Daily Relationship Functioning and Disordered Eating Behaviors Among Sexual Minority Women in Same-Sex Relationships.

BACKGROUND AND PURPOSE: The present study aimed to examine associations between different types of relationship functioning and disordered eating behaviors (DEBs) in the everyday lives of sexual minority women in same-sex relationships-an at-risk population that has not been assessed in this context. METHODS: Participants included 321 young sexual minority women (Mage = 27.56, SD = 3.67) in same-sex relationships who completed surveys assessing their daily relationship functioning and DEB use each day for a 14-day daily diary period. Multilevel structural equation modeling was used to examine daily-, person-, and couple-level associations among women's daily relationship functioning (general relationship functioning, positive and negative relational behaviors they and, separately, their partners engaged in) and DEBs (overeating, loss of control eating, emotional eating, and dietary restriction). RESULTS: Results generally indicated that more positive and less negative daily relationship functioning across all assessed constructs was associated with less same-day emotional eating. In contrast, associations between all daily relationship functioning constructs and loss of control eating were not significant, nor were any relationship functioning-DEB associations at the couple level. More circumscribed patterns of association were identified for associations between the relationship functioning constructs, and overeating and dietary restriction. CONCLUSIONS: Collectively, these findings provide insight into how aspects of daily relationship functioning map onto sexual minority women's daily engagement in DEBs that are linked to poor health long-term, and directions for future research and clinical practice that may warrant consideration moving forward to help advance the evidence-base and care for this historically overlooked and underserved population.

The present study examined associations between different types of relationship functioning (e.g., general relationship functioning, positive and negative relational behaviors that participants and their partners engaged in during their interactions with one another) and disordered eating behaviors (DEBs) in the everyday lives of sexual minority women in same-sex relationships. Results generally indicated that on days when women reported more positive and less negative daily relationship functioning, they also reported less emotional eating that day. In contrast, associations between different types of daily relationship functioning and loss of control eating were not significant. Furthermore, associations between different types of daily relationship functioning relative to overeating and dietary restriction varied based on the type of relationship functioning and DEB under consideration. Collectively, these findings provide insight into how different types of daily relationship functioning map onto sexual minority women's daily engagement in DEBs that are linked to poor health long-term. These findings also provide directions for future research and clinical practice that may warrant consideration moving forward to help advance the evidence base and care for this historically overlooked and underserved population.

Independent and interactive associations of negative affect, restraint, and impulsivity in relation to binge eating among women.

There is growing recognition that impulsivity may serve as an underlying risk factor for binge eating. In addition, the association of impulsivity with binge eating may be moderated by other affective and cognitive risk factors. This study examined independent and interactive associations of negative affect, dietary restraint, and facets of impulsivity with binge eating. A diverse sample of 566 undergraduate women completed online questionnaires of study variables. Results revealed a three-way interaction of negative affect, dietary restraint, and attentional impulsivity in relation to binge eating. Women who were high on each of these three variables reported the greatest levels of binge eating. In addition, a two-way interaction was found for negative affect and nonplanning impulsivity in relation to binge eating, such that nonplanning impulsivity strengthened the association between negative affect and binge eating. Attentional and nonplanning facets of impulsivity may function as an underlying trait-level risk factor interacts with affective and/or cognitive risk (e.g., negative affect, dietary restraint) factors to predict elevated binge eating.

Sexual Coercion, Drinking to Cope Motives, and Alcohol-Related Consequences among Self-Identified Bisexual Women.

BACKGROUND: Given higher sexual victimization and greater alcohol use among bisexual women, a critical public health challenge is to understand within-group variation that may heighten or explain these associations in bisexual women. OBJECTIVES: The present study tested a moderated-mediation model in which sexual coercion was hypothesized to be associated with alcohol-related consequences via drinking to cope motives in self-identified bisexual women who reported at least occasional binge drinking. Negative affect was hypothesized to moderate the sexual coercion-drinking to cope motives association. METHODS: Participants were a community sample of 107 self-identified bisexual women (age M = 20.97, SD = 2.11) who completed an online survey and reported at least one binge drinking episode as well as engaging in sexual activity in the past 30 days. RESULTS: Of these participants, 57 (53.3%) reported one or more experiences of sexual coercion in the past 30 days. Sexual coercion was associated with negative alcohol-related consequences via drinking to cope motives. Negative affect moderated the association between sexual coercion and drinking to cope motives such that the association was stronger among women with greater negative affect. Conclusions/Importance: Methods of addressing vulnerability to sexual coercion and educating young bisexual women about the association between sexual coercion and potentially problematic affective coping through alcohol use are needed.

Examining social support, rumination, and optimism in relation to binge eating among Caucasian and African-American college women.

PURPOSE: Binge eating is a significant concern among college age women-both Caucasian and African-American women. Research has shown that social support, coping, and optimism are associated with engaging in fewer negative health behaviors including binge eating among college students. However, the impact of sources of social support (i.e., support from family, friends, and a special person), rumination, and optimism on binge eating as a function of race/ethnicity has received less attention. The purpose of this study was to examine the association between social support, rumination, and optimism and binge eating among Caucasian and American-American women, separately. METHOD: Caucasian (n = 100) and African-American (n = 84) women from a university in the Mid-Atlantic US completed an online survey about eating behaviors and psychosocial health. RESULTS: Social support from friends was associated with less likelihood of binge eating among Caucasian women. Social support from family was associated with less likelihood of binge eating among African-American women, but greater likelihood of binge eating among Caucasian women. Rumination was associated with greater likelihood of binge eating among Caucasian and African-American women. Optimism was associated with less likelihood of binge eating among African-American women. CONCLUSIONS: These results demonstrate similarities and differences in correlates of binge eating as a function of race/ethnicity.

A daily diary study of perceived social isolation, dietary restraint, and negative affect in binge eating.

Negative affect and dietary restraint are key predictors of binge eating, yet less is known about the impact of social factors on binge eating. The study sought to replicate and extend research on the relationships between negative affect, dietary restraint, perceived social isolation and binge eating using a daily diary methodology. College women (N = 54) completed measures of dietary restraint, negative affect, perceived social isolation, and binge eating daily for 14 days. Participants completed the measures nightly each day. A series of generalized estimating equations showed that dietary restraint was associated with less binge eating while controlling for negative affect and for perceived social isolation separately. Negative affect and perceived social isolation were associated with greater binge eating while controlling for restraint in separate analyses, but only perceived social isolation was significant when modeled simultaneously. All two-way interactions between negative affect, dietary restraint, and perceived social isolation predicting binge eating were nonsignificant. This study furthers our understanding of predictors of binge eating in a nonclinical sample. Specifically, these data suggest perceived social isolation, negative affect, and dietary restraint are important variables associated with binge eating in daily life and warrant further research.

Predictors of perpetration of men's same-sex partner violence.

This study examined alcohol consumption, internalized homophobia, and outness as related to men's (N = 107) reports of the perpetration of violence against a same-sex partner. Higher typical weekly alcohol consumption, higher levels of internalized homophobia, and less outness (e.g., lower levels of disclosure of one's sexual orientation) predicted the perpetration of partner violence. In contrast to what we expected, the interaction between higher alcohol consumption and higher levels of outness about one's sexual orientation (i.e., being open to friends, family members, work colleagues) increased the likelihood of participants' reports of perpetrating physical violence. These results suggest the importance of both alcohol consumption and sexual minority stressors and their interactions in understanding men's perpetration of same-sex partner violence.

Profiles of binge eating: the interaction of depressive symptoms, eating styles, and body mass index.

Binge eating is associated with depressive symptoms, eating styles, and obesity. However, less is known about interactions between these variables and binge eating. This study examined the relationship between depressive symptoms, eating styles, body mass index, and binge eating. Individuals with a higher body mass index, who reported more depressive symptoms and more external eating, reported the greatest binge eating. Similarly, individuals with a higher body mass index who reported more depressive symptoms and more emotional eating reported the greatest binge eating. These findings demonstrate possible profiles of individuals most at risk for binge eating and associated eating disorders.

Event-Level Drinking Intentions, Social Drinking Contexts, and Motives Affect Alcohol Consumption Among Same-Sex Female Couples.

OBJECTIVE: Young sexual minority women (SMW; e.g., lesbian, bisexual women) are at increased risk for heavy drinking, although SMW in relationships may be at less risk than those who are single. The current study examined how SMW partners influence drinking in the moment, if their own intentions predict drinking beyond partner influence and if this association is moderated by partner influence, and if their own drinking motives moderate partner influence. METHOD: Young adult same-sex female couples (N = 162 couples) were recruited to participate in a 14-day daily diary study where they reported each morning their drinking intentions, motives, and behavior as well as whether their partner was present during drinking occasions. RESULTS: Findings from multilevel structural equation models revealed that own intentions and select partner influences (i.e., intentions, drinking) were uniquely linked to a greater quantity of drinking at the within-subject level. Significant interactions between own intentions and partner intentions, and between partner intentions and select drinking motives (social and enhancement), on same-day alcohol use were found at the within-subject level. CONCLUSIONS: Findings suggest that partner influences have a strong effect on drinking at the daily level and can be strengthened or weakened when drinking for specific reasons. These findings expand on prior daily diary research on the effects of drinking motives by examining how these processes unfold in same-sex female couples and their intersection with partner intentions.

Refining an ecological momentary assessment study of binge eating among sexual minority and heterosexual young women: a mixed methods pilot study.

Background: Ecological momentary assessment (EMA) is used to capture daily lived experiences, states, and environments. Although EMA is commonly used in behavioral health research, there remains a dearth of literature on how researchers account for design considerations of EMA techniques when designing studies. The goal of this formative mixed methods study was to elicit feedback on EMA study procedures and materials from the target populations for a larger study about binge eating among sexual minority and heterosexual young women, in which data are collected entirely remotely. Methods: Sexual minority (n=12) and heterosexual (n=9) women ages 18-30 who binge ate took part in a pilot EMA study and exit interview and survey. As part of the consent and orientation process, participants reviewed video and written materials describing the study purpose and procedures. Using a smartphone app, for seven consecutive days they completed a survey each morning, 5 random surveys per day, and self-initiated a survey each time they binge ate. Participants then provided feedback on the study via a 1-hour virtual interview and online survey. Interviews were transcribed and reviewed by two coders to identify themes on the acceptability and feasibility of the EMA procedures with a focus on: (I) the training and study description materials; (II) general smartphone app and survey preferences; and (III) specific EMA survey question content and wording. Results: The qualitative and quantitative data converged to suggest participants were able to easily download and use the app to complete surveys and report on binge eating events. Participants provided feedback that was incorporated into revisions on general study procedures, the training video content, and EMA question content for binge eating, identity-related stressors, and appearance-related pressures. No systematic themes in the quantitative or qualitative data emerged to suggest questions were perceived differently by sexual minority and heterosexual young women. Conclusions: These findings provide evidence for the feasibility of conducting a remote EMA study to assess young women's experiences around binge eating. This formative study provides an example of how a mixed methods approach can be used to refine EMA study methods and questions to improve study design.

Still stressful after all these years: a review of lesbians' and bisexual women's minority stress.

This article reviews the conceptualization of, and empirical literature on, lesbians' and bisexual women's sexual minority stress. In much of the early research, the experiences of sexual minority women and men were considered together (or women's experiences were inferred from men's), obscuring important differences. There is empirical and theoretical justification to consider the experiences of women and men separately and to develop and evaluate comprehensive models of sexual minority stress for women. Existing conceptualizations of sexual minority stress that include assessment of discrimination, victimization, harassment, concealment, internalized homonegativity may be applied, and perhaps adapted, to facilitate understanding of the unique stressors associated with women's sexual minority status. Future research must include mediators of the relationship between stressors and outcomes such as individual (e.g., coping and resilience) and group (e.g., social support, identification with a sexual minority community) resources. It is also essential to understand what factors may buffer the deleterious effects of these stressors.

Recruiting Cisgender Female Couples for Health Disparity-Focused Daily Diary Research: Challenges, Successes, and Lessons Learned.

The underlying mechanisms of sexual minority women's (SMW's) numerous physical and mental health disparities compared to heterosexual women are not well understood. The contribution of relationship factors is particularly understudied; few studies collect data from both same-sex female partners. Further, most research among SMW is cross sectional which limits our understanding of day-to-day experiences of same-sex women's couples. This paper aimed to describe the feasibility of recruiting a large sample of SMW and their female partners for a disparity-focused daily diary study investigating alcohol use and mental health. A firm specializing in sexual minority market research was enlisted to help with recruitment from multiple sources and conducted an initial pre-screening of SMW and their female partners, at least one of whom drank alcohol regularly. A total of 4182 individuals completed the pre-screener, with information for 930 individuals (465 couples) being sent to the research team. From this, 376 individuals (188 couples) completed the study screener, met the inclusion criteria, and were invited to participate. Ultimately, 326 individuals (163 couples) consented and completed baseline. A total of 321 individuals, from 162 couples, began the daily diary portion of the study. Compliance with study procedures was excellent. The use of multiple recruitment sources increased the diversity of the sample. Challenges to recruitment, changes in protocol, and characteristics of the final sample are discussed.

The role of alcohol demand on daily microaggressions and alcohol use among emerging adult bisexual+ women.

Objective: Bisexual women drink more and have more alcohol consequences than heterosexual and lesbian women. This higher risk may in part be attributable to sexual orientation microaggressions. Drinking to cope motivations and alcohol demand may influence the association between microaggressions and alcohol use. The present study used a daily diary design to examine the association between microaggressions and same-day alcohol use (yes/no, quantity) and consequences, and if drinking to cope and alcohol demand moderate this association among bisexual+ (i.e., bi+) women. Method: Participants were 103 emerging adult bi+ women who completed a baseline assessment, including an alcohol purchase task to measure alcohol demand. Subsequently, participants reported their experiences of microaggressions, alcohol use, and alcohol consequences for 28 days. Multilevel model analyses were conducted. Results: Microaggressions were associated with a higher likelihood to drink and greater same-day alcohol use and consequences. The association between microaggressions and alcohol quantity was stronger for those who had a lower price associated with the highest expenditure (lower P max). For those who would stop drinking at lower price values (lower breakpoint), reported spending less overall on alcohol (lower O max), and had lower P max values, microaggressions were associated with more consequences. For those with higher breakpoint, O max, and P max microaggressions were not associated with consequences. Conclusions: Microaggressions may have a deleterious impact on alcohol use and consequences for bi+ women, particularly for those with lower alcohol demand. Clinicians should encourage bi+ clients to consider how microaggressions influence their drinking and support clients to engage in positive coping skills. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Rationale and Design of an Ecological Momentary Assessment Study Examining Predictors of Binge Eating Among Sexual Minority and Heterosexual Young Women: Protocol for the Health and Experiences in Real Life (HER Life) Study.

BACKGROUND: Previous research has identified health disparities between sexual minority and heterosexual women, including increased rates of obesity and binge eating in sexual minority women. Established predictors of binge eating behavior include negative emotions and sociocultural processes; however, these studies are generally conducted in samples of young women where sexual identity is not known or reported. There is a dearth of research evaluating how sexual minority-specific factors (eg, minority stress and connectedness to the lesbian, gay, bisexual, transgender, and queer community) may affect binge eating in sexual minority women. In addition, no studies have examined these processes in racially diverse samples or considered how intersecting minority identities (eg, Black and sexual minority) may affect eating behaviors. OBJECTIVE: The Health and Experiences in Real Life (HER Life) Project aims to clarify real-world predictors of binge eating in young heterosexual and sexual minority women using ecological momentary assessment. The role of affective, social, and health behavior factors in binge eating will be examined for all women (aim 1), and sexual minority-specific predictors will also be considered for sexual minority women participants (aim 2). Person-level moderators of race, body- and eating-related factors, and sexual minority-specific factors will also be examined to better understand how real-world binge eating predictors may differ for various demographic groups (aim 3). METHODS: Researchers aim to recruit 150 sexual minority and 150 heterosexual women from across the United States, including at least 50 Black women for each group, using web-based recruitment methods. The eligibility criteria include identifying as a woman, being aged between 18 and 30 years, and having had at least two binge eating episodes in the last 2 weeks. Participants must endorse being only or mostly attracted to men (considered heterosexual) or only or mostly attracted to women or having a current or most recent female partner (considered sexual minority). Eligible participants complete an initial web-based baseline survey and then 14 days of ecological momentary assessment involving the completion of a morning and before-bed survey and 5 prompted surveys per day as well as a user-initiated survey after binge eating episodes. The data will be analyzed using a series of multilevel models. RESULTS: Data collection started in February 2021. We have currently enrolled 129 sexual minority women and 146 heterosexual women. Data collection is expected to conclude in fall 2022. CONCLUSIONS: The Health and Experiences in Real Life Project aims to elucidate potential differences between sexual minority and heterosexual women in within-person factors predicting binge eating and inform eating disorder interventions for sexual minority women. The challenges in recruiting sexual minority women, including the determination of eligibility criteria and considerations for remote data collection, are discussed. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/41199.

Associations between body dissatisfaction and relationship functioning among same-sex female couples: An actor-partner interdependence model.

Nearly all past research about body dissatisfaction and romantic relationship factors is among heterosexual couples; little is known about these associations in sexual minority couples. The present study aimed to fill gaps in the current literature by using actor-partner interdependence models (APIMs) to examine dyadic patterns of association between body dissatisfaction and different aspects of relationship functioning among same-sex female couples. Participants were 163 same-sex female romantic dyads (326 women) between the ages of 18-35 years who completed measures of body dissatisfaction and relationship factors. Results from significance testing of actor and partner effects indicated higher levels of women's own body dissatisfaction were associated with lower levels of their own, but not their partner's, relationship satisfaction, closeness, sexual satisfaction, and intimacy/connectedness. Significance testing alone indicated that the association between one's own body dissatisfaction and their partner's relationship satisfaction was not significant. However, dyadic pattern testing identified a partner pattern for this effect, which suggests that the association between one's own body dissatisfaction and one's own relationship satisfaction is similar in magnitude and direction as that between an individuals' own body dissatisfaction and their partner's relationship satisfaction. In this study, women's own body dissatisfaction was found to be negatively associated with their own relationship functioning, which is consistent with findings of women in male-female couples. Thus, these findings highlight the important role that body dissatisfaction plays in women's relationship experiences. More research is needed to better understand potential cross-partner effects of body dissatisfaction and relationship factors in same-sex female couples. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A dyadic examination of alcohol use and intimate partner aggression among women in same-sex relationships.

Despite considerable evidence linking alcohol use and intimate partner aggression among mixed-sex couples, scant research has examined this association in same-sex couples using a dyadic framework. The aim of the present study was to examine associations between one's own and their partner's alcohol use (i.e., drinks per week, hazardous alcohol use) and intimate partner aggression (physical, psychological) perpetration while accounting for the interdependence among partners in alcohol use. Participants were 326 women (Mage = 27.57, SD = 3.65) from 163 female-female couples who independently completed measures of drinks per week, hazardous alcohol use, psychological intimate partner aggression victimization and perpetration, and physical intimate partner aggression victimization and perpetration. Actor-partner interdependence structural equation models found that (1) actor drinks per week were positively associated with one's own physical assault perpetration (2) actor hazardous alcohol use was positively associated with one's own physical assault and psychological aggression perpetration and (3) partner drinks per week and hazardous alcohol use were positively associated with actor's psychological aggression perpetration. No other significant effects were detected. Collectively, findings highlight the nuanced relationship between alcohol use and intimate partner aggression among same-sex female couples and suggest that one's own alcohol use is associated with intimate partner psychological and physical aggression perpetration. In contrast, the only partner effect was partner's alcohol use in association with actor's psychological aggression perpetration. These findings differ from prior research with heterosexual couples and underscore the need for future research with same-sex couples rather than attempts to generalize findings across populations.

Minority stress and alcohol use in sexual minority women's daily lives.

Sexual minority women (i.e., women who identify as lesbian, bisexual, or other non-heterosexual orientations) report more hazardous drinking compared to heterosexual women. Sexual minority stress (SMS), or experiences related to sexual orientation-based discrimination and marginalization, have been implicated as contributing to these disparities. The association between sexual minority stress and alcohol use has been supported in cross-sectional, and to a limited extent, longitudinal studies. Few studies, however, have examined associations between SMS and alcohol use in sexual minority women's daily lives. Young sexual minority women (age 18-35; N = 321) were recruited to participate in a 14-day daily diary study in which they reported each morning on their SMS and alcohol use (drinking or not; drinking quantity; alcohol consequences) from the previous day. SMS was operationalized in four ways (global negative SMS experiences, specific SMS events, concealment of identity, discrimination). Results from concurrent multilevel models revealed that on days when sexual minority women experienced more global negative SMS, any specific SMS event, or discrimination, they were more likely to drink. Further, prospective models indicated that participants drank more and were more likely to report binge drinking on the day after they experienced at least one SMS event. These findings extend prior research by demonstrating that the association between SMS and alcohol use extends to the daily level of analysis among sexual minority women. Understanding the connection between SMS and alcohol use among sexual minority women is imperative to developing culturally tailored interventions to improve the health and well-being of this at-risk group. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Evaluating study procedure training methods for a remote daily diary study of sexual minority women.

BACKGROUND: Ecological momentary assessment (EMA) methods can be used to remotely assess physical and mental health in daily life for hard-to-reach, marginalized, and geographically dispersed populations in the U.S., such as sexual minority women (e.g., lesbian, bisexual). However, EMA studies are often complex, and engaging participants from afar can be a challenge. This study experimentally examined whether adding videos to written recruitment materials would improve consent rates, reduce dropout rates, and improve survey completion rates for an online daily diary study. METHODS: As part of a 2-week study of same-sex female couples' health, 376 women ages 18-35 were recruited from across the U.S. using a market research firm. Couples were randomized to an introductory information condition (written + video materials or written-only materials) prior to informed consent. RESULTS: Overall, 97.1% of eligible women reviewed introductory materials and of these 96.7% consented; consent rates did not differ by condition (written + video: 97.1%, written-only: 97.1%). Dropout rates were low (5.4%) and survey completion rates were high (90.4% of surveys completed); there were no group differences for study dropout (written + video: 3.6%, written-only: 7.0%) or survey completion (written + video: 92.5%, written-only: 88.4%). Data from women randomized to receive videos indicated more than half (53.3%) did not watch any of the five videos in full. However, among those who viewed the videos, time spent watching videos, watching more videos in full, and watching at least one video in full were each positive associated with survey completion rates. CONCLUSIONS: In summary, we had high consent rates, low dropout rates, and high survey completion rates regardless of video instructions. Although sexual minority women can be hard to reach, our potential participants appeared highly motivated to take part in research, and thus video recruitment materials were not necessary to improve participation. Future experimental research to maximize EMA study design and implementation could be important for populations less inclined to participate in EMA studies, or who are less familiar with research.

Psychometric analysis and validity of the Daily Sexual Minority Stressors Scale among young adult same-sex female couples.

Sexual minority women experience greater health disparities relative to heterosexual women, which is thought to be due to unique stressors related to their sexual identities. Daily diary or momentary assessments may provide a more nuanced approach to understanding how sexual minority stressors relate to health behaviors than cross-sectional studies provide. To date, there is no validated measure to examine daily sexual minority stressors. A recent pilot study developed a brief (8-item) measure for assessing sexual minority stressors in self-identified lesbian or mostly lesbian women (Heron et al., 2018). Although an optimal number of items were generated to best capture the daily experiences of lesbian women, psychometric examination and validation of this new measure is necessary. Using multilevel confirmatory factor analysis among a fully scaled sample of sexual minority women, the present study established that the Daily Sexual Minority Stressors Scale has good model fit as a unidimensional measure (i.e., one factor at each level of analysis). Intraclass correlations indicate the majority of variation (57%) is within person. Additionally, we established convergent and discriminant validity using similar measures (single-item assessment, general stressors, negative affect, history of discrimination, and heterosexism). Finally, criterion validity was supported. At the daily level, experiencing daily sexual minority stressors was associated with a significantly greater likelihood of drinking alcohol that day. Experiencing more daily sexual minority stressors during the study period was significantly associated with a history of harassment and discrimination, victimization, isolation, vigilance, and also with acceptance concerns, difficult processes, and internalized homonegativity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Sexual Minority Stress and Social Support Explain the Association between Sexual Identity with Physical and Mental Health Problems among Young Lesbian and Bisexual Women.

Bisexual women report more physical and psychological health problems than lesbian women do, which may be attributed to greater sexual minority stress and less social support. However, many studies combine lesbian and bisexual women into a single group. The current study examined if sexual minority stress and social support mediated the association between women's sexual identity (lesbian or bisexual) and health-related outcomes. A total of 650 U.S. young adult lesbian (n = 227) and bisexual (n = 423) women completed an online survey about sexual minority stress, social support, and physical and mental health problems. Bisexual women reported more physical and mental health problems. A sequential mediation model showed that bisexual women reported greater sexual minority stress than lesbian women, which in turn was associated with less social support, which was associated with more physical and mental health problems. Greater sexual minority stress and lower social support may help explain why bisexual women report more health-related problems than lesbian women. The results of the present study support the importance of examining risk and protective factors for health problems separately for lesbian and bisexual women. Health-related intervention programs that target sexual minority women may need to be tailored differently for lesbian and bisexual women.

Clustered Patterns of Behavioral and Health-Related Variables Among Young Lesbian Women.

Lesbian women are at increased risk for a variety of mental and physical health problems compared to heterosexual women. In order to inform treatment and prevention, the purpose of this study was to examine behavioral and health-related patterns among lesbian women and elucidate how these patterns are associated with general discrimination, sexual minority stress, affect, and social support. A sample of self-identified lesbian women (N = 436) completed an online survey from August 2014-March 2015. A latent profile analysis was conducted using measures of body mass index, hazardous alcohol use, binge eating, eating disorder risk, and exercise as indicators. A 5-class solution best fit the data and included two healthy groups: (a) low health risk, moderate exercise (54%), (b) low health risk + high exercise (22%); and three unhealthy risk groups: (c) obese + binge eating (14%); (d) disordered eating + hazardous alcohol use (5%); (e) disordered eating + high exercise (5%). The three unhealthy classes generally reported more general discrimination, sexual minority stress, social anxiety, negative affect, and lower social support compared to the healthy classes. These findings show that behavioral and health-related variables cluster together in several distinct patterns among lesbian women. In addition, general discrimination and sexual minority stress and associated psychosocial functioning may be related to these maladaptive behavioral and health-related patterns and may be important to consider in behavioral interventions.