Support,Discrimination, and Alcohol Use Among Racially/Ethnically Diverse Sexual Minority Youths

Rates of alcohol use for sexual minority youths are nearly twice that of their heterosexual peers, yet specific risk and protective factors associated with alcohol use among sexual minority youths remain unclear. Structural equation modeling is used to examine relations among alcohol use, peer and family support, and discrimination among 207 diverse sexual minority youths. Discrimination had no relationship to alcohol use; however, it was negatively associated with peer and family support. Peer support was associated with greater alcohol use among bisexual youths. This study adds to our understanding of the roles of discrimination, social support, and alcohol use among diverse sexual minority youths.     

Drinking Motives,Alcohol Use,and Sexual Attraction in Youth

Sexual minority youth were found to be more likely to drink alcohol during weekdays compared to heterosexual youth. Drinking during weekdays was associated with consuming alcohol as a coping strategy. Sexual minority youth also more frequently consumed alcohol to eliminate personal worries (coping) and to not be excluded by their peers (conformity). Sexual orientation–related alcohol problems should be addressed at an early stage. Such efforts are likely to be effective if insecurities and stress related to sexual orientation are addressed as well.     

Still stressful after all these years: a review of lesbians' and bisexual women's minority stress

This article reviews the conceptualization of, and empirical literature on, lesbians' and bisexual women's sexual minority stress. In much of the early research, the experiences of sexual minority women and men were considered together (or women's experiences were inferred from men's), obscuring important differences. There is empirical and theoretical justification to consider the experiences of women and men separately and to develop and evaluate comprehensive models of sexual minority stress for women. Existing conceptualizations of sexual minority stress that include assessment of discrimination, victimization, harassment, concealment, internalized homonegativity may be applied, and perhaps adapted, to facilitate understanding of the unique stressors associated with women's sexual minority status. Future research must include mediators of the relationship between stressors and outcomes such as individual (e.g., coping and resilience) and group (e.g., social support, identification with a sexual minority community) resources. It is also essential to understand what factors may buffer the deleterious effects of these stressors.     

Risk Factors of Gay,Lesbian, and Bisexual Adolescents

Abstract

Many researchers of gay, lesbian, and bisexual adolescents describe them as an “invisible” minority. These youth are also one of the most “at risk” youth populations, as they often experience a range of problems related to society's stigmatization of same-sex orientation. Although sexual orientation is not necessarily related to heightened difficulties, lack of social support, infrequent positive interactions, and chronic stress may lead to increased problem behaviors for these youth. To further understand the risk and protective factors experienced by sexual minority adolescents, this article explores a number of these factors and reviews the current empirical research on specific topics, including: family, peer and school, substance use, suicide, and HIV/AIDS issues. Finally, practice implications are discussed to guide clinicians in working more effectively with this youth population.     

Strengths and coping strategies in the life narratives of sexual minority women

This study explored self-described strengths and strategies for coping with stress among sexual minority women (SMW), drawing on qualitative narratives of sexual minority and heterosexual women who were recruited from a population-based sample. In-depth follow-up qualitative telephone interviews were conducted with 48 women who had participated in the National Alcohol Survey, a U.S. population-based survey. Participants included 25 SMW and 16 matched exclusively heterosexual women. Narrative data were analyzed using inductive thematic analysis and constant comparison to explore the study aim, with an emphasis on themes that diverged or that were particularly salient for SMW relative to heterosexual women. Strengths and coping strategies that were especially meaningful in the narratives of sexual minority women emerged in two areas. First, participants described development of intrapersonal strengths through nurturing an authentic sense of self and embracing multifaceted identity. Second, participants described multiple strategies for cultivation of interpersonal resources: navigating distance and closeness with family of origin, cultivating supportive friends and chosen family, connecting to community, finding solace and joy with animals, and engaging in collective action. Findings underscore the importance of considering protective factors that are salient to SMW in developing or refining prevention and intervention efforts.     

Gender attitudes,sexual violence,and HIV/AIDS risks among men and women in Cape Town,South Africa

This study examined gender attitudes and sexual violence‐supportive beliefs (rape myths) in a sample of South African men and women at risk for HIV transmission. Over 40% of women and 16% of men had been sexually assaulted, and more than one in five men openly admitted to having perpetrated sexual assault. Traditional attitudes toward women's social and gender roles, as well as rape myths, were endorsed by a significant minority of both men and women. Multivariate analyses showed that for men, sexual assault history and rape myth acceptance, along with alcohol and other drug use history, were significantly related to cumulative risks for HIV infection. In contrast, although we found that women were at substantial risk for sexually transmitted infection (STI), including HIV, women's risks were only related to lower levels of education and alcohol use history. We speculate that women's risks for STI/HIV are the product of partner characteristics and male‐dominated relationships, suggesting the critical importance of intervening with men to reduce women's risks for sexual assault and STI/HIV.     

Treated and untreated alcohol-use disorders: course and predictors of remission and relapse

The research described here focused on personal, life context, and help-related factors to trace the long-term course of treated and untreated alcohol-use disorders. A group of 461 individuals who sought help for alcohol problems was surveyed at baseline and 1, 3, 8, and 16 years later. Compared with individuals who remained untreated, individuals who entered treatment and/or Alcoholics Anonymous (AA), and participated in these modalities for a longer interval, were more likely to attain remission. Personal resources associated with social learning, stress and coping, behavior economic, and social control theories predicted the maintenance of remission.     

Region,Social Identities,and Disclosure Practices as Predictors of Heterosexist Discrimination Against Sexual Minorities in the United States

Exposure to heterosexist discrimination may vary by a person's place of residency. Utilizing a minority stress perspective, an online survey of self‐identified lesbian, gay, and bisexual (LGB) individuals (n = 285) examined whether rural and small town inhabitants experienced greater exposure to six types of enacted stigma. After comparing the frequency of enacted stigma by community type, findings demonstrated that rural LGBs reported experiencing more homophobic statements, property damage, and employment discrimination than urban LGBs. Small town LGBs also encountered additional amounts of housing discrimination and were more often chased by strangers compared with urban sexual minorities. Finally, disclosure practices and hierarchies based on race and social class also influenced exposure to discrimination. The importance of spatial factors often intensified when respondents disclosed their sexual identity more publicly. When exploring racial and class differences, affluent sexual minorities experienced less employment discrimination and white sexual minorities were less likely to experience several forms of heterosexist events (especially being punched and kicked).     

Psychosocial Problems Associated With Homelessness in Sexual Minority Youths

Sexual minorities are overrepresented among homeless youths, and this is often related to reactions to their status as sexual minorities. While on the streets, they are at increased risk for victimization, substance and alcohol use, sexual risk behaviors, and mental health issues compared to homeless heterosexual youths. This article uses ecological systems theory to examine psychosocial problems associated with homelessness among sexual minority youths and reviews empirical literature examining outcomes related to homeless sexual minority youths including mental health, substance use, and sexual risk behavior. Implications for social work are discussed including practice, policy, and suggestions for future studies.     

Contributions of Child Sexual Abuse,Self-Blame,Posttraumatic Stress Symptoms,and Alcohol Use to Women’s Risk for Forcible and Substance-Facilitated Sexual Assault

Child sexual abuse and adult sexual assault have been linked to increased self-blame, posttraumatic stress symptoms, and alcohol use. The current study aims to examine (a) whether these constructs explain women’s risk for later adult sexual assault and revictimization, (b) whether such factors differentially confer risk for specific types of adult sexual assault (i.e., substance-facilitated and forcible), and (c) if self-blame confers risk indirectly through other risk factors. Multiple types of self-blame, posttraumatic stress, and alcohol use were examined among 929 female college students as serial mediators of the relationship between child sexual abuse and adult sexual assault and as risk factors for sexual revictimization among child sexual abuse survivors. In the model predicting risk for substance-facilitated adult sexual assault, child sexual abuse indirectly predicted greater risk for substance-facilitated adult sexual assault mediated through two separate paths: global blame-to-posttraumatic-stress and global blame-to-alcohol use. In the model predicting risk for forcible adult sexual assault, child sexual abuse directly predicted greater risk for forcible adult sexual assault, and this relation was mediated by the global blame-to-posttraumatic-stress path. Among child sexual abuse survivors, child sexual abuse specific characterological and behavioral self-blame directly predicted greater risk for forcible and substance-facilitated revictimization, but the pathways were not mediated by posttraumatic stress or alcohol use. Results emphasize the importance of assessing different types of self-blame in predicting posttraumatic stress symptoms as well as examining risk for sexual victimization and revictimization. Findings did not support hypotheses that increased posttraumatic stress would predict increased alcohol use but did indicate that heightened self-blame is consistently associated with heightened posttraumatic stress and that heightened global self-blame predicts increased alcohol use. Implications for future research and intervention are discussed.     

An examination of the impact of maladaptive coping on the association between stressor type and alcohol use in college

Objective: Examine the impact of maladaptive coping style on the association between source of stress (academic, interpersonal, intrapersonal, environmental) and alcohol use (consumption, heavy episodic drinking, driving under the influence) among college students. Participants: 1,027 college students completed an online survey in April 2014. Methods: To test the mediating effects of maladaptive coping on the association between academic stress and alcohol use variables, indirect effects were examined using the PROCESS analytical framework for SPSS. Results: Maladaptive coping and academic stress were associated with alcohol use outcomes. Moreover, maladaptive coping mediated the relationship between academic stress and two of three alcohol use outcomes (consumption, heavy episodic drinking). Conclusions: Among college students, the association between academic stress and alcohol use may be driven by maladaptive coping. College students may benefit from interventions that seek to improve coping skills, potentially alleviating the burden of academic stress and decreasing problematic alcohol use.     

Resilience in the face of sexual minority stress: “Choices” between authenticity and self-determination

This qualitative study explored the experience of sexual minority stressors and corresponding resilience. Using a grounded theory approach, the core category identified in the analysis was minority stress results from systemic factors that cause lesbian, gay, and bisexual (LGB) people to face competition between their desires for authenticity and self-determination. These findings shed light upon the insidious nature of minority stress, especially within U.S. contexts that lack protective legislation, and the adaptive strategies people use to mitigate their effects. By positioning resilience as a choice between authenticity and self-determination, resilience is understood to lessen but not resolve the deleterious impact of sexual minority stress.     

The LGBQ Social Climate Matters: Policies,Protests, and Placards and Psychological Well-Being Among LGBQ Emerging Adults

Sexual minority youth, including emerging adults, are at risk for negative health outcomes. Minority stress theory posits that heterosexism can contribute to these outcomes among sexual minorities. Researchers have tested this theory with respect to interpersonal heterosexism; however, little attention has been given to macro-level and environmental forms of heterosexism, especially among lesbian, gay, bisexual, and queer (LGBQ) youth. In this study, we examine the role of objective social climate (LGB state-level policies) and experiential distal and proximal environmental microaggressions on the psychological well-being of LGBQ emerging adults. Furthermore, we examine the role of LGBQ identity salience as a moderating factor on the macro/environmental-heterosexism and well-being relationship. Multivariable linear regression results suggest that living in a state without same-sex marriage laws is associated with greater self-esteem, whereas both distal and proximal environmental microaggressions are risk factors for anxiety and perceived stress. Furthermore, identity salience can ameliorate the effects of distal microaggressions and intensify the effects of proximal microaggressions and same-sex marriage legislation. Implications for practice with sexual minority youth are discussed.     

Stigma and family relationships of middle-aged gay men in recovery

The primary objective of this study was to explore how middle-aged gay men in recovery cope with stigma and family relationships. For gay men, perceptions of acceptance of their sexual orientation and degree of social connectedness can play a role in their recovery from alcohol and substance use disorders. Yet gay men may have a more difficult time accessing certain family-level health resources because their families of origin may stigmatize, reject, or silence them on account of their sexual orientation. Semi-structured interviews were used to explore how participants in recovery constructed and coped with their experiences of stigma, family relationships, and alcohol and substance use. Participants (30 gay men ages 50 to 64) completed a questionnaire and interview. We used constructivist grounded theory method and minority stress theory as a theoretical framework to interpret the data. We identified the following themes: Internalization of Stigma, Changes in Coping Strategies, and Ongoing Stigma. Future research should explore how to incorporate familial support into gay men's recovery, address ongoing internalized stigma, and develop a social response to stigma, rather than leaving it to individuals to confront on their own.     

Differences between actual and perceived student norms: an examination of alcohol use, drug use, and sexual behavior

Researchers in the social norms area have previously focused primarily on alcohol consumption, paying comparatively less attention to drug use and sexual behavior. The major purposes of this study were to (1) compare perceptions of peer norms in the areas of alcohol use, drug use, and sexual behavior with actual behavior and (2) determine if a relationship existed between a student's perceptions of normative behavior and a student's actual behavior. Participants were 833 college students at a large, public university in the Northeast. Study participants overestimated alcohol use, drug use, and sexual behavior among their peers. There was also a positive relationship between actual behavior and perceived peer norms, although the effect sizes for all behaviors were small to moderate. The authors provide further support for the tenets of social norms theory and suggest that social norms interventions are appropriate both campus-wide and to targeted high-risk groups.     

Behavioral Escape Avoidance Coping in African-American Men Who Have Sex with Men

The purpose of this exploratory study was to investigate differences between African-American men who have sex with men (MSM) who use behavioral escape avoidance coping responses and those who do not. In particular, we investigated differences in the African-American MSM in our study on psychosocial factors such as internalized homonegativity, exploration phase sexual identity, and the importance of race/ethnicity identity to self-concept; and we investigated the association of these factors on the likelihood of the use of behavioral escape avoidance coping responses. Eighty-three African-American MSM completed our online assessment tool. Chi-square tests and modified Poisson regression were used to test our hypotheses. Our results revealed significant differences in the internalized homonegativity, exploration phase sexual identity, and in the importance of race/ethnicity identity to self-concept for the men in this study who endorsed behavioral escape avoidance coping responses compared to those who did not endorse behavioral escape avoidance coping responses.     

Longitudinal Study of the Psychological Effects of Sexual Abuse in African American Girls in Foster Care and Those Who Remain Home

This study longitudinally examined the effects of foster care placement versus remaining at home upon the psychological functioning of 64 African-American, sexually abused girls aged 5-16 years. The children were intitially evlauted with a multi-method assessment protocal within six months following report of the abuse and then reevaluated approximately one year later. The findings indicate that the group as a whole showed a decline in affective distress and depression. However, the children continued to show disturbed perceptions of relationships and high levels of stress relative to their adaptive coping skills. The caregivers continued to rate the children as showing many behavioral problems, low social competence, considerable sexual abuse-related anxiety and sexual acting-out behavior. Overall, there were no significant differences in the psychological functioning of the girls who remained at home and those who were placed in foster care. In supplementary, cross-sectional analyses involving 24 additional subjects, several maternal variables were found to be related to the child's adaptation.     

Gender Minority Social Stress in Adolescence: Disparities in Adolescent Bullying and Substance Use by Gender Identity

Bullying and substance use represent serious public health issues facing adolescents in the United States. Few large-sample national studies have examined differences in these indicators by gender identity. The Teen Health and Technology Study (N = 5,542) sampled adolescents ages 13 to 18 years old online. Weighted multivariable logistic regression models investigated disparities in substance use and tested a gender minority social stress hypothesis, comparing gender minority youth (i.e., who are transgender/gender nonconforming and have a gender different from their sex assigned at birth) and cisgender (i.e., whose gender identity or expression matches theirs assigned at birth). Overall, 11.5% of youth self-identified as gender minority. Gender minority youth had increased odds of past-12-month alcohol use, marijuana use, and nonmarijuana illicit drug use. Gender minority youth disproportionately experienced bullying and harassment in the past 12 months, and this victimization was associated with increased odds of all substance use indicators. Bullying mediated the elevated odds of substance use for gender minority youth compared to cisgender adolescents. Findings support the use of gender minority stress perspectives in designing early interventions aimed at addressing the negative health sequelae of bullying and harassment.     

Alcohol consumption, alcohol-related problems, and other substance use among lesbian and bisexual women

Relationships between sexual orientation and a wide range of substance use and problem variables were examined based on data from the 2000 National Alcohol Survey. Lesbians, bisexuals, and heterosexually identified women who report same-sex partners were compared to exclusively heterosexual women in relation to alcohol consumption, use of tobacco and other drugs, bar-going, alcohol-related problems, and past substance abuse treatment. Substance use patterns were complex and varied between sexual orientation groups. These differences underscore the importance of developing lesbian- and bisexual-sensitive prevention and treatment services and of including measures of sexual orientation identity and behavior in population-based surveys.     

Examining the correlates of engagement and disengagement coping among help-seeking battered women

This study examined several potential correlates of engagement and disengagement coping, including abuse-related factors, socioeconomic and social coping resources, and childhood trauma variables among a sample of battered women (N = 388). Relationship abuse frequency, particularly psychological aggression, and peritraumatic dissociation were the strongest positive predictors of the use of disengagement coping. Social coping resources, including tangible support and appraisals of social support and belonging, were associated with higher engagement coping and lower disengagement coping. A positive association was also found between interparental domestic violence and disengagement coping, and negative associations were found between both childhood physical and sexual abuse and engagement coping. Results suggest that coping strategies used by battered women are multidetermined and deserve further exploration.