Alcohol in the life narratives of women: Commonalities and differences by sexual orientation

Aim: The aim of this study was to explore social representations of alcohol use among women, with a focus on possible differences between sexual minority and heterosexual women. Methods: This qualitative study was part of a larger study examining mediators of heavier drinking among sexual minority women (lesbian identified, bisexual identified, and heterosexual identified with same sex partners) compared to heterosexual women based on the National Alcohol Survey. Qualitative in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey, including respondents representing different sexual orientation groups. Questions explored the lives and experiences of women, and how use of alcohol may connect to those experiences. Findings: Representations about normative and risky use included social use, use in relation to community connection, addictive use and self-medication. Other representations common across groups included articulation of boundaries that were defined by negative exemplars, marked by indicators of loss of control, and maintained through selective engagement of social networks. Although representations across groups were similar, some representations, such as alcohol use in fostering community connection, appeared to be more salient for sexual minority women. The findings of the study underscore the importance of considering both commonalities and potential differences among women by sexual orientation in meanings and perceived risks associated with alcohol use in future research and intervention efforts

Sexual Minority Women and Alcohol: Intersections between drinking, relational contexts, stress, and coping

Few studies explore sexual-minority women\u27s experiences and perceptions of alcohol. Qualitative interviews were conducted with six sexual-minority women who reported having sought help for alcohol problems in the past and six who did not. Themes emerged in two broad areas: (1) stressors that contributed to heavy or problem drinking and (2) factors that enhanced coping and reduced both stress and problem use. Alcohol use across groups was framed in terms of social context (e.g., bar patronage), stress management, and addiction. The findings of the study underscore the importance of considering the role of alcohol in managing stress as well as coping factors that may inform social service interventions

Lines in the sand: Social representations of substance use boundaries in life narratives

This study identifies social representations in interviews about alcohol and substance use in the discourse of 129 young adults, who were interviewed for 2.5 to 3.5 hr each for their life histories and use or nonuse of alcoholic beverages and drugs. Respondents spontaneously delineated their substance use boundaries, creating a continuum of behaviors with boundary points separating acceptable from unacceptable behaviors. They used signaling expressions to indicate go and stop signs and movement along the substance use continuum and reported negotiating substance use boundaries both internally and with peers. A ubiquitous narrative element was the cautionary tale, in which a negative exemplar goes too far with alcohol and/or drugs, providing an example of the possible negative outcomes of transgressing boundaries. In general, the narratives revealed complex relationships to alcohol and other drugs that may be useful in refining messages for more effective communication in prevention and intervention programs

Sexual Orientation Differences in the Relationship Between Victimization and Hazardous Drinking Among Women in the National Alcohol Survey

This study examined relationships between past experiences of victimization (sexual abuse and physical abuse in childhood, sexual abuse and physical abuse in adulthood, and lifetime victimization) and hazardous drinking among sexual minority women compared to exclusively heterosexual women. Data were from 11,169 women responding to sexual identity and sexual behavior questions from three National Alcohol Survey waves: 2000 (n = 3,880), 2005 (n = 3,464), and 2010 (n = 3,825). A hazardous drinking index was constructed from five dichotomous variables (5+ drinking in the past year, drinking two or more drinks daily, drinking to intoxication in the past year, two or more lifetime dependence symptoms, and two or more lifetime drinking-related negative consequences). Exclusively heterosexual women were compared with three groups of sexual minority women: lesbian, bisexual, and women who identified as heterosexual but reported same-sex partners. Each of the sexual minority groups reported significantly higher rates of lifetime victimization (59.1% lesbians, 76% bisexuals, and 64.4% heterosexual women reporting same-sex partners) than exclusively heterosexual women (42.3%). Odds for hazardous drinking among sexual minority women were attenuated when measures of victimization were included in the regression models. Sexual minority groups had significantly higher odds of hazardous drinking, even after controlling for demographic and victimization variables: lesbian (OR [sub]adj[sub] = 2.0, CI = 1.1–3.9, p \u3c .01; bisexual (OR [sub]adj[sub] = 1.8, CI = 1.0–3.3, p \u3c .05; heterosexual with same-sex partners (ORadj = 2.7; CI = 1.7–4.3, p \u3c .001). Higher rates of victimization likely contribute to, but do not fully explain, higher rates of hazardous drinking among sexual minority women. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)

Use of heavier drinking contexts among heterosexuals, homosexuals and bisexuals: Results from a national household probability survey.

Objective: Extensive use of specific social contexts (bars and parties, for instance) by homosexuals and bisexuals is thought to be a factor in the higher rates of drinking among these groups. However, much of the empirical evidence behind these assumptions has been based on studies with methodological or sampling shortcomings. This article examines the epidemiological patterns of alcohol contexts in relation to sexual identity, using a large, national, probability population survey. Method: We used the 2000 National Alcohol Survey for these analyses. The prevalence of spending leisure time in each of two social contexts (bars and parties) that are associated with heavier drinking is examined by sexual orientation (heterosexual, homosexual, bisexual and self-identified heterosexuals with same sex partners). In addition, we compare levels of drinking within these contexts by sexual orientation within these groups. Results: Exclusively heterosexual women spent less time in these two contexts relative to all other groups of women. Gay men spent considerably more time in bars compared with the other groups of men. Heterosexual women who reported same sex partners drink more at bars, and bisexual women drink more alcohol at both bars and parties than exclusively heterosexual women. For men, there were no significant differences for average consumption in any of these contexts. Entry of background and demographic variables into logistic regression analyses did little to modify these associations. Conclusions: There is empirical evidence that some groups of homosexual and bisexual women and men spend more time than heterosexual individuals in heavier drinking contexts. The frequency of being in these two social contexts does not appear to be associated with heavier drinking within these contexts for men, but it may be related to heavier drinking in those places among some groups of women

Reports of alcohol consumption and alcohol-related problems among homosexual, bisexual and heterosexual respondents: Results from the 2000 National Alcohol Survey

Objective: Few population-based studies have explored differences in alcohol consumption by sexual orientation. This study examined the prevalence of abstinence, drinking, heavier drinking, alcohol-related problems, alcohol dependence and help-seeking among homosexual and bisexual women and men compared with heterosexuals. Method: Data are from the 2000 National Alcohol Survey, a national population-based survey of adults (N = 7,612), a Random Digit Dialing telephone survey of all 50 states of the United States and Washington, DC. Four categories of sexual orientation were created using questions on both sexual orientation self-identification and behavior: homosexual identified, bisexual identified, heterosexual identified with same sex partners and exclusively heterosexual. Five alcohol measures (past year) were used in the analyses: (1) mean number of drinks, (2) days consuming five or more drinks on a single occasion, (3) drunkenness, (4) negative social consequences (2 or more) and (5) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, alcohol dependence. A lifetime measure of help-seeking for an alcohol problem was also analyzed. Results: Few significant differences were found among men by sexual orientation. By contrast, both lesbians and bisexual women had lower abstention rates and significantly greater odds of reporting alcohol-related social consequences, alcohol dependence and past help-seeking for an alcohol problem. Conclusions: These findings suggest that alcohol dependence and alcohol-related consequences differ by sexual orientation, particularly among women. These findings also emphasize the need for the inclusion of sexual-orientation items in population-based surveys so that prevalence rates within these subgroups can be effectively monitored

Gender Differences in Public and Private Drinking Contexts: A Multi-Level GENACIS Analysis

This multi-national study hypothesized that higher levels of country-level gender equality would predict smaller differences in the frequency of women’s compared to men’s drinking in public (like bars and restaurants) settings and possibly private (home or party) settings. GENACIS project survey data with drinking contexts included 22 countries in Europe (8); the Americas (7); Asia (3); Australasia (2), and Africa (2), analyzed using hierarchical linear models (individuals nested within country). Age, gender and marital status were individual predictors; country-level gender equality as well as equality in economic participation, education, and political participation, and reproductive autonomy and context of violence against women measures were country-level variables. In separate models, more reproductive autonomy, economic participation, and educational attainment and less violence against women predicted smaller differences in drinking in public settings. Once controlling for country-level economic status, only equality in economic participation predicted the size of the gender difference. Most country-level variables did not explain the gender difference in frequency of drinking in private settings. Where gender equality predicted this difference, the direction of the findings was opposite from the direction in public settings, with more equality predicting a larger gender difference, although this relationship was no longer significant after controlling for country-level economic status. Findings suggest that country-level gender equality may influence gender differences in drinking. However, the effects of gender equality on drinking may depend on the specific alcohol measure, in this case drinking context, as well as on the aspect of gender equality considered. Similar studies that use only global measures of gender equality may miss key relationships. We consider potential implications for alcohol related consequences, policy and public health

Body composition in young female eating-disorder patients with severe weight loss and controls: evidence from the four-component model and evaluation of DXA

BACKGROUND/OBJECTIVES: Whether fat-free mass (FFM) and its components are depleted in eating-disorder (ED) patients is uncertain. Dual energy X-ray absorptiometry (DXA) is widely used to assess body composition in pediatric ED patients; however, its accuracy in underweight populations remains unknown. We aimed (1) to assess body composition of young females with ED involving substantial weight loss, relative to healthy controls using the four-component (4C) model, and (2) to explore the validity of DXA body composition assessment in ED patients. SUBJECTS/METHODS: Body composition of 13 females with ED and 117 controls, aged 10-18 years, was investigated using the 4C model. Accuracy of DXA for estimation of FFM and fat mass (FM) was tested using the approach of Bland and Altman. RESULTS: Adjusting for age, height and pubertal stage, ED patients had significantly lower whole-body FM, FFM, protein mass (PM) and mineral mass (MM) compared with controls. Trunk and limb FM and limb lean soft tissue were significantly lower in ED patients. However, no significant difference in the hydration of FFM was detected. Compared with the 4C model, DXA overestimated FM by 5 +/- 36% and underestimated FFM by 1 +/- 9% in ED patients. CONCLUSION: Our study confirms that ED patients are depleted not only in FM but also in FFM, PM and MM. DXA has limitations for estimating body composition in individual young female ED patients

Science, technology, environment, and competitiveness in a North American context

Most economic activities pollute. Environmental regulations should serve the public good by providing incentives to reduce pollution caused by economic activity. Economic incentives include pollution taxes, subsidies for pollution abatement, and tradeable permits or allowances to pollute. Because of the political unacceptability of taxes and permits, much regulation imposes command and control measures and provides less incentive to minimize pollution. Efficient incentives would encourage pollution abatement up to the point where the cost of abatement equals the social and private benefit from the improvements in the environment. While these costs and benefits are difficult to measure, many analysts contend that the way environmental laws have been formulated and implemented in the US leads to very inefficient pollution control. This inefficiency can contribute to a decline in economic competitiveness in the long run, although economic studies do not support the ``pollution haven`` hypothesis. Better analysis (foresight) of the cost of transboundary pollution, significant in the Great Lakes region and along the US- Mexico border, as well as in rivers that flow between countries, is needed to formulate more effective policies and avoid sorry hindsight. Also, application of communal experience, technologies, and methods applied to shared problems can avoid costly duplication of searches for the optimal pollution abatement measures. 14 refs