The Influence of Multilevel Minority Stress on Hazardous Drinking among Sexual Minority Women

性少数群体妇女(如女同性恋者、双性恋者)是危险的最高风险群体之一 饮酒(HD；将个人置于有害风险中的酒精消耗量或模式 后果包括大量间歇性饮酒，不良饮酒后果，醉酒，以及 依赖症状)。SMW比异性恋妇女更有可能报告HD的指标； 例如，他们过去一年出现酒精依赖症状的几率是其他人的3-7倍。主要的解释是 因为这种差异是SMW暴露在少数群体压力源(例如，耻辱、歧视)下。然而，研究表明 主要集中在个人(例如，污名意识)或人际(例如，歧视)层面 各种因素。相对较少的研究考虑了结构性水平的少数群体压力来源(例如，歧视性法律或 政策)，而更少的人同时研究了不同水平的少数族裔压力对#年HD的影响 SMW。更好地了解多层次少数群体的动态、背景和相互关联的影响 压力源可以为预防和干预策略提供信息。在提议的博士后奖学金中，我将 通过结合《芝加哥健康与生活》21年纵向调查的数据来研究这些关系 妇女研究的经验(CHLEW；R01AA013328-14；T.Hughes，PI[主要导师])和公开 使用先前验证的国家LGBT政策指数，可获得与结构水平少数群体压力相关的数据 环境。在整合社会、生态和少数民族压力模式的指导下，具体目标 目的是：(1)研究个体水平的少数群体应激源(即，耻辱意识， 内在化污名/同性恋恐惧症)与过去一年的HD；(2)检验人际层面的关联 少数民族压力来源(例如，性别身份歧视、家庭对性身份披露的反应) 年的HD，同时考虑到个人层面的少数人应激源；以及(3)检查结构性- 过去一年HD水平的少数群体压力源(即国家LGBT政策环境)，同时考虑到个人 以及人际层面的少数民族压力源。认识到法定最低工资之间的多样性，就三项目标中的每一项而言 还将探讨性别身份(即女同性恋、双性恋)和种族/民族(即黑人、 白人，拉丁裔)。拟议的目标与国家酒精滥用和酒精中毒研究所(NIAAA)保持一致 研究目标和优先事项，以提供关于酒精滥用和精神障碍的预防战略 这项研究的目的是调查不同年龄段的人，并调查饮酒的社会文化根源。使用 由杰出研究人员组成的导师团队，在哥伦比亚资源丰富的环境中 在大学期间，我将发展酒精流行病学的专业知识和技能，多层次的少数民族压力，以及 先进的量化方法。我将在负责任的行为中获得经验和专业技能 研究、多学科合作、大手笔和学术写作。这将有助于建立一个强大的 基金会为我的独立研究事业发展专注于减少SMW中的高清。

Sexual minority women (SMW; e.g., lesbian, bisexual) represent one of the highest-risk groups for hazardous drinking (HD; a quantity or pattern of alcohol consumption that places individuals at risk for harmful consequences that includes heavy episodic drinking, adverse drinking consequences, intoxication, and dependence symptoms). SMW are much more likely than heterosexual women to report indicators of HD; for example, they have 3-7 times higher odds of past-year alcohol dependence symptoms. The major explanation for this disparity is SMW’s exposure to minority stressors (e.g., stigma, discrimination). However, research has been largely focused on individual- (e.g., stigma consciousness) or interpersonal- (e.g., discrimination) level factors. Relatively little research has considered structural-level minority stressors (e.g., discriminatory laws or policies) and even less has simultaneously examined the impact of multiple levels of minority stress on HD in SMW. Greater understanding of the dynamic, contextual, interrelated impact of multiple levels of minority stressors can inform prevention and intervention strategies. In the proposed predoctoral fellowship, I will investigate these relationships by combining data from the 21-year longitudinal Chicago Health and Life Experiences of Women study (CHLEW; R01AA013328-14; T. Hughes, PI [primary mentor]) and publicly available data related to structural level minority stress, using a previously validated index of state LGBT policy environment. Guided by an integration of the Social Ecological and Minority Stress Models, the specific aims are to: (1) Examine the associations of individual-level minority stressors (i.e., stigma consciousness, internalized stigma/homophobia) with past year HD; (2) Examine the associations of interpersonal-level minority stressors (i.e., sexual identity discrimination, family reactions to sexual identity disclosure) with past year HD while accounting for individual-level minority stressors; and (3) Examine the association of structural- level minority stressors (i.e., state LGBT policy environment) with past year HD while accounting for individual and interpersonal-level minority stressors. Recognizing the diversity among SMW, for each of the three aims I will also explore potential differences by sexual identity (i.e., lesbian, bisexual) and race/ethnicity (i.e., Black, White, Latina). The proposed aims align with the National Institute on Alcohol Abuse and Alcoholism (NIAAA) research goals and priorities to inform prevention strategies for alcohol misuse and disorders among individuals across the lifespan and to investigate socio-cultural origins of alcohol use. Working with a mentorship team of prominent researchers, and within the highly resourced environment of Columbia University, I will develop expertise and skills in alcohol epidemiology, multiple levels of minority stress, and advanced quantitative methods. I will gain experience and professional skills in the responsible conduct of research, multidisciplinary collaboration, grantsmanship, and academic writing. This will serve to build a strong foundation for the development of my independent research career focused on reducing HD among SMW.