Mereish Ethan H, Miranda Robert
Lavender Lab, Department of Psychology, University of Maryland, College Park, MD, USA.
Department of Health Studies, American University, Washington, DC, USA.
Neurobiol Stress. 2024 Aug 10;32:100668. doi: 10.1016/j.ynstr.2024.100668. eCollection 2024 Sep.
Sexual minority young adults are at increased risk for hazardous drinking and alcohol use disorder compared to heterosexual adults. Heterosexism-based stressors contribute and often explain inequities in alcohol outcomes. However, the extant research primarily relies on correlational designs, and often neglects the importance of alcohol craving, despite its foundational role in addiction. Leveraging a novel experimental mood induction paradigm, this study examined the effects of exposure to vicarious heterosexism-based stress on alcohol craving and negative affect among sexual minority young adults who drink heavily. We also examined its effects on cannabis and nicotine craving among participants who used cannabis and nicotine, respectively. Lastly, we examined moderating factors that could influence the impact of exposure to heterosexism-based stress on alcohol craving.
Participants were 101 heavy drinking sexual minority young adults, ages 20-35 ( = 26.46 years old; = 3.49), recruited from the community (51.5% female sex assigned at birth; 76.3% cisgender; 51.5% plurisexual; and 42.6% racial and ethnic minorities). They completed three mood induction trials counterbalanced over three visits on different days: heterosexism stress, general stress, and neutral. Structured interviews assessed criteria for DSM-5 alcohol use disorder (AUD) and substance use, and self-report measures assessed lifetime traumatic stressors.
Most participants met criteria for past-year AUD (74.7%). Exposure to heterosexism stress produced more negative affect and substance craving than the neutral mood induction, even while controlling for demographic variables and lifetime exposure to traumatic and heterosexism stressors. Exposure to heterosexism-based stress had large effects on alcohol craving among participants who had greater drinking to cope motives and heterosexism-specific rejection sensitivity, whereas the effects were small for those who had lower drinking to cope motives and heterosexism-specific rejection sensitivity. Demographic, lifetime stress, prior alcohol use, and AUD symptom severity variables were not significant moderators. Greater substance craving induced by heterosexism-based stress in the laboratory was associated with greater recent and current substance use.
This study findings show that vicarious exposure to heterosexism elicits negative mood and alcohol, cannabis, and nicotine craving among sexual minority young adults who engaged in heavy drinking. The effects for alcohol craving were largest among those who endorse high levels of drinking to cope motives and heterosexism-based rejection sensitivity. These findings have implications for oppression-based stress and motivational models of addiction.
与异性恋成年人相比，性少数青年成年人危险饮酒和酒精使用障碍的风险更高。基于异性恋主义的压力源会导致并常常解释酒精相关结果的不平等现象。然而，现有研究主要依赖相关设计，并且常常忽视酒精渴望的重要性，尽管其在成瘾中起着基础性作用。本研究利用一种新颖的实验性情绪诱导范式，考察了接触基于替代性异性恋主义的压力对大量饮酒的性少数青年成年人的酒精渴望和负面影响的影响。我们还分别考察了其对使用大麻和尼古丁的参与者的大麻和尼古丁渴望的影响。最后，我们考察了可能影响接触基于异性恋主义的压力对酒精渴望影响的调节因素。
参与者为101名大量饮酒的性少数青年成年人，年龄在20至35岁之间（平均年龄=26.46岁；标准差=3.49），从社区招募（出生时被指定为女性的占51.5%；顺性别者占76.3%；多元性取向者占51.5%；种族和少数民族占42.6%）。他们在不同日期分三次就诊完成了三次情绪诱导试验，试验顺序相互平衡：异性恋主义压力、一般压力和中性。结构化访谈评估了DSM-5酒精使用障碍（AUD）和物质使用的标准，自我报告测量评估了终生创伤性压力源。
大多数参与者符合过去一年AUD的标准（74.7%）。即使在控制了人口统计学变量以及终生接触创伤性和异性恋主义压力源的情况下，接触异性恋主义压力比中性情绪诱导产生了更多的负面影响和物质渴望。接触基于异性恋主义的压力对那些有更强的饮酒以应对动机和特定于异性恋主义的拒绝敏感性的参与者的酒精渴望有很大影响，而对那些饮酒以应对动机和特定于异性恋主义的拒绝敏感性较低的参与者影响较小。人口统计学、终生压力、先前的酒精使用和AUD症状严重程度变量不是显著的调节因素。在实验室中由基于异性恋主义的压力诱导的更强的物质渴望与最近和当前更多的物质使用相关。
本研究结果表明，替代性接触异性恋主义会引发大量饮酒的性少数青年成年人的负面情绪以及酒精、大麻和尼古丁渴望。对于那些认可高水平饮酒以应对动机和基于异性恋主义的拒绝敏感性的人来说，对酒精渴望的影响最大。这些发现对基于压迫的压力和成瘾的动机模型具有启示意义。
