Associations among sexual assault, posttraumatic stress, drinking to cope with anxiety, and alcohol use based on gender identity and sexual orientation

Kilimnik, Chelsea D.; García‐Ramírez, Grisel; Salamanca, Nashalys K.; Mazzone, G. Mitchell; Mullican, K. Nicole; Davis, Kelly Cue; Orchowski, Lindsay M.; Leone, Ruschelle M.; Kaysen, Debra; Gilmore, Amanda K.

doi:10.1111/acer.15194

Alcohol: Clinical and Experimental Research

2023

DOI: 10.1111/acer.15194

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Associations among sexual assault, posttraumatic stress, drinking to cope with anxiety, and alcohol use based on gender identity and sexual orientation

Chelsea D. Kilimnik,

Grisel García‐Ramírez,

Nashalys K. Salamanca

et al.

Abstract: BackgroundSexual assault (SA) is experienced by a substantial proportion of emerging adult college students and is associated with elevated rates of Post‐Traumatic Stress Disorder (PTSD) and alcohol use. The current study examines the mediating role of posttraumatic stress symptoms (PTSS) in the associations among SA severity, drinking to cope with anxiety, and average weekly drinks while considering the moderating roles of gender identity and sexual orientation.Methods2160 college students diverse in gender (… Show more

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2024

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Bisexual minority stress as a risk factor for sexual violence‐related posttraumatic stress disorder symptoms among bisexual+ women: A multilevel analysis

Salim,

Harper,

Livingston

et al. 2024

Journal of Traumatic Stress

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Bisexual+ (e.g., bisexual, pansexual, queer) women experience higher rates of sexual violence (SV) and posttraumatic stress disorder (PTSD) than heterosexual and lesbian women, as well as unique identity‐related minority stress. We examined between‐ and within‐person associations between bisexual minority stress and PTSD symptoms related to SV in a sample of young bisexual+ women (N = 133) who reported adult SV (Mage = 22.0 years, range: 18–25 years; 85.0% White; 99.3% cisgender). We analyzed data from four waves of data collection (baseline to 3‐month follow‐up) using multilevel models. Controlling for SV severity, there was a significant within‐person effect of antibisexual stigma from lesbian/gay people on PTSD, β = .17, p = .010, suggesting that at waves when women experienced more stigma, they also reported higher PTSD symptom levels. At the between‐person level, women who reported higher levels of antibisexual stigma from heterosexual people, β = .26, p = .043, and anticipated binegativity, β = .29, p = .005, on average across study waves also reported higher average levels of PTSD. Additionally, anticipated binegativity explained the association between average antibisexual stigma and PTSD, β = .15, p = .014, 95% CI [0.45, 4.61]. Bisexual minority stress may be associated with higher PTSD symptom severity following SV among young bisexual+ women, and the anticipation of binegativity may be a target mechanism in this association. Study findings highlight the importance of examining the joint contributions of SV and minority stress to identify novel targets for future research and practice to address PTSD symptoms.

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Bisexual minority stress as a risk factor for sexual violence‐related posttraumatic stress disorder symptoms among bisexual+ women: A multilevel analysis

Salim,

Harper,

Livingston

et al. 2024

Journal of Traumatic Stress

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Problematic alcohol use among gay, bisexual, and other men who have sex with men in Canada: the role of proximal stressors and anxiety

Zahran,

Dermody,

Berlin

et al. 2024

Subst Abuse Treat Prev Policy

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Background Gay, bisexual, and other men who have sex with men (GBM) report high rates of problematic alcohol use, anxiety, and depression. This may, in part, be due to stressors related to their sexual identity (i.e., minority stressors). However, few studies have examined both distal and proximal stressors, as well as the specific psychological mechanisms by which these stressors may be related to alcohol use outcomes, in a representative sample of GBM. We explored the relationship between distal and proximal stressors and alcohol use outcomes, as well as the role of anxiety and depression as potential mediators of these relationships. Methods We analyzed the baseline data of 2,449 GBM from Engage, a cohort study of sexually active GBM recruited using respondent-driven sampling (RDS) in Montreal, Toronto, and Vancouver from February 2017 to August 2019. Using structural equation modeling, we examined the associations between distal minority stressors (i.e., experiences of heterosexist harassment, rejection, and discrimination), proximal minority stressors (i.e., internalized homonegativity, concerns about acceptance, concealment, and lack of affirmation), anxiety and depression, and alcohol consumption and alcohol use problems. RDS-adjusted analyses controlled for age, income, sexual orientation, ethnicity, recruitment city, and HIV serostatus. Results There were positive direct associations between distal stress and proximal stress, anxiety, and depression, but not alcohol use outcomes. Proximal stress had a positive direct association with anxiety, depression, and alcohol use problems, but not alcohol consumption. Anxiety was positively associated with alcohol consumption and alcohol use problems. Depression was negatively associated with alcohol consumption but not alcohol use problems. Regarding indirect effects, distal stress was associated with alcohol use outcomes via proximal stress and anxiety, but not via depression. Conclusions We found support for a minority stress model as it relates to alcohol use outcomes among GBM. Findings suggest that proximal minority stress and anxiety differentially impact the problematic alcohol use among GBM who experience heterosexist discrimination. Clinical providers should consider incorporating the treatment of proximal minority stressors and anxiety into existing alcohol interventions for GBM.

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Associations among sexual assault, posttraumatic stress, drinking to cope with anxiety, and alcohol use based on gender identity and sexual orientation

Cited by 2 publications

References 80 publications

Bisexual minority stress as a risk factor for sexual violence‐related posttraumatic stress disorder symptoms among bisexual+ women: A multilevel analysis

Bisexual minority stress as a risk factor for sexual violence‐related posttraumatic stress disorder symptoms among bisexual+ women: A multilevel analysis

Problematic alcohol use among gay, bisexual, and other men who have sex with men in Canada: the role of proximal stressors and anxiety

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