Kilimnik Chelsea D, García-Ramírez Grisel, Salamanca Nashalys K, Mazzone G Mitchell, Mullican K Nicole, Davis Kelly Cue, Orchowski Lindsay M, Leone Ruschelle M, Kaysen Debra, Gilmore Amanda K
Department of Psychology & Neuroscience and the Renée Crown Wellness Institute, University of Colorado Boulder, Colorado, Boulder, USA.
Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Georgia, Atlanta, USA.
Alcohol Clin Exp Res (Hoboken). 2023 Nov;47(11):2169-2183. doi: 10.1111/acer.15194. Epub 2023 Oct 2.
Sexual assault (SA) is experienced by a substantial proportion of emerging adult college students and is associated with elevated rates of posttraumatic stress disorder (PTSD) and alcohol use. This study examines the mediating role of posttraumatic stress symptoms (PTSS) in the associations among SA severity, drinking to cope with anxiety, and average weekly drinks while considering the moderating roles of gender identity and sexual orientation.
A total of 2160 college students who were diverse in gender (cisgender women, 64.4%; cisgender men, 30.6%, and transgender and gender diverse [TGD] individuals = 4.9%) and sexual orientation (heterosexual = 68.0%, LGBQ+ = 32.0%) completed measures of SA severity, PTSS, drinking to cope with anxiety motives, and average weekly drinks.
The mediation model for the full sample indicated significant indirect effects of SA severity on drinking to cope with anxiety through PTSS, but not on average weekly drinks. Moderation analyses revealed differential relationships between the variables based on both gender identity and sexual orientation. For instance, the association between SA severity and PTSS was stronger for cisgender women and TGD individuals than cisgender men, and for LGBQ+ individuals than heterosexual individuals. While the association between PTSS and average weekly drinks was only significant for cisgender men, the association between PTSS and drinking to cope with anxiety was significant for both cisgender men and women but not TGD individuals. Furthermore, the association between SA severity and drinking to cope with anxiety was stronger for cisgender women than cisgender men.
Findings from this study demonstrate sexual orientation and gender identity differences and similarities in the associations of SA severity, PTSS, drinking to cope with anxiety, and alcohol use. Results are discussed in relation to the self-medication hypothesis and tailoring interventions for diverse groups.
相当一部分成年初期的大学生经历过性侵犯（SA），这与创伤后应激障碍（PTSD）和饮酒率升高有关。本研究考察了创伤后应激症状（PTSS）在SA严重程度、为应对焦虑而饮酒和平均每周饮酒量之间的关联中所起的中介作用，同时考虑了性别认同和性取向的调节作用。
共有2160名大学生参与研究，他们在性别（顺性别女性占64.4%；顺性别男性占30.6%，跨性别和性别多样化[TGD]个体占4.9%）和性取向（异性恋占68.0%，LGBQ+占32.0%）方面具有多样性。这些学生完成了关于SA严重程度、PTSS、为应对焦虑而饮酒的动机以及平均每周饮酒量的测量。
全样本的中介模型表明，SA严重程度通过PTSS对为应对焦虑而饮酒有显著的间接影响，但对平均每周饮酒量没有显著间接影响。调节分析揭示了基于性别认同和性取向的变量之间的差异关系。例如，SA严重程度与PTSS之间的关联在顺性别女性和TGD个体中比在顺性别男性中更强，在LGBQ+个体中比在异性恋个体中更强。虽然PTSS与平均每周饮酒量之间的关联仅在顺性别男性中显著，但PTSS与为应对焦虑而饮酒之间的关联在顺性别男性和女性中均显著，而在TGD个体中不显著。此外，SA严重程度与为应对焦虑而饮酒之间的关联在顺性别女性中比在顺性别男性中更强。
本研究结果表明，在SA严重程度、PTSS、为应对焦虑而饮酒和饮酒行为的关联方面，存在性取向和性别认同的差异与相似之处。结合自我药物治疗假说以及为不同群体量身定制干预措施对研究结果进行了讨论。
