Symposia
LGBQT+
Christina Dyar, Ph.D.
Assistant Professor
The Ohio State University
Columbus, Ohio
Debra Kaysen, ABPP, Ph.D.
Professor
Stanford University
Palo Alto, California
Michael Newcomb, Ph.D. (he/him/his)
Associate Professor
Northwestern University
Chicago, Illinois
Brian Mustanski, Ph.D.
Professor
Northwestern University
Chicago, Illinois
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 examined coping motives for substance use as a mechanism at the event-level.
Methods: We utilized data from a 30-day ecological momentary assessment study (two assessments per day) of 429 SMWGD to test a proposed mechanistic process in which minority stress (enacted and internalized stigma) predicts alcohol and cannabis use via coping motives for substance use at the event-level.
Results: At the event-level, when an individual experienced more enacted stigma than usual during one assessment, they were more likely to use cannabis to cope during the next assessment. In turn, when cannabis use was motivated by a desire to cope, individuals engaged in more sessions of cannabis use, were intoxicated for longer, reported higher subjective intoxication, and more consequences of use. All of these indirect effects were significant. Only one prospective indirect effect of internalized stigma was significant. Specifically, when an individual experienced more internalized stigma than usual during one assessment, they were more likely to use cannabis to cope during the next assessment, and this was associated with experiencing more cannabis consequences. 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. Surprisingly, results did not provide evidence for similar associations for alcohol use. Our findings suggest that interventions designed to reduce problematic cannabis use among SMWGD should attend to their experiences of minority stress and motives for cannabis use and teach alternative approaches to coping with minority stress.