Identifying Additional Treatment Targets for Alcohol Interventions for Sexual Minority Women

BACKGROUND AND PURPOSE: Sexual minority (e.g., lesbian, bisexual) women experience alcohol use disorder at approximately twice the rate of heterosexual women. Past research has found that disadvantaged populations, specifically women, racial minorities, and low-income individuals, experience more severe alcohol-related problems (i.e., distress and impairment related to alcohol use) at the same level of alcohol consumption as non-disadvantaged populations. Though relatively little is known about the factors influencing these disparities, a limited body of past research has found greater levels of depression and suppression to be associated with more severe alcohol-related problems and greater levels of social support to be associated with less severe alcohol-related problems, at the same level of alcohol consumption, for some disadvantaged populations. No known research has examined factors that may be associated with more or less severe alcohol-related problems, at the same level of alcohol consumption, for sexual minority women. This study aims to determine whether greater levels of depression and suppression are associated with more severe and greater levels of social support are associated with less severe alcohol-related problems, at the same level of alcohol consumption, for sexual minority women.

METHODS: A national sample of 1,725 sexual minority women participated in an online survey in 2017 through the PRIDE Study. Respondents self-reported demographics, levels of alcohol use, suppression, and social support, and number of depression and alcohol use symptoms. Multiple regression was utilized to determine if depression, suppression, and social support moderated the relationship between alcohol consumption and alcohol-related problems for sexual minority women, controlling for demographic characteristics.

RESULTS: As hypothesized, greater levels of depression were found to strengthen the relationship between amount of alcohol consumption and alcohol-related problems (β = 0.023; p < 0.01), whereas greater levels of social support were found to weaken the relationship (β = -0.029; p < 0.01). No support was found for greater levels of suppression strengthening the relationship between alcohol consumption and alcohol-related problems.

CONCLUSIONS AND IMPLICATIONS: Higher levels of depression were associated with more severe alcohol-related problems at the same level of alcohol consumption, and higher levels of social support were associated with less severe alcohol-related problems at the same level of alcohol consumption for sexual minority women. Though clinical efforts to reduce alcohol-related problems have primarily focused on reducing levels of alcohol consumption, these findings suggest that treating depression and fostering social support among sexual minority women may also help to reduce alcohol-related problems among this population. These additional treatment targets may be particularly valuable for supporting sexual minority women who are presently unwilling or unable to modify their levels of alcohol consumption. Future research should focus on developing and evaluating interventions that target depression and social support in service of reducing alcohol-related problems for this vulnerable population.