性少数女性中的饮酒行为、行为和心理健康求助以及治疗满意度。
Alcohol use, behavioral and mental health help-seeking, and treatment satisfaction among sexual minority women.
机构信息
Department of Psychology, Syracuse University, Syracuse, New York, USA.
Harvard Medical School, Harvard University, Boston, Massachusetts, USA.
出版信息
Alcohol Clin Exp Res. 2022 Apr;46(4):641-656. doi: 10.1111/acer.14789. Epub 2022 Mar 22.
BACKGROUND
Sexual minority women (SMW) report higher rates of heavy episodic drinking (HED) and adverse alcohol-related outcomes, including poor mental health, than heterosexual women. These disparities indicate a greater need for behavioral and mental health treatment for SMW. This study examined associations among alcohol outcomes, behavioral and mental health help-seeking, and treatment satisfaction among SMW by age, sexual identity, race/ethnicity, and income.
METHODS
Participants included a community sample of 695 SMW (M = 40.0, SD = 14.1; 74.1% lesbian, 25.9% bisexual; 37.6% White, 35.8% Black, 23.2% Latinx; 26.3% annual income $14,999 or less). We used bivariate analyses to characterize the sample's demographic characteristics and multivariable logistic regression analyses to examine associations among variables.
RESULTS
SMW subgroups based on age, race/ethnicity, and annual income differed in alcohol outcomes (i.e., HED, DSM-IV alcohol dependence, alcohol-related problem consequences, alcohol problem recognition, and motivation to reduce drinking); help-seeking; and treatment satisfaction. SMW who engaged in help-seeking for alcohol-related concerns were more likely than those who did not to meet criteria for DSM-IV alcohol dependence (adjusted odds ratio [aOR] = 7.13; 95% CI = 2.77; 18.36), endorse alcohol-related problem consequences (aOR = 11.44; 95% CI = 3.88; 33.71), recognize problematic drinking (aOR = 14.56; 95% CI = 3.37; 62.97), and report motivation to reduce drinking (aOR = 5.26; 95% CI = 1.74; 15.88). SMW's alcohol outcomes did not differ based on their satisfaction with treatment or with providers.
CONCLUSIONS
This study's findings confirm SMW's elevated risk for HED and other alcohol-related outcomes and underscore the importance of identity-affirmative and accessible behavioral and mental health treatment for young, Black, and low-income SMW. Clinicians and intervention scientists should develop or enhance existing brief behavioral and mental health treatments for SMW engaging in HED who may not recognize that their drinking is problematic or who are not motivated to reduce drinking.
背景
性少数女性（SMW）报告的重度间歇性饮酒（HED）和不良酒精相关后果的发生率高于异性恋女性，包括心理健康状况较差。这些差异表明，SMW 需要更多的行为和心理健康治疗。本研究通过年龄、性认同、种族/族裔和收入，研究了 SMW 中酒精相关结果、行为和心理健康寻求帮助以及治疗满意度之间的关联。
方法
参与者包括一个社区样本的 695 名 SMW（M = 40.0，SD = 14.1；74.1%是女同性恋者，25.9%是双性恋者；37.6%是白人，35.8%是黑人，23.2%是拉丁裔；26.3%的年收入为 14999 美元或以下）。我们使用了双变量分析来描述样本的人口统计学特征，并使用多变量逻辑回归分析来研究变量之间的关联。
结果
基于年龄、种族/族裔和年收入的 SMW 亚组在酒精相关结果（即 HED、DSM-IV 酒精依赖、酒精相关问题后果、酒精问题识别和减少饮酒的动机）、寻求帮助和治疗满意度方面存在差异。与没有寻求酒精相关问题帮助的 SMW 相比，寻求帮助的 SMW 更有可能符合 DSM-IV 酒精依赖的标准（调整后的优势比 [aOR] = 7.13；95%CI = 2.77；18.36），承认酒精相关问题后果（aOR = 11.44；95%CI = 3.88；33.71），认识到有问题的饮酒（aOR = 14.56；95%CI = 3.37；62.97），并报告减少饮酒的动机（aOR = 5.26；95%CI = 1.74；15.88）。SMW 的酒精相关结果与其对治疗或提供者的满意度无关。
结论
本研究的结果证实了 SMW 发生 HED 和其他酒精相关后果的风险较高，并强调了为年轻、黑人、低收入的 SMW 提供身份认同和可及的行为和心理健康治疗的重要性。临床医生和干预科学家应该为参与 HED 的 SMW 制定或增强现有的简短行为和心理健康治疗方法，这些 SMW 可能没有意识到自己的饮酒存在问题，或者没有减少饮酒的动机。
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