Emily R. Dworkin

Daily-level associations between PTSD and cannabis use among young sexual minority women

INTRODUCTION Sexual minority women have elevated trauma exposure and prevalence of posttraumatic stress disorder (PTSD) compared to heterosexual women and they are also more likely to use cannabis, although no research has examined relationships between PTSD and cannabis use in this population. Daily-level methodologies are necessary to examine proximal associations between PTSD and use. METHODS This study included 90 trauma-exposed young adult women who identified as sexual minorities (34.4% identified as lesbian and 48.9% identified as bisexual) and evaluated daily-level associations between their PTSD symptoms and cannabis use. Participants were assessed at two measurement waves, one year apart, each consisting of 14 consecutive daily assessments. RESULTS Cannabis use occurred on 22.8% of the days. Results from generalized linear mixed effects models showed that a persons mean level of PTSD symptom severity across days was strongly associated with same-day likelihood of cannabis use (OR=2.67 for 1 SD increase in PTSD score; p<0.001). However, daily deviation from ones average PTSD score was not associated with cannabis use on the same day. CONCLUSIONS Findings suggest that PTSD severity may confer general risk for cannabis use, rather than being a state-dependent risk factor.

Patterns of alcohol use and marijuana use among students at 2- and 4-year institutions

Abstract Objective: The objective of this study was to understand substance use patterns of alcohol, marijuana, and simultaneous alcohol and marijuana (SAM) use among 2- and 4-year college students. Participants: Participants were 526 young adults aged 18–23 (n = 355 4-year students; n = 171 2-year students) recruited from February 2015 to January 2016 who were participating in a larger longitudinal study. Methods: Latent class analysis (LCA) was used to identify past-month classes of alcohol, marijuana, and SAM use. Results: Among both 2- and 4-year students, a four-class solution yielded the best-fitting model, with 2-year classes tending to include greater marijuana use and less alcohol use and 4-year classes tending to include heavy alcohol use. Demographic characteristics were largely similar across classes. Conclusions: Classes of alcohol, marijuana, and SAM use differed by education status. Screening and prevention efforts for 4-year students may need to be tailored for the needs of 2-year students.

For the Good of the Group? Balancing Individual and Collective Risks and Benefits in Community Psychology Research

Balancing risks and benefits is a necessary ethical task for social science researchers. Community psychologists must often consider risks and benefits not just for individual participants, but also for the group, system, or society that those individuals inhabit. Little ethical guidance currently exists for how to navigate this ethical challenge across these multiple levels. In this article, we use a case example of social network research incorporating multiple levels of analysis to identify common risks and benefits and understand their relationship to each other. We conclude by discussing distinctive ethical considerations revealed by this case example.

Sexual identity of drinking companions, drinking motives, and drinking behaviors among young sexual minority women: An analysis of daily data.

Research has indicated that sexual minority women (SMW) drink more than do their heterosexual counterparts. Minority stress theory postulates that this increased drinking is motivated by efforts to modulate distress related to minority status, highlighting the potential importance of coping and enhancement drinking motives. Social learning theory postulates that SMW are motivated to drink more because their social companions model drinking behavior and convey social norms regarding appropriate alcohol consumption, suggesting that socialization and conformity motives may be important. The degree to which different motives for drinking affect SMW’s alcohol consumption may depend in part on whether SMW drink with other sexual minorities, but this has not been investigated. This study examined daily data across 2 separate 14-day bursts to understand associations among daily drinking motives, the sexual identity of drinking companions, and alcohol consumption among 67 young SMW who reported on 553 social drinking days. On days when SMW had higher than typical socialization and enhancement motives, they tended to drink more, and SMW who typically had higher coping motives tended to drink more on any given day. Further, higher than typical enhancement motives were associated with heavier drinking on days when SMW drank with only heterosexual companions, relative to days when they drank with only sexual minority companions or in mixed sexual-identity groups. SMW’s typical conformity motives were more strongly related to drinking on days when SMW drank in mixed sexual-identity groups relative to heterosexual companions only. These results indicate that SMW’s drinking motives and drinking companions may be important targets for future research and intervention.

Predicting PTSD severity from experiences of trauma and heterosexism in lesbian and bisexual women: A longitudinal study of cognitive mediators.

Sexual minority women (SMW) are at high risk of trauma exposure and, subsequently, the development of posttraumatic stress disorder (PTSD). The authors extended a theoretical model explaining the higher risk of mental disorders in minority populations to the maintenance and exacerbation of PTSD symptoms among young adult SMW specifically. This study used observational longitudinal data from a sample of 348 trauma-exposed 18- to 25-year-old individuals assigned female sex at birth who identified as either bisexual (60.1%) or lesbian (39.9%) and met screening criteria for PTSD. Participants identified as White (82.8%), Hispanic/Latina (12.4%), American Indian/Alaska Native (13.5%), Black/African American (13.8%), and/or Asian/Asian American (4.9%). The authors investigated whether distal stressors (i.e., criterion A traumatic events, daily experiences of heterosexism) produced proximal stressors (i.e., trauma-related cognitions, internalized heterosexism) that maintained or exacerbated PTSD symptoms. Findings indicated that daily heterosexism longitudinally predicted trauma-related cognitions (i.e., cognitions related to the self, world, and self-blame). Internalized heterosexism and cognitions about the self longitudinally predicted PTSD symptom severity. In addition, a significant indirect effect was identified between daily heterosexism and PTSD symptoms via self-related posttraumatic cognitions. These findings suggest that exposure to minority-specific distal stressors appears to promote nonminority-specific cognitive processes that, in turn, may maintain or exacerbate PTSD among young adult SMW exposed to trauma. Clinicians should consider addressing daily heterosexism in young adult SMW presenting with PTSD and evaluate how these experiences might promote clients’ global, negative views regarding themselves.

Proximal relationships between social support and PTSD symptom severity: A daily diary study of sexual assault survivors

In cross‐sectional studies, social support and posttraumatic stress disorder (PTSD) symptoms appear related, in that higher severity of PTSD is associated with lower social support and vice versa. Theoretical models of the causal direction of this relationship differ. Most longitudinal studies suggest that PTSD symptoms erode social support over time, although some suggest that higher social support is prospectively associated with decrease in PTSD symptom severity. It is unclear, though, how social support and PTSD affect each other in the short term. The purpose of this study was to test day‐to‐day relationships between PTSD and social support to elucidate how PTSD and social support influence each other.