Stress Reactivity and Substance Use among Sexual Minority Girls

描述（由申请人提供）：本研究的中心目标是检查性少数女孩（SMG;报告同性吸引、同性性行为和/或双性恋或女同性恋身份的女孩）对社会和同性恋相关压力源的生理和情感反应，以及她们与药物使用和滥用的预期关联。少数压力理论（MST; Meyer，2003年）声称，歧视，暴力和受害是SMG之间物质使用和其他心理健康差异的主要驱动机制。提议的PI最近发表的几项研究支持这一假设。荟萃分析结果显示，与异性恋女孩相比，SMG使用药物和酒精的可能性高出400%（Marshal et al 2008），轨迹分析显示，随着SMG过渡到年轻成年期，这种差异可能会增加（Marshal et al 2009，2012）。另外两项研究表明，与异性恋女孩相比，SMG经历自杀倾向的可能性几乎高出300%，报告在学校遭到袭击的可能性高出300%以上（Friedman，Marshal等人，2011; Marshal等人，2011）。本研究将招募 120名14-18岁的少女（50% SMG，50%非裔美国人），以解决拟议的目标。我们提出了一个修改后的少数民族压力模型，声称生理和情绪压力反应是少数民族压力过程的重要组成部分，以及SMG之间物质使用和其他心理健康结果的途径的介质。我们的具体目标是：（1）使用生态瞬时评估（EMA）来记录日常社会和同性恋相关的压力源，检查这些压力源与物质使用、抑郁和HIV风险行为之间的“真实的时间”联系;（2）确定SMG是否表现出对基于实验室的社会和同性恋相关压力任务的生理和主观反应的改变;以及（3）确定慢性压力暴露和压力反应性生物标志物是否可预测长期物质使用、HIV风险行为和其他心理健康结果。这将是第一项使用基于实验室和生态有效的EMA方法来评估、记录和描述SMG之间的应激反应过程的研究。没有经验支持的针对性少数青少年的药物使用干预措施。这项研究的结果将加速发展急需的预防和干预计划的SMG风险。

DESCRIPTION (provided by applicant): The central goal of this study is to examine physiological and emotional reactivity to social and gay- related stressors among sexual minority girls (SMGs; girls who report same-sex attraction, same-sex sexual behavior, and/or a bisexual or lesbian identity), and their prospective associations with substance use and abuse. Minority Stress Theory (MST; Meyer, 2003) asserts that discrimination, violence, and victimization are the primary driving mechanisms of substance use and other mental health disparities among SMGs. Several recent studies published by the proposed PI support this hypothesis. Meta-analysis results showed that compared with heterosexual girls, SMGs were 400% more likely to have used drugs and alcohol (Marshal et al 2008), and trajectory analyses show that this disparity is likely to increase as SMGs transition to young adulthood (Marshal et al 2009, 2012). Two other studies showed that compared with heterosexual girls, SMGs were almost 300% more likely to experience suicidality and over 300% more likely to report being assaulted at school (Friedman, Marshal, et al., 2011; Marshal et al, 2011). This study will recruit 120 adolescent girls ages 14-18 (50% SMGs, 50% African-American) to address the proposed aims. We are proposing a modified minority stress model, asserting that physiological and emotional stress reactivity are important components of the minority stress process, and mediators of the pathway to substance use and other mental health outcomes among SMGs. Our specific aims are to: (1) use ecological momentary assessment (EMA) to document the daily social and gay-related stressors examine the "real time" links between these stressors and substance use, depression, and HIV risk behavior; (2) determine whether SMGs exhibit altered physiological and subjective responses to lab-based social and gay-related stress tasks; and (3) determine whether chronic stress exposure and biomarkers of stress reactivity predict long-term substance use, HIV risk behaviors, and other mental health outcomes. This will be the first study to assess, document, and describe stress reactivity processes among SMGs using lab-based and ecologically valid EMA methodologies. There are no empirically supported substance use interventions for sexual minority youth. Results from this study will accelerate progress towards the development of much needed prevention and intervention programs for SMGs at risk.