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Bochicchio L, Porsch L, Zollweg S, Matthews AK, Hughes TL. Health Outcomes of Sexual Minority Women Who Have Experienced Adverse Childhood Experiences: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:764-794. [PMID: 37070743 PMCID: PMC10582204 DOI: 10.1177/15248380231162973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Sexual minority women (SMW; e.g., lesbian, bisexual) report higher rates of almost every negative physical health (e.g., asthma, arthritis, cardiovascular disease), mental health (e.g., depression, anxiety), and substance use outcome compared to heterosexual women. Adverse Childhood Experiences (ACEs) have been identified as risk factors for negative health outcomes. Despite this, no study to date has synthesized existing literature examining ACEs and health outcomes among SMW. This gap is important because SMW are significantly more likely than heterosexual women to report every type of ACE and a higher total number of ACEs. Therefore, using a scoping review methodology, we sought to expand understanding of the relationship between ACEs and health outcomes among SMW. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for. Scoping Reviews protocol, we searched five databases: Web of Science, PsycInfo, CINAHL, PubMed, and Embase for studies published between January 2000 and June 2021 that examined mental health, physical health, and/or substance use risk factors and outcomes among adult cisgender SMW who report ACEs. Our search yielded 840 unique results. Studies were screened independently by two authors to determine eligibility, and 42 met full inclusion criteria. Our findings provide strong evidence that ACEs are an important risk factor for multiple negative mental health and substance use outcomes among SMW. However, findings were mixed with respect to some health risk behaviors and physical health outcomes among SMW, highlighting the need for future research to clarify these relationships.
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Affiliation(s)
| | - Lauren Porsch
- Columbia University School of Nursing, New York, NY, USA
| | - Sarah Zollweg
- Columbia University School of Nursing, New York, NY, USA
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Talley AE, Veldhuis C, Wall MM, Wilsnack SC, Everett BG, Hughes TL. Associations of adult roles and minority stressors with trajectories of alcohol dependence symptoms throughout adulthood among sexual minority women. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:559-570. [PMID: 35849352 PMCID: PMC9845428 DOI: 10.1037/adb0000869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE In the present study, we sought to identify trajectories of symptoms of potential alcohol dependence (AD) among adult sexual minority women (SMW). Theoretical correlates were examined in relation to the empirically identified trajectories. METHOD Data were collected at three time points between 2000 and 2012 from SMW drinkers (n = 434) enrolled in a longitudinal study (M Age = 37.49 at baseline, SD = 11.55). Using an accelerated-cohort longitudinal design, latent growth curve mixture models identified homogeneous patterns of any past-year symptoms of potential AD. Correlates of trajectories included alcohol-related developmental risk factors, adult roles, and exposure to minority stressors. RESULTS Three trajectories were identified that captured risk of symptoms of potential AD over time, reflecting: (a) relatively consistent, low risk over time; (b) deceleration in risk throughout adulthood; (c) relatively persistent, high risk over time. Consistent with prior work, SMW drinkers who reported higher levels of perceived stigma or masculinity showed persistently high risk of reporting at least one past-year symptom of potential AD. CONCLUSIONS Most SMW drinkers report deceleration in risk of AD symptoms over time. Findings have implications for prevention and intervention efforts tailored to SMW drinkers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | - Melanie M. Wall
- Research Foundation for Mental Hygiene
- Columbia University Department of Psychiatry
- New York State Psychiatric Institute
| | | | | | - Tonda L. Hughes
- Columbia University School of Nursing
- Columbia University Department of Psychiatry
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Bochicchio L, Xu M, Veldhuis CB, McTavish C, Hughes TL. Mental health and substance use among sexual minority women who report childhood sexual abuse: A systematic literature review. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023:2023-70239-001. [PMID: 37166921 PMCID: PMC10638469 DOI: 10.1037/tra0001476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVE A growing body of literature provides evidence that sexual minority women (SMW; e.g., lesbian, bisexual) are at greater risk of negative mental health and substance use outcomes than are heterosexual women. While minority stress may partially explain these disparities, it does not fully account for them. Therefore, it is necessary to identify how other risk factors (i.e., childhood sexual abuse [CSA]) contribute to SMW's increased risk of negative mental health and substance use outcomes. METHOD We conducted a systematic literature review to identify and synthesize the state of knowledge about CSA and mental health and substance use outcomes among SMW. Two independent reviewers screened 347 articles identified in searches of five databases (Web of Science, PsycInfo, CINAHL, PubMed, and Embase). Eligible articles were peer-reviewed, reported quantitative or mixed methods results focused on mental health or substance use outcomes among adult SMW with a history of CSA. RESULTS Twenty-four papers were included in the review. Findings clearly show that SMW report higher rates of CSA than heterosexual women. Findings also suggest that CSA may mediate the relationship between minority sexual identity and some negative outcomes. CONCLUSIONS Future studies should include minority stress factors, a broader range of mental health outcomes (apart from substance use and suicide), and more nuanced measures of CSA. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Mariah Xu
- School of Nursing, Columbia University
| | - Cindy B Veldhuis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | | | - Tonda L Hughes
- School of Nursing, Columbia University Irving School of Medicine
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DeLaney EN, Williams CD, Jones SCT, Hood KB, Cage J, Coston BE, Hawn SE, Santana A, Dick DM. Sexual Victimization and Mental Health Among LGBQ + College Students: Examining Social Support and Trauma-Related Drinking as Mediators. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-022-00997-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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McCabe SE, Hughes TL, Fish JN, Hoak S, Kcomt L, Evans-Polce RJ, Engstrom C, Leary K, Veliz P, West BT, McCabe VV, Boyd CJ. Is it all in the family? Sexual identity differences in DSM-5 alcohol and other drug use disorders and associations with alcohol and other drug misuse history among parents, offspring, and other relatives. Subst Abus 2022; 43:1277-1285. [PMID: 35849748 PMCID: PMC10469272 DOI: 10.1080/08897077.2022.2095080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Background: The objectives of this study were to: (1) estimate the prevalence of family history of alcohol and other drug (AOD) misuse (positive family history [FH+]) in first- and second-degree relatives across sexual identity subgroups (i.e., lesbian, gay, bisexual, heterosexual); (2) compare AOD misuse among offspring of sexual minority and heterosexual parents; and (3) examine the relationships between FH+ and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alcohol use disorder (AUD) and other drug use disorder (ODUD) across sexual identity subgroups. Methods: Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 36,309 non-institutionalized U.S. adults aged ≥ 18 years). Data collection occurred in households using structured diagnostic face-to-face interviews during 2012-2013. Results: The presence of FH+ in first- and second-degree relatives was most prevalent among bisexual women relative to all other sexual orientation subgroups. Multivariable regression analyses indicated that the odds of AUD and ODUD were higher among FH+ adults relative to negative family history (FH-) adults. Lesbian and bisexual women had higher odds of AUD compared to heterosexual women, controlling for any FH+; this sexual identity difference was not found for men. There were no significant differences in ODUD between heterosexual FH- men and gay FH- men. We found differences in AOD misuse among offspring of bisexual parents, but not gay or lesbian parents compared to heterosexual parents. Conclusions: Health professionals should consider the higher likelihood of a family history of AOD misuse among sexual minorities, especially bisexual women, when treating these individuals. The lack of differences in AOD misuse among offspring of gay or lesbian parents relative to heterosexual parents warrants attention for legal, policy, and clinical decisions.
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Affiliation(s)
- Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, North Campus Research Complex, Ann Arbor, Michigan, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Tonda L. Hughes
- School of Nursing, Columbia University, New York, New York, USA
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Jessica N. Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Sebastian Hoak
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- School of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Luisa Kcomt
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- School of Social Work, Wayne State University, Detroit, Michigan, USA
| | - Rebecca J. Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Curtiss Engstrom
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Kate Leary
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Philip Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Brady T. West
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, North Campus Research Complex, Ann Arbor, Michigan, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Vita V. McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Carol J. Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
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Karriker-Jaffe KJ, Drabble LA, Li L, Munroe C, Mericle AA, Trocki KF, Hughes TL. Comparing substance use outcomes by sexual identity among women: Differences using propensity score methods. Drug Alcohol Depend 2022; 238:109567. [PMID: 35901534 PMCID: PMC9869911 DOI: 10.1016/j.drugalcdep.2022.109567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/22/2022] [Accepted: 07/07/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Differences in alcohol, tobacco, and other drug (ATOD) use by sexual identity vary across samples of women recruited using different sampling methods. We used propensity score (PS) weighting methods to address two methodological questions: (1) Do disparities between sexual minority women (SMW) and heterosexual women persist when differences in risk and protective factors are similarly distributed between groups, and (2) Does accounting for SMW-specific resiliency factors impact differences between non-probability samples of SMW? METHODS Four samples included SMW from a longitudinal study with a nonprobability sample (n = 373), a national general population panel sample (n = 373), and a national LGBTQ-specific panel sample (n = 311), as well as a national probability sample of heterosexual women (n = 446). Between-groups analyses using double-robust PS weighted models estimated differences in ATOD use under hypothetical conditions in which samples have similar risk and protective factors. RESULTS After PS weighting, imbalance in confounders between SMW and heterosexual samples was substantially reduced, but not eliminated. In double-robust PS weighted models, SMW samples consistently had significantly greater odds of drug use than heterosexuals, with odds from 8.8 to 5.6 times greater for frequent marijuana use and 4.8-3.2 greater for other drug use. Few differences between SMW samples in ATOD outcomes or other variables remained after PS weighting. CONCLUSION Relative to heterosexual women, disparities in marijuana and other drug use among SMW are evident regardless of sampling strategy. The results provide some reassurance about the validity of large nonprobability samples, which remain an important recruitment strategy in research with SMW.
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Affiliation(s)
| | - Laurie A. Drabble
- San José State University, College of Health and Human Sciences, One Washington Square, San José, USA,Corresponding author. (L.A. Drabble)
| | - Libo Li
- Alcohol Research Group, 6001 Shellmound St, Suite 450, Emeryville, CA 94608, USA.
| | - Cat Munroe
- Alcohol Research Group, 6001 Shellmound St, Suite 450, Emeryville, CA 94608, USA.
| | - Amy A. Mericle
- Alcohol Research Group, 6001 Shellmound St, Suite 450, Emeryville, CA 94608, USA
| | - Karen F. Trocki
- Alcohol Research Group, 6001 Shellmound St, Suite 450, Emeryville, CA 94608, USA
| | - Tonda L. Hughes
- School of Nursing & Department of Psychiatry, Columbia University, 630 West 168th Street, Mail Box Code 6, New York, NY 10032, USA
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Veldhuis CB, Juster RP, Corbeil T, Wall M, Poteat T, Hughes TL. Testing whether the combination of victimization and minority stressors exacerbate PTSD risks in a diverse community sample of sexual minority women. PSYCHOLOGY & SEXUALITY 2022; 14:252-278. [PMID: 38549608 PMCID: PMC10978045 DOI: 10.1080/19419899.2022.2106147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 07/19/2022] [Indexed: 10/16/2022]
Abstract
Informed by minority stress and intersectionality frameworks, we examined: 1) associations of sexual identity and race/ethnicity with probable diagnosis of post-traumatic stress disorder (PTSD-PD) among sexual minority women (SMW; e.g., lesbian, bisexual); and 2) potential additive and interactive associations of minority stressors (discrimination, stigma consciousness, and internalized homonegativity) and potentially traumatic childhood and adulthood events (PTEs) with PTSD-PD. Data come from a large and diverse community sample of SMW (N = 662; age range: 18-82; M = 40.0, SD = 14.0). The sample included 35.8% Black, 23.4% Latinx, and 37.2% White participants. Logistic regressions tested associations of sexual identity and race/ethnicity, minority stressors, and PTEs with PTSD-PD. More than one-third of SMW (37.2%) had PTSD-PD with significantly higher prevalence among bisexual, particularly White bisexual women, than lesbian women. Discrimination, stigma consciousness, and internalized homonegativity were each associated with higher odds of PTSD-PD, but only internalized homonegativity was additively associated with PTSD-PD in mutually adjusted models above and beyond effects of PTEs. No evidence for interactive effects between PTEs and minority stressors was found. In a diverse community sample of sexual minority women, PTSD is strongly associated with potentially traumatic childhood events and with minority stressors above and beyond the associations with other potentially traumatic events and stressors in adulthood. Our findings suggest a strong need for therapists to address the effects of stigma and homophobia in treatment for PTSD, as these minority stressors likely maintain and exacerbate the effects of past traumas.
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Affiliation(s)
| | | | - Thomas Corbeil
- Mental Health Data Science, New York State Psychiatric Institute
| | - Melanie Wall
- Mental Health Data Science, New York State Psychiatric Institute
| | - Tonia Poteat
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill
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Haase S, Müller A, Zweigenthal V. Sexual health behavior, health status, and knowledge among queer womxn and trans men in Kenya: An online cross-sectional study. PLoS One 2022; 17:e0268298. [PMID: 35714150 PMCID: PMC9205489 DOI: 10.1371/journal.pone.0268298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 04/23/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Little research has been conducted on the sexual health needs and risk behaviors of queer womxn and trans men, making it difficult to identify specific health needs and disparities. This is especially the case in the Global South, where their needs are poorly understood. This study presents findings on demographics, sources of information, sexual (risk) behaviors, and substance use in Kenyan queer womxn and trans men. Methods An online survey among 335 Kenyan queer womxn and trans men was used to collect data on sexual health, risk behavior, health information sources, and substance use. The participants needed to have had at least one self-identified female sexual partner. Results The sample presented young, highly-educated queer womxn and trans men. A high incidence of childhood sexual trauma found was found. Risk behaviors included sexual activities with partners of multiple genders, violence, and low use of barrier methods. One in three participants had been treated for an STD in the previous year. The incidences of smoking and drinking were high, and a quarter of participants indicated having taken drugs at least once a month or more. The internet was either the first or second most important source of sexual health information for 44.1% of the participants, followed by schools (30.9%). Discussion and conclusion Our findings indicate that queer womxn and trans men are at risk of negative sexual health outcomes due to a lack of appropriate information, risk behavior, substance use, and low uptake of sexual health services. Kenya’s Penal Code still criminalizes consensual same-sex activities and may play a role in perpetuating barriers that prohibit them from making healthier choices. Developing tailored programming and policies require local, national, and global stakeholders to engage with the inclusion of queer womxn and trans men’s sexual health needs within strategic planning and healthcare delivery.
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Affiliation(s)
- Stephanie Haase
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- * E-mail:
| | - Alex Müller
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Virginia Zweigenthal
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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McCabe SE, Hughes TL, Beal S, Evans-Polce RJ, Kcomt L, Engstrom C, West BT, Veliz P, Leary K, McCabe VV, Boyd CJ. Sexual orientation differences in childhood sexual abuse, suicide attempts, and DSM-5 alcohol, tobacco, other drug use, and mental health disorders in the US. CHILD ABUSE & NEGLECT 2022; 123:105377. [PMID: 34773839 PMCID: PMC9110097 DOI: 10.1016/j.chiabu.2021.105377] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND Childhood sexual abuse (CSA) contributes to increased risk of substance use and mental health disorders in the general population. OBJECTIVE To assess the prevalence and associations of CSA and suicide attempts, substance use, and mental health disorders as a function of sex (female, male) and sexual orientation (lesbian, gay, bisexual, heterosexual-identified with same-sex attraction and/or behavior, heterosexual-identified without same-sex attraction and/or behavior, and unsure). PARTICIPANTS AND SETTING Data were collected using structured diagnostic face-to-face interviews in a nationally representative sample of 36,309 US adults. METHODS We used descriptive statistics and logistic regression modeling to analyze data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III). RESULTS Childhood sexual abuse was most prevalent among sexual minorities, especially bisexual females. Nearly one-third of bisexual females (30.6%) reported experiencing two or more types of CSA, p < .001. Among all participants, exposure to one or more types of CSA was associated with greater odds of lifetime suicide attempts, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alcohol, tobacco or other drug use disorder, and mental health disorders, after adjusting for other childhood adversity/maltreatment and general life stressors. CONCLUSIONS Sexual minority females and males in the US are more likely than their heterosexual counterparts to report CSA. Higher risk of suicide attempts and DSM-5 alcohol, tobacco, other drug use, and mental health disorders in adulthood was directly associated with CSA, particularly among bisexual females. Health professionals working with individuals who have experienced CSA should assess these risks and intervene as needed.
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Affiliation(s)
- Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; Institute for Research on Women and Gender, University of Michigan, 1136 Lane Hall, 204 S. State St., Ann Arbor, MI 48109, USA; Institute for Healthcare Policy and Innovation, University of Michigan, North Campus Research Complex (NCRC), Building 16, 2800 Plymouth Rd., Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, 4118 ISR Building, 426 Thompson St., Ann Arbor, MI 48104, USA; Rogel Cancer Center, University of Michigan, CCGC 6-303, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA.
| | - Tonda L Hughes
- School of Nursing, Columbia University, 560 W. 168th St., New York, NY 10032, USA; Department of Psychiatry, Columbia University, 1051 Riverside Dr., New York, NY 10032, USA.
| | - Sarah Beal
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave., Cincinnati, OH 45267, USA.
| | - Rebecca J Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA.
| | - Luisa Kcomt
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; School of Social Work, Wayne State University, 5447 Woodward Avenue, Detroit, MI 48202, USA.
| | - Curtiss Engstrom
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, 4118 ISR Building, 426 Thompson St., Ann Arbor, MI 48104, USA.
| | - Brady T West
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; Institute for Healthcare Policy and Innovation, University of Michigan, North Campus Research Complex (NCRC), Building 16, 2800 Plymouth Rd., Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, 4118 ISR Building, 426 Thompson St., Ann Arbor, MI 48104, USA.
| | - Phil Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; Institute for Research on Women and Gender, University of Michigan, 1136 Lane Hall, 204 S. State St., Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, 4118 ISR Building, 426 Thompson St., Ann Arbor, MI 48104, USA.
| | - Kate Leary
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA.
| | - Vita V McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; Department of Psychiatry, University of Michigan, 1500 E Medical Center Dr., Ann Arbor, MI 48109, USA; Department of Surgery, University of Michigan, 1500 E Medical Center Dr., Ann Arbor, MI 48109, USA.
| | - Carol J Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA; Institute for Research on Women and Gender, University of Michigan, 1136 Lane Hall, 204 S. State St., Ann Arbor, MI 48109, USA; Department of Psychiatry, University of Michigan, 1500 E Medical Center Dr., Ann Arbor, MI 48109, USA.
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The Mediating Role of Cognitive Flexibility in the Relationship between Traumatic Experiences in the Childhood Period and Substance Abuse Proclivity. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021. [DOI: 10.1007/s10942-020-00385-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Veldhuis CB, Porsch LM, Bochicchio LA, Campbell J, Johnson TP, LeBlanc AJ, Leonard KE, Wall M, Wilsnack SC, Xu M, Hughes TL. The Chicago Health and Life Experiences of Women Couples Study: Protocol for a Study of Stress, Hazardous Drinking, and Intimate Partner Aggression Among Sexual Minority Women and Their Partners. JMIR Res Protoc 2021; 10:e28080. [PMID: 34665154 PMCID: PMC8564669 DOI: 10.2196/28080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/26/2021] [Accepted: 08/11/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Large gaps exist in research on alcohol use and intimate partner aggression (IPA) among sexual minority women (SMW; eg, lesbian, bisexual). Dyadic research with SMW and their partners can illuminate how couple-level factors operate in conjunction with individual-level factors to shape well-being in this understudied and vulnerable population. Given the traditionally gendered lens with which women are primarily viewed as victims and men as perpetrators, understanding the dynamics of IPA in same-sex female couples can also advance research and practice related to IPA more generally. OBJECTIVE Guided by a recent extension of the minority stress model that includes relational (couple-level) sexual minority stress and the I-cubed theoretical perspective on IPA, we will collect individual and dyadic data to better characterize the links between hazardous drinking and IPA among SMW and their partners. First, this study aims to examine the associations among minority stress, hazardous drinking, and IPA in SMW and their partners. Minority stressors will be assessed as both individual and couple-level constructs, thus further extending the minority stress model. Second, we aim to examine potential mediators and moderators of the associations among minority stress, hazardous drinking, and IPA. Finally, we aim to test models guided by the I-cubed theoretical perspective that includes instigating (eg, relationship conflict), impelling (eg, negative affect and trait anger), and inhibiting (eg, relationship commitment and emotion regulation) or disinhibiting (eg, hazardous drinking) influences on IPA perpetration. METHODS This United States National Institutes of Health-funded project will draw from a large and diverse cohort of SMW currently enrolled in the Chicago Health and Life Experiences of Women (CHLEW) study-a 21-year longitudinal study of risk factors and consequences associated with SMW hazardous drinking. SMW currently enrolled in the CHLEW and their partners will be invited to participate in the CHLEW Couples Study. By analyzing dyadic data using actor-partner interdependence models, we will examine how each partner's minority stress, hazardous drinking, and IPA experiences are associated with both her own and her partner's minority stress, hazardous drinking, and IPA perpetration. RESULTS Data collection began in February 2021 and will likely continue through 2023. Initial results should be available by mid-2024. CONCLUSIONS The CHLEW Couples Study will fill important gaps in knowledge and provide the basis for future research aimed at clarifying the causal pathways linking hazardous drinking and IPA among SMW. This will support the development of culturally appropriate targeted individual and dyadic prevention and intervention strategies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/28080.
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Affiliation(s)
- Cindy B Veldhuis
- School of Nursing, Columbia University, New York, NY, United States
| | - Lauren M Porsch
- School of Nursing, Columbia University, New York, NY, United States
| | | | - Jacquelyn Campbell
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Timothy P Johnson
- Department of Public Administration, University of Illinois - Chicago, Chicago, IL, United States
| | - Allen J LeBlanc
- Health Equity Institute, San Francisco State University, San Francisco, CA, United States
| | - Kenneth E Leonard
- Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, NY, United States
| | - Melanie Wall
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Sharon C Wilsnack
- School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND, United States
| | - Mariah Xu
- School of Nursing, Columbia University, New York, NY, United States
| | - Tonda L Hughes
- School of Nursing, Columbia University, New York, NY, United States
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Câncer de mama e homossexualidade feminina. PSICO 2021. [DOI: 10.15448/1980-8623.2021.2.36109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Devido aos avanços dos tratamentos oncológicos, a sobrevida das pacientes com neoplasias mamárias tem aumentado significativamente, o que impõe a necessidade de compreender seus aspectos psicossociais. Diferenças de gênero e orientação sexual favorecem a ocorrência de desigualdades dentro dos serviços de saúde. Este estudo teve por objetivo analisar a produção científica nacional e internacional sobre variáveis relacionadas à saúde de mulheres lésbicas com câncer de mama. O levantamento bibliográfico foi realizado a partir das bases LILACS, PubMed, CINAHL e PsycINFO. Foram selecionados 20 artigos publicados entre 2007 e 2017. A análise permitiu delinear os temas: repercussões físicas e psicológicas do tratamento, enfrentamento, riscos de morbidade e mortalidade, qualidade de vida, menopausa e estudos de base populacional. A literatura explora de que modo a doença e o tratamento impactam de forma diferenciada a qualidade de vida de mulheres lésbicas acometidas por câncer de mama. Esse conhecimento é fundamental para subsidiar um cuidado sensível às necessidades dos segmentos minoritários da população.
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Hughes TL, Wilsnack SC, Martin K, Matthews A(P, Johnson TP. Alcohol use among sexual minority women: Methods used and lessons learned in the 20-Year Chicago Health and Life Experiences of Women Study. INTERNATIONAL JOURNAL OF ALCOHOL AND DRUG RESEARCH 2021; 9:30-42. [PMID: 37946724 PMCID: PMC10634638 DOI: 10.7895/ijadr.289] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Background Two decades ago, there was almost no research on alcohol use among sexual minority women (SMW, e.g., lesbian, bisexual). Since then, a growing body of scientific literature documents substantial sexual orientation-related disparities in alcohol use and alcohol-related problems. Research has identified multiple risk factors associated with high-risk/hazardous drinking among SMW. However, this research has almost exclusively used cross-sectional designs, limiting the ability to draw conclusions about processes through which sexual minority status affects alcohol use. Longitudinal designs, although very rare in research on alcohol use among SMW, are important for testing mediational mechanisms and necessary to understanding how changes in social determinants impact alcohol use. Aim To describe the processes and lessons learned in conducting a 20-year longitudinal study focused on alcohol use among SMW. Methods The Chicago Health and Life Experiences of Women (CHLEW) study includes five waves of data collection (2000-present) with an age and racially/ethnically diverse sample of 815 SMW (ages 18-83) originally recruited in the Chicago Metropolitan Area in Illinois, a midwestern state in the United States (U.S.). Measures and focus have evolved over the course of the study. Results The CHLEW study is the longest-running and most comprehensive study of SMW's drinking in the U.S. or elsewhere. Findings reported in more than 50 published manuscripts have contributed to understanding variations in SMW's risk for hazardous/harmful drinking based on sexual identity, age, race/ethnicity, sex/gender of partner, and many other factors. Conclusions By describing the process used in conducting this long-term study, its major findings, and the lessons learned, we hope to encourage and support other researchers in conducting longitudinal research focused on SMW's health. Such research is critically important in understanding and ultimately eliminating sexual orientation-related health disparities.
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Affiliation(s)
- Tonda L. Hughes
- School of Nursing and Department of Psychiatry, Columbia University
| | - Sharon C. Wilsnack
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine & Health Sciences
| | - Kelly Martin
- School of Nursing and Department of Psychiatry, Columbia University
| | | | - Timothy P. Johnson
- Center for Clinical and Translational Science, University of Illinois at Chicago
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John-Henderson NA, Counts CJ, Ginty AT. Associations Between Childhood Abuse and COVID-19 Hyperarousal in Adulthood: The Role of Social Environment. Front Psychol 2021; 12:565610. [PMID: 33716845 PMCID: PMC7943606 DOI: 10.3389/fpsyg.2021.565610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 02/01/2021] [Indexed: 11/24/2022] Open
Abstract
Background Childhood abuse increases risk for high levels of distress in response to future stressors. Interpersonal social support is protective for health, particularly during stress, and may be particularly beneficial for individuals who experienced childhood abuse. Objective Investigate whether childhood abuse predicts levels of posttraumatic stress disorder (PTSD) symptoms related to the COVID-19 pandemic, and test whether the perceived availability of social companionship preceding the pandemic moderates this relationship. Methods During Phase 1, adults (N = 120; Age M[SD] = 19.4 [0.94]) completed a retrospective measure of childhood adversity along with a measure of perceived availability of opportunities for social engagement immediately preceding the pandemic. Two weeks after the COVID-19 pandemic declaration, participants completed the Impact of Event Scale-Revised (IES-R) with respect to the pandemic. Hierarchical linear regression analyses examined the interaction between childhood abuse and the perceived availability of social companionship preceding the pandemic as a predictor of PTSD symptoms. Results Adjusting for covariates, the interaction between childhood abuse and perceived availability of others to engage with before the onset of the pandemic was a significant predictor of IES-hyperarousal (β = −0.19, t = −2.06, p = 0.04, ΔR2 = 0.032, CI: [−0.31 to −0.01]). Conclusion Levels of perceived opportunities for social companionship before the pandemic associates with levels of hyperarousal related to the pandemic, particularly for individuals who experienced high levels of childhood abuse. More research is needed to understand how to mitigate the higher levels of distress related to the pandemic for these individuals in order to reduce risk for future psychiatric disorders.
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Affiliation(s)
- Neha A John-Henderson
- Department of Psychology, College of Letters and Science, Montana State University, Bozeman, MT, United States
| | - Cory J Counts
- Department of Psychology, College of Letters and Science, Montana State University, Bozeman, MT, United States
| | - Annie T Ginty
- Department of Psychology and Neuroscience, College of Arts & Sciences, Baylor University, Waco, TX, United States
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Trujillo O, Cantu JI, Charak R. Unique and Cumulative Effects of Intimate Partner Cybervictimization Types on Alcohol Use in Lesbian, Gay, and Bisexual Emerging Adults. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 23:743-751. [PMID: 32799548 DOI: 10.1089/cyber.2019.0773] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The use of modern technology has inadvertently created newer platforms for intimate partner victimization to take place. The present study investigated (1) whether psychological, sexual, and stalking cyber intimate partner victimization (cyber IPV) types were uniquely associated with alcohol use, and (2) whether there was additive effect of cyber IPV types on alcohol use, after controlling for histories of childhood maltreatment types and face-to-face intimate partner victimization among lesbian, gay, and bisexual (LGB) emerging adults. Participants were 277 self-identifying LGB individuals in the age range of 18-29 years (M = 25.39, SD = 2.77; 16.6% lesbian, 25.6% gay, 43% bisexual women). Participants completed an online questionnaire assessing cyber IPV types, namely, psychological, sexual, and stalking, five forms of childhood maltreatment, face-to-face IPV types (i.e., physical, psychological, and sexual), and alcohol use. Findings indicated that 29.2% (n = 81) endorsed all three types of cyber IPV. Hierarchical regression analysis showed that only sexual cyber IPV was uniquely associated with alcohol use. In support of the cumulative risk hypothesis, those with exposure to three types of cyber IPV were more likely to have greater alcohol use compared to those with exposure to any one type of cyber IPV. Findings indicate that cyber IPV can lead to behavioral health challenges, such as an increase in alcohol use among LGB emerging adults. Findings call for interventions focusing on generating awareness regarding the ill effects of cyber IPV and for mental health professionals to develop treatment programs to aid in the well-being of the victim.
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Affiliation(s)
- Oscar Trujillo
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Jorge I Cantu
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Ruby Charak
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
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Hughes TL, Veldhuis CB, Drabble LA, Wilsnack SC. Research on alcohol and other drug (AOD) use among sexual minority women: A global scoping review. PLoS One 2020; 15:e0229869. [PMID: 32187200 PMCID: PMC7080264 DOI: 10.1371/journal.pone.0229869] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/15/2020] [Indexed: 12/31/2022] Open
Abstract
Until the 1980s, the limited research on alcohol and other drug (AOD) use among sexual minority women (SMW) focused on alcohol and used samples recruited from gay bars, resulting in inflated estimates of hazardous drinking. Over the past several decades the number of AOD studies with SMW has increased dramatically. To characterize this literature, we conducted a scoping review to answer the following questions: What do we know, and what are the gaps in research about AOD use among SMW? We searched multiple electronic databases (Medline [PubMed], CINAHL, PsycInfo, and Web of Science) for peer-reviewed research articles about AOD use among adult SMW published between January 1, 2000 and May 31, 2017. After duplicates were removed the search identified 4,204 articles. We reviewed the titles and abstracts and removed articles that did not meet inclusion criteria. We used full-text review of the remaining 229 articles to make a final determination regarding inclusion and we retained 181 articles for review. Although the quantity of AOD research with SMW has grown substantially, the great majority of studies have been conducted in the United States (US) and most focus on hazardous drinking; relatively little research has focused on other drugs. In addition, although there has been marked improvement in theories and methods used in this research, many gaps and limitations remain. Examples are the lack of longitudinal research; reliance on samples that tend to over-represent white, well-educated, and relatively young women; sparse attention to mechanisms underlying the disproportionately high rates of AOD use among SMW; and the absence of intervention research. In general, more high-quality research on SMW's use of AODs is needed, but gaps and limitations are particularly large in non-western countries. Addressing these research gaps and limitations is essential for providing information that can be used to develop more effective prevention and early intervention strategies, as well as for informing policies that can help to reduce risky drinking and drug misuse among SMW.
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Affiliation(s)
- Tonda L. Hughes
- School of Nursing, Columbia University, New York, New York, United States of America
| | - Cindy B. Veldhuis
- School of Nursing, Columbia University, New York, New York, United States of America
| | - Laurie A. Drabble
- San Jose State University, San Jose, California, United States of America
| | - Sharon C. Wilsnack
- University of North Dakota, Grand Forks, North Dakota, United States of America
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Cerezo A, Williams C, Cummings M, Ching D, Holmes M. Minority Stress and Drinking: Connecting Race, Gender Identity and Sexual Orientation. COUNSELING PSYCHOLOGIST 2019. [DOI: 10.1177/0011000019887493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We carried out a constructivist grounded theory-based qualitative exploration on the relations between intersectional minority stress and drinking among a community sample of 20 Latinx and African American sexual minority, gender expansive women. Our overarching goal was to illuminate the nuanced ways in which participants’ lived experiences; in relation to race and ethnicity, gender identity, and sexual orientation, intersected to create complex forms of minority stress rarely captured in the research literature. Semi-structured interviews and lifeline methodology were employed to assess participants’ major life stressors and drinking history; particularly, when and how drinking became a regular part of participants’ lives. Our findings indicated that drinking was primarily connected to same-sex romantic partnerships, cultural and familial ties to alcohol, social norms within queer spaces, familial rejection and loss of racial and ethnic community, and chronic stress. Recommendations for research, practice, advocacy, education, and training are discussed.
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Affiliation(s)
| | | | | | - Derek Ching
- San Francisco State University, San Francisco, CA, USA
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McGeough BL, Sterzing PR. A Systematic Review of Family Victimization Experiences Among Sexual Minority Youth. J Prim Prev 2019; 39:491-528. [PMID: 30206750 DOI: 10.1007/s10935-018-0523-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sexual minority youth experience substantially higher rates of family victimization than their heterosexual peers. No systematic review has yet identified the predictors and consequences in this vulnerable population of childhood abuse, exposure to sibling abuse and domestic violence, and sibling aggression. This systematic review aims to (a) describe differences in these family victimization rates by sexual orientation, gender, and race/ethnicity; (b) identify potential sexual minority and non-sexual minority-specific risk factors; and (c) identify physical, mental, and behavioral health and extrafamilial victimization correlates. The systematic review, which followed PRISMA guidelines, yielded 32 articles that met study inclusion criteria. Rates of childhood physical, sexual, and emotional abuse were consistently higher for sexual minority youth than for their heterosexual peers. Bisexual youth appear to be at greater risk for physical abuse than their gay and lesbian peers. Younger age at sexual minority milestones (first awareness, disclosure, and same-sex sexual contact) and higher levels of sexual minority-specific (sexuality disclosure, gender non-conformity) and non-sexual minority-specific (delinquent behaviors, parental drinking) risk factors were associated with higher rates of family victimization. Sexual minorities who experienced some form of childhood abuse reported more frequent physical (higher rates of HIV, higher BMIs, lower levels of perceived health), mental (higher rates of depression, PTSD symptoms, experiential avoidance, internalized homophobia), and behavioral (higher rates of suicidality, substance misuse, earlier sexual debut, unprotected anal sex) health problems relative to heterosexual or non-abused sexual minority peers. Sexual minority females who experienced childhood physical or sexual abuse were at greater risk than abused sexual minority males for sexual assault later in life. We conclude this systematic review with recommendations for future research, including the necessity for longitudinal research that utilizes a poly-victimization conceptual framework to identify the developmental pathways connecting risk factors, different types of family victimization, and health and extrafamilial victimization consequences.
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Affiliation(s)
- Briana L McGeough
- School of Social Welfare, University of California, Berkeley, 120 Haviland Hall #7400, Berkeley, CA, 94720-7400, USA.
| | - Paul R Sterzing
- School of Social Welfare, University of California, Berkeley, 120 Haviland Hall #7400, Berkeley, CA, 94720-7400, USA
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Affiliation(s)
| | - Tonda L Hughes
- Professor and Director of Global Health Research, Columbia University School of Nursing
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20
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Ports KA, Holman DM, Guinn AS, Pampati S, Dyer KE, Merrick MT, Lunsford NB, Metzler M. Adverse Childhood Experiences and the Presence of Cancer Risk Factors in Adulthood: A Scoping Review of the Literature From 2005 to 2015. J Pediatr Nurs 2019; 44:81-96. [PMID: 30683285 PMCID: PMC6355255 DOI: 10.1016/j.pedn.2018.10.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 02/07/2023]
Abstract
Exposure to Adverse Childhood Experiences (ACEs) is associated with a host of harmful outcomes, including increased risk for cancer. A scoping review was conducted to gain a better understanding of how ACEs have been studied in association with risk factors for cancer. This review includes 155 quantitative, peer-reviewed articles published between 2005 and 2015 that examined associations between ACEs and modifiable cancer risk factors, including alcohol, environmental carcinogens, chronic inflammation, sex hormones, immunosuppression, infectious agents, obesity, radiation, ultraviolet (UV) radiation, and tobacco, among U.S. adults. This review highlights the growing body of research connecting ACEs to cancer risk factors, particularly alcohol, obesity, and tobacco. Fewer studies investigated the links between ACEs and chronic inflammation or infectious agents. No included publications investigated associations between ACEs and environmental carcinogens, hormones, immunosuppression, radiation, or ultraviolet radiation. Mitigating the impact of ACEs may provide innovative ways to effect comprehensive, upstream cancer prevention.
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Affiliation(s)
- Katie A Ports
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Dawn M Holman
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Angie S Guinn
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sanjana Pampati
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Karen E Dyer
- Virginia Commonwealth University, School of Medicine, Department of Health Behavior and Policy, Richmond, VA, USA.
| | - Melissa T Merrick
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Marilyn Metzler
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Dworkin ER, Kaysen D, Bedard-Gilligan M, Rhew IC, Lee CM. Daily-level associations between PTSD and cannabis use among young sexual minority women. Addict Behav 2017; 74:118-121. [PMID: 28618391 PMCID: PMC5538382 DOI: 10.1016/j.addbeh.2017.06.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 06/06/2017] [Accepted: 06/07/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Sexual minority women have elevated trauma exposure and prevalence of posttraumatic stress disorder (PTSD) compared to heterosexual women and they are also more likely to use cannabis, although no research has examined relationships between PTSD and cannabis use in this population. Daily-level methodologies are necessary to examine proximal associations between PTSD and use. METHODS This study included 90 trauma-exposed young adult women who identified as sexual minorities (34.4% identified as lesbian and 48.9% identified as bisexual) and evaluated daily-level associations between their PTSD symptoms and cannabis use. Participants were assessed at two measurement waves, one year apart, each consisting of 14 consecutive daily assessments. RESULTS Cannabis use occurred on 22.8% of the days. Results from generalized linear mixed effects models showed that a person's mean level of PTSD symptom severity across days was strongly associated with same-day likelihood of cannabis use (OR=2.67 for 1 SD increase in PTSD score; p<0.001). However, daily deviation from one's average PTSD score was not associated with cannabis use on the same day. CONCLUSIONS Findings suggest that PTSD severity may confer general risk for cannabis use, rather than being a state-dependent risk factor.
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Affiliation(s)
- Emily R Dworkin
- University of Washington, 1100 NE 45th Street, Suite 300, UW Box 354944, Seattle, WA 98195, United States.
| | - Debra Kaysen
- University of Washington, 1100 NE 45th Street, Suite 300, UW Box 354944, Seattle, WA 98195, United States
| | - Michele Bedard-Gilligan
- University of Washington, 1100 NE 45th Street, Suite 300, UW Box 354944, Seattle, WA 98195, United States
| | - Isaac C Rhew
- University of Washington, 1100 NE 45th Street, Suite 300, UW Box 354944, Seattle, WA 98195, United States
| | - Christine M Lee
- University of Washington, 1100 NE 45th Street, Suite 300, UW Box 354944, Seattle, WA 98195, United States
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Investigating the relationship between childhood maltreatment and alcohol misuse in a sample of Danish young adults: Exploring gender differences. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017. [DOI: 10.1515/nsad-2016-0022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background This study examined the relationship between alcohol misuse and different types of childhood maltreatment in a sample of young adults while controlling for posttraumatic stress disorder (PTSD) symptoms and current mental disorders. This study further examined if these associations were different for males and females. Methods Data were collected from a Danish national study conducted by The Danish National Centre for Social Research in 2008 and 2009. A sample of 4718 young adults (24 years of age) was randomly selected using the total birth cohort of children born in 1984. Structured interviews were conducted with a response rate of 63%, equating to a total sample size of 2980 participants. Results Three types of child maltreatment were assessed; emotional abuse (N =263), sexual abuse (N=59), and multiple abuse (N=64) alongside a non-abused (N=2595) control group. Findings indicated the three maltreatment groups were all related to alcohol misuse. Maltreated women in particular had a 16-to-25-fold increased risk of alcohol misuse. For males these associations were attenuated with odds ratios (OR) ranging between 3 and 5 for emotional and multiple abuse groups. PTSD symptoms were associated with alcohol misuse for both genders, whilst current mental health disorder was non-significant for both males and females. Conclusion A significant relationship was found between the child maltreatment and alcohol misuse. This relationship was significantly stronger for maltreated women, which identifies a gap in the literature. High associations between maltreatment and alcohol misuse in females may suggest alcohol is used as a coping strategy following childhood maltreatment.
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Riley BB, Hughes TL, Wilsnack SC, Johnson TP, Benson P, Aranda F. Validating a Hazardous Drinking Index in a Sample of Sexual Minority Women: Reliability, Validity, and Predictive Accuracy. Subst Use Misuse 2017; 52:43-51. [PMID: 27661289 PMCID: PMC5304983 DOI: 10.1080/10826084.2016.1214150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although sexual minority women (SMW) are at increased risk of hazardous drinking (HD), efforts to validate HD measures have yet to focus on this population. OBJECTIVES Validation of a 13-item Hazardous Drinking Index (HDI) in a large sample of SMW. METHODS Data were from 700 adult SMW (age 18-82) enrolled in the Chicago Health and Life Experiences of Women study. Criterion measures included counts of depressive symptoms and post-traumatic stress disorder (PTSD) symptoms, average daily and 30-day ethanol consumption, risky sexual behavior, and Diagnostic and Statistical Manual (DSM-IV) measures of alcohol abuse/dependence. Analyses included assessment of internal consistency, construction of receiver operating characteristic (ROC) curves to predict alcohol abuse/dependence, and correlations between HDI and criterion measures. We compared the psychometric properties (diagnostic accuracy and correlates of hazardous drinking) of the HDI to the commonly used CAGE instrument. RESULTS KR-20 reliability for the HDI was 0.80, compared to 0.74 for the CAGE. Predictive accuracy, as measured by the area under the receiver operating characteristic curve for alcohol abuse/dependence, was HDI: 0.89; CAGE: 0.84. The HDI evidenced the best predictive efficacy and tradeoff between sensitivity and specificity. Results supported the concurrent validity of the HDI measure. CONCLUSIONS The Hazardous Drinking Index is a reliable and valid measure of hazardous drinking for sexual minority women.
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Affiliation(s)
- Barth B Riley
- a Department of Health Systems Science , University of Illinois at Chicago , Chicago , Illinois , USA
| | - Tonda L Hughes
- a Department of Health Systems Science , University of Illinois at Chicago , Chicago , Illinois , USA
| | - Sharon C Wilsnack
- b University of North Dakota School of Medicine and Health Sciences , Grand Forks , North Dakota , USA
| | - Timothy P Johnson
- a Department of Health Systems Science , University of Illinois at Chicago , Chicago , Illinois , USA
| | - Perry Benson
- b University of North Dakota School of Medicine and Health Sciences , Grand Forks , North Dakota , USA
| | - Frances Aranda
- c Rush University Medical Center , Chicago , Illinois , USA
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Rausch MA. Systemic Acceptance of Same-Sex Relationships and the Impact on Intimate Partner Violence Among Cisgender Identified Lesbian and Queer Individuals. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2016. [DOI: 10.1080/15401383.2016.1222322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kecojevic A, Corliss HL, Lankenau SE. Motivations for prescription drug misuse among young men who have sex with men (YMSM) in Philadelphia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:764-71. [PMID: 25936445 DOI: 10.1016/j.drugpo.2015.03.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 02/02/2015] [Accepted: 03/27/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Prescription drug misuse (i.e. opioids, tranquilizers and stimulants) has become the fastest growing area of substance abuse among young adults. Limited studies focus on prescription drug misuse among young men who have sex with men (YMSM, aged 18-29 years). Furthermore, little is known about YMSM's motivations for misuse. The purpose of this study was to explore personal motivations for prescription drug misuse among YMSM, including the possible connection between misuse and sexual behaviors. METHODS As part of a larger mixed methods study of 191 YMSM recruited in Philadelphia during 2012-2013, we conducted semi-structured qualitative interviews with 25 of these participants to gather additional contextual information about their prescription drug misuse. We conducted thematic analysis of qualitative data. RESULTS While our results corroborated previous literature on motives for misuse of prescription drugs, our data yielded some distinct motivations specific among YMSM. These motives included social/recreational motives, facilitating sex with other men (including motives such as use of opioids for less painful anal receptive sex), and psychological motives such as depression, stress management, coping with everyday hardships (opioids and tranquilizers) or feeling more energized (stimulants). Prescription drugs were commonly misused within the broader contexts of participants' polysubstance use, adding to the significance of this problem. CONCLUSIONS Our findings offer insights into YMSM's motivations for prescription drug misuse, and point to the importance of recognizing and addressing them. While substance use is likely related to various psychosocial issues impacting YMSM, it also may lead to significant health consequences. Results support the need to include prescription drugs and polysubstance use in harm reduction messages and treatment approaches aimed at substance using YMSM.
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Affiliation(s)
- Aleksandar Kecojevic
- San Diego State University (SDSU) Graduate School of Public Health, Division of Health Promotion and Behavioral Science, 9245 Sky Park Court, Suite 100, San Diego, CA 92123, United States.
| | - Heather L Corliss
- San Diego State University (SDSU) Graduate School of Public Health, Division of Health Promotion and Behavioral Science, 9245 Sky Park Court, Suite 100, San Diego, CA 92123, United States
| | - Stephen E Lankenau
- Drexel University School of Public Health, Department of Community Health and Prevention, 3215 Market Street, Nesbitt Building, 4th Floor, Philadelphia, PA 19104, United States
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Martin K, Johnson TP, Hughes TL. USING RESPONDENT DRIVEN SAMPLING TO RECRUIT SEXUAL MINORITY WOMEN. SURVEY PRACTICE 2015; 8:273. [PMID: 27761354 DOI: 10.29115/sp-2015-0004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- Kelly Martin
- Department of Health Systems Sciences, College of Nursing, University of Illinois at Chicago, Chicago, IL
| | - Timothy P Johnson
- Survey Research Laboratory, University of Illinois at Chicago, Chicago, IL
| | - Tonda L Hughes
- Department of Health Systems Sciences, College of Nursing, University of Illinois at Chicago, Chicago, IL
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Assis SGD, Gomes R, Pires TDO. [Adolescence, sexual behavior and risk factors to health]. Rev Saude Publica 2014; 48:43-51. [PMID: 24789636 PMCID: PMC4206123 DOI: 10.1590/s0034-8910.2014048004638] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 09/30/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze the relationships between sexual behavior and risk factors to
physical and mental health in adolescents. METHODS Study of 3,195 pupils aged 15 to 19 in secondary education, in public and
private schools in 10 state capitals in Brazil between 2007 and 2008.
Multi-stage (schools and pupils) cluster sampling was used in each city and
public and private educational network. All of the students selected
completed a questionnaire on the following items: socioeconomic and
demographic data; sexual behavior; having sex with those of the same sex,
the opposite sex, or both; alcohol and cannabis use; using condoms;
traumatic sexual experiences as a child or adolescent; suicidal thoughts.
The analysis included describing frequencies, Chi-square test, analysis of
multiple and cluster correspondence. Responses to an open ended question in
which the adolescent expressed general comments about themselves and their
lives were qualitatively analyzed using content analysis. RESULTS Around 3.0% of adolescents reported homosexual or bisexual behavior, with no
difference according to sex, age, skin color, social status family structure
or educational network. Adolescents with homosexual/bisexual sexual
behavior, compared to their heterosexual peers, reported: (p < 0.05):
getting drunk (18.7% and 10.5%, respectively), frequent cannabis use (6.1%
and 2.1%, respectively), suicidal thoughts (42.5% and 18.7%, respectively),
and having been the victim of sexual violence (11.7% and 1.5%;
respectively). Adolescents with homosexual/bisexual sexual behavior reported
that they used condoms less frequently (74.2%) than their heterosexual peers
(48.6%, p < 0.001). In the correspondence analysis, three groups were
found, one composed of adolescents with homosexual/bisexual behavior and
experiencing risk factors; suffering sexual violence, never using a condom,
suicidal thoughts, frequent cannabis use; another composed of occasional
cannabis and condom users, who got drunk frequently, and adolescents with
heterosexual behavior and none of the risk factors investigated. More of the
risk factors were found in adolescents with homosexual/bisexual behavior
compared with those with heterosexual behavior. Adolescents with
homosexual/bisexual sexual behavior were more likely to talk about their
positive personal experiences and negative relationship experiences that
their heterosexual peers, but spoke less about religion. CONCLUSIONS Not only should this issue be studied in more detail, but preventative
actions aimed at adolescents with homosexual/bisexual behavior should be
widened.
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Lehavot K, Browne KC, Simpson TL. Examining sexual orientation disparities in alcohol misuse among women veterans. Am J Prev Med 2014; 47:554-62. [PMID: 25241197 DOI: 10.1016/j.amepre.2014.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 05/26/2014] [Accepted: 07/01/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alcohol misuse is a significant health concern among women veterans, especially among lesbian and bisexual veterans. Mediators that might explain alcohol disparities between heterosexual and sexual minority veterans have not yet been identified. PURPOSE To examine the role of civilian and military traumas and mental health symptoms (i.e., depression, post-traumatic stress disorder) in explaining sexual orientation disparities in alcohol misuse between sexual minority and heterosexual women veterans across the U.S. METHODS Women veterans were recruited using Internet methods to participate in an online, anonymous, national survey (N=699, 37% lesbian or bisexual) from February to May 2013. Path analysis was used to examine a model wherein sexual orientation both directly and indirectly predicted alcohol misuse through trauma exposures and mental health symptoms. Data were analyzed in November 2013. RESULTS Findings indicated significant disparities in alcohol misuse among women veterans by sexual orientation, with indirect effects via childhood trauma, physical victimization in adulthood both during the military and as a civilian, and depressive and post-traumatic stress disorder symptoms. CONCLUSIONS Lesbian and bisexual women veterans reported higher rates of some trauma exposures and mental health symptoms than their heterosexual counterparts, partly accounting for their higher rates of alcohol misuse. Interventions that attend to both victimization and drinking among this population are needed, as well as future research that addresses other factors influencing alcohol misuse.
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Affiliation(s)
- Keren Lehavot
- Mental Illness Research, Education, and Clinical Center, Seattle, Washington; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, Seattle, Washington.
| | - Kendall C Browne
- Mental Illness Research, Education, and Clinical Center, Seattle, Washington; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, Seattle, Washington
| | - Tracy L Simpson
- Mental Illness Research, Education, and Clinical Center, Seattle, Washington; Center of Excellence in Substance Abuse Treatment and Education, Veterans Affairs Puget Sound Health Care System, Seattle, Washington; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, Seattle, Washington
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Sorsdahl K, Stein DJ, Williams DR, Anthony J, Myers B. Childhood Punishment and Risk for Alcohol use Disorders: Data from South Africa. Int J Ment Health Addict 2014. [DOI: 10.1007/s11469-014-9516-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Schneeberger AR, Dietl MF, Muenzenmaier KH, Huber CG, Lang UE. Stressful childhood experiences and health outcomes in sexual minority populations: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2014; 49:1427-45. [PMID: 24643297 DOI: 10.1007/s00127-014-0854-8] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 02/27/2014] [Indexed: 01/05/2023]
Abstract
PURPOSE Stressful childhood experiences (SCE) are associated with many different health outcomes, such as psychiatric symptoms, physical illnesses, alcohol and drug abuse, and victimization experiences. Lesbian, gay, bisexual, and transgender (LGBT) people are at risk to be victims of SCE and show higher prevalence of SCE when compared with heterosexual controls. METHODS This review analyzed systematically 73 articles that addressed different types of SCE in sexual minority populations and included items of household dysfunction. The samples included adults who identified either their sexual orientation as non-heterosexual or their gender identity as transgender. RESULTS The studies reported childhood sexual abuse (CSA), childhood physical abuse (CPA), childhood emotional abuse (CEA), childhood physical neglect, and childhood emotional neglect. Items of household dysfunction were substance abuse of caregiver, parental separation, family history of mental illness, incarceration of caregiver, and witnessing violence. Prevalence of CSA showed a median of 33.5 % for studies using non-probability sampling and 20.7 % for those with probability sampling, the rates for CPA were 23.5 % (non-probability sampling) and 28.7 % (probability sampling). For CEA, the rates were 48.5 %, non-probability sampling, and 47.5 %, probability sampling. Outcomes related to SCE in LGBT populations included psychiatric symptoms, substance abuse, revictimization, dysfunctional behavioral adjustments, and others. CONCLUSIONS LGBT populations showed high prevalence of SCE. Outcomes related to SCE ranged from psychiatric symptoms and disorders to physical ailments. Most studies were based in the USA. Future research should aim to target culturally different LGBT population in the rest of the world.
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Affiliation(s)
- Andres R Schneeberger
- Psychiatrische Dienste Graubuenden (PDGR), Plazza Paracelsus 2, 7500, St. Moritz, Switzerland,
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Dearing RL, Hequembourg AL. Culturally (in)competent? Dismantling health care barriers for sexual minority women. SOCIAL WORK IN HEALTH CARE 2014; 53:739-761. [PMID: 25255338 DOI: 10.1080/00981389.2014.944250] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Lesbian and bisexual (LB) women exhibit elevated rates of a variety of behaviors (i.e., smoking, excessive caloric intake, physical inactivity, heavy alcohol consumption) that put them at risk for adverse health consequences. Furthermore, LB women experience numerous barriers to obtaining culturally competent health care. In this article we review risk behaviors and health care barriers and we discuss the role of stress as an important contributing factor in LB women's health outcomes. We suggest future research, health care delivery changes, and training improvements that will prepare social workers to effectively address the needs of their LB clients.
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Affiliation(s)
- Ronda L Dearing
- a Research Institute on Addictions, University at Buffalo, The State University of New York , Buffalo , New York , USA
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Talley AE, Hughes TL, Aranda F, Birkett M, Marshal MP. Exploring alcohol-use behaviors among heterosexual and sexual minority adolescents: intersections with sex, age, and race/ethnicity. Am J Public Health 2013; 104:295-303. [PMID: 24328614 DOI: 10.2105/ajph.2013.301627] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined sexual orientation status differences in alcohol use among youths aged 13 to 18 years or older, and whether differences were moderated by sex, age, or race/ethnicity. METHODS We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys and conducted weighted analyses, adjusting for complex design effects. We operationalized sexual orientation status with items assessing sexual orientation identity, sexual behavior, sexual attraction, or combinations of these. RESULTS Compared with exclusively heterosexual youths, sexual-minority youths were more likely to report each of the primary study outcomes (i.e., lifetime and past-month alcohol use, past-month heavy episodic drinking, earlier onset of drinking, and more frequent past-month drinking). Alcohol-use disparities were larger and more robust for (1) bisexual youths than lesbian or gay youths, (2) girls than boys, and (3) younger than older youths. Few differences in outcomes were moderated by race/ethnicity. CONCLUSIONS Bisexual youths, sexual-minority girls, and younger sexual-minority youths showed the largest alcohol-use disparities. Research is needed that focuses on identifying explanatory or mediating mechanisms, psychiatric or mental health comorbidities, and long-term consequences of early onset alcohol use, particularly frequent or heavy use, among sexual-minority youths.
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Affiliation(s)
- Amelia E Talley
- Amelia E. Talley is with the Department of Psychology, Texas Tech University, Lubbock. Tonda L. Hughes and Frances Aranda are with the Department of Health Systems Science, the University of Illinois at Chicago. Michelle Birkett is with the Department of Medical Social Sciences, Northwestern University, Chicago. Michael P. Marshal is with the Department of Psychiatry and Pediatrics, the University of Pittsburgh, Pittsburgh, PA
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Sexual victimization, health status, and VA healthcare utilization among lesbian and bisexual OEF/OIF veterans. J Gen Intern Med 2013; 28 Suppl 2:S604-8. [PMID: 23807072 PMCID: PMC3695265 DOI: 10.1007/s11606-013-2357-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Many lesbian and bisexual (LB) women veterans may have been targets of victimization in the military based on their gender and presumed sexual orientation, and yet little is known regarding the health or mental health of LB veterans, nor the degree to which they feel comfortable receiving care in the VA. OBJECTIVE The purpose of this study was to examine the prevalence of mental health and gender-specific conditions, VA healthcare satisfaction and trauma exposure among LB veterans receiving VA care compared with heterosexually-identified women veterans receiving. DESIGN Prospective cohort study of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) women veterans at two large VA facilities. PARTICIPANTS Three hundred and sixty five women veterans that completed a baseline survey. Thirty-five veterans (9.6 %) identified as gay or lesbian (4.7 %), or bisexual (4.9 %). MAIN MEASURES Measures included sexual orientation, military sexual trauma, mental and gender-specific health diagnoses, and VA healthcare utilization and satisfaction. KEY RESULTS LB OEF/OIF veterans were significantly more likely to have experienced both military and childhood sexual trauma than heterosexual women (MST: 31 % vs. 13 %, p < .001; childhood sexual trauma: 60 % vs. 36 %, p = .01), to be hazardous drinkers (32 % vs. 16 %, p = .03) and rate their current mental health as worse than before deployment (35 % vs. 16 %, p < .001). CONCLUSIONS Many LB veterans have experienced sexual victimization, both within the military and as children, and struggle with substance abuse and poor mental health. Health care providers working with female Veterans should be aware of high rates of military sexual trauma and childhood abuse and refer women to appropriate VA treatment and support groups for sequelae of these experiences. Future research should focus on expanding this study to include a larger and more diverse sample of lesbian, gay, bisexual, and transgender veterans receiving care at VA facilities across the country.
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Johnson TP, Hughes TL, Cho YI, Wilsnack SC, Aranda F, Szalacha LA. Hazardous drinking, depression, and anxiety among sexual-minority women: self-medication or impaired functioning? J Stud Alcohol Drugs 2013; 74:565-75. [PMID: 23739020 PMCID: PMC3711347 DOI: 10.15288/jsad.2013.74.565] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Sexual-minority women are at heightened risk for a number of mental health problems, including hazardous alcohol consumption, depression, and anxiety. We examined self-medication and impaired-functioning models of the associations among these variables and interpreted results within a life course framework that considered the unique social stressors experienced by sexual-minority women. METHOD Data were from a sample of 384 women interviewed during the first two waves of the Chicago Health and Life Experiences of Women (CHLEW) study. RESULTS Covariance structure modeling revealed that (a) consistent with a self-medication process, anxiety was prospectively associated with hazardous drinking and (b) consistent with an impaired-functioning process, hazardous drinking was prospectively associated with depression. CONCLUSIONS Our findings support a life course perspective that interprets the mental health of adult sexual-minority women as influenced by adverse childhood experiences, age at drinking onset, first heterosexual intercourse, and first sexual identity disclosure, as well as by processes associated with self-medication and impaired functioning during adulthood.
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Affiliation(s)
- Timothy P. Johnson
- Survey Research Laboratory, University of Illinois at
Chicago, Chicago, Illinois,Correspondence may be sent to Timothy P.
Johnson at the Survey Research Laboratory, University of Illinois at Chicago, 412 S.
Peoria Street, Chicago, IL 60607, or via email at:
| | - Tonda L. Hughes
- Department of Health Systems Science, College of Nursing,
University of Illinois at Chicago, Chicago, Illinois
| | - Young Ik Cho
- Joseph J. Zilber School of Public Health, University of
Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Sharon C. Wilsnack
- Department of Clinical Neuroscience, University of North
Dakota School of Medicine & Health Sciences, Grand Forks, North Dakota
| | - Frances Aranda
- Department of Health Systems Science, College of Nursing,
University of Illinois at Chicago, Chicago, Illinois
| | - Laura A. Szalacha
- Center for Research and Transdisciplinary Scholarship,
The Ohio State University College of Nursing, Columbus, Ohio
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Drabble L, Trocki KF, Hughes TL, Korcha RA, Lown AE. Sexual orientation differences in the relationship between victimization and hazardous drinking among women in the National Alcohol Survey. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2013; 27:639-48. [PMID: 23438246 DOI: 10.1037/a0031486] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study examined relationships between past experiences of victimization (sexual abuse and physical abuse in childhood, sexual abuse and physical abuse in adulthood, and lifetime victimization) and hazardous drinking among sexual minority women compared to exclusively heterosexual women. Data were from 11,169 women responding to sexual identity and sexual behavior questions from three National Alcohol Survey waves: 2000 (n = 3,880), 2005 (n = 3,464), and 2010 (n = 3,825). A hazardous drinking index was constructed from five dichotomous variables (5+ drinking in the past year, drinking two or more drinks daily, drinking to intoxication in the past year, two or more lifetime dependence symptoms, and two or more lifetime drinking-related negative consequences). Exclusively heterosexual women were compared with three groups of sexual minority women: lesbian, bisexual, and women who identified as heterosexual but reported same-sex partners. Each of the sexual minority groups reported significantly higher rates of lifetime victimization (59.1% lesbians, 76% bisexuals, and 64.4% heterosexual women reporting same-sex partners) than exclusively heterosexual women (42.3%). Odds for hazardous drinking among sexual minority women were attenuated when measures of victimization were included in the regression models. Sexual minority groups had significantly higher odds of hazardous drinking, even after controlling for demographic and victimization variables: lesbian (ORadj = 2.0, CI = 1.1-3.9, p < .01; bisexual (ORadj = 1.8, CI = 1.0-3.3, p < .05; heterosexual with same-sex partners (ORadj = 2.7; CI = 1.7-4.3, p < .001). Higher rates of victimization likely contribute to, but do not fully explain, higher rates of hazardous drinking among sexual minority women.
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Reisner SL, Falb KL, Wagenen AV, Grasso C, Bradford J. Sexual orientation disparities in substance misuse: the role of childhood abuse and intimate partner violence among patients in care at an urban community health center. Subst Use Misuse 2013; 48:274-89. [PMID: 23368669 PMCID: PMC3918899 DOI: 10.3109/10826084.2012.755702] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study examined disparities in lifetime substance misuse by sexual orientation among 2,653 patients engaged in care at an urban community health center in Boston, MA, as well as the potential mediating roles of childhood abuse <age 15 (CA) and intimate partner violence (IPV). Violence indicators were highly associated with substance misuse, as was identifying as a sexual minority compared to heterosexual. CA and IPV experiences partly explained disparities in substance abuse by sexual orientation with differences seen by sex. Clinicians should assess history of CA and IPV among sexual minorities presenting with a history of substance abuse disorders. The study's limitations are noted.
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Affiliation(s)
- Sari L Reisner
- The Fenway Institute, Fenway Health, Boston, MA 02215, USA.
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Talley AE, Tomko RL, Littlefield AK, Trull TJ, Sher KJ. The influence of general identity disturbance on reports of lifetime substance use disorders and related outcomes among sexual minority adults with a history of substance use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2012; 25:530-41. [PMID: 21480677 DOI: 10.1037/a0023022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Previous research has shown that sexual minority (i.e., nonheterosexual) individuals report increased problematic substance use involvement, compared with their sexual majority counterparts. We hypothesize that feelings of an unstable sense of self (i.e., identity disturbance) may potentially drive problematic substance use. The purpose of the current study is to examine identity disturbance among sexual minorities as a potential explanatory mechanism of increased sexual minority lifetime rates of substance dependence. Measures of identity disturbance and three indicators of sexual orientation from lifetime female (n = 16,629) and male (n = 13,553) alcohol/illicit drug users in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Findings generally showed that the increased prevalence of alcohol dependence, illicit drug dependence, and combined alcohol/illicit drug dependence as well as a younger age of alcohol use initiation among sexual minority women was associated with elevated levels of identity disturbance. The results were consistent with a mediational role for identity disturbance in explaining the association between sexual minority status and substance dependence and were generally replicated among male sexual minority respondents. The current research suggests that identity disturbance, a predictor of substance use, may contribute to heightened risk for substance dependence among certain subgroups of sexual minority individuals.
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Affiliation(s)
- Amelia E Talley
- Department of Psychological Sciences, University of Missouri-Columbia, 200 South Seventh Street, Columbia, MO 65211-0001, USA.
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Abstract
In this article I describe the historical context for research on sexual minority women's drinking, including the age-old tendency to link homosexuality and alcoholism; I summarize gaps and limitations that characterized much of the research on sexual minority women's drinking over the past several decades; and I review recent literature to highlight progress in the field-with a particular focus on my own research related to risk and protective factors for heavy drinking and drinking-related problems among sexual minority women. I conclude with a discussion of barriers to treatment for sexual minority women and recommendations for substance abuse treatment providers.
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Affiliation(s)
- Tonda Hughes
- University of Illinois at Chicago, College of Nursing, Department of Health Systems Sciences, Chicago, Illinois USA
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Booth BM, Mengeling M, Torner J, Sadler AG. Rape, sex partnership, and substance use consequences in women veterans. J Trauma Stress 2011; 24:287-94. [PMID: 21567476 DOI: 10.1002/jts.20643] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The association of rape history and sexual partnership with alcohol and drug use consequences in women veterans is unknown. Midwestern women veterans (N = 1,004) completed a retrospective telephone interview assessing demographics, rape history, substance abuse and dependence, depression, and posttraumatic stress disorder (PTSD). One third met lifetime criteria for substance use disorder (SUD), half reported lifetime completed rape, a third childhood rape, one quarter in-military rape, 11% sex with women. Lifetime SUD was higher for women with rape history (64% vs. 44%). Women with women as sex partners had significantly higher rates of all measures of rape, and also lifetime substance use disorder. Postmilitary rape, sex partnership, and current depression were significantly associated with lifetime SUD in multivariate models (odds ratio = 2.3, 3.6, 2.1, respectively). Many women veterans have a high need for comprehensive mental health services.
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Affiliation(s)
- Brenda M Booth
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
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40
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Condit M, Kitaji K, Drabble L, Trocki K. Sexual Minority Women and Alcohol: Intersections between drinking, relational contexts, stress and coping. JOURNAL OF GAY & LESBIAN SOCIAL SERVICES 2011; 23:351-375. [PMID: 22228984 PMCID: PMC3252391 DOI: 10.1080/10538720.2011.588930] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Few studies explore sexual minority women's experiences and perceptions of alcohol. Qualitative interviews were conducted with six sexual minority women who reported having sought help for alcohol problems in the past and six who did not. Themes emerged in two broad areas: stressors that contributed to heavy or problem drinking and factors that enhanced coping and reduced both stress and problem use. Alcohol use across groups was framed in terms of social context (e.g., bar patronage), stress management, and addiction. The findings of the study underscore the importance of considering the role of alcohol in managing stress as well coping factors that may inform social service interventions.
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Cheng HG, Huang Y, Anthony JC. Childhood physical punishment and later alcohol drinking consequences: evidence from a Chinese context. J Stud Alcohol Drugs 2011; 72:24-33. [PMID: 21138708 PMCID: PMC3001678 DOI: 10.15288/jsad.2011.72.24] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 07/06/2010] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The aim of the current study is to estimate a link between early physical punishment in childhood and later alcohol outcomes, taking family history of drinking problems into account, with epidemiological data from China. The yield from previous studies on this relationship is mixed evidence, largely traceable to research design variations, including model specifications that concern parental alcohol or other drug problems (AODPs) that might account for both earlier discipline practices and later drinking problems in the offspring. METHOD Data are from the World Mental Health Surveys-metropolitan China study, with cross-sectional representative sample surveys of adult household residents living in two metropolitan cities, Beijing and Shanghai. Participants in this general mental health survey were asked about early life experiences (e.g., parental AODP, childhood misbehavior), as well as their own drinking outcomes. Stratification was used to control for parental AODP. RESULTS Logistic regressions found robust associations linking childhood physical punishment with drinking outcomes, even with stratification for parental AODP and childhood misbehavior. CONCLUSIONS These results from a cross-sectional survey lay a foundation for future prospective and longitudinal research on possible causal relationships that link childhood physical punishment with later drinking outcomes in China.
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Affiliation(s)
- Hui G. Cheng
- Department of Epidemiology, B601 West Fee Hall, Michigan State University, East Lansing, Michigan 48824
| | - Yueqin Huang
- Department of Epidemiology, B601 West Fee Hall, Michigan State University, East Lansing, Michigan 48824
| | - James C. Anthony
- Department of Epidemiology, B601 West Fee Hall, Michigan State University, East Lansing, Michigan 48824
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Hughes TL, Szalacha LA, Johnson TP, Kinnison KE, Wilsnack SC, Cho Y. Sexual victimization and hazardous drinking among heterosexual and sexual minority women. Addict Behav 2010; 35:1152-6. [PMID: 20692771 DOI: 10.1016/j.addbeh.2010.07.004] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2010] [Accepted: 07/14/2010] [Indexed: 11/29/2022]
Abstract
AIMS Although research shows that sexual minority women report high rates of lifetime sexual victimization and high rates of hazardous drinking, investigators have yet to explore the relationships between sexual victimization and hazardous drinking in this population. In addition, because the rates of these problems may vary within the sexual minority population, we examined and compared relationships between sexual victimization and hazardous drinking in exclusively heterosexual and sexual minority (mostly heterosexual, bisexual, mostly lesbian and exclusively lesbian) women. METHOD Data from 548 participants in the National Study of Health and Life Experiences of Women and 405 participants in the Chicago Health and Life Experiences of Women study were pooled to address these relationships. We compared hazardous drinking, childhood sexual abuse (CSA), adult sexual assault (ASA), and revictimization (both CSA and ASA) across the five sexual identity subgroups. We then fit a multilevel general linear model to examine group differences in the relationships between hazardous drinking and sexual victimization and to test for potential interactions between victimization and identity on hazardous drinking. RESULTS Sexual minority women reported higher levels of hazardous drinking and higher rates of CSA and sexual revictimization than did exclusively heterosexual women. Revictimization was the strongest predictor of hazardous drinking among women who identified as mostly heterosexual and mostly lesbian. CONCLUSIONS This study extends previous research by examining associations between sexual victimization and hazardous drinking in heterosexual and sexual minority women and by exploring within-group variations in these associations among sexual minority women. Higher rates of lifetime sexual victimization and revictimization may help to explain sexual minority women's heightened risk for hazardous drinking. The findings highlight the need for additional research that examines the meanings of sexual identity labels to more fully understand differences in risk within groups of sexual minority women as well as how sexual identity may affect responses to and interpretations of sexual victimization.
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Affiliation(s)
- Tonda L Hughes
- University of Illinois at Chicago, College of Nursing (M/C 802), 845 South Damen Avenue, Room 956, Chicago, IL 60612, United States.
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Cheng HG, Anthony JC, Huang Y. Harsh physical punishment as a specific childhood adversity linked to adult drinking consequences: evidence from China. Addiction 2010; 105:2097-105. [PMID: 20854335 PMCID: PMC2975861 DOI: 10.1111/j.1360-0443.2010.03079.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS The aim of the current study is to estimate the association between childhood physical punishment (CPP) and level of alcohol use disorder (AUD), using two different approaches to take other childhood adversities into account. DESIGN AND SETTING Population survey using face-to-face interviews to a representative sample of non-institutionalized adult residents of Beijing and Shanghai, China. PARTICIPANTS A total of 5201 participants aged 18-70 years. MEASUREMENTS A version of the World Mental Health Composite International Diagnostic Interview was used. Standardized assessments covered early life experiences of childhood physical punishment, other childhood adversities, parental drinking problems, childhood conduct problems and clinical features of AUD. FINDINGS A robust association linking CPP and level of AUD was found, holding other childhood adversities constant (probit coefficient = 0.70, 95% CI = 0.40, 1.00) via covariate terms in structural equations modeling. Furthermore, there was evidence that CPP might exert an additional influence on level of AUD over and above a generally noxious family environment (probit coefficient = 0.20, 95% CI = 0.02, 0.38). CONCLUSIONS There appears to be a robust association between reports of harsh punishment in childhood and alcohol dependence in adulthood adjusting for a range of possible confounding factors. Whether the association is causal or whether both are related to a common underlying factor or recall bias needs to be investigated further.
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Affiliation(s)
- Hui G. Cheng
- Peking University Institute of Mental Health, Key Laboratory of Ministry of Health (Peking University), Department of Epidemiology, Michigan State University, B601 West Fee Hall, East Lansing, Michigan 48824, USA
| | - James C. Anthony
- Department of Epidemiology, Michigan State University, B601 West Fee Hall, East Lansing, Michigan 48824, USA
| | - Yueqin Huang
- Peking University Institute of Mental Health, Key Laboratory of Ministry of Health (Peking University)
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Hughes T, McCabe SE, Wilsnack SC, West BT, Boyd CJ. Victimization and substance use disorders in a national sample of heterosexual and sexual minority women and men. Addiction 2010; 105:2130-40. [PMID: 20840174 PMCID: PMC3006226 DOI: 10.1111/j.1360-0443.2010.03088.x] [Citation(s) in RCA: 182] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
CONTEXT There is consensus in the research literature that substance use disparities exist among sexual minority women and men; however, few studies have examined risk factors that may contribute to these disparities. AIMS To compare reports of life-time victimization experiences in a US national sample of adult heterosexual and sexual minority women and men and to examine the relationships between victimization experiences and past-year substance use disorders. DESIGN, PARTICIPANTS, MEASUREMENTS The secondary data analyses used 2004-05 (wave 2) National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) data collected in structured diagnostic face-to-face interviews in the United States. Substance use disorders (SUDs) were defined according to DSM-IV criteria and included past-year alcohol abuse, alcohol dependence, drug abuse and drug dependence. The sample consisted of 34 653 adults aged 20 years and older; approximately 2% of the respondents self-identified as sexual minority (lesbian, gay or bisexual). FINDINGS Results showed strong associations between victimization and any past-year SUDs and confirmed findings from several previous studies indicating that, compared with heterosexuals, sexual minority women and men are at heightened risk for life-time victimization. However, prevalence of the seven victimization experiences and the degree of association between individual victimization experiences and SUDs varied substantially across sexual minority subgroups. The childhood victimization variables-especially childhood neglect-showed the strongest and most consistent associations with SUDs. Odds of SUDs were generally higher among both female and male respondents, regardless of sexual identity, who reported multiple (two or more) victimization experiences than among those who reported no life-time victimization, suggesting a possible cumulative effect of multiple victimization experiences. CONCLUSIONS Higher rates of life-time victimization, particularly victimization experienced in childhood, may help to explain higher rates of substance use disorders among sexual minorities. However, more research is needed to understand better the complex relationships among sexual orientation, victimization and substance use.
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Affiliation(s)
- Tonda Hughes
- College of Nursing (MC 802), University of Illinois at Chicago, Chicago, IL 60612-7350, USA.
| | - Sean Esteban McCabe
- Substance Abuse Research Center, Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA
| | - Sharon C. Wilsnack
- Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
| | - Brady T. West
- Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Carol J. Boyd
- Institute for Research on Women and Gender, School of Nursing and Women’s Studies Department, University of Michigan, Ann Arbor, MI, USA
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Comparison of childhood sexual histories in subjects with pedophilia or opiate addiction and healthy controls: is childhood sexual abuse a risk factor for addictions? J Psychiatr Pract 2010; 16:394-404. [PMID: 21107144 DOI: 10.1097/01.pra.0000390758.27451.79] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Given the recent interest in the concept of sexual addictions, it is instructive to study subjects with pedophilia alongside chemically addicted individuals and non-addicted controls in order to help identify which factors may determine the objects of people's respective addictions, as well as any factors that may predispose people to developing an addictive disorder. METHOD In this study, we considered whether childhood sexual abuse (CSA) is a specific risk factor for pedophilia as opposed to other types of addictive disorders by comparing the childhood sexual histories of 48 pedophilic sex offenders, 25 subjects with opiate addiction in remission, and 61 healthy controls. CSA was assessed with The Sexual History Questionnaire and the Child Trauma Questionnaire (CTQ). RESULTS Compared with both opiate addicted subjects and healthy controls, subjects with pedophilia were more likely to report experiencing adult sexual advances when they were children and a first sexual contact by age 13 with a partner at least 5 years older. Although both subjects with pedophilia and those with opiate addiction first had sex at a younger age than healthy controls, opiate addicted subjects, compared with healthy controls, reported neither increased reception of sexual advances as children nor increased rates of first sexual contact before age 13 with a partner at least 5 years older. Further, subjects with pedophilia but not those with opiate addiction scored significantly higher than healthy controls on the CTQ. CONCLUSION Sexual abuse in childhood may be a specific risk factor for sexual addictions such as pedophilia but may not be a specific risk factor for chemical addictions.
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Balsam KF, Lehavot K, Beadnell B, Circo E. Childhood abuse and mental health indicators among ethnically diverse lesbian, gay, and bisexual adults. J Consult Clin Psychol 2010; 78:459-68. [PMID: 20658803 PMCID: PMC2911995 DOI: 10.1037/a0018661] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Prior research has established that lesbian, gay, and bisexual (LGB) people experience higher rates of childhood abuse than heterosexuals. However, there has been little research on the mental health impact of these experiences or how race/ethnicity might influence prevalence and mental health impact of childhood abuse in this population. The study's objective was to examine the relationships between race/ethnicity, childhood abuse, and mental health indicators in a national sample of LGB adults. METHOD Participants were recruited via the Internet through snowball and targeted sampling methods. Six hundred and sixty-nine LGB adults, 21% of whom were people of color, participated in an online survey. Participants completed the Childhood Trauma Questionnaire-Short Form, the Center for Epidemiologic Studies Depression Scale, the Patient Health Questionnaire Generalized Anxiety Disorder Scale, the Posttraumatic Stress Disorder (PTSD) Checklist-Civilian Version, and the Perceived Stress Scale-Short Form. RESULTS Latina/o and Asian American participants reported the highest levels of physical abuse (p < .01), and Latina/o and African American participants reported the highest levels of sexual abuse (p < .01). Childhood emotional abuse was the strongest predictor of psychopathology symptoms for all participants (ps < .01). Relative to White participants, emotional abuse showed a stronger relationship with PTSD and anxiety symptoms for African American participants (ps < .01), and physical abuse showed a stronger relationship with PTSD and anxiety symptoms for Latina/o participants (ps < .05). CONCLUSIONS Race/ethnicity may be an important factor when examining childhood abuse and mental health correlates among LGB populations.
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Affiliation(s)
- Kimberly F Balsam
- School of Social Work, University of Washington, Seattle, WA 98195, USA.
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Jun HJ, Austin SB, Wylie SA, Corliss HL, Jackson B, Spiegelman D, Pazaris MJ, Wright RJ. The mediating effect of childhood abuse in sexual orientation disparities in tobacco and alcohol use during adolescence: results from the Nurses' Health Study II. Cancer Causes Control 2010; 21:1817-28. [PMID: 20640883 DOI: 10.1007/s10552-010-9609-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Accepted: 06/23/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine the mediating effect of childhood abuse on sexual orientation disparities in tobacco and alcohol use during adolescence. METHODS We carried out analyses with data from over 62,000 women in the ongoing Nurses' Health Study II cohort who provided information on sexual orientation, childhood abuse occurring by age 11, and tobacco and alcohol use in adolescence. We used multivariate regression analyses, controlling for confounders, to estimate the mediating effect of childhood abuse on the association between sexual orientation and tobacco and alcohol use in adolescence. RESULTS Lesbian and bisexual orientation and childhood abuse were positively associated with greater risk of tobacco and alcohol use during adolescence. For lesbians, the estimated proportion of excess tobacco and alcohol use in adolescence relative to use among heterosexual women that was mediated by abuse in childhood ranged from 7 to 18%; for bisexual women, the estimated proportion of excess use mediated by abuse ranged from 6 to 13%. CONCLUSIONS Elevated childhood abuse in lesbian and bisexual women partially mediated excess tobacco and alcohol use in adolescence relative to heterosexual women. Interventions to prevent child abuse may reduce sexual orientation disparities in some of the leading causes of cancer in women.
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Affiliation(s)
- Hee-Jin Jun
- Channing Laboratory, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
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Corte C, Rongmuang D, Farchaus Stein K. Nursing knowledge about alcohol use and alcohol problems in women: a review of the literature. J Am Psychiatr Nurses Assoc 2010; 16:252-61. [PMID: 21659277 PMCID: PMC5002222 DOI: 10.1177/1078390310378042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this article, the authors review the nursing empirical literature on alcohol and women's health published over the past 5 years (2005-2010). A total of 36 data-based articles authored by nurse investigators met eligibility criteria and were included in this review. Most were single studies by individual nurse investigators; few studies reflected ongoing programs of research related to alcohol and women's health. Studies were categorized into four main groups, including (a) determinants of alcohol use and alcohol problems; (b) patterns of use, assessment of alcohol use, and comorbidity; (c) consequences of alcohol use; and (d) the effects of treatment or specific interventions and the contributions of nursing research to the knowledge base of each group are summarized. The authors then propose a research agenda for nursing that addresses the most pressing issues related to alcohol use and alcohol problems in women.
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Affiliation(s)
- Colleen Corte
- University of Illinois at Chicago, Chicago, IL, USA,
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Wylie SA, Corliss HL, Boulanger V, Prokop LA, Austin SB. Socially assigned gender nonconformity: A brief measure for use in surveillance and investigation of health disparities. SEX ROLES 2010; 63:264-276. [PMID: 24077680 DOI: 10.1007/s11199-010-9798-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Discrimination and violence targeting people perceived as gender nonconforming have been linked to a range of negative health outcomes, and large-scale representative data are needed to begin population surveillance of associated health disparities. A brief self-report measure of gender expression as perceived by others was tested using cognitive interviewing methods in a diverse sample of 82 young adults aged 18-30 years, recruited from the New England region in the U.S. Results identified themes related to item clarity, gender expression variation, undesirability of highest or lowest ends of item range, and tension between self and others' perceptions. The item performed as expected and is recommended for use on studies of health disparities, including statewide and national public health surveillance tools.
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Affiliation(s)
- Sarah A Wylie
- Division of Adolescent and Young Adult Medicine, Children's Hospital, Boston, MA, USA
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Bostwick WB, Boyd CJ, Hughes TL, McCabe SE. Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. Am J Public Health 2009; 100:468-75. [PMID: 19696380 DOI: 10.2105/ajph.2008.152942] [Citation(s) in RCA: 481] [Impact Index Per Article: 32.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We used data from a nationally representative sample to examine the associations among 3 dimensions of sexual orientation (identity, attraction, and behavior), lifetime and past-year mood and anxiety disorders, and sex. METHODS We analyzed data from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. RESULTS Mental health outcomes differed by sex, dimension of sexual orientation, and sexual minority group. Whereas a lesbian, gay, or bisexual identity was associated with higher odds of any mood or anxiety disorder for both men and women, women reporting only same-sex sexual partners in their lifetime had the lowest rates of most disorders. Higher odds of any lifetime mood or anxiety disorder were more consistent and pronounced among sexual minority men than among sexual minority women. Finally, bisexual behavior conferred the highest odds of any mood or anxiety disorder for both males and females. CONCLUSIONS Findings point to mental health disparities among some, but not all, sexual minority groups and emphasize the importance of including multiple measures of sexual orientation in population-based health studies.
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