Background

Sexual minority women and gender diverse individuals (SMWGD) are at heightened risk for alcohol and cannabis use disorders compared to heterosexual and cisgender individuals, and their heightened risk has been attributed to minority stress. However, few longitudinal studies have examined mechanisms through which minority stress may impact substance use, and none have done so at the event-level.

Methods

We utilized data from a 30-day ecological momentary assessment study of 429 SMWGD who used alcohol or cannabis regularly to test a mechanistic process in which minority stress predicts alcohol and cannabis use via coping motives for use at the event-level.

Results

When individuals experienced more enacted stigma (e.g., microaggressions) than usual during one assessment, they were more likely to use cannabis to cope during the next. In turn, occasions when cannabis was used to cope were marked by more sessions of cannabis use, longer intoxication, higher subjective intoxication, and more cannabis consequences. Indirect effects of enacted stigma on cannabis use via coping motives were significant. However, only one of internalized stigma’s indirect effects was significant, with internalized stigma predicting cannabis consequences via daily coping motives. No indirect effects predicting alcohol use were significant.

Conclusions

Findings provide robust evidence that using to cope is a mechanism through which enacted stigma predicts cannabis use and internalized stigma predicts cannabis consequences. Results did not provide evidence for similar associations for alcohol. Our findings suggest that interventions designed to reduce cannabis use among SMWGD should attend to their minority stress experiences and cannabis use motives and teach alternative coping strategies.

中文翻译：

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性少数女性和性别多样化个体中少数群体压力、应对动机和药物使用之间的事件级关联

背景

与异性恋和顺性别个体相比，性少数女性和性别多元化个体（SWGD）患酒精和大麻使用障碍的风险更高，而她们的风险升高归因于少数群体压力。然而，很少有纵向研究探讨少数群体压力可能影响药物使用的机制，而且没有一个在事件层面进行过此类研究。

方法

我们利用对 429 名经常使用酒精或大麻的 SMWGD 进行的 30 天生态瞬时评估研究的数据来测试一个机制过程，其中少数群体压力通过事件层面的使用应对动机来预测酒精和大麻的使用。

结果

当个人在一次评估中比平时经历更多的耻辱（例如微侵犯）时，他们更有可能在下一次评估中使用大麻来应对。反过来，使用大麻来应对的情况的特点是使用大麻次数更多、中毒时间更长、主观中毒程度更高以及大麻后果更多。所制定的耻辱通过应对动机对大麻使用产生了显着的间接影响。然而，只有一种内在耻辱的间接影响是显着的，内在耻辱通过日常应对动机预测大麻的后果。预测饮酒的间接影响不显着。

结论

研究结果提供了强有力的证据，表明使用应对是一种机制，通过这种机制，制定的耻辱可以预测大麻的使用，而内在的耻辱可以预测大麻的后果。结果没有提供与酒精有类似关联的证据。我们的研究结果表明，旨在减少 SMWGD 中大麻使用的干预措施应关注他们的少数群体压力经历和大麻使用动机，并教授替代应对策略。