques Dos Santos
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil.,Bolsista da Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Brasil
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Veldhuis CB, Talley AE, Hancock DW, Wilsnack SC, Hughes TL. Alcohol Use, Age, and Self-Rated Mental and Physical Health in a Community Sample of Lesbian and Bisexual Women. LGBT Health 2017; 4:419-426. [PMID: 29099308 DOI: 10.1089/lgbt.2017.0056] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
PURPOSE Given that self-perceptions of mental and physical health are important predictors of health outcomes and well-being, particularly among older adults, this study focuses on associations among age, alcohol consumption, and indicators of both self-rated mental health and self-rated physical health in a sample of sexual minority women (SMW). METHODS This study uses a community sample of SMW to examine the associations among age, drinking, and self-rated mental and physical health. RESULTS Heavy drinking among older adult SMW (55+) was less prevalent than among young SMW, ages 18-25 and ages 26-39, but similar to rates reported among SMW ages 40-54. In addition, older SMW reported significantly higher levels of self-rated mental health, compared with SMW in the other age groups, but we found no significant associations between age and self-rated physical health. Across all age groups, moderate drinkers reported better self-rated physical health than alcohol abstainers. CONCLUSIONS Overall, these results suggest that, among SMW, drinking does not decline as sharply with age as it does for heterosexual women in the general population. Given the current and projected increases in the aging population and the risks that heavy drinking presents for morbidity and mortality, interventions aimed at older SMW are needed.
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Affiliation(s)
- Cindy B Veldhuis
- 1 Center for Research on Women and Gender, University of Illinois at Chicago , Chicago, Illinois.,2 Department of Health Systems Science, College of Nursing, University of Illinois at Chicago , Chicago, Illinois.,3 School of Nursing, Columbia University , New York, New York
| | - Amelia E Talley
- 4 Department of Psychological Sciences, Texas Tech University , Lubbock, Texas
| | - David W Hancock
- 4 Department of Psychological Sciences, Texas Tech University , Lubbock, Texas
| | - Sharon C Wilsnack
- 5 Department of Psychiatry and Behavioral Science, University of North Dakota , Grand Forks, North Dakota
| | - Tonda L Hughes
- 2 Department of Health Systems Science, College of Nursing, University of Illinois at Chicago , Chicago, Illinois.,3 School of Nursing, Columbia University , New York, New York
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