Project Summary/Abstract
Women disproportionately experience violence compared to men;21-23 however, violence against women is not
distributed randomly. Due, in part, to their stigmatized identity, sexual minority women (SMW) are 2-3 times
more likely to face violence than heterosexual women.21, 24-26 Many women use alcohol to cope with the
negative sequelae of violence (e.g., PTSD).28 This comorbidity may be exacerbated among SMW given their
experiences of psychosocial stressors (i.e., violence and minority stressors such as discrimination).11 Despite
the public health necessity of developing targeted alcohol treatment approaches for victimized SMW, current
alcohol treatment models do not specify unique stressors and clinical needs of this population. Consistent with
the NIAAA’s research priorities,11, 14 the K01 will provide major advances in understanding biopsychosocial
mechanisms (e.g., minority stressors, physiological reactivity, PTSD) and moderators (e.g., race/ethnicity)
influencing the heterogeneity in hazardous drinking among SMW as well as the role that these core factors
play in SMW’s differential need for and response to treatment. The project will include: 1) an epidemiologic
assessment that uncovers distinct combinations of psychosocial stressors among SMW, identifies racial/ethnic
differences in classes of psychosocial stressors, and determines how these patterns of psychosocial stressors
predict comorbid PTSD and hazardous drinking over 11 years (n = 450-600); 2) a lab-based study that advances
knowledge of the influence of minority stressors on allostatic load (e.g., salivary cortisol, heart rate, heart rate
variability, and skin conductance) among victimized SMW (n = 125); and, 3) a once-daily ecological
momentary assessment (EMA) approach over 21 days that determines the role of minority stressors as
antecedents to daily fluctuations in PTSD and hazardous drinking using the same sample of SMW from the
lab-based study. The proposed training plan in this K01 application will provide essential knowledge and skills
that the principal investigator, Jillian R. Scheer, PhD, needs to become an independent, interdisciplinary
alcohol scientist. The advanced training acquired by Dr. Scheer via this timely and innovative project will target
3 objectives: (1) rigorous alcohol research methodology and its application to studying determinants of
hazardous drinking patterns; (2) physiological measurement of stress reactivity as a tool to assess biological
mechanisms underlying the influence of minority stressors on comorbid PTSD and hazardous drinking; and, (3)
EMA approaches to assess the proximal effects of minority stressors on daily comorbid PTSD and hazardous
drinking among racially diverse SMW. Dr. Scheer will be primarily mentored by John Pachankis, PhD, at Yale
University, with additional mentoring from Tonda Hughes, PhD (Columbia University), Rajita Sinha, PhD (Yale
University), Tami Sullivan, PhD (Yale University), Joshua Warren, PhD (Yale University), and Robert Pietrzak,
PhD, MPH (Yale University). Dr. Scheer’s training through the K01 award will ensure her success as an
independent scientist whose work informs public health and clinical efforts to reduce alcohol use among SMW.
