Simultaneous Alcohol and Cannabis Use and High-Risk Sexual Behaviors.

Background: Alcohol and cannabis use rates are highest in college-aged young adults, and both alcohol and cannabis use are independently related to high-risk sexual behaviors (HRSBs). HRSBs (e.g., sex without protection against sexually transmitted infections) are a prevalent public health problem in college students, with little research examining simultaneous alcohol and cannabis use (i.e., using both alcohol and cannabis at the same time so the effects overlap) and HRSBs. Method: We examined simultaneous alcohol and cannabis-related HRSB frequency, gender differences in simultaneous alcohol and cannabis-related HRSBs, and differences in HRSBs between simultaneous and non-simultaneous users. Alcohol and cannabis using college students (N = 534; Average Age = 19; 66.9% reported identifying as female) were recruited through a psychology department's human subjects research pool and completed a one-time, online, self-report survey. Results: One-third of participants engaged in simultaneous alcohol and cannabis use prior to sexual intercourse in the past 3 months. Additionally, over one-third of participants reported heavy drinking (4/5 or more drinks for women/men) simultaneously with cannabis use prior to sexual intercourse in the past 3 months. Simultaneous alcohol and cannabis use was significantly and positively related to sexual intercourse after simultaneous use and after heavy drinking simultaneously with cannabis use. Past year simultaneous alcohol and cannabis users, relative to non-simultaneous users, reported increased incidents of sex without protection against sexually transmitted infections. No gender differences in simultaneous alcohol and cannabis-related HRSBs were found. Conclusions: Future research should continue examining simultaneous alcohol and cannabis use and HRSBs.

Trauma and Alcohol Use Among Transgender and Gender Diverse Women: An Examination of the Stress-Buffering Hypothesis of Social Support.

Transgender and gender diverse (TGD) women (i.e., individuals who were assigned male at birth and identify as women or trans women) experience trauma at disproportionate rates compared to cisgender populations. While trauma is associated with increased alcohol use among TGD women, research regarding factors that are protective of this association is scant. The stress-buffering hypothesis of social support suggests that perceived social support, defined as the judgment that social network members will be helpful when individuals experience stress, may buffer and reduce the association between trauma symptoms and alcohol use. However, this relationship has not been examined among TGD women. We examined whether perceived social support moderates the association between trauma and alcohol use among 89 TGD women. Exploratory multiple regression analyses provided support for this hypothesis, insofar as trauma symptoms were related to alcohol use by individuals with low, relative to high levels of perceived social support. Exploratory analyses demonstrated that this finding was driven by perceived social support from friends and family. Our results are the first to suggest that social support reduces alcohol use among TGD women and add to the literature on their trauma and alcohol use.

Emotion dysregulation moderates the relationship between alcohol use and eating pathology among heavy-drinking college men.

OBJECTIVES: There is limited research examining the relationship between alcohol use and eating pathology in men or factors that may moderate this association. The current study investigated the relationship between alcohol use and eating pathology, and examined emotion dysregulation as a moderator of this association, among heavy-drinking college men. METHOD: Men mandated to receive an alcohol intervention (N = 88; average age = 19 years) completed questionnaires related to alcohol use, emotion dysregulation, and eating pathology. RESULTS: Results demonstrated positive relationships between alcohol use and some eating pathology, and a significant interaction between alcohol use and emotion dysregulation. However, results were contrary to hypotheses, such that there was a positive relationship between alcohol use and eating pathology at low levels of emotion dysregulation. CONCLUSION: Future studies should continue to examine the overall presentation of eating pathology in men and investigate factors that may impact the relationship between alcohol use and eating pathology.

Gender minority stress, sleep disturbance, and sexual victimization in transgender and gender nonconforming adults.

OBJECTIVE: The current study examined facets of gender minority stress (nonaffirmation, internalized transphobia) and protective factors (community connectedness, transgender identity pride) as potential moderators of the relationship between sexual victimization and sleep disturbances among transgender and gender nonconforming (TGNC) adults. METHODS: TGNC adults (n = 191) were recruited through Amazon's Mechanical Turk. The average age was 30.28 years old (SD = 7.09; range 18-71) and the majority (55%) identified in the transfemale spectrum. RESULTS: Results demonstrated a significant two-way interaction between sexual victimization and internalized transphobia, such that sexual victimization was more strongly related to sleep disturbances when internalized transphobia was low (ß = .14, p = .017) relative to high (ß = -0.09, p = .221). CONCLUSIONS: This study is the first to establish the relationship between sexual victimization and sleep disturbances in TGNC individuals. Additional research is needed to replicate these findings longitudinally.

Predicting sexual behaviors from mid-adolescence to emerging adulthood: The roles of dating violence victimization and substance use.

The purpose of the present study was to determine whether dating violence victimization (psychological, physical, and sexual) and substance use (alcohol and marijuana) predicted sexual behaviors that increase risk for poor outcomes from ages 15-19. Adolescents (N = 1042; 56% female) were recruited from high schools in Southeast Texas in 2010 and followed annually for six years. The mean age of the sample at baseline was 15.09 (SD = 0.79). Participants primarily identified as Hispanic (31.4%), White (29.4%), and Black/African American (27.9%). Participants completed measures of dating violence victimization, substance use, and sexual behaviors annually. We examined unique and interactive associations between substance use and dating violence victimization with sexual behaviors that increase risk for poor outcomes. Multilevel modeling demonstrated that, when examining predictors simultaneously, marijuana use and psychological victimization predicted sexual behaviors over time for males. For females, marijuana use, and physical and psychological victimization all predicted sexual behaviors over time, with marijuana exerting the strongest effect, particularly among females who also used alcohol. Prevention efforts for adolescent sexual behaviors that increase risk for poor outcomes should include a focus on reducing substance use, particularly marijuana, and the effects of dating violence victimization.

PTSD Symptoms Mediate the Relationship Between Sexual Abuse and Substance Use Risk in Juvenile Justice-Involved Youth.

Juvenile justice-involved youth face disproportionate rates of sexual abuse, which increases the risk of post-traumatic stress disorder (PTSD) and substance use disorders (SUDs), both of which are associated with poor long-term outcomes. The present study tested two mediation and moderation models, controlling for age, race, and history of physical abuse, with gender as a moderator, to determine whether PTSD symptoms serve as a risk factor and/or mechanism in the relationship between sexual abuse and substance use. Data were examined for 197 juvenile justice-involved youth (mean age = 15.45, 68.9% non-White, 78.4% male) that completed court-ordered psychological assessments. Results indicated that PTSD symptoms significantly mediated the relationship between sexual abuse and drug (ß = 3.44, confidence interval [CI] [0.26, 7.41]; test for indirect effect z = 2.41, p = .02) and alcohol use (ß = 1.42, CI [0.20, 3.46]; test for indirect effect z = 2.23, p = .03). PTSD symptoms and gender were not significant moderators. Overall, PTSD symptoms mediate the relationship between sexual abuse and SUDs in juvenile justice-involved youth, which suggests viability of targeting PTSD symptoms as a modifiable risk factor to reduce the effects of sexual abuse on substance use in this high-risk population.

Conduct Disorder Symptoms and Illicit Drug Use in Juvenile Justice Involved Youth: The Reciprocal Relationship Between Positive Illicit Drug-Use Attitudes and Illicit Drug Use.

Conduct disorder (CD) symptoms cooccur at high rates with illicit drug use in juvenile justice involved youth, which results in poorer outcomes; however, research has not identified where best to intervene in this relationship, limiting the identification of modifiable risk factors to reduce negative effects of CD symptoms. Two mediation models were examined to investigate the potential for CD symptoms to influence a reciprocal relationship between illicit drug use and positive drug attitudes, controlling for age, gender, and race. Data were examined for 245 juvenile justice involved youth (mean age = 15.46, SD = 1.30, range 12-18, 64.9% Black, 80.4% male) who completed court-ordered psychological assessments. Findings indicate: (1) Positive attitudes toward illicit drug use significantly mediated the relationship between CD symptoms and illicit drug use (ß = 0.16, CI 0.09-0.27; test for indirect effect z = 4.17, p < .001) and (2) illicit drug use significantly mediated the relationship between CD symptoms and positive attitudes toward illicit drug use (ß = 0.20, CI 0.12-0.32; test for indirect effect z = 4.87, p < .001). Overall, the present study suggests that CD symptoms impart risk for illicit drug use both indirectly, through more positive attitudes toward illicit drug use, and directly, which further strengthens positive attitudes toward illicit drug use.