Testing whether the combination of victimization and minority stressors exacerbate PTSD risks in a diverse community sample of sexual minority women

Abstract

ABSTRACT Informed by minority stress and intersectionality frameworks, we examined 1) associations of sexual identity and race/ethnicity with probable diagnosis of post-traumatic stress disorder (PTSD-PD) among sexual minority women (SMW; e.g. lesbian, bisexual) and 2) potential additive and interactive associations of minority stressors (discrimination, stigma consciousness and internalised homonegativity) and potentially traumatic childhood and adulthood events (PTEs) with PTSD-PD. The data come from a large and diverse community sample in the United States of SMW (N=662; age range: 18–82; M=40.0, SD=14.0). The sample included 35.8% Black, 23.4% Latinx and 37.2% White participants. More than one-third of SMW (37.2%) had PTSD-PD with significantly higher prevalence among bisexual, particularly White bisexual women, than lesbian women. Discrimination, stigma consciousness and internalised homonegativity were each associated with higher odds of PTSD-PD, but only internalised homonegativity was additively associated with PTSD-PD above and beyond effects of PTEs. We found no evidence for interactive effects between PTEs and minority stressors. PTSD was strongly associated with childhood PTEs and with minority stressors above and beyond associations with adulthood PTEs and stressors. Our findings suggest a strong need to address effects of marginalization in treatment for PTSD, as minority stressors likely maintain and exacerbate effects of past traumas.