Associations Between Latent Classes of Trauma Exposure and Minority Stressors and Substance Use Among Cisgender Sexual Minority Women

Abstract

Psychosocial stressors (e.g., minority stressors, trauma exposure) profoundly impact sexual minority women’s (SMW’s) risk of alcohol and other drug (AOD) use. However, research has not examined whether there are distinct typologies (i.e., patterns) of psychosocial stressors and whether these vary based on sociodemographic characteristics or are differentially associated with AOD outcomes (e.g., alcohol dependence) among SMW. This study aimed to identify latent classes of SMW reporting distinct typologies of psychosocial stressors and examine predictors and outcomes of latent classes of psychosocial stressors among SMW. Participants included a community sample of 602 SMW ( Mage = 39.9, SD = 14.0; 74.0% lesbian; 37.4% White, 36.6% Black, 22.3% Latinx; 26.6% annual income ≤$14,999). Latent class analysis was used to identify typologies of psychosocial stressors. Regression analyses were employed to examine sociodemographic predictors and AOD outcomes of class membership. Three classes of psychosocial stressors emerged. Participants in Class 1 were likely to report relatively low adversity. SMW in Class 2, who reported childhood physical abuse (CPA), severe childhood sexual abuse, and adult physical assault, were vulnerable to discrimination and stigma consciousness. A distinct subgroup of SMW (Class 3) was at heightened risk of CPA, adult sexual assault (ASA), and stigma consciousness. Older SMW, Black SMW, and SMW with lower social support were more likely to be in classes characterized by higher adversity. Older SMW were at disproportionate risk of CPA and ASA. Different combinations of psychosocial stressors were uniquely associated with AOD outcomes. Findings underscore the importance of considering within-group heterogeneity in SMW’s differential risk of psychosocial stressors and AOD outcomes. Routine screening of psychosocial stressors across several dimensions, brief interventions targeting AOD outcomes, and policies mitigating structural drivers of SMW’s increased risk of trauma and minority stressors may be especially important for older SMW, Black SMW, and SMW who lack social support.

Expressive writing treatments to reduce PTSD symptom severity and negative alcohol-related outcomes among trauma-exposed sexual minority women and transgender/nonbinary people: Study protocol for a mixed-method pilot trial

“…These disparities are rooted in SMW's and TNB individuals' disproportionate exposure to stigma and associated stress responses (i.e., minority stressors), trauma, and inadequate social safety [ [5] , [6] , [7] ]. Some research suggests a dose-response relationship between adverse experiences (e.g., minority stressors, childhood maltreatment) and risk of PTSD and negative alcohol-related outcomes among SMW and TNB individuals [ 8 ]. Alcohol is often used to reduce distressing negative internal experiences, including PTSD symptoms [ 9 ].…”

Examining the impact of daily discrimination on alcohol use among racially diverse, trauma-exposed sexually minoritized adults: A pilot study.

“…Even when identity-based stressors do not conform to DSM-5 Criterion A (i.e., involve violent victimization), chronic exposure to them can provoke a parallel set of secondary consequences (e.g., coping-motivated alcohol use, AUD, symptoms, and/or disorder suggestive of PTSD; Alessi et al, 2013). SM individuals who report a higher (vs. lower) degree of exposure to both identity-based and traumatic stressors are more likely to report recognition of problematic drinking and meet criteria for AUD (Scheer et al, 2023), which suggests that identity-based stress exposure may increase vulnerability to unhealthy patterns of alcohol use among trauma-exposed minoritized people. As such, SM and/or BIPOC individuals with a history exposure to stressors at the intersection of trauma and identity may be at risk for escalation of unhealthy drinking, and, in turn, be prime candidates for targeted secondary prevention efforts geared toward preventing trauma-related sequelae, like AUD, by detecting and intervening upon low-risk drinking early in on in its expression to curb its progression.…”