Project Summary/Abstract
Alcohol use is a prevalent problem among bi+ (bisexual, pansexual, queer) college students. Bi+ col-
lege students report disproportionately high rates of drinking and heavy episodic drinking (HED; i.e., consum-
ing 5+ drinks among people assigned male at birth, consuming 4+ drinks among people assigned female at
birth in 2 hours) relative to monosexual college students. Rates of trauma exposure and post-traumatic stress
disorder (PTSD) symptoms are also often highest among bi+ individuals. Bi+ people endure unique sexual mi-
nority stressors, including binegative discrimination from gay/lesbian and heterosexual individuals (enacted
stigma) and internalized binegativity (internalized stigma). Individuals with trauma histories may be vulnerable
to heightened stress responses to minority stressors and experiencing enacted stigma can provoke and exac-
erbate PTSD symptoms. Prior research supports the relationship between PTSD symptoms and alcohol use
and between sexual minority stress and alcohol use; however, there is limited understanding into whether
these factors synergistically increase the risk for alcohol use among bi+ young adults. Minority stress theory
(MST) suggests that health inequity among sexual minority individuals can be partially attributed to general life
stressors and sexual identity-related stressors, including enacted stigma and internalized stigma. The self-
medication model suggests that individuals with PTSD symptoms are more likely to drink alcohol to manage
distress. An integrated MST and self-medication model would suggest that the risk of alcohol use may be high-
est among those who experience co-occurring PTSD symptoms and minority stress. Additionally, risk for drink-
ing following enacted stigma may be especially high among bi+ individuals with elevated internalized stigma.
The overall objective of the proposed study is to elucidate the proximal associations between enacted stigma,
PTSD symptoms, and alcohol use among trauma-exposed bi+ college students. The study will identify the in-
teracting effects between daily enacted stigma and daily PTSD symptoms as well as between trait internalized
stigma and daily enacted stigma utilizing an ecological momentary assessment (EMA) design. No prior re-
search has examined the relationship between bi+ college students’ minority stress, PTSD symptoms, and al-
cohol use and whether these risk factors interact to predict increased drinking. Guided by MST and the self-
medication model, the proposed study will advance the understanding and prevention of alcohol misuse. The
specific aims of this proposed study are to: (1) evaluate whether PTSD symptoms and enacted stigma tempo-
rally relate to alcohol use (any, HED, and number of drinks) and (2) evaluate whether PTSD symptoms and
trait internalized stigma moderate the temporal association between enacted stigma and drinking. The pro-
posed study will examine these factors in 60 bi+ college students with trauma histories utilizing an innovative
EMA design. The proposed study is significant because it will identify specific risk factors to address in the pre-
vention and intervention of alcohol use among bi+ college students.
