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女同性恋者对危险饮酒的脆弱性的充分证据。然而，人们对增加女同性恋者危险饮酒风险的因素知之甚少。我们建议建立和扩展我们的性身份和饮酒的研究，使用横截面和纵向数据来模拟女同性恋者危险饮酒的累积压力的影响。女同性恋者报告创伤事件的发生率很高。除了这些急性压力源外，还有性少数群体特有的慢性压力源，造成了累积的压力，这种压力可能会在有色人种女同性恋者中加剧。数据将收集从一个大的，多样化的样本384成年女同性恋者（50%的种族/少数民族）采访了以前在2000年和2004年，并从一个新的面板（n=250）招募的受访者驱动的抽样，与过抽样的年轻（18-25岁），黑人和拉丁裔女同性恋者。数据将由训练有素的女性访谈员通过计算机辅助个人访谈收集。本研究的具体目的是：（1）使用横截面数据检验女同性恋者累积压力与危险饮酒之间关系的模型;（2）使用新调查和我们以前调查的纵向数据检验早期和晚期危险因素与危险饮酒之间关系的模型（原始样品的3个时间点）;以及（3）在我们的女同性恋样本和来自全国妇女健康和生活经历研究的异性恋妇女子样本中，比较早期和晚期风险因素与危险饮酒之间关联的纵向模型（NSHLEW）。横断面分析将允许更全面的评估种族/少数民族，年龄和队列对危险饮酒的影响。我们将使用结构方程模型来确定早期风险因素的积累（例如，儿童期性虐待）和成人风险因素（例如，成人性侵犯、性少数压力源和种族/民族少数压力源）预测女同性恋者的危险饮酒，并确定危险饮酒风险最高的女同性恋者的特征。纵向分析将使我们能够检查饮酒模式和问题的变化，随着时间的推移，并比较模式和预测的饮酒变化的女同性恋者与异性恋妇女在NSHLEW。拟议的研究，加上2000年和2004年的调查，将提供迄今为止关于女同性恋者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之间的相似性和差异以及规划有效针对这些群体的需要的预防和治疗战略至关重要。研究结果将对确定危险饮酒风险最大的群体和制定文化敏感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.