Fahey Kalina M L, Cservenka Anita, Peltier Mackenzie R, Mereish Ethan H, Dermody Sarah S
School of Psychological Science, Oregon State University, Corvallis, Oregon, USA.
Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
Alcohol Clin Exp Res (Hoboken). 2024 Feb;48(2):345-361. doi: 10.1111/acer.15255. Epub 2024 Jan 23.
Sexual minority women (SMW) use alcohol at higher rates and experience greater alcohol-related harms than their heterosexual counterparts. Evidence from observational studies suggests that minority stress (i.e., stress experienced due to marginalization in society) is an important risk factor among SMW, yet there is a lack of experimental evidence to establish a direct causal role of minority stress on alcohol use in this population. We adapted the preexisting personalized guided stress induction paradigm to conduct a pilot study of how minority stress is related to stress response (assessed via subjective measures and salivary cortisol) and mechanisms of alcohol use (craving, demand, and risky decision making) in SMW.
Using a within-subjects design (N = 8) cisgender SMW who endorsed high-risk drinking (≥1 heavy drinking episode in the past 30 days) completed three study visits: a script development session and two in-person imagery induction appointments (minority stress and neutral). Analyses examined feasibility and acceptability, stress response, and mechanisms of alcohol use.
The paradigm significantly increased subjective stress response (g = 1.32). Data supported the feasibility, acceptability, and appropriateness of the paradigm for use with SMW. While the paradigm did not significantly change scores on minority stress and alcohol outcomes measures, effect sizes for craving and minority stress outcomes were in the small-to-medium range (gs = 0.24-0.54).
The adapted minority stress paradigm appears to be feasible and appropriate for use with SMW to induce stress in laboratory settings. Future research can use this paradigm to understand the causal effects of minority stress on alcohol use and related outcomes.
性少数群体女性（SMW）饮酒率高于异性恋女性，且遭受与酒精相关的危害更大。观察性研究的证据表明，少数群体压力（即因社会边缘化而经历的压力）是SMW中的一个重要风险因素，但缺乏实验证据来确立少数群体压力对该人群饮酒的直接因果作用。我们采用现有的个性化引导压力诱导范式，对少数群体压力与压力反应（通过主观测量和唾液皮质醇评估）以及SMW饮酒机制（渴望、需求和风险决策）之间的关系进行了一项试点研究。
采用内组设计（N = 8），认可高风险饮酒（过去30天内≥1次重度饮酒事件）的顺性别SMW完成了三次研究访视：一次脚本开发会议和两次现场意象诱导预约（少数群体压力和中性）。分析考察了可行性、可接受性、压力反应和饮酒机制。
该范式显著增加了主观压力反应（g = 1.32）。数据支持该范式用于SMW的可行性、可接受性和适宜性。虽然该范式没有显著改变少数群体压力和酒精结果测量的得分，但渴望和少数群体压力结果的效应大小在小到中等范围内（gs = 0.24 - 0.54）。
改编后的少数群体压力范式似乎适用于在实验室环境中对SMW诱导压力。未来的研究可以使用该范式来理解少数群体压力对饮酒及相关结果的因果效应。
