Lifetime Trauma Endorsement, Posttraumatic Stress Disorder, and Alcohol Dependence as a Function of Sexual Minority Status

Clinical Impact Statement This study indicates that the relationship between trauma endorsement and alcohol dependence is stronger for individuals who identify as lesbian, gay, or bisexual (LGB), relative to heterosexual individuals. However, perceived LGB discrimination does not appear to account for this association. It is possible that LGB individuals show a stronger association between trauma endorsement and alcohol dependence due to greater likelihood of exposure to traumatic events. Therefore, efforts to prevent trauma and/or decrease the impact of trauma in LGB individuals may result in lower rates of alcohol dependence. Objective: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur, with elevated rates of both disorders in lesbian, gay, or bisexual (LGB) samples. Few studies have compared the strength of PTSD-AUD associations between LGB and heterosexual individuals or evaluated the role of nontraumatic LGB discrimination in these relationships among sexual minorities. Method: The current study utilized nationally representative epidemiological data (N = 29,646) to (a) examine whether associations between lifetime trauma endorsement/PTSD and lifetime alcohol dependence (AD) differ as a function of sexual minority status and (b) evaluate the role of LGB-specific discrimination in trauma/PTSD and AD associations among LGB individuals. Results: Logistic regression analyses showed the association between lifetime trauma endorsement and lifetime AD was significantly greater in magnitude for LGB individuals (odds ratio [OR] = 2.17) compared to heterosexual individuals (OR = 1.32; Z = 2.51, p < .05). The magnitude of the association between lifetime PTSD and lifetime AD was not greater in the LGB subsample (OR = 2.11) than the heterosexual subsample (OR = 1.71; Z = 0.63, p > .05), after controlling for trauma endorsement. Among the LGB subsample, logistic regression analyses did not support a significant main effect for LGB discrimination nor an interaction between trauma endorsement and nontraumatic LGB discrimination, nor between PTSD and nontraumatic LGB discrimination, on lifetime AD (ps > .05). Conclusions: LGB individuals demonstrate stronger associations between lifetime trauma endorsement and AD, relative to heterosexual counterparts; however, this association may not be accounted for or moderated by nontraumatic LGB discrimination.