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Renley BM, Argenyi MS, Mereish EH, Watson RJ. Experiences of stress and social safety among sexual and gender minority youth by disability status. Disabil Health J 2024:101614. [PMID: 38521733 DOI: 10.1016/j.dhjo.2024.101614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Though separate bodies of research have shown sexual and gender minority (SGM) youth, and youth with disabilities, separately, face distinct social and health disparities, little is known about youth who both identify as SGM and have disabilities. OBJECTIVE The current study examined differences in wellbeing among SGM youth by disability category (i.e., physical, developmental, psychiatric) across victimization, bullying, dating violence, school safety, and experienced stress. METHODS Using self-reported data from 9418 SGM youth aged 13-17 in the United States, multivariate linear regressions were conducted to examine how stress and social safety experiences varied across disability status. RESULTS Compared to SGM youth without a disability, SGM youth across all disability categories (physical, developmental, psychiatric) had greater odds of LGBT- and disability-based victimization, greater average stress, as well as lower levels of school safety. SGM youth with any disability, physical disability, or psychiatric disability also had greater odds of dating violence compared to SGM youth without a disability. CONCLUSION SGM youth with disabilities may be in particular need of targeted programs that address both disability and sexual/gender identities, and may benefit from increased supports across developmental contexts (e.g., against bullying in school). Stakeholders should consider how such support can be improved, tailored, and implemented, for SGM youth and the diversity of disabilities they have.
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Affiliation(s)
- Benton M Renley
- University of Connecticut, Department of Human Development & Family Sciences, Storrs, CT, USA.
| | - Michael S Argenyi
- University of Massachusetts Chan Medical School, Department of Family Medicine and Community Health, Worcester, MA, USA
| | - Ethan H Mereish
- Lavender Lab, Department of Psychology, University of Maryland, College Park, USA
| | - Ryan J Watson
- University of Connecticut, Department of Human Development & Family Sciences, Storrs, CT, USA
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2
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Parnes JE, Le TP, Mereish EH, Miranda R. Daily associations between resilience factors, substance use, and affect among sexual minority youth. Psychol Addict Behav 2024:2024-54430-001. [PMID: 38358656 DOI: 10.1037/adb0000998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
OBJECTIVE Past research has highlighted that sexual minority youth (SMY) are at particular risk for heightened substance use compared to their heterosexual peers; however, few studies have investigated the associations between resilience factors and substance use among SMY. In the present preregistered study, we examined the associations among three different forms of resilience factors (i.e., general social support, lesbian, gay, bisexual, transgender, and queer (LGBTQ)-identity affirmation, LGBTQ community involvement) and alcohol, nicotine, and cannabis use, as well as on positive and negative affect. METHOD SMY (n = 82, ages 15-19, 56.1% cisgender women, 84.4% White) completed a baseline assessment then a 30-day ecological momentary assessment study. Multilevel regression models evaluated within-day and between-person associations between resilience factors and odds of substance use (alcohol, nicotine, cannabis), substance use quantity on use days (alcohol, cannabis), positive affect, and negative affect. RESULTS On the day level, general social support was associated with greater positive affect, lesser negative affect, and greater drinks on drinking days. LGBTQ-identity affirmation was associated with greater positive affect, lesser negative affect, and greater odds of nicotine use. LGBTQ community involvement was associated with greater positive affect. CONCLUSIONS These results highlight the nuanced ways that resilience may engender more positive affect and reduce negative affect while simultaneously promoting substance use. Future research disentangling the mechanisms connecting resilience and substance use among SMY is necessary. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Jamie E Parnes
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University
| | | | - Ethan H Mereish
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University
| | - Robert Miranda
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University
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3
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Janssen T, Gamarel KE, Mereish EH, Colby SM, Haikalis M, Jackson KM. Associations Among Enacted Stigma, Perceived Chances for Success, Life Satisfaction, and Substance Use Among Sexual Minority and Heterosexual Youth. Subst Use Misuse 2023; 58:1121-1131. [PMID: 37216278 PMCID: PMC10388366 DOI: 10.1080/10826084.2023.2212282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Background: Sexual minority youth report high rates of substance use compared to heterosexual youth. Stigma can diminish perceptions of future success and life satisfaction and contribute to elevated substance use. This study examined whether experiences of enacted stigma (i.e., discrimination) and substance use among sexual minority and heterosexual youth were indirectly associated through perceived chances for success and life satisfaction. Method: In a sample of 487 adolescents who indicated their sexual identity (58% female, M age = 16.0, 20% sexual minority), we assessed substance use status and factors that might explain sexual minority disparities in substance use. Using structural equation modeling, we examined indirect associations between sexual minority status and substance use status through these factors. Results: Compared to heterosexual youth, sexual minority youth reported greater stigma, which was associated with both lower perceived chances for success and life satisfaction, which were in turn associated with greater likelihood of substance use. Conclusions: Findings highlight the importance of attending to stigma, perceived chances for success, and general life satisfaction to understand and intervene to prevent substance use among sexual minority youth.
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Affiliation(s)
- Tim Janssen
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Kristi E. Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health
| | - Ethan H. Mereish
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
- Department of Health Studies, American University
| | - Suzanne M. Colby
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Michelle Haikalis
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
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4
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Mereish EH, Peters JR, Brick LAD, Killam MA, Yen S. A daily diary study of minority stressors, suicidal ideation, nonsuicidal self-injury ideation, and affective mechanisms among sexual and gender minority youth. J Psychopathol Clin Sci 2023; 132:372-384. [PMID: 36996184 PMCID: PMC10164073 DOI: 10.1037/abn0000813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Sexual and gender minority youth (SGMY) are at greater risk than their heterosexual and cisgender counterparts for suicidal thoughts and behaviors (STB) and nonsuicidal self-injury (NSSI). Unique stressors (i.e., minority stressors) specific to SGMY's stigmatized identities such as discrimination or concealment of one's identity are posited to explain these disparities. However, there is limited research examining the associations among minority stressors, affective mediating processes, and STB and NSSI in SGMY's daily lives. We conducted a 28-day daily diary study to test the mediating effects of daily negative and positive affect and emotion dysregulation between minority stressors and STB and NSSI among SGMY who were recruited from clinical and community settings. Participants were 92 SGMY, aged 12-19 years old (M = 16.45; SD = 1.81; 64% cisgender; 69% White). Results indicated that on days SGMY experienced external and internalized minority stressors, they reported greater intensity of suicidal and nonsuicidal self-injurious ideation and affective distress (i.e., greater negative affect, lower positive affect, and more emotion dysregulation). Greater affective reactivity processes were associated with greater suicidal and nonsuicidal self-injurious ideation intensity on the same day. Most of the within-person associations between external and internalized minority stressors and ideation intensity were mediated by heightened negative affect and emotion dysregulation but not lower positive affect. Our results provide the first evidence of these associations among SGMY, advance the minority stress model, and have implications for clinical interventions as we identified modifiable affective mechanisms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Psychology, University of Maryland
| | - Jessica R Peters
- Department of Psychiatry and Human Behavior, Warren Alpert Brown Medical School, Brown University
| | - Leslie A D Brick
- Department of Psychiatry and Human Behavior, Warren Alpert Brown Medical School, Brown University
| | - Matthew A Killam
- Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School
| | - Shirley Yen
- Department of Psychiatry and Human Behavior, Warren Alpert Brown Medical School, Brown University
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Feinstein BA, Mereish EH, Mamey MR, Chang CJ, Goldbach JT. Age Differences in the Associations Between Outness and Suicidality Among LGBTQ+ Youth. Arch Suicide Res 2023; 27:734-748. [PMID: 35506502 PMCID: PMC9719400 DOI: 10.1080/13811118.2022.2066493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth are at increased risk for suicidality compared to their heterosexual and cisgender peers, and outness (the extent to which an individual is open about their LGBTQ+ identity to others) is an important correlate of suicidality. However, previous research has led to mixed findings regarding whether outness functions as a risk or protective factor for suicidality, and the available evidence suggests that age may play an important role. As such, the goal of the current study was to examine whether the associations between outness and suicidality differed between LGBTQ+ adolescents (ages 12-17) and emerging adults (ages 18-24). METHOD The analytic sample included 475 LGBTQ+ youth who completed an online survey after contacting a national, LGBTQ+ crisis service provider. RESULTS Results indicated that age significantly moderated the association between outness and suicidal ideation, such that greater outness was significantly associated with greater suicidal ideation for adolescents, but not for emerging adults. In contrast, age did not significantly moderate the associations between outness and likelihood of a past suicide attempt or perceived likelihood of a future suicide attempt. However, the main effect of outness was significant in both models, such that greater outness was significantly associated with a greater likelihood of a past suicide attempt and a greater perceived likelihood of a future suicide attempt. CONCLUSIONS These findings suggest that the associations between outness and suicidality among LGBTQ+ youth may depend on age as well as the dimension of suicidality (ideation versus attempt). HighlightsBeing more open about one's LGBTQ+ identity may confer risk for suicidality.The influence of outness on suicidal ideation may be strongest during adolescence.There is a need for LGBTQ+ affirming policies and laws to reduce suicidality.
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Affiliation(s)
- Brian A. Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science
| | | | - Mary Rose Mamey
- Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Cindy J. Chang
- Graduate School of Applied and Professional Psychology, Rutgers University
| | - Jeremy T. Goldbach
- Suzanne Dworak-Peck School of Social Work, University of Southern California
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6
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Parnes JE, Mereish EH, Meisel SN, Treloar Padovano H, Miranda R. In the Presence of Parents: Parental Heterosexism and Momentary Negative Affect and Substance Craving Among Sexual Minority Youth. J Adolesc Health 2023; 72:230-236. [PMID: 36473778 PMCID: PMC10262696 DOI: 10.1016/j.jadohealth.2022.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 08/15/2022] [Accepted: 09/23/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE We examined the influence of parental heterosexism on in vivo negative affect and substance craving among sexual minority youth (SMY) who use nicotine and other substances, and if that relation was strengthened when in the presence of their parent(s). METHODS SMY (n = 42, ages 15-19) completed baseline assessments, including experiences of parental heterosexism (PH), and a 30-day ecological momentary assessment. Ecological momentary assessment reports included affective states (i.e., anger, anxiety, depression), substance craving (i.e., nicotine, cannabis, alcohol), and other contextual factors (e.g., presence of parents). Multilevel logistic regression models evaluated the study hypotheses. RESULTS PH was associated with greater odds of reporting in-the-moment anger, depression, cannabis craving, and alcohol craving. Parental presence was associated with lower odds of reporting anxiety or depression, and greater odds of reporting nicotine craving. There was a significant interaction when predicting the odds of reporting anxiety. For SMY low in PH, parental presence was related to lower odds of reporting anxiety. As PH increased, parental presence had diminishing associations with the odds of reporting anxiety. DISCUSSION Parenting behaviors can serve as protective and risk factors for negative affect and substance craving among SMY. Improving family-based interventions for SMY may be integral for enhancing healthy development and reducing health disparities.
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Affiliation(s)
- Jamie E Parnes
- Center for Alcohol and Addiction Studies, Department of Behavioral & Social Sciences, Brown University, Providence, Rhode Island; E. P. Bradley Hospital, Riverside, Rhode Island
| | - Ethan H Mereish
- Center for Alcohol and Addiction Studies, Department of Behavioral & Social Sciences, Brown University, Providence, Rhode Island; Department of Psychology, University of Maryland, College Park, Maryland; Department of Health Studies, American University, Washington, District of Columbia.
| | - Samuel N Meisel
- Center for Alcohol and Addiction Studies, Department of Behavioral & Social Sciences, Brown University, Providence, Rhode Island; E. P. Bradley Hospital, Riverside, Rhode Island
| | - Hayley Treloar Padovano
- Center for Alcohol and Addiction Studies, Department of Behavioral & Social Sciences, Brown University, Providence, Rhode Island
| | - Robert Miranda
- Center for Alcohol and Addiction Studies, Department of Behavioral & Social Sciences, Brown University, Providence, Rhode Island; E. P. Bradley Hospital, Riverside, Rhode Island
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Argenyi MS, Mereish EH, Watson RJ. Mental and Physical Health Disparities Among Sexual and Gender Minority Adolescents Based on Disability Status. LGBT Health 2023; 10:130-137. [PMID: 36301253 PMCID: PMC9986008 DOI: 10.1089/lgbt.2022.0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Sexual and gender minority (SGM) youth and youth with disabilities both experience health disparities. Little data exist on whether SGM youth with disabilities have worse health outcomes compared with SGM youth without disabilities. This study aimed to examine differences in health behaviors and outcomes among a sample of SGM youth by different types of disabilities. Methods: Secondary analyses were conducted with a subset (N = 9418) of the LGBTQ National Teen Survey, a comprehensive survey of risk and protective factors and health outcomes of SGM youth across the United States collected in 2017. Multiple types of disabilities (physical, cognitive, or psychiatric) and mental, behavioral, and physical health outcomes were self-reported. Results: Of the sample, 18.3% reported a disability. Significant findings included higher odds of exercise avoidance, greater depressive symptoms and sleep concerns, and lower self-esteem and overall health ratings among SGM youth who reported any form of disability compared with SGM youth who reported no disability. Youth with cognitive disabilities had lower odds of alcohol use than youth with no disability. Youth with psychiatric disabilities had higher odds of cannabis and cigarette use, and lower physical activity than youth with no disability. Youth with either psychiatric or physical disabilities reported higher body mass index than youth with no disability. Conclusion: SGM youth with disabilities experience greater health disparities than SGM youth with no reported disabilities. Results provide groundwork evidence about the impact of disability status on SGM adolescents. Disability-inclusive or -specific frameworks are needed for future interventions and studies of SGM youth.
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Affiliation(s)
- Michael S Argenyi
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.,Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Ethan H Mereish
- Department of Health Studies, American University, Washington, District of Columbia, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
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Mereish EH, Fish JN, Watson RJ. Intersectional Minority Stress and Alcohol, Tobacco, and Cannabis Use Among Sexual and Gender Minority Adolescents of Color: Moderating Role of Family Support. LGBT Health 2023; 10:18-25. [PMID: 35914084 PMCID: PMC10024056 DOI: 10.1089/lgbt.2021.0430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Purpose: We examined the associations between intersectional minority stress and substance use among sexual and gender minority (SGM) adolescents of color and the moderating role of family support on these associations. Methods: Data were from a national U.S. sample of SGM adolescents of color (N = 3423). Intersectional minority stress was assessed with the LGBT People of Color Microaggressions Scale. Results: Intersectional minority stress was associated with greater odds of recent and heavy alcohol and recent cannabis use, but not tobacco use. When examining specific domains of intersectional minority stress, racism from SGM communities was associated with greater odds of recent and heavy alcohol, and recent cannabis use, whereas heterosexism from same racial/ethnic communities was associated with greater odds of recent cigarette and cigar use. Family support was associated with lower substance use. Family support was not a significant moderator. Conclusions: Findings underscore the need to examine intersectional stressors that SGM adolescents of color experience and to bolster family supports to prevent substance use. Family support did not buffer the effects of intersectional minority stress on substance use outcomes, suggesting that other strategies, such as other forms of family support (e.g., identity-specific support) and community-level and structural changes that target reducing and dismantling oppression are needed to reduce the deleterious impact of intersectional minority stress.
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Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Health Studies, American University, Washington, District of Columbia, USA
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
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Mereish EH, Treloar Padovano H, Parlette B, Miranda R. Momentary Associations Among Minority Stress, Craving, Affect, and Nicotine Use Among Sexual Minority Youth. J Clin Child Adolesc Psychol 2022; 51:877-891. [PMID: 35895311 PMCID: PMC9617755 DOI: 10.1080/15374416.2022.2093208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Sexual minority youth are more likely to use nicotine relative to heterosexual youth. The minority stress model posits these disparities are partly due to unique stress (i.e., minority stress) specific to their stigmatized identities. However, there is a dearth of research exploring the fine-grained dynamic interplay between minority stressors, mediating processes, and nicotine use in sexual minority youth's daily lives and natural environment. We leveraged ecological momentary assessment over a 30-day monitoring period to test the mediating effects of craving and negative and positive affect on the momentary associations between minority stressors and subsequent nicotine use among sexual minority youth who were active nicotine users and recruited from the community. METHODS Participants were 85 nicotine users, ages 15-19 years old (M age = 17.96, SD = 1.10; 56.6% cisgender female; 56.6% bisexual; 73.5% non-Hispanic White) and half (51.8%) were daily nicotine users. RESULTS Results indicated that exposure to a minority stressor was associated with momentary elevations in nicotine craving and negative affect and decreases in positive affect. Nicotine craving and positive affect were also associated with greater probability of subsequent nicotine use. The associations between minority stressors and subsequent nicotine use were mediated through craving and positive, but not negative affect. CONCLUSIONS Our findings provide the first ecological momentary assessment evidence of these associations among sexual minority youth and help support and advance both addictions and sexual minority-specific models (e.g., minority stress) of nicotine use among youth.
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Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Health Studies, American University
| | | | | | - Robert Miranda
- Center for Alcohol and Addiction Studies, Brown University
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10
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Abstract
Given recent and growing societal movements focusing on sexual assault, such as the #MeToo Movement, it is imperative to understand current attitudes about sexual assault and these movements. The aim of this study was to examine negative attitudes and beliefs about sexual assault in the context of the #MeToo Movement by qualitatively analyzing social media posts (i.e., tweets) containing the hashtag "metoo" on Twitter, a popular social media platform. The initial sample consisted of 4,559 tweets that were publicly posted by Twitter users across a four-day timeframe and represented events and attitudes regarding both about an accuser and an accused. Data were cleaned and coded, and a remaining 508 tweets were included because they contained content that was categorized as negative in their attitudes or beliefs (either through attitudes of condemnation or ambivalence towards accusers and/or the #MeToo Movement). Results from a qualitative content analysis of tweets demonstrated that negative attitudes and beliefs about sexual assault within the context of the #MeToo Movement were conveyed through six main themes: (1) invalidating the accusations made as part of the #MeToo Movement; (2) insisting, and likely believing, that accusations made were false; (3) claiming that there were alternative motives for those accusations; (4) showing a concern for the harm that accusations may cause those accused; (5) exhibiting concerns about the effects of the Movement on male power, privilege, and status; and (6) questioning the integrity of the #MeToo Movement as a whole. These findings provide a deeper understanding of attitudes and beliefs about the #MeToo Movement, including novel beliefs not often addressed in the literature. Most importantly, these findings show that rape culture continues to persist despite current interventions and social movements. Results underscore the need for future interventions that aim to educate and improve societal attitudes towards sexual assault.
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Mereish EH, Cox DJ, Goldbach JT. Heterosexist Bullying Victimization and Perpetration and Substance Use Among Heterosexual Adolescents. Int J Behav Med 2022; 30:431-437. [PMID: 35698020 DOI: 10.1007/s12529-022-10109-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although heterosexist bullying mainly affects sexual minority adolescents, heterosexual adolescents may also be targets. Research is needed to understand the impact of heterosexist bullying victimization on heterosexual adolescents' behavioral health. Moreover, there is a dearth of research examining the negative consequences of perpetrating heterosexist bullying among heterosexual adolescents. The purpose of this study was to examine the associations between heterosexist bullying victimization and perpetration and substance use in a racially diverse sample of heterosexual adolescents. METHODS A probability sample of middle and high school heterosexual students (N = 2,337; aged 11-19; 52.7% female; 35.9% Black or African American and 31.9% White) using random cluster methods was obtained from a southeastern US school district. Multiple logistic regression models were used to test the relationships between experiencing and perpetrating heterosexist bullying and substance use while accounting for sociodemographics. RESULTS Of the participants, 7.1% reported heterosexist bullying victimization and 7.8% reported perpetration of heterosexist bullying. Of those engaging in heterosexist bullying, 29.5% also experienced it as a victim. Perpetrating heterosexist bullying was associated with greater odds of recent and lifetime alcohol, cigarette, e-cigarette, cannabis, and prescription drug use. Heterosexist bullying victimization was only associated with recent and lifetime cigarette use and lifetime e-cigarette use. CONCLUSIONS The results demonstrate the negative correlates of heterosexist bullying victimization and perpetration on heterosexual adolescents' substance use. The findings underscore the need to address sexual stigma, such as heterosexist bullying, among not only adolescents experiencing it but also its perpetrators to help reduce substance use among all adolescents.
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Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Health Studies, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA.
| | - Diana J Cox
- Department of Psychology, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA
| | - Jeremy T Goldbach
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
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12
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Abstract
Among sexual minorities, bisexual individuals experience higher rates of victimization and symptoms of PTSD than their lesbian and gay peers as well as heterosexual individuals. Despite these disparities, little work has examined factors contributing to PTSD symptoms among bisexual adults. The current study examined the associations between bisexual-specific minority stress and PTSD symptoms in a sample of adults with bisexual orientation and tested social support as a potential mediator of this association. Participants were 488 adults (378 cisgender women, 49 cisgender men, 61 transgender individuals), ages 18 to 66 years, with bisexual orientation based on identity and/or attraction to multiple genders. Greater anti-bisexual prejudice was associated with greater PTSD symptoms (β = 0.16) and lower social support (β = -.16), while accounting for sociodemographics and sexual identity-based victimization. Social support was associated with lower PTSD symptoms (β = -.25), while accounting for sociodemographics, sexual identity-based victimization, and anti-bisexual prejudice. Mediation analyses indicated that anti-bisexual prejudice was indirectly associated with greater PTSD symptoms through lower social support. Addressing bisexual-specific minority stress and its role in diminishing social support for bisexual individuals represents a critical component of trauma-informed research and intervention development in the bisexual community.
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Affiliation(s)
- Julie M Woulfe
- Syracuse University Barnes Center at the Arch, Syracuse, New York, USA
| | - Ethan H Mereish
- Department of Health studies, American University, Washington, DC, USA
| | - Sabra L Katz-Wise
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachussets, USA
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13
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Jhe GB, Mereish EH, Gordon AR, Woulfe JM, Katz-Wise SL. Associations between anti-bisexual minority stress and body esteem and emotional eating among bi+ individuals: The protective role of individual- and community-level factors. Eat Behav 2021; 43:101575. [PMID: 34757266 PMCID: PMC8739806 DOI: 10.1016/j.eatbeh.2021.101575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 09/29/2021] [Accepted: 10/08/2021] [Indexed: 11/27/2022]
Abstract
Bisexual individuals experience prejudice specifically related to their bisexual identity, and these experiences may compound extant risk for disordered eating behaviors and body esteem concerns. However, little is known about how sexual minority stress related to bisexual orientation is associated with emotional eating and body esteem. The current study examined the associations between bisexual-specific minority stress and emotional eating and body esteem in a sample of bisexual plus (bi+) adults (including bisexual, pansexual, queer, and those with attractions to more than one gender regardless of identity), and tested the moderating effects of identity centrality, affirmation, and community connectedness as potential protective factors. This study leveraged data from an online survey of 498 adults (77.46% cisgender women; 79.7% White), ages 18 to 64 years (M = 28.5; SD = 9.59). Bisexual-specific minority stress was associated with more emotional eating (β = 0.15, p = .013) and lower body esteem (β = -0.16, p = .005), while controlling for sociodemographic characteristics, body mass index, and heterosexist minority stress. This finding remained the same when sensitivity analyses were conducted with participants who identified specifically as bisexual. Identity centrality and affirmation and community connectedness did not demonstrate moderating effects but they had main effects, such that they were positively associated with body esteem (β = 0.16, p = .001; β = 0.21, p < .001; β = 0.13, p = .004, respectively). Results suggest that anti-bisexual minority stress has a unique association with bi+ individuals' emotional eating and body esteem, and identified potential individual- and community-level protective factors for body esteem. These findings inform future research and interventions for this understudied population.
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Affiliation(s)
- Grace B. Jhe
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, United States of America,Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America,Corresponding author at: Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115, United States of America. (G.B. Jhe)
| | - Ethan H. Mereish
- Department of Health Studies, American University, Washington, DC, United States of America
| | - Allegra R. Gordon
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, United States of America,Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States of America
| | - Julie M. Woulfe
- Barnes Center at the Arch, Syracuse University, Syracuse, NY, United States of America
| | - Sabra L. Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, United States of America,Department of Pediatrics, Harvard Medical School, Boston, MA, United States of America,Department of Social and Behavioral Sciences, Harvard T. H Chan School of Public Health, Boston, MA, United States of America
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14
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Scheer JR, Mereish EH. Intimate Partner Violence and Illicit Substance Use Among Sexual and Gender Minority Youth: The Protective Role of Cognitive Reappraisal. J Interpers Violence 2021; 36:9956-9976. [PMID: 31608738 PMCID: PMC7153976 DOI: 10.1177/0886260519881001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Sexual and gender minority youth (SGMY) disproportionately experience intimate partner violence (IPV) and report illicit substance use compared with cisgender heterosexual youth. Cognitive reappraisal strategies have been shown to decrease trauma-exposed individuals' likelihood of engaging in substance use. However, virtually no research has examined the relationship between various forms of IPV, including identity abuse, and illicit substance use, as well as the protective role of cognitive reappraisal among IPV-exposed SGMY. The current study addressed these limitations and examined cognitive reappraisal as a moderator of the associations between various IPV forms and illicit substance use among 149 SGMY (ages 18-25; 28.9% bisexual, 42.3% transgender or gender nonbinary, 45.0% racial and ethnic minority) between 2016 and 2017. Results indicated that many SGMY used cocaine in the past 6 months (24.8%), followed by hallucinogens (24.8%), stimulants (22.8%), and heroin (20.8%). More than half (62.4%) of SGMY experienced psychological abuse, 44.3% physical abuse, and 43.6% identity abuse in the past year. Cognitive reappraisal buffered the associations between two forms of IPV, identity abuse and physical abuse, and illicit substance use among SGMY, underscoring its importance for clinical intervention. Specifically, past year identity abuse and physical abuse were associated with greater illicit substance use only for SGMY with lower cognitive reappraisal, not for youth with higher cognitive reappraisal. This study adds to the burgeoning literature on identity, physical, and psychological forms of IPV and illicit substance use among SGMY. Our findings provide evidence that cognitive reappraisal strategies buffer the effect of identity abuse and physical abuse on illicit drug use among SGMY. These findings shed light on new avenues for clinical intervention that may help to reduce the prevalence of illicit substance use among IPV-exposed SGMY.
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15
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Mann I, Jenzer T, Miranda R, Mereish EH. Minority Stress and Nicotine Use and Dependence among Sexual Minority Youth. Subst Use Misuse 2021; 56:2264-2268. [PMID: 34519262 PMCID: PMC8753784 DOI: 10.1080/10826084.2021.1972315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Sexual minority youth (SMY), especially those who are plurisexual (e.g. bisexual, pansexual, queer), are more likely to use nicotine or develop nicotine dependence than their heterosexual peers, and this disparity is often attributed to minority stress (e.g. discrimination). This study tested the association between minority stress and nicotine use and dependence among SMY and examined the moderating role of impulsivity. A sample of SMY (N = 85; aged 14-19; 80.6% White; 80% plurisexual) who were active nicotine users were recruited from the community. Results indicated that greater discrimination experiences were associated with more nicotine use days and higher nicotine dependence symptoms. However, impulsivity did not moderate the relationship between discrimination and nicotine use or dependence. These results highlight the potential importance of minority stress in understanding SMY's risk for nicotine use and dependence. This research suggests the need for identifying factors that could place some SMY at greater risk for nicotine use and dependence and points to potential clinical implications for nicotine cessation interventions for SMY.
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Affiliation(s)
- Iris Mann
- Skidmore College, Saratoga Springs, New York, USA
| | | | - Robert Miranda
- Brown University Center for Alcohol and Addiction Studies, Providence, Rhode Island, USA
| | - Ethan H Mereish
- Department of Health Studies, American University, Washington DC, USA
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16
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Mereish EH, Miranda R, Liu Y, Hawthorne DJ. A daily diary study of minority stress and negative and positive affect among racially diverse sexual minority adolescents. J Couns Psychol 2021; 68:670-681. [PMID: 34166050 DOI: 10.1037/cou0000556] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We conducted an intensive longitudinal study of sexual minority adolescents to address gaps in the literature, limitations in retrospective reporting, and test tenets of the minority stress model. We examined the frequency of daily minority stressors and their within-person associations with negative and positive affect. We also tested the moderating effects of depressive symptomology on these associations. Sexual minority adolescents (N = 94; 35.1% were bisexual; 31.9% were gender minority; 45.2% were racial/ethnic minority), ages 12-18 years old (M = 16.1, SD = 1.5), were recruited from the community and completed a baseline questionnaire and then a 21-day daily dairy (82.5% response rate). Participants experienced at least one minority stressor, with an average of 16.96 minority stressors (SD = 18.7, Range: 0-83), over the 21-day monitoring period. Some minority stressors were more commonly experienced than others (e.g., vicarious minority stress) and most participants attributed their sexual orientation to these stressors. Participants also attributed other marginalized identities to these stressors (e.g., gender identity, race). Daily minority stressors were associated with greater negative affect but not positive affect. Participants had greater negative affect on days where sexual-orientation-specific minority stressors were endorsed compared to days where minority stressors were not reported. These associations were not moderated by depression symptomology. The results underscore that minority stressors are pervasive experiences of sexual minority adolescents' daily life and natural environment and they are associated with daily emotions. The findings have implications for the minority stress model and future research and interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Health Studies, American University
| | - Robert Miranda
- Center for Alcohol and Addiction Studies, Brown University
| | - Yang Liu
- Department of Human Development and Quantitative Methodology, University of Maryland
| | - David J Hawthorne
- Department of Behavioral and Community Health, University of Maryland School of Public Health
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17
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Harris JC, Mereish EH, Faulkner ML, Assari S, Choi K, Leggio L, Farokhnia M. Racial Differences in the Association Between Alcohol Drinking and Cigarette Smoking: Preliminary Findings From an Alcohol Research Program. Alcohol Alcohol 2021; 57:330-339. [PMID: 34086845 DOI: 10.1093/alcalc/agab038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 11/12/2022] Open
Abstract
AIMS Important differences have been shown in alcohol drinking and cigarette smoking prevalence, patterns and consequences among individuals from different racial backgrounds. Alcohol and nicotine are often co-used, and the association between drinking and smoking may differ between racial groups-a question explored in the present study. METHODS Data from the NIAAA natural history and screening protocols were utilized; non-Hispanic Black and non-Hispanic White individuals were included in the analyses [N = 1692; 65.2% male; 58.3% met criteria for current alcohol use disorder (AUD); 37.8% were current cigarette smokers]. Bivariate associations between assessments related to alcohol drinking and cigarette smoking were examined, and the strength and direction of these associations were compared between the two groups. RESULTS The sample included 796 Black and 896 White individuals. Black participants had higher frequency (P < 0.0001) and severity (P = 0.007) of AUD, as well as higher frequency (P < 0.0001) of cigarette smoking. Bivariate analyses showed that the expected positive associations between alcohol drinking and cigarette smoking, observed among White individuals, were blunted or absent among Black individuals [age at first cigarette-AUD identification test (AUDIT) score: F(1, 292) = 7.60, P = 0.006; cigarette pack years-AUDIT score: F(1, 1111) = 10.97, P = 0.001]. CONCLUSIONS Some decoupling in the association between alcohol drinking and cigarette smoking was found among Black compared to White individuals. The sample was drawn from a specific population enrolled in alcohol research protocols, which is a limitation of the present study. These preliminary findings highlight the importance of considering racial/ethnic background in preventive and therapeutic strategies for comorbid alcohol and nicotine use.
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Affiliation(s)
- Julia C Harris
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD 20892, USA.,Department of Psychology, College of Arts and Sciences, American University, Washington, D.C. 20016, USA
| | - Ethan H Mereish
- Department of Health Studies, College of Arts and Sciences, American University, Washington, D.C. 20016, USA
| | - Monica L Faulkner
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD 20892, USA
| | - Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD 20892, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD 20892, USA.,Center on Compulsive Behaviors, National Institutes of Health, Bethesda, MD 20892, USA.,Medication Development Program, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA.,Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02906, USA.,Division of Addiction Medicine, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.,Department of Neuroscience, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Mehdi Farokhnia
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD 20892, USA.,Center on Compulsive Behaviors, National Institutes of Health, Bethesda, MD 20892, USA.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
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18
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Mereish EH, Feinstein BA, Mamey MR, Goldbach JT. Characteristics and Perceptions of Sexual and Gender Minority Youth Who Utilized a National Sexual and Gender Minority-Focused Crisis Service. Crisis 2021; 43:127-134. [PMID: 33620255 DOI: 10.1027/0227-5910/a000765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Sexual and gender minority youth (SGMY) have heightened risk of suicidality; yet, we know little about their experiences when utilizing crisis services. Aims: The purpose of this study was to understand the characteristics and experiences of SGMY when in contact with SGMY-specific suicide crisis services. Method: Data were from 592 SGMY who contacted the most widely utilized national US SGMY-specific crisis services provider. Results: High rates of suicide ideation (65.2%) and attempts (31.9%) were documented, with gender minority youth endorsing higher rates of suicide attempts. Participants contacted the center by phone (57.8%) more than by online chat/text (42.2%). Participants reported discussing their sexual orientation (60.6%), gender identity (43.8%), and identity disclosure stress (56.6%) with counselors. Participants rated the crisis service as helpful. The counselors were perceived as warm, compassionate, and knowledgeable about common concerns for SGMY and they were likely to contact the crisis center again. Participants reported using chat/text over phone because it provided them with more confidentiality and privacy; however, phone contacts were rated more positively than text/chat. Limitations: The sample was predominately White and was not representative of the broader population of SGMY, limiting the generalizability of the results. Conclusion: SGMY reported positive experiences with a national SGMY-specific crisis service. The findings highlight the critical need for and utility of SGMY-specific suicide prevention crisis services.
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Affiliation(s)
- Ethan H Mereish
- Department of Health Studies, American University, Washington, DC, USA
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Mary Rose Mamey
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jeremy T Goldbach
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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19
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Mereish EH, Miranda R. A Preliminary Experimental Study of Minority Stress, Startle Reactivity, and Alcohol Use among Heavy Drinking Sexual Minority Young Adults. Subst Use Misuse 2021; 56:162-168. [PMID: 33222602 DOI: 10.1080/10826084.2020.1846197] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Sexual minorities (e.g. lesbian, gay, bisexual) are at increased risk for alcohol use disorder (AUD) compared to heterosexuals. The minority stress model postulates that disparities in AUD stem, in part, from stress specific to sexual minorities (e.g. heterosexism). However, little research has examined psychophysiological markers of minority stress reactivity and how psychophysiological stress reactivity is associated with lifetime minority stress and alcohol use among sexual minorities. Emotion modulation of the startle response is a well-established paradigm for capturing psychophysiological stress reactivity under controlled laboratory conditions. Purpose: This preliminary study is the first to use the startle experimental paradigm to examine psychophysiological reactivity to stigma among sexual minorities. Procedures: Sexual minority participants (N = 20; 55% female), aged 18 to 27 years (M = 21.80, SD = 2.65), were recruited from the community. We compared startle reactivity in response to three types of stimuli (stigma, negative, and neutral) among heavy drinking sexual minority young adults. Although statistically underpowered, we also explored the associations between startle reactivity and self-reported drinking behaviors and lifetime minority stress. Results: Both stigma and general unpleasant stimuli produced more psychophysiological stress reactivity than neutral stimuli among sexual minorities. Psychophysiological stress reactivity was correlated with greater quantity of drinks reported on drinking days in the past month, but not greater frequency. Additionally, lifetime exposure to minority stress was associated with a blunted reactivity to stigma stimuli. Conclusions: These findings provide methodological advances and important implications for minority stress theory and alcohol use among sexual minorities.
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Affiliation(s)
- Ethan H Mereish
- Department of Health Studies, American University, Washington, DC, USA.,Center for Alcohol and Addiction Studies (CAAS), Brown University, Providence, Rhode Island, USA
| | - Robert Miranda
- Center for Alcohol and Addiction Studies (CAAS), Brown University, Providence, Rhode Island, USA
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20
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Abstract
BACKGROUND Sexual minority adults are at greater risk for cardiovascular disease (CVD) risk factors than heterosexual adults. There is a dearth of research identifying factors that are associated with CVD risk among sexual minorities. This study examined the associations between distal and proximal minority stressors and CVD risk. We also tested a sense of mastery as one mechanism that might explain the link between minority stressors and CVD risk. METHODS Participants were 670 sexual minority adults (53.6% male; 76% White), ages 18 to 76 years (M = 41.19, SD = 14.73), obtained from a non-probability sample. Using an online survey, participants self-reported family history of CVD risk, physiological conditions (diabetes mellitus, high cholesterol, hypertension), and health behaviors (e.g., tobacco use, diet, exercise) that confer or protect against CVD risk. A weighted CVD risk index was computed. Linear and logistic regressions were conducted to test the effects of minority stressors on the CVD risk index and its specific indicators and to examine mediation. RESULTS Minority stressors were associated with a sense of mastery, and mastery was associated with lower CVD risk index scores. Proximal and distal minority stressors were not directly associated with the overall CVD risk index but were associated with some specific risk indicators. Mediation analyses revealed that both distal and proximal minority stressors were indirectly associated with the CVD risk index through mastery. CONCLUSIONS Research and interventions should aim to reduce CVD risk factors and target minority stressors and mastery to improve the cardiovascular health of sexual minorities.
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Affiliation(s)
- Ethan H Mereish
- Department of Health Studies, American University, Washington, DC, USA.
| | - Carly M Goldstein
- Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI, USA
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21
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Peters JR, Mereish EH, Krek MA, Chuong A, Ranney ML, Solomon J, Spirito A, Yen S. Sexual orientation differences in non-suicidal self-injury, suicidality, and psychosocial factors among an inpatient psychiatric sample of adolescents. Psychiatry Res 2020; 284:112664. [PMID: 31732188 PMCID: PMC7014818 DOI: 10.1016/j.psychres.2019.112664] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 10/20/2019] [Accepted: 10/26/2019] [Indexed: 01/07/2023]
Abstract
Within broader community samples, sexual minority adolescents (SMA, e.g., lesbian, gay, bisexual, queer) are at greater risk than their heterosexual counterparts for nonsuicidal self-injury (NSSI) and suicidal thoughts and behaviors. The present study investigated whether sexual minority orientation continues to confer additional risk for these behaviors in an already higher-risk sample of youth. Frequency and function of NSSI, suicidal behavior, and psychosocial factors were assessed in a sample of 52 adolescents (aged 12-18 years) admitted to an inpatient psychiatric unit due to suicide risk; 27 of them identified as SMA, and 25 as heterosexual (HA). Greater proportions of SMA reported engaging in lifetime NSSI, compared to HA, with a greater variety and frequency of NSSI behaviors and greater endorsement of intrapersonal NSSI functions. SMA reported higher levels of suicide ideation than HA, but not suicidal behavior. Group differences in NSSI and SI persisted when controlling for the greater prevalence of abuse and levels of peer-victimization reported by SMA. In inpatient clinical settings, SMA may be more likely than heterosexual youth to engage in NSSI, including more severe forms, and to experience suicide ideation. Providing alternative coping mechanisms may serve as treatment goals for reducing NSSI in SMA.
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Affiliation(s)
- Jessica R Peters
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States.
| | - Ethan H Mereish
- Department of Health Studies, American University, Washington, DC, United States
| | - Maya A Krek
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - Adam Chuong
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - Megan L Ranney
- Emergency Digital Health Innovation program, Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, United States
| | - Joel Solomon
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, United States
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - Shirley Yen
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States; Department of Psychiatry, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, United States
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22
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Livingston NA, Flentje A, Brennan J, Mereish EH, Reed O, Cochran BN. Real-time associations between discrimination and anxious and depressed mood among sexual and gender minorities: The moderating effects of lifetime victimization and identity concealment. Psychol Sex Orientat Gend Divers 2020; 7:132-141. [PMID: 34026920 DOI: 10.1037/sgd0000371] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background Sexual and gender minorities (SGM) experience higher rates of depression and anxiety, which are linked to higher rates of discrimination and victimization. SGM individuals may conceal their SGM identities to decrease discrimination and victimization exposure; however, these experiences still occur, and concealment itself is often associated with greater anxiety and depression. However, it remains unclear whether lifetime victimization and identity concealment moderate the effect of day-to-day discrimination, which we evaluated in the current study using ecological momentary assessment (EMA). Methods Fifty SGM participants (Mage=21.82, SD=4.70; 84% White) completed baseline assessment (e.g., concealment and lifetime victimization) followed by EMA of daily discrimination and anxious and depressed mood for 14 days. Results As hypothesized, daily discrimination predicted momentary increases in anxious and depressed mood, b = .34, p < .001. Notably, these effects were more pronounced among individuals who reported higher levels of identity concealment, b = .25, p < .001, and previous SGM-based victimization experiences (marginally), b = .18, p = .05. Main effects of cumulative lifetime victimization and identity concealment, measured at baseline, were associated with higher ratings of anxious and depressed mood over the two-week study. Discussion While identity concealment may reduce exposure to discrimination and victimization, we found that concealment and prior victimization predict heightened reactivity to daily discrimination experiences. Additional research is needed to further explicate real-time effects of minority stress exposure, and to develop interventions that may mitigate risk among SGM individuals with prior victimization exposure and higher levels of identity concealment in particular.
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Affiliation(s)
- Nicholas A Livingston
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Annesa Flentje
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA
| | - James Brennan
- Department of Psychology, University of Montana, Missoula, MT
| | - Ethan H Mereish
- Department of Health Studies, American University, Washington, D.C
| | - Oakleigh Reed
- Department of Psychology, University of Montana, Missoula, MT
| | - Bryan N Cochran
- Department of Psychology, University of Montana, Missoula, MT
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23
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Abstract
Sexual and gender minority youth are at greater risk for substance use and misuse compared to their heterosexual and cisgender peers. This select review of the literature found that recent studies continue to document disparities in substance use. These disparities are partially explained by general and unique stressors as well as social, interpersonal, and cultural factors experienced by sexual and gender minority youth. There are many gaps in the literature, including limited research on protective factors or interventions to prevent or decrease substance use. Despite emerging empirical literature over the past two years, more research is needed to address sexual and gender minority youth's greater risk for substance use. Innovative methodologies and interdisciplinary efforts are needed to help advance our understanding of disparities in substance use in order to reduce and eliminate them and create more affirming experiences for sexual and gender minority youth.
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Affiliation(s)
- Ethan H Mereish
- Department of Health Studies, American University, Washington, DC, United States of America.
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24
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Miranda R, Wemm SE, Treloar Padovano H, Carpenter RW, Emery NN, Gray JC, Mereish EH. Weaker Memory Performance Exacerbates Stress-Induced Cannabis Craving in Youths' Daily Lives. Clin Psychol Sci 2019; 7:1094-1108. [PMID: 31737439 DOI: 10.1177/2167702619841976] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Theories of addiction posit that stimuli associated with drug use, including both exteroceptive (e.g., paraphernalia) and interoceptive (e.g., feeling tense or "stressed"), evoke craving and contribute to the pathogenesis of substance misuse. Control over drug cue response and stress is essential for moderating use. Building from laboratory data supporting associations between cue exposure, stress, and craving, this study tested whether these associations generalize to real-world settings and examined whether a well-vetted neurocognitive control capacity, i.e., working memory (WM), moderated associations. Youth (N = 85; 15-24 years) completed baseline and ecological momentary assessments. Cue exposure and participants' average stress predicted higher craving. Youth with weaker WM experienced stronger craving at higher-stress moments but not when faced with cues. Interactions were present for both previous-moment and same-moment stress. Craving among adolescents with stronger WM was not swayed by momentary stress. Findings suggest stronger WM protects against craving at more stressful moments.
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Affiliation(s)
- Robert Miranda
- Center for Alcohol and Addiction Studies, Brown University
| | | | | | | | - Noah N Emery
- Center for Alcohol and Addiction Studies, Brown University
| | - Joshua C Gray
- Department of Medical and Clinical Psychology, Uniformed Services University
| | - Ethan H Mereish
- Center for Alcohol and Addiction Studies, Brown University; Department of Health Studies, American University
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25
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Mereish EH, Sheskier M, Hawthorne D, Goldbach JT. Sexual orientation disparities in mental health and substance use among Black American young people in the USA: effects of cyber and bias-based victimisation. Cult Health Sex 2019; 21:985-998. [PMID: 30601086 PMCID: PMC6602804 DOI: 10.1080/13691058.2018.1532113] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 09/27/2018] [Indexed: 05/05/2023]
Abstract
Few studies have explored sexual orientation disparities in mental health and substance use outcomes among racial minorities. This study examined sexual orientation disparities in depression, suicidality and substance use among Black American young people in the USA, and the mediating role of cyber and bias-based victimisation in accounting for these disparities. Secondary analyses were performed on data from a probability sample of young people (N = 1,129) collected in a school district in the south-eastern USA. Participants reported socio-demographics, depressive symptoms, suicidality, substance use and experiences of bias-based and cyber victimisation. With some exceptions, Black participants who were lesbian, gay, bisexual or mostly heterosexual reported higher rates of depression, suicidal ideation, suicide planning and substance use than Black heterosexual participants. Black lesbian, gay, bisexual and mostly heterosexual participants reported more cyber and bias-based victimisation than Black heterosexual participants. Sexual orientation disparities in mental health and, to some extent, substance use were partially explained by both forms of victimisation. Further research is needed to address the role of bias-based and cyber victimisation in disparities in mental health and substance use among Black sexual minority young people. The present study carries implications for prevention and treatment efforts for racially diverse sexual minorities.
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Affiliation(s)
- Ethan H. Mereish
- Department of Health Studies, American University, Washington, DC, USA
| | - Mikela Sheskier
- Department of Psychology, American University, Washington, DC, USA
| | - David Hawthorne
- Department of Health Studies, American University, Washington, DC, USA
| | - Jeremy T. Goldbach
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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26
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Woodward EN, Cunningham JL, Flynn AWP, Mereish EH, Banks RJ, Landes SJ, Kirchner JE, Pantalone DW. Sexual minority men want provider behavior consistent with attitudes and norms during patient-provider interactions regarding HIV prevention. PSYCHOL HEALTH MED 2019; 25:354-367. [PMID: 31429323 DOI: 10.1080/13548506.2019.1656338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
HIV is a health problem for sexual minority men in the United States. One factor among many that contributes to this HIV disparity is poor patient-provider interactions. We focused on specific provider behavior preferred by sexual minority men during patient-provider interactions about HIV prevention. We interviewed 20 HIV-negative sexual minority men who endorsed 1+ psychosocial HIV risk factor. We used follow up interviews and conventional content analysis. Among our sample, 55% identified as White; 50% as bisexual, (Mage = 28.45). Findings suggested even some providers knowledgeable about sexual minority health provided unhelpful care to sexual minority men (knowledge-behavior discrepancy). Some knowledgeable providers engaged in affirmative, tailored treatment (knowledge-behavior consistency). Specific behaviors of preferred patient-provider interactions regarding HIV prevention are reported. Our recommendations are based on patient perceptions, which is a limit and strength. We identified an important type of unhelpful patient-provider interaction for HIV-negative sexual minority men beyond discriminatory experiences. Patient-provider interaction efforts need to go beyond education to help providers practice skills. With increased focus on cultural competency for sexual minority patients, more providers may advertise their practice as affirmative, yet interactions will likely vary, may require lifelong practice of cultural humility, and impact HIV prevention.
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Affiliation(s)
- Eva N Woodward
- Central Arkansas Veterans Healthcare System, VA Center for Mental Healthcare and Outcomes Research, North Little Rock, AR, USA.,Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Anthony W P Flynn
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA.,Department of Counseling Psychology, University of Wisconsin, Madison, WI, USA
| | - Ethan H Mereish
- Department of Health Studies, American University, Washington, DC, USA
| | - Regina J Banks
- Degree Completion Program, Fresno Pacific University, Fresno, CA, USA
| | - Sara J Landes
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,US Department of Veterans Affairs, VA QUERI for Team Based Behavioral Health, North Little Rock, AR
| | - Joann E Kirchner
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,US Department of Veterans Affairs, VA QUERI for Team Based Behavioral Health, North Little Rock, AR
| | - David W Pantalone
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA.,The Fenway Institute, Fenway Health, Boston, MA, USA
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Mereish EH, Miranda R. Exposure to Stigma Elicits Negative Affect and Alcohol Craving Among Young Adult Sexual Minority Heavy Drinkers. Alcohol Clin Exp Res 2019; 43:1263-1272. [PMID: 31099903 DOI: 10.1111/acer.14055] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 03/28/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Sexual orientation disparities in alcohol use disorder (AUD) are thought to be explained by stigma specific to sexual minorities. Despite the importance of negative affect and craving in addiction, research has yet to test the effects of stigma on affect and alcohol craving among sexual minorities. This laboratory study examined the effects of 3 novel mood inductions (stigma, general unpleasant, and neutral) on affect and alcohol craving among heavy-drinking sexual minority young adults. We also paired these mood inductions with an established alcohol cue reactivity paradigm to explore the effects of stigma on cue-elicited craving. METHODS Sexual minority participants (N = 20; 55% female), aged 18 to 27 years (M = 21.80, standard deviation = 2.65), were recruited from the community. Participants completed 3 mood induction and cue reactivity trials counterbalanced over 3 visits on different days: stigma, general unpleasant, and neutral mood inductions. A structured interview assessed criteria for DSM-5 AUD, and self-report measures assessed lifetime adverse experiences. RESULTS Most participants met criteria for past-year AUD (75%). Exposure to stigma produced more negative affect and greater alcohol craving than the neutral and general unpleasant mood induction conditions. The general unpleasant mood induction did not predict greater alcohol craving than the neutral mood induction. Stigma enhanced alcohol cue reactivity effects, as measured with a single-item craving measure, compared to the general unpleasant mood condition, and this effect remained significant while controlling for covariates. CONCLUSIONS Findings are the first to demonstrate how stigma uniquely predicts negative affect and alcohol craving among sexual minorities. This study suggests that being exposed to stigma, specifically heterosexism, elicits negative mood and alcohol craving among sexual minority young adults who are heavy drinkers.
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Affiliation(s)
- Ethan H Mereish
- Department of Health Studies, (EHM), American University, Washington, District of Columbia.,Center for Alcohol and Addiction Studies (CAAS), (EHM, RM), Brown University, Providence, Rhode Island
| | - Robert Miranda
- Center for Alcohol and Addiction Studies (CAAS), (EHM, RM), Brown University, Providence, Rhode Island
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Yen S, Ranney ML, Krek M, Peters JR, Mereish EH, Tezanos KM, Kahler CW, Solomon J, Beard C, Spirito A. Skills to Enhance Positivity in Suicidal Adolescents: Results from a Pilot Randomized Clinical Trial. J Posit Psychol 2019; 15:348-361. [PMID: 32884576 DOI: 10.1080/17439760.2019.1615105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The objective of this study was to examine the feasibility, acceptability, and preliminary effects of an intervention, Skills to Enhance Positivity (STEP) that aims to increase attention to positive emotions and experiences and to decrease suicidal events. STEP involves four in-person individual sessions delivered during an inpatient psychiatric admission, followed by one month of weekly phone calls and daily text messages with mood monitoring and skills practice. A pilot randomized controlled trial of STEP vs. enhanced treatment as usual (ETAU) was conducted with 52 adolescents. Results indicated that on average 83% of sessions were completed and that on 70% of days, participants engaged with the text-messaging component of the intervention. Acceptability for both in-person and text-messaging components were also high, with satisfaction ratings averaging between good and excellent. STEP participants reported fewer suicide events than ETAU participants (6 vs. 13) after six months of follow-up.
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Affiliation(s)
- Shirley Yen
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, USA.,Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Megan L Ranney
- Injury Prevention Center, Rhode Island Hospital, Providence, USA.,Department of Emergency Medicine, Emergency Digital Health Innovation Program, Alpert School of Medicine, Brown University, Providence, USA
| | - Maya Krek
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, USA
| | - Jessica R Peters
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, USA
| | - Ethan H Mereish
- Department of Health Studies, American University, Washington DC, USA
| | | | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, USA
| | - Joel Solomon
- McLean Hospital, Harvard Medical School, Belmont, USA
| | | | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, USA
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Peters JR, Mereish EH, Solomon JB, Spirito AS, Yen S. Suicide Ideation in Adolescents Following Inpatient Hospitalization: Examination of Intensity and Lability Over 6 Months. Suicide Life Threat Behav 2019; 49:572-585. [PMID: 29577366 PMCID: PMC6157009 DOI: 10.1111/sltb.12448] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/12/2018] [Indexed: 11/27/2022]
Abstract
Understanding suicide ideation (SI) in adolescents, especially during the high-risk time following hospitalization for a suicidal event, is a crucial component of improving risk assessment. Most studies rely on single assessments of SI, despite the potential for SI to vary considerably over time. This study examined how indices of SI intensity (mean values) and lability (mean squared successive difference values) over a 6-month period predict suicide attempts (SAs) and self-harm, as well as how they relate to psychosocial risk factors and affective functioning, in a sample of 103 adolescents hospitalized for a SA or significant SI. Across the sample, SI intensity, but not lability, was associated with SAs and nonsuicidal self-injury at 6-month follow-up. SI intensity performed similarly to single time point SI assessments, and its relations were not moderated by SI lability. SI intensity was also associated with borderline personality disorder criteria and a history of sexual abuse. In contrast, SI lability was associated with greater negative affect intensity and lability. These findings suggest that intensity of SI may confer more risk posthospitalization, and provide support for using these statistical methods to capture two distinct parameters of SI.
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Affiliation(s)
- Jessica R. Peters
- Alpert Medical School of Brown University,Rhode Island Hospital,Corresponding Author: Alpert Medical School of Brown University, Box G-BH, Providence, RI 02906,
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Mereish EH, Peters JR, Yen S. Minority Stress and Relational Mechanisms of Suicide among Sexual Minorities: Subgroup Differences in the Associations Between Heterosexist Victimization, Shame, Rejection Sensitivity, and Suicide Risk. Suicide Life Threat Behav 2019; 49:547-560. [PMID: 29604113 PMCID: PMC6167193 DOI: 10.1111/sltb.12458] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 01/10/2018] [Indexed: 12/01/2022]
Abstract
Despite sexual orientation disparities in suicide, there is limited research examining factors associated with suicide risk among sexual minorities while considering subgroup differences within this group. This study identified differences between sexual minorities at risk for suicide and those not at risk. The study also examined heterosexist victimization, as one form of minority stress, and two relational mechanisms (i.e., shame and rejection sensitivity) as risk factors for suicidality. We examined a moderated-mediation model, in which we tested gender and sexual orientation differences in the mediating effects of the relational mechanisms on the association between heterosexist victimization and suicide risk. Participants were recruited online and completed an online survey. The sample included 719 sexual minority adults. Of the sample, 27.7% were at risk for suicide. Suicide risk varied by age, gender, sexual orientation, income, education, and relationship status. Heterosexist victimization, shame, and rejection sensitivity were significant risk factors for suicide. Shame and rejection sensitivity were mediators of the association between heterosexist victimization and suicide risk for subgroups of sexual minorities, mostly lesbian and gay individuals and to some extent bisexual individuals. The findings underscore minority stress, shame, and rejection sensitivity as key intervention points.
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Affiliation(s)
- Ethan H. Mereish
- Department of Health Studies, American University, Washington, DC
| | - Jessica R. Peters
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University; Rhode Island Hospital, Providence, Rhode Island
| | - Shirley Yen
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
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31
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Doan Van EE, Mereish EH, Woulfe JM, Katz-Wise SL. Perceived Discrimination, Coping Mechanisms, and Effects on Health in Bisexual and Other Non-Monosexual Adults. Arch Sex Behav 2019; 48:159-174. [PMID: 30105618 PMCID: PMC6349472 DOI: 10.1007/s10508-018-1254-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 06/01/2023]
Abstract
Bisexual individuals experience unique discrimination related to their sexual orientation, which may increase their risk of adverse health outcomes. The study goal was to investigate how bisexual and other non-monosexual individuals experience discrimination, understand how they perceive discrimination to affect their health, and examine the ways in which they cope with discrimination by analyzing responses to open-ended survey questions. The sample included 442 bisexual and other non-monosexual adults, ages 18-68 years (M = 28.97, SD = 10.30), who either reported a bisexual identity or reported attractions to more than one gender. Gender identities included women (n = 347), men (n = 42), and transgender/non-binary individuals (n = 53); 29% of participants were currently located outside of the U.S. Participants completed an online survey, including three open-ended questions regarding their experiences with discrimination, how discrimination affects their health, and methods used to cope with discrimination. Themes related to perceived discrimination included: double discrimination of bisexuals and other non-monosexual individuals by heterosexuals, lesbian and gay individuals; bisexual invalidation and erasure; and sexual victimization. Themes related to the perceived effects of discrimination on health included: impact on mental health; impact on physical health; and effect of discrimination in healthcare. Themes related to coping with discrimination included: social support; resilience; and identity-specific media consumption. Findings demonstrate that bisexual and other non-monosexual individuals' experiences of discrimination can be additive, based on other marginalized facets of identity, including race/ethnicity, gender, and socioeconomic status. Our findings have implications for advancing bisexual health research from an intersectionality framework.
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Affiliation(s)
- Emilie E Doan Van
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Ethan H Mereish
- Department of Health Studies, American University, Washington, DC, USA
| | - Julie M Woulfe
- Division of Psychiatry and Behavioral Sciences, Montefiore Medical Center, Bronx, NY, USA
| | - Sabra L Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
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32
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Mereish EH. Addressing Research Gaps in Sexual and Gender Minority Adolescents' Substance Use and Misuse. J Adolesc Health 2018; 62:645-646. [PMID: 29784109 DOI: 10.1016/j.jadohealth.2018.03.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 03/23/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Ethan H Mereish
- Department of Health Studies, American University, Washington, D.C
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33
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Mereish EH, Kuerbis A, Morgenstern J. A daily diary study of stressful and positive events, alcohol use, and addiction severity among heavy drinking sexual minority men. Drug Alcohol Depend 2018; 187:149-154. [PMID: 29665493 PMCID: PMC6063512 DOI: 10.1016/j.drugalcdep.2018.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/01/2018] [Accepted: 03/02/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The purpose of this study is to examine the conditions under which daily stressful and positive events are associated with alcohol use among heavy drinking sexual minority men (SMM). Specifically, we examined the moderating effects of two indicators of alcohol addiction severity (i.e., alcohol dependence severity and negative drinking consequences) on the associations between daily stressful events and alcohol use and between daily positive events and alcohol use among heavy drinking SMM. PROCEDURES Secondary data analyses were performed using data from a randomized controlled trial of heavy drinking and treatment seeking SMM who were assigned male at birth (N = 200). Participants responded to a daily survey delivered via interactive voice recording (IVR). The first seven days of the IVR were analyzed for this study. RESULTS While accounting for treatment condition, weekday/weekend, and baseline drinking, stressful and positive events were both associated with increased daily drinking; however, indicators of alcohol addiction severity moderated these associations. For heavy drinkers with high alcohol addiction severity, daily stressful events were not associated with alcohol use, and daily positive events were associated with increased alcohol use. In contrast, for heavy drinkers with low alcohol addiction severity, daily stressful events were associated with less drinking, and daily positive events were not associated with alcohol use. CONCLUSIONS The findings of this study indicate that alcohol addiction severity plays a key role in explaining when daily stressful or positive events are associated with daily alcohol use among heavy drinking SMM.
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Affiliation(s)
- Ethan H. Mereish
- Department of Health Studies, American University, Gray Hall 119, 4400 Massachusetts Ave, NW, Washington, DC 20015, USA
| | - Alexis Kuerbis
- Silberman School of Social Work, Hunter College at City University of New York, 2180 Third Avenue, New York, NY 10035, USA.
| | - Jon Morgenstern
- Northwell Health, 1010 Northern Blvd. Suite 311, Great Neck, NY 11021, USA.
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Puckett JA, Mereish EH, Levitt HM, Horne SG, Hayes-Skelton SA. Internalized heterosexism and psychological distress: The moderating effects of decentering. Stigma and Health 2018. [DOI: 10.1037/sah0000065] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
BACKGROUND Disparities in substance use have been observed in sexual minority youth, but less is known about willingness to use substances, an important precursor to actual use. OBJECTIVE The goal of this study was to examine willingness to use cigarettes, alcohol, and marijuana among sexual minority youth compared to their non-sexual minority counterparts using both cross-sectional and longitudinal data. METHODS The present study drew on two waves (Times 1 and 2; 6 months apart) of data collected during high school as part of a prospective study of substance use initiation and progression in Rhode Island. At Time 1, participants (N = 443) ranged in age from 15 to 20 years (M age = 16.7 years, 26.6% sexual minority, 59.5% female, 72.0% White). Participants self-reported their sexual identity and attraction, lifetime use of alcohol, cigarettes and marijuana, and cigarette, alcohol, and marijuana use willingness (i.e., if offered by a best friend or group of friends). RESULTS In cross-sectional multivariate regression models, sexual minority youth were more likely to report willingness to use cigarettes (p <.05) and marijuana (p <.01) compared to their non-sexual minority counterparts. Longitudinal multivariate regression models revealed that sexual minorities were only significantly more likely to report cigarette willingness at Time 2 compared to their non-sexual minority counterparts (p <.01). There were no significant differences in alcohol use willingness in multivariable cross-sectional or longitudinal models by sexual minority status. CONCLUSIONS Sexual minority youth reported more willingness than non-sexual minority youth to use substances offered by peers; however, longitudinal analyses revealed that peers appear to play a role only in willingness to smoke cigarettes for these youth, and thus peer influence may be a contributing factor in explaining tobacco-related disparities among sexual minority youth. Given that stigma and peer groups may a particular risk factor for tobacco among sexual minority youth, our findings highlight the importance of prevention programs such as social marketing approaches that correct social norms, reduce stigma, and provide refusal-skills training to reduce tobacco-related disparities among sexual minorities.
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Affiliation(s)
- Kristi E Gamarel
- a Center for Alcohol & Addiction Studies , Brown University School of Public Health , Providence , Rhode Island , USA
- b Department of Behavioral & Social Sciences , Brown University School of Public Health , Providence , Rhode Island , USA
| | - Ethan H Mereish
- a Center for Alcohol & Addiction Studies , Brown University School of Public Health , Providence , Rhode Island , USA
- c Department of Health Studies , American University , Providence , Rhode Island , USA
| | - Suzanne M Colby
- a Center for Alcohol & Addiction Studies , Brown University School of Public Health , Providence , Rhode Island , USA
- d Department of Psychiatry and Human Behavior , Alpert Medical School of Brown University , Providence , Rhode Island , USA
| | - Nancy P Barnett
- a Center for Alcohol & Addiction Studies , Brown University School of Public Health , Providence , Rhode Island , USA
- b Department of Behavioral & Social Sciences , Brown University School of Public Health , Providence , Rhode Island , USA
| | - Kerri Hayes
- a Center for Alcohol & Addiction Studies , Brown University School of Public Health , Providence , Rhode Island , USA
| | - Kristina M Jackson
- a Center for Alcohol & Addiction Studies , Brown University School of Public Health , Providence , Rhode Island , USA
- b Department of Behavioral & Social Sciences , Brown University School of Public Health , Providence , Rhode Island , USA
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Kuerbis A, Mereish EH, Hayes M, Davis CM, Shao S, Morgenstern J. Testing Cross-Sectional and Prospective Mediators of Internalized Heterosexism on Heavy Drinking, Alcohol Problems, and Psychological Distress Among Heavy Drinking Men Who Have Sex With Men. J Stud Alcohol Drugs 2017; 78:113-123. [PMID: 27936371 DOI: 10.15288/jsad.2017.78.113] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Minority stress theory is one of the primary theories used to understand substance use among lesbian, gay, and bisexual populations. This study tested whether drinking to cope with stress (DTC), loneliness, and gay community participation (GCP) mediated the relationship between one type of minority stress (i.e., internalized heterosexism) and behavioral health outcomes. METHOD Using secondary data analysis and the PROCESS procedure, relationships between internalized heterosexism, the mediators (DTC, loneliness, and GCP), and outcomes (heavy drinking, alcohol problems, and psychological distress) were explored, both cross-sectionally and in a lagged manner, among both treatment-seeking and non-treatment-seeking problem drinking men who have sex with men. Problem drinkers (N = 187) were assessed, provided brief normative feedback about their drinking, given the choice to receive brief alcohol use disorder treatment or change on their own, and then followed for 9 months. RESULTS Cross-sectional findings revealed that internalized heterosexism was significantly associated with heavy drinking, alcohol problems, and psychological distress. DTC emerged as a significant mediator of internalized heterosexism for all the health outcomes. Loneliness and GCP were significant mediators of internalized heterosexism for alcohol problems and psychological distress. Multiple mediation models reveal that all three mediators significantly contribute to internalized heterosexism's effect on health outcomes. Lagged analyses did not yield any significant indirect effects. CONCLUSIONS DTC, loneliness, and GCP all play an integral, mediational role in the relationship between internalized heterosexism and alcohol problems and psychological distress. Findings underscore the necessity of addressing internalized heterosexism in psychosocial interventions along with coping skills training, emphasizing culturally relevant social support and loneliness.
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Affiliation(s)
- Alexis Kuerbis
- Silberman School of Social Work, Hunter College at City University of New York, New York, New York
| | - Ethan H Mereish
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island.,Department of Health Studies, American University, Washington, DC
| | - Marie Hayes
- Center for Addiction Services and Psychotherapy Intervention Research (CASPIR), Northwell Health, Great Neck, New York
| | - Christine M Davis
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, New Brunswick, New Jersey
| | - Sijing Shao
- Center for Addiction Services and Psychotherapy Intervention Research (CASPIR), Northwell Health, Great Neck, New York
| | - Jon Morgenstern
- Center for Addiction Services and Psychotherapy Intervention Research (CASPIR), Northwell Health, Great Neck, New York
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Katz-Wise SL, Mereish EH, Woulfe J. Associations of Bisexual-Specific Minority Stress and Health Among Cisgender and Transgender Adults with Bisexual Orientation. J Sex Res 2017; 54:899-910. [PMID: 27834488 PMCID: PMC6296471 DOI: 10.1080/00224499.2016.1236181] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Among sexual minorities, bisexuals are at the greatest risk for poor health due in part to prejudice and stigma. This research examined associations of bisexual-specific minority stress and health among cisgender (non-transgender) and transgender adults with bisexual orientation. Participants were 488 adults (378 cisgender women, 49 cisgender men, 61 transgender individuals), age 18 to 66 years, with bisexual orientation based on identity and/or attractions to multiple genders. Participants completed an online survey. Hierarchical linear regression analyses were conducted with sexual minority stress and bisexual-specific minority stress as the predictors and physical health, measured by the 36-Item Short Form Survey (SF-36), as the outcome. Models controlled for demographic variables. Moderation analyses were conducted to test for gender differences. Greater bisexual-specific minority stress significantly predicted poorer overall physical health (β = -0.16), greater pain (β = -0.16), and poorer general health (β = -0.25) above and beyond the effects of sexual minority stress. Gender moderated the association between bisexual-specific minority stress and health, such that bisexual-specific minority stress predicted overall physical health and role limitations for transgender individuals but not for cisgender women. Addressing bisexual-specific minority stress is necessary to improve the health and well-being of bisexual individuals.
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Affiliation(s)
- Sabra L Katz-Wise
- a Division of Adolescent/Young Adult Medicine, Boston Children's Hospital
- b Department of Pediatrics , Harvard Medical School
- c Department of Social and Behavioral Sciences , Harvard T. H. Chan School of Public Health
| | | | - Julie Woulfe
- e Department of Counseling, Developmental, and Educational Psychology , Boston College
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Abstract
BACKGROUND Prescription drug, e-cigarette, smokeless tobacco, and synthetic marijuana use has risen dramatically in the United States over the past decade. OBJECTIVES This paper investigates the use of risky substances among adolescents, and examines disparities between sexual minority (i.e., mostly heterosexual and lesbian, gay, bisexual; LGB) and heterosexual adolescents in use of novel and emerging substances. Given the public health risk and the imminence of these substances in the media, emerging drug use was examined in a county wide sample of adolescents in a Southern state. METHODS A probability sample of middle and high school students (N = 3012; ages 11-18) using random cluster methods was obtained in a mid-sized school district in the Southeastern United States. RESULTS LGB adolescents reported higher past-30 day and lifetime use of cigarettes (AORs =2.77, 2.90, respectively), smokeless tobacco (lifetime only: AOR = 1.88), e-cigarettes (lifetime only; AOR = 1.92), alcohol (AORs = 1.7, 2.20), marijuana (AORs = 3.02, 3.06), synesthetic marijuana (AORs = 3.77, 2.48), and prescription drugs (AORs = 3.82, 2.55). Adolescents who self-identified as "mostly heterosexual" reported higher lifetime cigarette use, and past 30-day use of e-cigarettes and prescription drugs as compared with heterosexual adolescents. CONCLUSIONS Our results are notable given the dearth of data documenting use of increasingly emerging or "trendy" substances such as prescription drugs. More research is needed to understand the underlying cause of these disparities, and efforts should be targeted toward this population to reduce negative outcomes from misuse.
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Affiliation(s)
- Jeremy T Goldbach
- a School of Social Work, University of Southern California , Los Angeles , California , USA
| | - Ethan H Mereish
- b Center for Alcohol and Addiction Studies, Brown University , Providence , Rhode Island , USA
| | - Claire Burgess
- c Department of Clinical Science , University of Southern California , Los Angeles , California , USA
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Mereish EH, Katz-Wise SL, Woulfe J. We're Here and We're Queer: Sexual Orientation and Sexual Fluidity Differences Between Bisexual and Queer Women. J Bisex 2016; 17:125-139. [PMID: 29249909 PMCID: PMC5730064 DOI: 10.1080/15299716.2016.1217448] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Theorists and researchers have noted an overlap between bisexually-identified and queer-identified individuals. Whereas early definitions of bisexuality may have been predominantly binary (i.e., attracted to women and men), in recent years there has been a move toward a more "queer" understanding of bisexuality (e.g., attraction to more than one gender beyond female and male). The purpose of this study was to examine similarities and differences between bisexually-identified and queer-identified adult women, ages 18-66 years, on sociodemographic characteristic, two dimensions of sexual orientation (sexual behaviors and attractions), fluidity in attractions and sexual orientation identity, and identity centrality and affirmation in an online sample (N = 489), which was mostly from the United States (73.5%). Our results indicated that bisexual and queer women were similar in terms of sociodemographic characteristics, with the exception of education; queer women were more educated than bisexual women. Queer women were also more likely than bisexual women to report variability in their sexual behaviors and attractions and more fluidity in their sexual orientation identity. Additionally, queer women reported higher levels of identity centrality and affirmation than bisexual women. Considerations for sexual minority women's health research are discussed.
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Affiliation(s)
- Ethan H Mereish
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI
| | - Sabra L Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Julie Woulfe
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Boston, MA
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Gamarel KE, Kahler CW, Lee JH, Reisner SL, Mereish EH, Matthews AK, Operario D. Sexual orientation disparities in smoking vary by sex and household smoking among US adults: Findings from the 2003-2012 National Health and Nutrition Examination Surveys. Prev Med 2016; 82:1-6. [PMID: 26598804 PMCID: PMC4803669 DOI: 10.1016/j.ypmed.2015.10.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 10/13/2015] [Accepted: 10/17/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study examined whether sexual orientation-related smoking disparities in males and females varied by household smoking behaviors in a nationally representative sample of American adults. METHODS Data were drawn from the 2003-2012 National Health and Nutrition Examination Surveys, which assessed 14,972 individuals ages 20 to 59years for sexual orientation, current smoking status, and household smoking. Weighted multivariable logistic models were fit to examine whether differences in current smoking status among sexual minority adults compared to heterosexuals was moderated by household smoking and sex, adjusting for covariates. RESULTS The main effects of identifying as a sexual minority, being male, and living with a household smoker were all associated with a significantly higher odds of being a current smoker. However, there also was a significant three-way interaction among these variables (adjusted odds ratio=3.75, 95% confidence interval: 1.33, 10.54). Follow-up analyses by sex indicated that the interaction between sexual identity and household smoking was significant for both males (AOR=6.40, 95% confidence interval: 1.27, 32.28) and females (AOR=0.43, 95% confidence interval: 0.23, 0.81) but was in the opposite direction. Among males, living with a smoker was associated more strongly with greater odds of smoking among gay and bisexual males, compared to heterosexual males. In contrast, among females, living with a smoker was more strongly associated with greater odds of smoking for heterosexuals compared to lesbians and bisexuals. CONCLUSIONS Future research is warranted to examine characteristics of households, including smoking behaviors and composition, to guide more effective and tailored smoking cessation interventions for males and females by sexual orientation.
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Affiliation(s)
- Kristi E Gamarel
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
| | - Christopher W Kahler
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA; Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI, USA
| | - Ji Hyun Lee
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA
| | - Sari L Reisner
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; The Fenway Institute, Fenway Health, Boston, MA, USA; Division of General Pediatrics, Boston Children's Hospital/Harvard Medical School, Boston, MA, USA
| | - Ethan H Mereish
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI, USA
| | - Alicia K Matthews
- Department of Health Systems Sciences, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Don Operario
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA; Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI, USA
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Mereish EH, N’cho HS, Green CE, Jernigan MM, Helms JE. Discrimination and Depressive Symptoms Among Black American Men: Moderated-Mediation Effects of Ethnicity and Self-Esteem. Behav Med 2016; 42:190-6. [PMID: 27337623 PMCID: PMC4982390 DOI: 10.1080/08964289.2016.1150804] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Discrimination is related to depression and poor self-esteem among Black men. Poorer self-esteem is also associated with depression. However, there is limited research identifying how self-esteem may mediate the associations between discrimination and depressive symptoms for disparate ethnic groups of Black men. The purpose of this study was to examine ethnic groups as a moderator of the mediating effects of self-esteem on the relationship between discrimination and depressive symptoms among a nationally representative sample of African American (n = 1201) and Afro-Caribbean American men (n = 545) in the National Survey of American Life. Due to cultural socialization differences, we hypothesized that self-esteem would mediate the associations between discrimination and depressive symptoms only for African American men, but not Afro-Caribbean American men. Moderated-mediation regression analyses indicated that the conditional indirect effects of discrimination on depressive symptoms through self-esteem were significant for African American men, but not for Afro-Caribbean men. Our results highlight important ethnic differences among Black men.
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Affiliation(s)
- Ethan H. Mereish
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University,
| | | | | | - Maryam M. Jernigan
- Department of Psychology, University of Saint Joseph, 1678 Asylum Avenue, West Hartford, CT 06117,
| | - Janet E. Helms
- Institute for the Study and Promotion of Race and Culture, Department of Counseling, Developmental, and Educational, Boston College,
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Puckett JA, Woodward EN, Mereish EH, Pantalone DW. Parental Rejection Following Sexual Orientation Disclosure: Impact on Internalized Homophobia, Social Support, and Mental Health. LGBT Health 2015; 2:265-9. [DOI: 10.1089/lgbt.2013.0024] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Julia A. Puckett
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts
| | - Eva N. Woodward
- Department of Psychology, Suffolk University, Boston, Massachusetts
| | - Ethan H. Mereish
- Department of Counseling, Educational, and Developmental Psychology, Boston College, Boston, Massachusetts
| | - David W. Pantalone
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts
- The Fenway Institute, Fenway Health, Boston, Massachusetts
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Mereish EH, Poteat VP. The Conditions under which Growth-Fostering Relationships Promote Resilience and Alleviate Psychological Distress among Sexual Minorities: Applications of Relational Cultural Theory. Psychol Sex Orientat Gend Divers 2015; 2:339-344. [PMID: 26380836 DOI: 10.1037/sgd0000121] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Relational cultural theory posits that resilience and psychological growth are rooted in relational connections and are facilitated through growth-fostering relationships. Framed within this theory, the current study examined the associations between growth-fostering relationships (i.e., relationships characterized by authenticity and mutuality) with a close friend and psychological distress among sexual minorities. More specifically, we tested the moderating effects of individuals' internalized homophobia and their friend's sexual orientation on the associations between growth-fostering relationship with their close friend and level of psychological distress. A sample of sexual minorities (N = 661) were recruited online and completed a questionnaire. The 3-way interaction between (a) growth-fostering relationship with a close friend, (b) the close friend's sexual orientation, and (c) internalized homophobia was significant in predicting psychological distress. Among participants with low levels of internalized homophobia, a stronger growth-fostering relationship with a close heterosexual or LGBT friend was associated with less psychological distress. Among participants with high levels of internalized homophobia, a stronger growth-fostering relationship with a close LGBT friend was associated with less psychological distress but not with a heterosexual friend. Our results demonstrate that growth-fostering relationships may be associated with less psychological distress but under specific conditions. These findings illuminate a potential mechanism for sexual minorities' resilience and provide support for relational cultural theory. Understanding resilience factors among sexual minorities is critical for culturally sensitive and affirmative clinical practice and future research.
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Affiliation(s)
- Ethan H Mereish
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Box G-S121-4, Providence, RI 02912, Tel: (401) 863-6631,
| | - V Paul Poteat
- Department of Counseling, Developmental, and Educational Psychology, Campion Hall 307, 140 Commonwealth Ave., Chestnut Hill, MA 02467,
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Mereish EH, Lee JH, Gamarel KE, Zaller ND, Operario D. Sexual orientation disparities in psychiatric and drug use disorders among a nationally representative sample of women with alcohol use disorders. Addict Behav 2015; 47:80-5. [PMID: 25899096 DOI: 10.1016/j.addbeh.2015.03.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 03/13/2015] [Accepted: 03/24/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Sexual minority women (SMW) are at greater risk for alcohol use disorders (AUDs) compared to heterosexual women. However, there is a dearth of research on sexual orientation disparities in co-occurring disorders among women with AUDs. We examined disparities in lifetime co-occurring psychiatric and drug use disorders among a nationally representative sample of women with lifetime AUDs. METHODS Data were analyzed from the 2004-2005 (Wave 2) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), which was collected in structured diagnostic face-to-face interviews. Adult women with AUDs (N=4342) were included in the analyses and approximately 191 of those women self-identified as SMW. Lifetime alcohol and drug use disorders and psychiatric disorders were assessed using DSM-IV criteria. We conducted multivariate logistic regression analyses to compare SMW and heterosexual women with lifetime AUDs on lifetime psychiatric disorders and drug use disorders, while adjusting for sociodemographic variables. FINDINGS While accounting for several covariates, SMW with lifetime AUDs were more likely than heterosexual women with lifetime AUDs to have lifetime psychiatric disorders (e.g., mood, anxiety, panic disorders) and drug use disorders (e.g., prescription drugs, cannabis use disorders). CONCLUSIONS Sexual minority women with lifetime alcohol use disorders are at heightened risk for co-occurring psychiatric and drug use disorders than heterosexual women with lifetime alcohol use disorders. The findings warrant the need for more research and empirically based interventions for the comprehensive treatment and prevention of alcohol use disorders among sexual minority women.
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Affiliation(s)
- Ethan H Mereish
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Box G-S121-4, Providence RI 02912, USA.
| | - Ji Hyun Lee
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Box G-S121-4, Providence RI 02912, USA
| | - Kristi E Gamarel
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Nickolas D Zaller
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Little Rock, AR, USA
| | - Don Operario
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Box G-S121-4, Providence RI 02912, USA
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Mereish EH, Poteat VP. Let's Get Physical: Sexual Orientation Disparities in Physical Activity, Sports Involvement, and Obesity Among a Population-Based Sample of Adolescents. Am J Public Health 2015; 105:1842-8. [PMID: 26180946 DOI: 10.2105/ajph.2015.302682] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined sexual orientation disparities in physical activity, sports involvement, and obesity among a population-based adolescent sample. METHODS We analyzed data from the 2012 Dane County Youth Assessment for 13,933 students in grades 9 through 12 in 22 Wisconsin high schools. We conducted logistic regressions to examine sexual orientation disparities in physical activity, sports involvement, and body mass index among male and female adolescents. RESULTS When we accounted for several covariates, compared with heterosexual females, sexual minority females were less likely to participate in team sports (adjusted odds ratio [AOR] = 0.44; 95% confidence interval [CI] = 0.37, 0.53) and more likely to be overweight (AOR = 1.28; 95% CI = 1.02, 1.62) or obese (AOR = 1.88; 95% CI = 1.43, 2.48). Sexual minority males were less likely than heterosexual males to be physically active (AOR = 0.62; 95% CI = 0.46, 0.83) or to participate in team sports (AOR = 0.26; 95% CI = 0.20, 0.32), but the 2 groups did not differ in their risk of obesity. CONCLUSIONS Sexual orientation health disparities in physical activity and obesity are evident during adolescence. Culturally affirming research, interventions, and policies are needed for sexual minority youths.
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Affiliation(s)
- Ethan H Mereish
- Ethan H. Mereish is with the Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI. V. Paul Poteat is with the Department of Counseling, Developmental, and Educational Psychology, Boston College, Chestnut Hill, MA
| | - V Paul Poteat
- Ethan H. Mereish is with the Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI. V. Paul Poteat is with the Department of Counseling, Developmental, and Educational Psychology, Boston College, Chestnut Hill, MA
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Mereish EH, Poteat VP. A relational model of sexual minority mental and physical health: The negative effects of shame on relationships, loneliness, and health. J Couns Psychol 2015; 62:425-437. [PMID: 26010289 DOI: 10.1037/cou0000088] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sexual minorities (e.g., lesbians, gay men, bisexual individuals) are at an increased risk for poorer mental and physical health outcomes than heterosexuals, and some of these health disparities relate to minority stressors such as discrimination. Yet, there is little research elucidating pathways that predict health or that promote resiliency among sexual minorities. Building on the minority stress model, the present study utilized relational cultural theory to situate sexual minority health within a relational framework. Specifically, the study tested mediators of the relationships between distal (i.e., discrimination, rejection, victimization) and proximal stressors (i.e., internalized homophobia, sexual orientation concealment) and psychological and physical distress for sexual minorities. Among 719 sexual minority adults, structural equation modeling analyses were used to test 4 models reflecting the mediating effects of shame, poorer relationships with a close peer and the lesbian/gay/bisexual/transgender (LGBT) community, and loneliness on the associations between minority stressors and psychological distress (i.e., depression and anxiety) and physical distress (i.e., distressing physical symptoms). As hypothesized, the associations between distal and proximal minority stressors and distress were mediated by shame, poorer relationships with a close peer and the LGBT community, and loneliness. Findings underscore the possible relational and interpersonal mechanisms by which sexual minority stressors lead to psychological and physical distress.
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Affiliation(s)
- Ethan H Mereish
- Department of Behavioral and Social Sciences, Brown University
| | - V Paul Poteat
- Department of Counseling, Developmental and Educational Psychology, Boston College
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Gamarel KE, Mereish EH, Manning D, Iwamoto M, Operario D, Nemoto T. Minority Stress, Smoking Patterns, and Cessation Attempts: Findings From a Community-Sample of Transgender Women in the San Francisco Bay Area. Nicotine Tob Res 2015; 18:306-13. [PMID: 25782458 DOI: 10.1093/ntr/ntv066] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 03/10/2015] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Research has demonstrated associations between reports of minority stressors and smoking behaviors among lesbian, gay, and bisexual populations; however, little is known about how minority stressors are related to smoking behaviors and cessation attempts among transgender women. The purpose of this study was twofold: (1) to examine the associations between transgender-based discrimination and smoking patterns among a sample of transgender women; and (2) to identify barriers to smoking cessation in a sample of transgender women with a history of smoking. METHODS A community sample of 241 transgender women completed a one-time survey. Binary and multinomial logistic regression models examined associations between minority stressors and (1) smoking behaviors and (2) cessation attempts. Both models adjusted for income, education, race/ethnicity, recent sex work, HIV status, depression, alcohol use, and current hormone use. RESULTS Overall, 83% of participants indicated that they had smoked a cigarette in the last month. Of these women, 62.3% reported daily smoking and 51.7% reported an unsuccessful quit attempt. Discrimination was positively associated with currently smoking (adjusted odds ratio [AOR] = 1.04, 95% confidence interval [CI]: 1.01, 1.08). Discrimination was positively associated with unsuccessful cessation (AOR = 1.03, 95% CI: 1.01, 1.18) and never attempting (AOR = 1.04, 95% CI: 1.01, 1.11) compared to successful cessation. Discrimination was also positively associated with never attempting compared to unsuccessful cessation (AOR = 1.01, 95% CI: 1.00, 1.03). CONCLUSIONS Smoking cessation may be driven by unique transgender-related minority stressors, such as discrimination. Future research is warranted to address unique stigmatizing contexts when understanding and providing tailored intervention addressing smoking among transgender women.
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Affiliation(s)
- Kristi E Gamarel
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI;
| | - Ethan H Mereish
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI; Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI
| | - David Manning
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI
| | | | - Don Operario
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI; Center for Alcohol and Addiction Studies, Brown University, Providence, RI; Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI
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Mereish EH. The weight of discrimination: The relationship between heterosexist discrimination and obesity among lesbian women. Psychology of Sexual Orientation and Gender Diversity 2014. [DOI: 10.1037/sgd0000056] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Poteat VP, Scheer JR, Mereish EH. Factors affecting academic achievement among sexual minority and gender-variant youth. Adv Child Dev Behav 2014; 47:261-300. [PMID: 25344999 DOI: 10.1016/bs.acdb.2014.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Experiences of victimization among sexual minority youth (e.g., lesbian, gay, bisexual, transgender; LGBT) and gender-variant youth remain pronounced in many schools. Although much work has shown the connection between homophobic bullying and mental and physical health, there has been limited attention to how victimization impedes learning, academic achievement, and other school-related outcomes for these youth. In this chapter, we propose several pathways through which victimization leads to academic disparities among sexual minority and gender-variant youth, with attention to its effects on individual learning processes (e.g., motivation, concentration, self efficacy, and other cognitive stressors) as well as broader psychological and social processes (e.g., mental health, school avoidance, harmful coping strategies, exclusionary discipline). We also consider protective factors (e.g., social support, Gay-Straight Alliances, extracurricular involvement, nondiscrimination policies, inclusive curriculum) that could promote resilience and suggest potential mechanisms by which they may operate. In doing so, we aim to stimulate ideas for an advancement of research in this area.
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Mereish EH, Bradford JB. Intersecting identities and substance use problems: sexual orientation, gender, race, and lifetime substance use problems. J Stud Alcohol Drugs 2014; 75:179-88. [PMID: 24411810 DOI: 10.15288/jsad.2014.75.179] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Research has documented that sexual minorities are at greater risk for substance use than heterosexuals. However, there are limited studies and mixed findings when investigating these health disparities among racial and ethnic minority samples. We used an intersectionality framework to examine disparities in lifetime substance use problems between heterosexual and sexual minority men and women and within sexual minority groups among a racially diverse sample. METHOD A nonprobability sample of heterosexual (n = 1,091) and sexual minority (n = 1,465) patients from an urban community health center ranged in age from 18 to 72 years. Participants completed a brief patient survey and reported demographic information and history of lifetime substance use problems. Logistic regressions analyses were used to examine interactions between and among sexual orientation, gender, and race. RESULTS We found a significant three-way interaction among sexual orientation, gender, and race. Sexual minorities had a greater risk of self-reported lifetime substance use problems than heterosexuals, with nuanced gender and racial differences. Of greatest note, sexual minority women of color had greater risks than heterosexual women of color and than White sexual minority women. Sexual minority men of color did not differ in their risk when compared with heterosexual men of color, and they had lower risk than White sexual minority men. CONCLUSIONS The results of this study demonstrate that an intersectionality framework is crucial to clearly identify lifetime substance use disparities between racially diverse sexual minority and heterosexual men and women. Future research, treatment, and policy should use intersectionality approaches when addressing substance use disparities.
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Affiliation(s)
- Ethan H Mereish
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Chestnut Hill, Massachusetts, Cambridge Health Alliance/Harvard Medical School, Cambridge, Massachusetts
| | - Judith B Bradford
- Center for Population Research in LGBT Health, The Fenway Institute, Fenway Health, Boston, Massachusetts
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