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DSM-5 Alcohol Use Disorder Severity as a Function of Sexual Orientation Discrimination: A National Study.
Alcohol Clin Exp Res. 2019 03; 43(3):497-508.AC

Abstract

BACKGROUND

Sexual minorities are more likely than their heterosexual counterparts to develop alcohol use disorder (AUD), and understanding the underlying reasons for this heightened risk is a public health priority. This study examined relationships between sexual orientation discrimination and DSM-5 AUD severity.

METHODS

The 2012 to 2013 National Epidemiologic Survey on Alcohol and Related Conditions III conducted in-person interviews with a nationally representative sample of U.S. adults (N = 36,309). Approximately 2.8% of the target population self-identified as lesbian, gay, or bisexual, 3.1% had at least 1 past-year same-sex sexual partner, and 8.3% reported same-sex sexual attraction.

RESULTS

Adults who identified as lesbian, gay, bisexual, heterosexual with same-sex attraction and/or current same-sex sexual partners, and those not sure of their sexual identity, had higher rates of individual DSM-5 AUD criteria than heterosexual-identified adults with only opposite-sex attraction and sexual partners. Respondents who were bisexual or unsure of their sexual identity consistently had the highest probabilities of endorsing each of these AUD criteria relative to the other subgroups. Differences in AUD severity across sexual orientation subgroups were much larger among women than among men. Sexual minorities who experienced higher levels of sexual orientation discrimination had significantly higher levels of AUD severity than sexual minorities who experienced lower levels or no discrimination. In particular, greater levels of sexual orientation discrimination increased the odds of impaired control criteria and pharmacologic criteria. Associations between prior-to-past-year sexual orientation discrimination and AUD severity were not as robust as those involving past-year discrimination.

CONCLUSIONS

Sexual minorities are at substantially greater risk of severe DSM-5 AUD, and this is particularly true among those who experience high levels of sexual orientation discrimination. Findings indicate that proximal experiences of discrimination are more salient than distal experiences. AUD treatment should address recent sexual orientation discrimination given that such experiences are associated with more severe AUD.

Authors+Show Affiliations

Center for the Study of Drugs, Alcohol, Smoking, and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan. Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan. Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.Department of Psychiatry, School of Nursing, Columbia University, New York, New York.Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan.Center for the Study of Drugs, Alcohol, Smoking, and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan. Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan.Center for the Study of Drugs, Alcohol, Smoking, and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan. Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan. Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan. Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

30740750

Citation

McCabe, Sean Esteban, et al. "DSM-5 Alcohol Use Disorder Severity as a Function of Sexual Orientation Discrimination: a National Study." Alcoholism, Clinical and Experimental Research, vol. 43, no. 3, 2019, pp. 497-508.
McCabe SE, Hughes TL, West BT, et al. DSM-5 Alcohol Use Disorder Severity as a Function of Sexual Orientation Discrimination: A National Study. Alcohol Clin Exp Res. 2019;43(3):497-508.
McCabe, S. E., Hughes, T. L., West, B. T., Veliz, P., & Boyd, C. J. (2019). DSM-5 Alcohol Use Disorder Severity as a Function of Sexual Orientation Discrimination: A National Study. Alcoholism, Clinical and Experimental Research, 43(3), 497-508. https://doi.org/10.1111/acer.13960
McCabe SE, et al. DSM-5 Alcohol Use Disorder Severity as a Function of Sexual Orientation Discrimination: a National Study. Alcohol Clin Exp Res. 2019;43(3):497-508. PubMed PMID: 30740750.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - DSM-5 Alcohol Use Disorder Severity as a Function of Sexual Orientation Discrimination: A National Study. AU - McCabe,Sean Esteban, AU - Hughes,Tonda L, AU - West,Brady T, AU - Veliz,Phil, AU - Boyd,Carol J, Y1 - 2019/02/11/ PY - 2018/06/07/received PY - 2019/01/08/accepted PY - 2019/2/12/pubmed PY - 2020/5/12/medline PY - 2019/2/12/entrez KW - Alcohol Use Disorder KW - DSM-5 KW - Discrimination KW - Severity KW - Sexual Orientation SP - 497 EP - 508 JF - Alcoholism, clinical and experimental research JO - Alcohol Clin Exp Res VL - 43 IS - 3 N2 - BACKGROUND: Sexual minorities are more likely than their heterosexual counterparts to develop alcohol use disorder (AUD), and understanding the underlying reasons for this heightened risk is a public health priority. This study examined relationships between sexual orientation discrimination and DSM-5 AUD severity. METHODS: The 2012 to 2013 National Epidemiologic Survey on Alcohol and Related Conditions III conducted in-person interviews with a nationally representative sample of U.S. adults (N = 36,309). Approximately 2.8% of the target population self-identified as lesbian, gay, or bisexual, 3.1% had at least 1 past-year same-sex sexual partner, and 8.3% reported same-sex sexual attraction. RESULTS: Adults who identified as lesbian, gay, bisexual, heterosexual with same-sex attraction and/or current same-sex sexual partners, and those not sure of their sexual identity, had higher rates of individual DSM-5 AUD criteria than heterosexual-identified adults with only opposite-sex attraction and sexual partners. Respondents who were bisexual or unsure of their sexual identity consistently had the highest probabilities of endorsing each of these AUD criteria relative to the other subgroups. Differences in AUD severity across sexual orientation subgroups were much larger among women than among men. Sexual minorities who experienced higher levels of sexual orientation discrimination had significantly higher levels of AUD severity than sexual minorities who experienced lower levels or no discrimination. In particular, greater levels of sexual orientation discrimination increased the odds of impaired control criteria and pharmacologic criteria. Associations between prior-to-past-year sexual orientation discrimination and AUD severity were not as robust as those involving past-year discrimination. CONCLUSIONS: Sexual minorities are at substantially greater risk of severe DSM-5 AUD, and this is particularly true among those who experience high levels of sexual orientation discrimination. Findings indicate that proximal experiences of discrimination are more salient than distal experiences. AUD treatment should address recent sexual orientation discrimination given that such experiences are associated with more severe AUD. SN - 1530-0277 UR - https://www.unboundmedicine.com/medline/citation/30740750/DSM_5_Alcohol_Use_Disorder_Severity_as_a_Function_of_Sexual_Orientation_Discrimination:_A_National_Study_ L2 - https://doi.org/10.1111/acer.13960 DB - PRIME DP - Unbound Medicine ER -