Cumulative Stress and Hazardous Drinking in a Community Sample of Adult Lesbians

描述（由申请人提供）：使用概率和非概率样本的研究提供了充分的证据，证明女同性恋容易受到有害饮酒的影响。然而，人们对增加女同性恋酗酒风险的因素知之甚少。我们建议在性别认同和饮酒关系研究的基础上进行扩展，使用横断面和纵向数据来模拟累积压力对女同性恋危险饮酒的影响。女同性恋者的创伤性事件发生率很高。除了这些急性压力源之外，还有性少数群体特有的慢性压力源，造成了累积的压力，这可能会在有色人种的女同性恋中加剧。数据将从2000年和2004年之前采访的384名成年女同性恋者（50%是种族/少数民族）和一个新的小组（n=250）中收集，通过受访者驱动的抽样，对年轻（18-25岁），黑人和拉丁裔女同性恋者进行过抽样。数据将由训练有素的女性采访者在电脑辅助下进行个人访谈。该研究的具体目的是：(1)使用横断面数据测试女同性恋者累积压力和危险饮酒之间关系的模型；(2)利用新调查和之前调查（原始样本为3个时间点）的纵向数据，检验早期和晚期危险因素与有害饮酒之间的关系模型；(3)比较我们的女同性恋样本和来自全国妇女健康与生活经历研究（NSHLEW）的异性恋女性亚样本中早期和后期风险因素与有害饮酒之间的纵向模型。横断面分析将允许更全面地评估种族/少数民族、年龄和队列对有害饮酒的影响。我们将使用结构方程模型来确定早期风险因素（如儿童期性虐待）和成年风险因素（如成年性侵犯、性少数压力源和种族/少数民族压力源）的积累是否能预测女同性恋的危险饮酒，并确定危险饮酒风险最高的女同性恋的特征。纵向分析将使我们能够检查饮酒模式的变化和随时间的问题，并比较NSHLEW中女同性恋和异性恋女性饮酒变化的模式和预测因素。拟议的研究与2000年和2004年的调查相结合，将提供迄今为止关于女同性恋危险饮酒的特点和决定因素的最全面的数据。这些信息对于阐明妇女各亚群体之间的异同和规划预防和治疗战略以有效地满足这些群体的需要至关重要。研究结果将对确定危险饮酒风险最大的群体和制定具有文化敏感性的预防和干预战略具有重要的科学和公共卫生意义。

DESCRIPTION (provided by applicant): Studies using both probability and nonprobability samples provide ample evidence of lesbians' vulnerability to hazardous drinking. However, very little is known about the factors that increase lesbians' risk for hazardous drinking. We propose to build on and extend our study of sexual identity and drinking, using both cross-sectional and longitudinal data to model effects of cumulative stress on hazardous drinking among lesbians. Lesbians report high rates of traumatic events. Added to these acute stressors are chronic stressors unique to sexual minorities, creating cumulative stress that may be compounded in lesbians of color. Data will be collected from a large, diverse sample of 384 adult lesbians (50% racial/ethnic minority) interviewed previously in 2000 and 2004 and from a new panel (n=250) recruited by respondent-driven sampling, with oversampling of young (age 18-25), Black, and Latina lesbians. Data will be collected in computer-assisted personal interviews conducted by highly trained female interviewers. The specific aims of the proposed study are (1) to test models of the relationships between cumulative stress and hazardous drinking in lesbians using cross-sectional data; (2) to test models of the relationships between early and later risk factors and hazardous drinking using longitudinal data from the new survey and our previous surveys (3 time points for the original sample); and (3) to compare longitudinal models of associations among early and later risk factors and hazardous drinking in our lesbian sample and in a subsample of heterosexual women from the National Study of Health and Life Experiences of Women (NSHLEW). Cross-sectional analyses will permit fuller assessment of racial/ethnic minority, age and cohort effects on hazardous drinking. We will use structural equation modeling to determine whether the accumulation of early risk factors (e.g., childhood sexual abuse) and adult risk factors (e.g., adult sexual assault, sexual- minority stressors, and racial/ethnic-minority stressors) predict hazardous drinking in lesbians, and to identify characteristics of lesbians at highest risk for hazardous drinking. Longitudinal analyses will allow us to examine changes in drinking patterns and problems over time, and to compare patterns and predictors of drinking changes in lesbians with those among heterosexual women in the NSHLEW. The proposed study, combined with the 2000 and 2004 surveys, will provide the most comprehensive data yet available on the characteristics and determinants of hazardous drinking among lesbians. Such information is critical for explicating similarities and differences across subgroups of women and for planning prevention and treatment strategies to effectively target the needs of these groups. Findings will have important scientific and public health implications for identifying groups at greatest risk for hazardous drinking and for developing culturally sensitive prevention and intervention strategies.