Dyadic effects of minority stress and problematic alcohol use on sexual intimate partner violence in same sex couples.

Little is known about the factors that facilitate the perpetration of sexual violence within the context of same-sex romantic relationships (sexual intimate partner violence perpetration [S-IPV]). The present study sought to identify the effects of external and internal minority stress and problematic drinking on perpetration of S-IPV within a dyadic framework. A community-based sample of 137 sexual and gender minority (SGM) couples (N = 274; 59 male assigned at birth and 78 female assigned at birth couples) completed self-report surveys about minority stressors, alcohol use, and S-IPV perpetration. Multilevel logistic regression analyses were conducted within an actor-partner interdependence framework. This approach accounted for both actor effects (e.g., how much one's S-IPV perpetration is predicted by their own risk factors) and partner effects (e.g., how much one's S-IPV perpetration is influenced by their partner's risk factors). Both Actor external minority stress and internal minority stress were positively associated with Actor S-IPV perpetration. Actor problematic drinking was not associated with Actor S-IPV perpetration; however, Partner problematic drinking was positively associated with Actor S-IPV perpetration. Observed effects were robust above the addition of other risk factors. This research innovatively extricates S-IPV perpetration from other forms of IPV and indicates that Actor minority stress and Partner problematic drinking increase S-IPV likelihood. Results serve as a starting point for development of etiological models to inform the design of culturally-informed interventions to reduce S-IPV among SGM couples.

COVID Stress, socioeconomic deprivation, and intimate partner aggression during the COVID-19 pandemic.

BACKGROUND: Intimate partner aggression (IPA) is a prevalent public health concern that is associated with multiple negative consequences. Rates of IPA in the U.S. have increased since the onset of the Coronavirus Disease 2019 (COVID-19) pandemic, likely due to stress associated with the pandemic. Socioeconomic deprivation is associated with COVID-19 outcomes as well as IPA. However, whether socioeconomic deprivation interacts with COVID-19 stress in predicting IPA remains unclear. METHODS: Using a sample of 510 individuals recruited via Qualtrics Research Services in April 2020, the present study tested whether socioeconomic deprivation moderates the association between COVID-19 stress and IPA perpetration and victimization. Participants completed a questionnaire battery that included measures of COVID-19 stressors and physical and psychological IPA perpetration and victimization. In addition, participants reported their residential zip codes, which were subsequently matched with scores on the Social Deprivation Index, a composite measure of seven demographic variables from the 5-year American Community Survey. RESULTS: Sequential generalized linear models in Mplus Version 8.7 showed that the effects of COVID-19 stress on physical IPA perpetration and psychological IPA victimization can be best understood through its interactive effects with socioeconomic deprivation. Higher COVID-19 stress was associated with higher levels of physical IPA perpetration and psychological IPA victimization when socioeconomic deprivation was low but not when socioeconomic deprivation was high. Importantly, however, overall rates of IPA were higher among individuals with higher socioeconomic deprivation than among individuals with lower socioeconomic deprivation, regardless of the amount of COVID-19 stress they experienced. CONCLUSIONS: The present analyses implicate COVID-19 stress as a critical correlate of IPA and show that the association between this stress and physical IPA perpetration and psychological IPA victimization may be particularly salient among individuals who live in areas of lower socioeconomic deprivation. Furthermore, our results clearly pinpoint the detrimental effects of socioeconomic deprivation more broadly, showing that individuals who live in more deprived areas tend to have high levels of IPA regardless of their level of COVID-19 stress. These findings call for public health policies at the community and societal level that target not only COVID-related stress but also the impacts of socioeconomic inequality.

The Effect of State, Trait, and Situational Factors on Young Men's Coercive Condom Use Resistance.

Coercive Condom Use Resistance (CUR) is a significant problem, associated with increases in STIs, unplanned pregnancy, feelings of betrayal, and a loss of sexual autonomy. Furthermore, young men are much more likely to perpetrate coercive CUR than young women. Thus, the present study sought to examine the past experiences, trait characteristics, and state emotions which may precede coercive CUR perpetration intentions, including alcohol intoxication, childhood emotional abuse, trait impulsivity, sexual sensation seeking, state impulsivity, and state anxiety, using an alcohol administration procedure. Young, single, non-problem drinking, and sexually active men who have sex with women from the United States (N = 297; 66% White, 9.4% Black, 10.7% Multi-racial, 5.1% Asian, 1.0% Native American, 1.0% Pacific Islander, and 10.4% Hispanic or Latino) were recruited for participation. They were randomly assigned to either receive alcohol or remain sober before projecting themselves into a hypothetical sexual scenario with a woman who asked to use a condom. Results showed that greater levels of childhood emotional abuse were associated with increased trait impulsivity and sexual sensation seeking, and that sexual sensation seeking was associated with increased state impulsivity and subsequent anxiety during the scenario. Finally, alcohol intoxication moderated the relationship between state anxiety and coercive CUR such that state anxiety was positively associated with coercive CUR among intoxicated men only. Findings suggest that interventions targeting coercive CUR behavior may be improved by focusing on men who have experienced childhood trauma, as well as their alcohol consumption and in-the-moment experiences of impulsivity and anxiety.

The Role of Alcohol-Related Behavioral Risk in the Design of HIV Prevention Interventions in the Era of Antiretrovirals: Alcohol Challenge Studies and Research Agenda.

HIV/AIDS remains a significant health threat and alcohol is a robust contributing factor. After 25 years of alcohol challenge studies investigating alcohol-related behavioral risk (ARBR), much has been learned delineating how drinking influences sexual transmission. We examine this research and consider its relevance for interventions in the era of antiretrovirals. We consider prototypic alcohol challenge methods, illustrative findings, and prevention/intervention implications, noting three perspectives: (a) scale up/extend existing interventions, including identifying under-targeted risk groups and intersecting with PrEP/PEP interventions; (b) modify existing interventions by cultivating psychoeducational content related to alcohol expectancies, alcohol myopia, sexual arousal, risk perception, sexual abdication, and condom use resistance; and (c) innovate new interventions through Science of Behavior Change approaches and repurposing ARBR paradigms. Finally, we suggest research directions concluding that until HIV incidence diminishes significantly, psychosocial interventions addressing the nexus of alcohol use, sexual transmission, and adherence to biomedical protocols will be an important priority.

Predicting rape events: The influence of intimate partner violence history, condom use resistance, and heavy drinking.

Sexual aggression perpetration is a public health epidemic, and burgeoning research aims to delineate risk factors for individuals who perpetrate completed rape. The current study investigated physical and psychological intimate partner violence (IPV) history, coercive condom use resistance (CUR), and heavy episodic drinking (HED) as prospective risk factors for rape perpetration. Young adult men (N = 430) ages 21-30 completed background measures as well as follow-up assessments regarding rape events perpetrated over the course of 3 months. Negative binomial regression with log link function was utilized to examine whether these risk factors interacted to prospectively predict completed rape. There was a significant interaction between physical IPV and HED predicting completed rape; men with high HED and greater physical IPV histories perpetrated more completed rapes during follow-up than men with low HED at the same level of physical IPV. Moreover, psychological IPV and coercive CUR interacted to predict completed rape such that men with high coercive CUR and greater psychological IPV histories perpetrated more completed rapes throughout the follow-up period than men with low coercive CUR at the same level of psychological IPV. Findings suggest targets for intervention efforts and highlight the need to understand the topography of different forms of aggression perpetration.

Sexual Assault Severity and Depressive Symptoms as Longitudinal Predictors of the Quality of Women's Sexual Experiences.

Depressive symptoms are one consequence of adult/adolescent sexual victimization (ASV) and are linked to sexual health. Female nonproblem drinkers (N = 419) with an ASV history participated in a one-year longitudinal study. Participants completed measures of lifetime ASV severity and four quarterly assessments of depressive symptoms, ASV severity, and sexual experience quality. Multilevel models revealed that depressive symptoms interacted with ASV severity: Women with low-lifetime ASV severity reported higher ratings of sexual pain as depressive symptoms increased. ASV reported during assessment months predicted sexual experience quality. Interventions to improve survivors' sexual experiences should consider incorporating treatment for depressive symptoms.

Women's Sex-Related Dissociation: The Effects of Alcohol Intoxication, Attentional Control Instructions, and History of Childhood Sexual Abuse.

This study examined influences of alcohol intoxication, attentional control, and childhood sexual abuse (CSA) severity on sex-related dissociation. Sex-related dissociation is defined here as dissociation (e.g., feeling as if the world is unreal and feeling disconnected from one's body) during sexual activity or in the presence of sexual stimuli. Women (N = 70) were randomized to a 2 (alcohol condition: none,.10% peak breath alcohol concentration) X 2 (attentional control instructions: none, "relax and maximize" sexual arousal) experiment and exposed to sexual stimuli. Alcohol intoxication was positively associated with sex-related dissociation. CSA severity and sex-related dissociation were positively associated in the no-instruction condition but not in the "relax and maximize" condition. For some women, efforts to relax and maximize sexual arousal may buffer the association between CSA and sex-related dissociation.

Partner Pressure, Victimization History, and Alcohol: Women's Condom-Decision Abdication Mediated by Mood and Anticipated Negative Partner Reaction.

Highly intoxicated versus sober women were evaluated using multi-group path analyses to test the hypothesis that sexual victimization history would interact with partner pressure to forgo condom use, resulting in greater condom-decision abdication-letting the man decide whether or not to use a condom. After beverage administration, community women (n = 408) projected themselves into a scenario depicting a male partner exerting high or low pressure for unprotected sex. Mood, anticipated negative reactions from the partner, and condom-decision abdication were assessed. In both control and alcohol models, high pressure increased anticipated negative partner reaction, and positive mood was associated with increased abdication. In the alcohol model, victimization predicted abdication via anticipated negative partner reaction, and pressure decreased positive mood and abdication. In the control model, under high pressure, victimization history severity was positively associated with abdication. Findings implicate condom-decision abdication as an important construct in understanding how women's sexual victimization histories may exert sustained impact on sexual interactions.

Distal and Proximal Influences on Men's Intentions to Resist Condoms: Alcohol, Sexual Aggression History, Impulsivity, and Social-Cognitive Factors.

Recent scientific evidence demonstrates that many young men commonly resist condom use with their female sex partners and that both alcohol intoxication and a history of sexual aggression may increase the risk of condom use resistance (CUR). Using a community sample of heterosexual male non-problem drinkers with elevated sexual risk (N = 311), this alcohol administration study examined the direct and indirect effects of intoxication and sexual aggression history on men's CUR intentions through a sexual risk analogue. State impulsivity, CUR-related attitudes, and CUR-related self-efficacy were assessed as mediators. Results demonstrated that alcohol intoxication directly increased CUR intentions, and sexual aggression history both directly and indirectly increased CUR intentions. These findings highlight the importance of addressing both alcohol use and sexual aggression in risky sex prevention programs, as well as indicate the continued worth of research regarding the intersection of men's alcohol use, sexual aggression, and sexual risk behaviors, especially CUR.

Preliminary Efficacy of a Web-Based Alcohol and Emotion Regulation Intervention on Sexual Risk Behaviors Among College Women.

OBJECTIVE: Using substances before sex may impact sexual decision-making among young women and increase their risk for a variety of negative consequences, including sexual victimization, sexually transmitted infections, and unwanted pregnancies. A brief, web-based intervention combining alcohol reduction strategies with emotion regulation (ER) skills demonstrated initial efficacy at reducing heavy drinking and improving ER abilities among college women with sexual victimization histories. The present study represents a secondary analysis of this intervention to evaluate its preliminary efficacy on reducing sexual risk behaviors, specifically alcohol and drug use before sex. METHOD: The sample comprised 200 heavy drinking college women with histories of sexual victimization randomized to an assessment only control or the intervention consisting of 14 brief online alcohol reduction and ER skill building modules administered daily over a two-week period. The analytic sample included 173 women who reported on their substance use before sex at baseline and at least one of two (1-mo and/or 6-mo) follow-up surveys. RESULTS: Repeated measures mixed models revealed significant time-by-intervention interaction effects on alcohol use. Women who received the intervention had a significant decrease in alcohol use before sex from baseline to 1-month follow-up. Although levels of alcohol use before sex continued to be lower at the 6-month follow-up relative to baseline, differences did not reach statistical significance. Time-by-intervention interaction effects on drug use before sex were not statistically significant. CONCLUSIONS: Skills to reduce alcohol use and improve ER skills may be beneficial in helping women make adaptive decisions surrounding their sexual wellbeing.

Alcohol-involved rape: Limitations of the "rape exception" for abortion access.

OBJECTIVE: In June 2022, the U.S. Supreme Court removed federal abortion protections, giving individual states the authority to enact abortion regulations. Since that ruling, many states have enacted abortion bans; however, several of these states allow "rape exceptions," theoretically providing rape victims who become pregnant access to abortion services. Notably, alcohol use by the rape victim and perpetrator is common. In this brief report, we describe findings from research on alcohol-involved rape that have the potential to impact the utility of rape exceptions. METHOD: In this synthesis of the research literature pertaining to alcohol-involved rape victimization and perpetration, we focus on key concepts detailed in extant research likely relevant to accessing abortion services through rape exceptions. RESULTS: Victim alcohol intoxication may limit the use of rape exceptions to abortion bans by delaying rape acknowledgment, increasing victim blame, undermining victim credibility, and deterring rape reporting. Commensurately, perpetrator alcohol intoxication may increase the need for victims to access abortion services by reducing perpetrator condom use during rape and increasing other sexually aggressive acts such as nonconsensual condom removal. CONCLUSIONS: Research evidence suggests that alcohol-involved rape incidents present critical obstacles to utilizing statutory rape exceptions to banned abortion services beyond challenges that non-alcohol-involved rape survivors are also likely to experience. Rape survivors from oppressed communities (e.g., people of color, gender minorities, and/or sexual minorities) may be disproportionately impacted. Empirical investigations specifically examining how substance use during rape impacts reproductive health care accessibility are paramount for informing health care providers, law enforcement, legal practitioners, and policymakers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Alcohol Expectancies for Sexual Enhancement, Event-Level Alcohol Use, and Likelihood of Sexual Aggression Perpetration: A Timeline Followback Approach.

Sexual aggression (SA) is a significant public health problem, with the majority of SA involving alcohol. The present study examined associations between alcohol expectancies for sexual enhancement, event-level alcohol use, and the likelihood of SA perpetration. Young, adult non-problem drinking men participated in a laboratory session and completed a background survey that included measures of alcohol expectancies. Subsequently, men completed 6-week and 3-month follow-up surveys in which they reported their sexual experiences each day during the intervening 6-week period using Timeline Followback procedures. The analytic sample consisted of the 421 men (Mage = 24.66, SD = 2.69) who reported having sex at least once during the follow-up period. Multilevel models showed a significant alcohol expectancies X alcohol use interaction at the between-person level: Controlling for time and alcohol expectancies for aggression, stronger alcohol expectancies for sexual enhancement were associated with greater SA perpetration likelihood among men who consumed high amounts of alcohol before sexual encounters but not among men who consumed low amounts. Alcohol prevention programs should consider addressing men's alcohol expectancies for sexual enhancement to reduce risk for SA perpetration.

Men's Coercive Condom Use Resistance: The Roles of Alcohol and Emotional Factors.

OBJECTIVE: Men's coercive condom use resistance (CUR) with female partners is common and is associated with greater alcohol consumption than men's noncoercive CUR engagement. Prior research indicates that emotion-related factors are relevant to alcohol-involved coercive CUR. Thus, in this alcohol administration study, we examined emotional factors as distal and proximal predictors of alcohol-involved coercive CUR among young men who have sex with women. METHOD: Non-problem drinking young adult men who have sex with women (N = 282) were recruited from the local community, and as part of a larger study, completed a background survey and an in-lab alcohol administration session that included a mood induction and sexual scenario task using a 2 (sober vs. intoxicated) x 2 (positive mood vs. negative mood) experimental design. RESULTS: Path analysis testing a moderated mediation model revealed that for participants in the sober, positive mood, and intoxicated, negative mood conditions, there was a positive association between distal ER difficulties and motives to have sex to cope with negative emotions. Additionally, distal ER difficulties were positively associated with proximal difficulties modulating one's emotions among intoxicated participants. Among those with greater proximal difficulties modulating their emotions, state anger was positively associated with coercive CUR intentions. CONCLUSIONS: Results demonstrate the importance of alcohol intoxication, emotions and emotion regulation, and sexual coping motives in men's coercive CUR likelihood, demonstrating potential malleable targets for prevention efforts.

Preliminary Efficacy of a Cognitive Restructuring Intervention for Intimate Partner Aggression: Emotional Clarity as a Mechanism of Change.

Despite the fact that intimate partner aggression (IPA) is a widespread public health problem, empirically supported interventions for IPA are limited. Furthermore, existing interventions tend to be resource-intensive and may not adequately address the risk factors that serve to maintain IPA, resulting in challenges to intervention dissemination and implementation. Based on theoretical and empirical findings linking emotional clarity and IPA, this study represents a secondary data analysis to evaluate the preliminary efficacy of a brief web-based cognitive restructuring (CR) intervention to reduce psychological and physical IPA perpetration intentions by increasing emotional clarity skills. In all, 137 men were randomized into a CR intervention versus control condition and subsequently completed an aggression analog scenario. Results of structural equation modeling analyses showed a significant indirect effect of the intervention on psychological IPA intentions via increased emotional clarity. Specifically, men in the CR intervention condition evidenced greater emotional clarity as compared to men in the control condition, which, in turn, was related to lower intentions to perpetrate psychological IPA. The indirect effect from the CR intervention to physical IPA intentions via emotional clarity was not statistically significant. These findings provide promising initial support for the usefulness of the current CR intervention in reducing psychological IPA. Next steps in this line of research include expansion to a randomized controlled trial that tests intervention effects on real-world IPA perpetration across more diverse samples. Importantly, our findings highlight that CR skills can be delivered via a brief web-based intervention, which decreases potential barriers to dissemination and implementation.

Preliminary Efficacy of a Web-Based Alcohol and Emotion Regulation Intervention on Intimate Partner Aggression Among College Women.

Objective: Intimate partner aggression (IPA), encompassing psychological and physical aggression, is a public health concern due to its high rates among young adults. Research and theory connect heavy drinking and emotion regulation (ER) difficulties to IPA and highlight their potential role in reducing IPA. A web-based intervention combining alcohol reduction strategies with ER skills demonstrated initial efficacy at reducing heavy drinking and improving ER abilities among college women with sexual assault victimization histories. Method: The present study represents a secondary analysis of this brief web-based intervention to evaluate its preliminary efficacy on IPA. The sample comprised 200 heavy drinking college women with histories of sexual assault victimization randomized to an assessment only control or the intervention consisting of 14 brief online alcohol reduction and ER skill building modules administered daily over a two-week period. The analytic sample included 103 women who reported their psychological and physical IPA at both the 1- and 6-month follow-up surveys. Results: After controlling for alcohol use, repeated measures mixed models examining changes from baseline to 6-month follow-up by condition revealed a significant time-by-intervention interaction effect on psychological IPA. Women who received the intervention had a significant decrease in psychological IPA from baseline to 6-month follow-up; there was no change in psychological IPA among women in the control condition. There was no significant effect of the intervention on physical IPA. Conclusion: Reducing alcohol use and improving ER skills may be beneficial in helping women cope with relational conflict, thereby decreasing their use of psychological IPA.

Personalized normative feedback for hazardous drinking among college women: Differential outcomes by history of incapacitated rape.

OBJECTIVE: Personalized normative feedback (PNF) interventions are effective at reducing hazardous drinking in college. However, little is known about who is most receptive to PNF. College women with a history of alcohol-related incapacitated rape (IR) are at elevated risk for hazardous drinking, but it is unclear what impact intervention messaging may have on this group and how their outcomes compare to those without past IR. To address this gap, this study involved secondary data analysis of a large web-based clinical trial. METHOD: Heavy drinking college women (N = 1,188) were randomized into PNF (n = 895) or control conditions (n = 293). Postintervention, women reported their reactions to intervention messaging. Hazardous drinking outcomes (typical drinking, heavy episodic drinking [HED], peak estimated blood alcohol content [eBAC], blackout frequency) were assessed at baseline and 12 months. RESULTS: Past IR was reported by 16.3% (n = 194) of women. Women with a history of IR reported more baseline hazardous drinking and greater readiness to change than women without IR. For those who received PNF, history of IR related to greater perceived impact of the intervention, but no difference in satisfaction with the message. After controlling for baseline drinking, regressions revealed the effect of PNF was moderated by IR for frequency of HED at 12 months. Simple main effects revealed PNF was associated with lower levels of hazardous drinking at follow-up among women with past IR. CONCLUSIONS: This initial investigation suggests PNF is a low resource and easily disseminated intervention that can have a positive impact on college women with past IR. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Emotion Regulation and Intimate Partner Violence Perpetration in Undergraduate Samples: A Review of the Literature.

Intimate partner violence (IPV) perpetration increases throughout young adulthood and is particularly widespread among college students, resulting in mental health and academic consequences. Deficits in emotion regulation (ER) are an important factor associated with IPV perpetration; the developmental tasks and challenges associated with college, including relationship stressors and hazardous alcohol use, implicate ER as a particularly relevant risk factor for IPV perpetration. Thus, college presents an important opportunity for intervention in order to change the trajectories of IPV perpetration across young adulthood. The purpose of this review was to synthesize findings regarding ER and psychological, physical, and sexual IPV perpetration among college students. Twenty-one articles met inclusion criteria. Studies were organized into five categories: (a) direct associations of ER with IPV perpetration, (b) qualitative assessment of ER and IPV, (c) ER in indirect effects models, (d) ER in moderation models, and (e) experiments with ER instructional sets. Overall, ER emerged as an important inhibiting factor for IPV perpetration, particularly impulse control and access to ER strategies. ER deficits in the context of impelling (e.g., negative affect, trauma history) and instigating (e.g., provocation) factors emerged as consistent predictors of psychological and physical IPV perpetration for both male and female students. Deficits in ER were associated with sexual IPV perpetration among men; however, very few studies examined sexual IPV. Experimental paradigms suggest cognitive reappraisal may reduce IPV perpetration, while suppression may, in some contexts, increase perpetration. Methodological strengths and weaknesses and implications for IPV prevention and interventions programming for college students are discussed.

A pilot study of the acceptability, efficacy, and iatrogenic effects of a brief dynamic norms intervention for reducing young adult alcohol use.

BACKGROUND: Alcohol use and its related consequences are a public health problem among young adults. Building upon efficacious personalized normative feedback interventions, dynamic norms can be used to highlight the decreasing prevalence of alcohol use over time among young adults' peers, thereby increasing their motivation to change drinking consistent with the trend. Because limited research has examined dynamic norms feedback interventions for alcohol use, we examined the acceptability and initial efficacy of such an intervention, and potential iatrogenic effects of showing norms feedback about drinking to light drinkers and nondrinkers. METHODS: Participants were 546 unvaccinated young adults ages 18-24 who completed a baseline survey, intervention, and 1-month follow-up assessment. Participants were block randomized to receive a brief web-based dynamic norms intervention, with feedback content focused on either (a) alcohol-related behaviors (intervention) or (b) COVID-19 vaccine behaviors (the attention-matched control for the present study). RESULTS: On average, participants who received the alcohol intervention rated it as generally engaging, helpful, and acceptable, with the majority (90.8%) indicating that they would recommend it to a friend. Supporting initial efficacy, in generalized linear models controlling for demographics and baseline alcohol outcomes, at 1-month follow-up the alcohol intervention was associated with statistically and clinically significant reductions in all indices of perceived drinking norms, drinking quantity, drinking frequency, and driving after drinking occasions. Lighter drinkers showed no adverse iatrogenic effects. CONCLUSIONS: Presenting alcohol-related personalized normative feedback using dynamic trends is a promising intervention for reducing alcohol use in a community sample of young adults. Further research clarifying the optimal presentation of dynamic norms is needed.

Cannabis to cope with COVID-19 in college.

Objective: Cannabis use in college students has increased over time and is linked to negative consequences. During the COVID-19 pandemic, many students experienced greater stress, which could heighten cannabis use and related consequences. This study was designed to clarify motivations for cannabis use that may link pandemic-related stressors to time spent high and cannabis-related consequences.Participants: A total of 488 cannabis-using college students (75% women) participated.Methods: A cross-sectional survey was administered in Fall 2020 and Spring 2021 to examine students' experiences during the pandemic.Results: Indirect effects revealed that pandemic-related social stressors were linked to coping and boredom motives, and in turn, more hours spent high and cannabis-related consequences. Similarly, pandemic-related distress was associated with more coping motives and in turn, more hours spent high and cannabis-related consequences.Conclusions: Findings suggest prevention and intervention efforts may benefit from emphasizing alternative coping methods, including enhanced social support, during prolonged stressors.

An event-level evaluation of women's self-medicated drinking: The role of sexual assault severity, affect, and drinking motives.

OBJECTIVE: Women with sexual assault (SA) histories report heavier and more frequent drinking. Consistent with the motivational model of alcohol use, women with SA histories may consume alcohol to both downregulate negative emotions and upregulate positive ones. The present event-level study used a Bayesian multilevel moderated mediation approach to examine the extent to which women's alcohol use and intoxication was influenced by coping and enhancement drinking motives to downregulate or upregulate affect, respectively. METHOD: Women ages 21-30 were recruited from the community to participate in a larger study that included a 32-day daily diary assessment of affect, drinking motives, and alcohol use. RESULTS: We found consistent support for women's tendencies to be motivated to drink to cope or enhance negative or positive affect, respectively, and those drinking motives were associated with indicators of increased drinking. Becoming intoxicated to downregulate negative emotion was common and this pathway was particularly strong for women who reported more severe SA histories. Although women with more severe SA histories were generally more likely to drink more, they were not likely to do so as a way to enhance positive experiences. CONCLUSIONS: Alcohol interventions that provide adaptive regulatory strategies are needed for women who experience increased negative or positive affect, with a particular focus on self-medication for young women with more severe SA histories. (PsycInfo Database Record (c) 2023 APA, all rights reserved).