Developmental Pathways of Substance Use among Sexual Minority Women

 描述(由申请人提供)：性少数族裔妇女中的酒精和药物滥用(SMW)在美国是一个日益受到认可的公共卫生问题。在众多具有全国代表性的样本中，SMW人群报告了一生中较高的物质使用和障碍(SU/D)率，并进一步报告了儿童和青春期作为污名化群体成员的更高水平的逆境。1，2尽管少数群体压力模型表明，较高水平的逆境可能解释性别少数群体之间的心理健康差异，3，4很少有研究研究SMW在整个发展阶段的逆境对预测晚年SU/D的影响；没有人研究这一拟议途径的心理中介因素；也没有人研究这一发展途径的调节因素。本提案的目的是研究逆境对跨发展的SU/D心理风险因素的影响，并解决降低SMW中以后SU/D风险的保护性因素。具体地说，这项拟议的研究将测试儿童和青春期SMW的逆境和随后情绪失调(ED)的增加是否导致青春期SU/D水平较高，并将研究青春期同龄人和父母的社会支持是否缓冲了这一拟议的风险途径。数据将来自参与匹兹堡女孩研究的2278名异性恋女性和173名性少数族裔女性。匹兹堡女孩研究是一个大的、多样化的样本，跟踪调查了从5岁到23岁的市中心女孩，并包含了SMW的一个大的纵向样本，以满足拟议的研究目标。本研究将运用因子分析、潜在成长曲线模型(LGM)和多组结构方程模型(SEM)来检验1)儿童期和青春期的ED和逆境经历是否可以预测青春期SU/D的增加和更高水平；2)ED是否中介逆境和SMW状态对SU/D的影响，以及ED是否调节青春期逆境对SU/D的影响；以及3)社会支持是否在性取向群体中调节ED和早期和青春期逆境对后来SU/D的影响。解决这些问题将为预防和治疗干预努力提供信息，以减少女同性恋者、男同性恋者和双性恋者群体中物质障碍的流行率，方法是及早确定与发育过程中的性少数群体相关的环境风险因素；确定对女同性恋者、男同性恋者和双性恋者的物质使用和障碍有直接影响的目标心理过程；以及在高危人群的社会支持的背景下解决风险和复原力。

 DESCRIPTION (provided by applicant): Alcohol and drug abuse among sexual minority women (SMW) is an increasingly recognized public health concern in the United States. Across a multitude of nationally-representative samples, SMW populations report higher rates of substance use and disorder (SU/D) across the lifespan, and further report greater levels of adversity in both childhood and adolescence as members of a stigmatized group.1,2 Although minority stress models suggest that higher levels of adversity may explain mental health disparity among sexual minority populations,3,4 few studies have examined the impact of adversity across development among SMW in predicting SU/D in later life; none have examined psychological mediators of this proposed pathway; and none have examined moderators of this developmental pathway. The goal of the present proposal is to examine the impact of adversity on psychological risk factors of SU/D across development and address protective factors that reduce risk for later SU/D among SMW. Specifically, the proposed study will test whether adversity and subsequent increases in emotion dysregulation (ED) among SMW in childhood and adolescence account for higher levels of SU/D through young adulthood, and will examine whether social support from peers and parents within adolescence buffers this proposed risk pathway. Data will be drawn from 2,278 heterosexual and 173 sexual minority women who participated in the Pittsburgh Girls Study. The Pittsburgh Girls Study is a large, diverse sample of inner-city girls followed prospectively from age 5 to age 23, and contains a large longitudinal sample of SMW ideal for addressing the proposed study aims. Factor analysis, latent growth curve modeling (LGM), and multi-group structural equation modeling (SEM) will be used to test 1) whether ED and adversity experiences in childhood and adolescence predict increases and higher levels of SU/D through young adulthood; 2) whether ED mediates the effects of adversity and SMW status on SU/D, and whether ED moderates the impact of adolescent adversity on SU/D; and 3) whether social support moderates the effect of ED and early and adolescent adversity on later SU/D across sexual orientation groups. Addressing these questions will inform both preventative and treatment intervention efforts to reduce the prevalence of substance disorder among lesbian, gay, and bisexual populations by informing the early identification of environmental risk factors associated with sexual minority status across development; by identifying target psychological processes that have a direct impact on substance use and disorder among lesbian, gay, and bisexual individuals; and by addressing risk and resilience in the context of social support within this at-risk population.