(PS7-A13) Minority Stressors and PTSD Symptoms Predict Alcohol Use/problems in Sexual Minority Young Adults

LGBQ+ young adults report higher rates of alcohol misuse, on average, relative to heterosexual young adults (Connors et al., 2019). Research suggests that LGBQ+ individuals may drink more alcohol to cope with distal (e.g., heterosexist discrimination) and proximal (e.g., internalized heterosexism, identity concealment) sexual minority stressors (Dorn-Medeiros, 2018; Kuerbis et al., 2017; Meyer, 2003; Villarreal et al., 2021). However, studies linking identity concealment/disclosure, or one’s attempt to hide their sexual orientation from others, to alcohol use/problems among LGBQ+ people have mixed findings (Feinstein et al., 2019; Pachankis et al., 2020; Villarreal et al., 2021). Despite high rates of post-traumatic stress disorder (PTSD) symptoms among LGBQ+ young adults and its association with alcohol use/problems (Dworkin et al., 2021; Roberts et al., 2010), few studies have considered the simultaneous and interacting effect of minority stress and PTSD symptoms on alcohol use/problems. We hypothesized that internalized heterosexism, heterosexist discrimination, and identity concealment would positively relate to alcohol use/problems, identity disclosure would negatively relate to alcohol use/problems, and that these associations would be stronger at medium and high levels of PTSD symptoms.

LGBQ+ young adults (N=342, M_age=21.42, 60.23% women, 28.65% men, 23.62% non-binary/gender expansive) in dating relationships completed an online survey containing the Heterosexist Harassment, Rejection, and Discrimination Scale, an adapted version of the Multi-Axial Gay Men’s Inventory-Men’s Short Version, the Nebraska Outness Scale, the PTSD Checklist for DSM-5, and the Alcohol Use Disorders Identification Test. Participants identified as bisexual (39.94%), lesbian (19.24%), gay (13.41%), queer (11.95%), pansexual (11.66%), and other sexual identities (3.49%). We used multiple regression to test study hypotheses, controlling for age.

PTSD symptoms (B=.04, p=.02), internalized heterosexism (B=.07, p=.01), and identity concealment (B=.24, p< .05) were positively related to alcohol use/problems. Identity disclosure (B=-.25, p=.03) was negatively related to alcohol use/problems. Heterosexist discrimination was not related to alcohol use/problems (B=.02, p=.61). Only the interaction between identity concealment and PTSD symptoms was significantly related to alcohol use/problems (B=.01, p=.02). Identity concealment was related to alcohol use/problems at medium (B=.24, p< .05) and high (B=.49, p< .01), but not low (B=-.01, p=.98) levels of PTSD symptoms.

These findings suggest that proximal minority stressors relate to alcohol use/problems over and above the effects of distal minority stressors. Additionally, individuals who conceal their sexual identities and have elevated PTSD symptoms report higher alcohol use/problems. Interventions simultaneously targeting structural stigma, minority stress, factors that drive identity concealment/non-disclosure, and PTSD symptoms might be beneficial for reducing alcohol use/problems among LGBQ+ people.