Event-level Antecedents of Heavy Drinking Among Bisexual and Heterosexual Women with and without Histories of Sexual Assault

项目总结 酗酒和性侵犯同时发生，双性恋女性患上这两种疾病的风险都很高。大致 25%的双性恋女性与11%的异性恋女性报告有大量饮酒 (Hed；一次4杯以上的饮料)。双性恋女性患HED的风险增加被认为主要是由 终生暴露于多种慢性压力源，包括性侵犯。此外，双性恋女性的 性侵犯风险的增加在一定程度上是由饮酒导致的，这使得理解和 最终在这一组中对酗酒进行干预。尽管如此，双性恋女性的 大量饮酒和终身性侵犯，目前还没有发表过关于重度饮酒和终身性侵犯的事件水平前置因素的研究 双性恋女性中的饮酒行为。双性恋人群大量饮酒的重要理论前因 有性侵病史的女性包括心理困扰、应对动机和微侵犯。至 检查这些构造的事件级别影响，将在以下四个方面采用混合方法 目标。本次马赛克K99/R00的K99阶段的具体目的是：1)深入了解 大量饮酒的前驱因素以及双性恋和异性恋女性之间的差异 性侵犯和2)改进研究酗酒事件水平预测因素的措施和方法 在双性恋和异性恋女性中。为了实现这些目标，定性的方法(个人 采访了40名双性恋或异性恋女性；对16名完成试点的女性进行了离职采访 生态瞬时评估(EMA)研究)将用于制定和完善全面的EMA研究。R00 阶段将包括一项更大规模的EMA研究，该研究将评估双性恋者大量饮酒的前因 有(n=50)和没有(n=50)性侵病史的妇女和有(n=50)异性恋妇女(n=50) 并无(n=50)性侵病史。R00阶段的具体目标包括3)表征 由于心理困扰、应对动机、 以及双性恋和异性恋女性之间的微攻击性，以及4)检查SA病史如何进一步 增加了双性恋女性在活动层面上酗酒的风险。私家侦探L博士将与 经验丰富、知识渊博的导师团队(Jennifer Merrill博士、Kristina Jackson博士、Lindsay Orchowski博士) 发展五个培训领域的专门知识：(1)EMA方法，(2)纵向数据分析，(3)定性 方法(4)干预发展；(5)专业发展技能。圆满完成 本提案中详细说明的研究和培训将为PI成为独立的临床科学家做好准备 并制定一项关于有性行为史的双性恋女性酒精使用差异的研究计划 人身攻击罪。调查结果将有助于我们了解在活动中大量饮酒的最接近的风险因素： 在双性恋和异性恋女性中的水平。确定风险因素将是开发的第一步 及时干预以减少酗酒。

PROJECT SUMMARY Heavy drinking and sexual assault co-occur, and bisexual women are at elevated risk for both. Approximately 25% of bisexual women relative to 11% of heterosexual women report engaging in heavy episodic drinking (HED; 4+ drinks on one occasion). Bisexual women’s elevated risk for HED is believed to be driven largely by lifetime exposure to multiple and chronic stressors, including sexual assault. Further, bisexual women’s elevated risk for sexual assault is in part driven by alcohol use, making it even more critical to understand and ultimately intervene upon heavy drinking in this group. Despite that bisexual women have the highest rates of heavy drinking and lifetime sexual assault, there is no published research on event-level antecedents of heavy drinking among bisexual women. Theoretically important antecedents of heavy drinking among bisexual women with sexual assault histories include psychological distress, coping motives, and microaggressions. To examine event-level influences of these constructs, a mixed-methods approach will be employed across four aims. The specific aims of the K99 phase of this MOSAIC K99/R00 are to 1) gain an in-depth understanding of antecedents of heavy drinking and how they differ between bisexual and heterosexual women who have been sexually assaulted and 2) refine measures and methods for studying event-level predictors of heavy drinking among bisexual and heterosexual women. To accomplish these aims, a qualitative approach (individual interviews with 40 either bisexual or heterosexual women; exit interviews with 16 women who complete a pilot ecological momentary assessment (EMA) study) will be used to develop and refine a full EMA study. The R00 phase will include a larger-scale EMA study that will assess heavy drinking antecedents among bisexual women with (n = 50) and without (n = 50) histories of sexual assault and heterosexual women with (n = 50) and without (n = 50) histories of sexual assault. The specific aims of the R00 phase include to 3) characterize the extent to which heavier event-level drinking occurs as a result of psychological distress, coping motives, and microaggression among bisexual versus heterosexual women and 4) examine how SA history further increases risk of heavier drinking at the event level for bisexual women. The PI, Dr. López, will work with an experienced and knowledgeable team of mentors (Drs. Jennifer Merrill, Kristina Jackson, Lindsay Orchowski) to develop expertise in five areas of training: (1) EMA methods, (2) longitudinal data analysis, (3) qualitative methods (4) intervention development, and (5) professional development skills. Successful completion of the research and training detailed in this proposal will prepare the PI to become an independent clinical scientist and develop a program of research on alcohol use disparities among bisexual women with histories of sexual assault. Findings will inform an understanding of the most proximal risk factors for heavy drinking at the event- level among bisexual and heterosexual women. Identifying risk factors will be the first step in the development of just-in-time intervention to decrease heavy drinking.