Substance Use and Sexual-Minority Status: Examining the Mediating Roles of Stress and Emotion Dysregulation in Young Adult Women

Connor J. McCabe, Alison E. Hipwell, Kate Keenan, Stephanie D. Stepp, Tammy Chung, Kevin M. King

Publication Date: 09/15/2021

Sexual-minority women (SMW) report higher rates of substance use and disorder across the life span and greater levels of minority stress in adolescence and young adulthood. Minority stress mediation models propose that higher levels of social stressors may increase emotion dysregulation, which in turn increases the propensity toward substance misuse. Few studies, however, have prospectively examined the impact of stressors and emotion dysregulation among SMW on early and escalating substance use. In this longitudinal study, we examined whether emotion dysregulation and social stress mediated the association between sexual-minority status and developing substance use (ages 17–22) in a sample of 2,201 heterosexual and 246 SMW participants in the Pittsburgh Girls Study. Results supported serial mediation processes of marijuana-use risk: SMW reported higher levels of social stress in late adolescence, which in turn predicted greater emotion dysregulation that was associated with greater marijuana use by young adulthood.