Stigma towards sexual minorities increases alcohol craving


Exposure to stigma elicits negative mood and alcohol craving among sexual minority young adults who are heavy drinkers, according to findings from a novel study at American University, Washington, DC, and Brown University, Rhode Island.

Sexual minority young adults are at higher risk of hazardous drinking and alcohol use disorder than their heterosexual counterparts, with many adverse consequences for health and well-being. However, little has been known about the causes of alcohol use and misuse among this group.

The new study examined the effects of vicarious exposure to stigma on mood and alcohol cravings among twenty heavy-drinking young adults who self-identified as bisexual, gay, lesbian or queer. Most of the participants met diagnostic criteria for alcohol use disorder. In a laboratory setting, the participants were shown images of real-life examples of sexual stigma ─such as hate crime scenes, heterosexist grafitti, and news reports – and were asked to imagine that they were the victims of these scenes. On another visit to the laboratory, participants viewed images of negative events against heterosexual people (classed for research purposes as ‘general unpleasant’ images), and on a third visit viewed images of events involving everyday people (classed as ‘neutral’). After viewing each set of images, participants rated their current mood and the strength of their craving for alcohol.  Alcohol craving was also assessed after exposing participants to a glass of their usual alcoholic beverage.  

The researchers found that exposure to stigma images elicited significantly more negative emotion than the ‘generally unpleasant’ and ‘neutral’ images. Stigma images also generated  greater alcohol craving than the other image sets, after controlling for other factors such as participants’ adverse life experiences and severity of alcohol use disorder. Viewing the stigma images enhanced alcohol craving to some extent even after exposure to an ‘alcohol cue’ (the glass of an alcoholic beverage), suggesting that sexual stigma continues to have an effect on craving when alcohol cues are present. In previous research, negative mood and craving have been linked to each other and to the development of alcohol addiction.

Although larger studies are needed to confirm and expand on these results, the findings may inform approaches to preventing and treating problem drinking and alcohol use disorder among sexual minority young adults ─for example, by assessing for and increasing patients’ resilience to stigma. This study also reinforces the need to target sexual stigma and discrimination at all levels, including through law and policy, and through sensitive media portrayal of acts of sexual stigma to mitigate against vicarious harms.

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