Parnes Jamie E, Kiekens Wouter J, Mereish Ethan H, Sawyer Kelsey, Miranda Robert
Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA.
E. P. Bradley Hospital, Riverside, RI, USA.
Curr Addict Rep. 2024 Dec;11(6):1055-1071. doi: 10.1007/s40429-024-00603-w. Epub 2024 Sep 24.
There are disproportionately elevated rates of cannabis use and cannabis use disorder (CUD) among sexual and gender minoritized (SGM) individuals. Minority stressors (e.g., victimization, internalized stigma) are a robust predictor of SGM cannabis and related outcomes. The psychological mediation framework posits that changes in coping and emotion regulation, social/interpersonal, cognitive, and SGM group-specific functioning explain associations between minority stress and cannabis outcomes. This systematic review covers the extant literature evaluating the putative mechanisms that link minority stress to cannabis use and related outcomes.
Searches were conducted on MEDLINE, Embase, PsycInfo, CINAHL, and Web of Science through November 2023. We identified 12 articles. We sorted mechanisms using categories from the psychological mediation framework. Several studies evaluated coping and emotion regulation mechanisms, with strongest support for cannabis coping motives and preliminary support for depressive symptoms and emotion dysregulation. Few studies evaluated social/interpersonal and cognitive mechanisms, and none found support for these mechanisms. Lastly, there was preliminary support for internalized hetero/cissexism as a group-specific mechanism.
The findings of this review provide some support for the psychological mediation framework, highlight future directions for research testing this framework, and underscore some targets of intervention related to cannabis use and CUD among SGM individuals.
在性取向和性别少数群体(SGM)中,大麻使用和大麻使用障碍(CUD)的发生率异常升高。少数群体压力源(例如,受害、内化耻辱感)是SGM人群大麻使用及相关结果的有力预测因素。心理中介框架认为,应对方式和情绪调节、社会/人际、认知以及SGM群体特定功能的变化解释了少数群体压力与大麻使用结果之间的关联。本系统综述涵盖了现有文献,评估了将少数群体压力与大麻使用及相关结果联系起来的假定机制。
截至2023年11月,我们在MEDLINE、Embase、PsycInfo、CINAHL和Web of Science上进行了检索。我们共识别出12篇文章。我们根据心理中介框架的类别对机制进行了分类。几项研究评估了应对方式和情绪调节机制,对大麻应对动机的支持最强,对抑郁症状和情绪失调有初步支持。很少有研究评估社会/人际和认知机制,且均未发现对这些机制的支持。最后,对于内化的异性恋/顺性别歧视作为一种群体特定机制有初步支持。
本综述的结果为心理中介框架提供了一些支持,突出了测试该框架的未来研究方向,并强调了一些与SGM个体大麻使用和CUD相关的干预目标。