Lifetime trauma endorsement, posttraumatic stress disorder, and alcohol dependence as a function of sexual minority status.

Abstract

Objective: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur, with elevated rates of both disorders in lesbian, gay, or bisexual (LGB) samples. Few studies have compared the strength of PTSD-AUD associations between LGB and heterosexual individuals or evaluated the role of nontraumatic LGB discrimination in these relationships among sexual minorities. Method: The current study utilized nationally representative epidemiological data (N = 29,646) to (a) examine whether associations between lifetime trauma endorsement/PTSD and lifetime alcohol dependence (AD) differ as a function of sexual minority status and (b) evaluate the role of LGB-specific discrimination in trauma/PTSD and AD associations among LGB individuals. Results: Logistic regression analyses showed the association between lifetime trauma endorsement and lifetime AD was significantly greater in magnitude for LGB individuals (odds ratio [OR] = 2.17) compared to heterosexual individuals (OR = 1.32; Z = 2.51, p < .05). The magnitude of the association between lifetime PTSD and lifetime AD was not greater in the LGB subsample (OR = 2.11) than the heterosexual subsample (OR = 1.71; Z = 0.63, p > .05), after controlling for trauma endorsement. Among the LGB subsample, logistic regression analyses did not support a significant main effect for LGB discrimination nor an interaction between trauma endorsement and nontraumatic LGB discrimination, nor between PTSD and nontraumatic LGB discrimination, on lifetime AD (ps > .05). Conclusions: LGB individuals demonstrate stronger associations between lifetime trauma endorsement and AD, relative to heterosexual counterparts; however, this association may not be accounted for or moderated by nontraumatic LGB discrimination.

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

“…While research has defined several motives for alcohol use (e.g., coping, enhancement, and social conformity), coping motivated alcohol use may be particularly relevant to individuals from minoritized identities due to the increased prevalence of stressors (Dworkin, Cadigan, et al, 2018; Kalb et al, 2018; Tse & Wong, 2015). The emerging literature indicates initial support for the self‐medication hypothesis in individuals from sexual minoritized identities (Banerjee et al, 2018; Bing‐Canar et al, 2020; Dworkin, Cadigan, et al, 2018; Dworkin, Jaffe, et al, 2021; Gilmore et al, 2014; Rhew et al, 2017). Indeed, this would align with the psychological mediation framework that proposes reduced coping efficacy as one impact of ongoing minority‐related stressors (Hatzenbuehler, 2009).…”

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

“…Importantly, a history of exposure to trauma appears to exacerbate alcohol-related disparities among minoritized individuals. For example, the association between lifetime DSM-5 trauma exposure and likelihood of AUD is relatively stronger for SM (vs. heterosexual; Bing-Canar et al, 2020) and certain BIPOC (i.e., Hispanic women and Native American men vs. White; Meyers et al, 2018) populations.…”