The Indirect Effect of Emotion Regulation on Minority Stress and Problematic Substance Use in Lesbian, Gay, and Bisexual Individuals.

Amelia Aldao,Andrew H. Rogers,Nathaniel Haines,Ilana Seager,Hunter Hahn,Woo-Young Ahn

doi:10.3389/fpsyg.2017.01881

Abstract

Lesbian, gay, and bisexual (LGB) individuals report higher levels of problematic alcohol and substance use than their heterosexual peers. This disparity is linked to the experience of LGB-specific stressors, termed minority stress. Additionally, bisexual individuals show increased rates of psychopathology, including problematic alcohol and substance use, above and beyond lesbian and gay individuals. However, not everyone experiencing minority stress reports increased rates of alcohol and substance misuse. Emotion regulation (ER), which plays a critical role in psychopathology in general, is theorized to modulate the link between minority stress and psychopathology. However, it remains largely unknown whether ER plays a role in linking instances of minority stress with substance and alcohol use outcomes. To address the gap, the current study assessed 305 LGB individuals’ instances of minority stress, ER, and substance and alcohol use outcomes. We assessed the role of ER in problematic alcohol and substance use among LGB individuals using moderated mediation, where sexual minority status was entered as the moderator, and ER difficulties was entered as the mediator. The results indicated significant indirect effects of minority stress, through ER difficulties, on both problematic alcohol and substance use. However, there was no significant interaction with sexual orientation status, suggesting that ER may be important for all LGB individuals in predicting problematic alcohol and substance use. These results highlight the important role that ER plays between instances of minority stress and substance and alcohol use in LGB individuals, suggesting that ER skills may serve as a novel target for intervention.

Highlights

Compared to lesbian and gay individuals, bisexual individuals report more current stress, more past adverse events, as well as less support from family or friends (Jorm et al, 2002). These results suggest that bisexual individuals may respond differently to instances of discrimination than to lesbian and gay individuals
Independent samples t-tests showed a significant difference of age between lesbian/gay and bisexual individuals, where lesbian/gay individuals were, on average, older, (p < 0.001), as well as a significant difference for gender, where bisexual individuals were, on average, more likely to be female
The average problematic alcohol use reported for lesbian/gay individuals was 1.56 (SD = 2.56), and the average problematic substance use reported for lesbian/gay individuals was 1.23 (SD = 1.96)

Summary

Introduction

Gay, and bisexual (LGB) individuals experience elevated rates of problematic alcohol and substance use compared to their heterosexual peers (Meyer, 2003; Hatzenbuehler et al, 2008; Bostwick et al, 2010; Coulter et al, 2016; Gillan et al, 2016; Lee et al, 2016; Pakula et al, 2016). Researchers have linked the elevated rates of problematic alcohol and substance use observed in LGB populations to sexual minority-specific stressors (e.g., discrimination; Meyer, 2003; Bostwick et al, 2010; Drazdowski et al, 2016). In line with minority stress theory, lower rates of LGB-specific discrimination were associated with decreased rates of problematic alcohol use (Lewis et al, 2016), suggesting that minority stress may be a critical explanatory factor for these elevated rates of problematic alcohol and substance use

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