Ecological momentary assessment of daily discrimination experiences and nicotine, alcohol, and drug use among sexual and gender minority individuals
Open accessAbstract
OBJECTIVE: Sexual and gender minority (SGM) individuals experience elevated rates of minority stress, which has been linked to higher rates of nicotine and substance use. Research on this disparity to date is largely predicated on methodology that is insensitive to within day SGM-based discrimination experiences, or their relation to momentary nicotine and substance use risk. We address this knowledge gap in the current study using ecological momentary assessment (EMA). METHOD: Fifty SGM individuals, between 18 and 45 years of age, were recruited from an inland northwestern university, regardless of their nicotine or substance use history, and invited to participate in an EMA study. Each were prompted to provide data, six times daily (between 10:00 a.m. and 10:00 p.m.) for 14 days, regarding SGM-based discrimination, other forms of mistreatment, and nicotine, drug, and alcohol use since their last prompt. RESULTS: Discrimination experiences that occurred since individuals' last measurement prompt were associated with greater odds of nicotine and substance use during the same measurement window. Substance use was also more likely to occur in relation to discrimination reported two measurements prior in lagged models. Relative to other forms of mistreatment, discrimination effects were consistently larger in magnitude and became stronger throughout the day/evening. CONCLUSION: This study adds to existing minority stress research by highlighting the both immediate and delayed correlates of daily SGM-based discrimination experiences. These results also contribute to our understanding of daily stress processes and provide insight into ways we might mitigate these effects using real-time monitoring and intervention technology. (PsycINFO Database Record
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The control condition's weekly self-monitoring has been shown to produce reductions in depression symptoms and improvements in behavioral health outcomes.
“This type of self-monitoring has been shown to produce reductions in depression symptoms over time and yield improvement in behavioral health outcomes (Kauer et al., 2012; Livingston et al., 2017).”
From Guided internet-based LGBTQ-affirmative cognitive-behavioral therapy: A randomized controlled trial among sexual minority men in China (2024) · cites this paper as Livingston et al., 2017
The Clinical Implications section describes monitoring as a possible intervention that could help people identify substance-use risks, but does not report reductions in depression symptoms or improvements in behavioral health outcomes. The Results report no detectable change in nicotine or substance-use reports between weeks; a search for depression symptoms and monitoring-related improvements found no supporting passage. (LLM, conf=0.74)
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- Authors
- Livingston, N. A., Flentje, A., Heck, N. C., Szalda-Petree, A., & Cochran, B. N.
- Affiliations
- VA Boston Healthcare System (US)
- University of California, San Francisco (US)
- Marquette University (US)
- University of Montana (US)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2017-12
- Volume
- 85
- Issue
- 12
- Pages
- 1131-1143
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC5726448
- OpenAlex
- W2773450731
- Cited by
- 132
- References
- 73
- Citations by year
- 2026: 10 · 2025: 21 · 2024: 23 · 2023: 15 · 2022: 16 · 2021: 19 · 2020: 13 · 2019: 9 · 2018: 6
- FWCI
- 10.96
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- e-Publications@Marquette (Marquette University) (submittedVersion)
- Funders
- American Psychological Association
- Association for Psychological Science
- University of Montana
- National Institute on Drug Abuse (K23DA039800)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- discrimination experiences, minority stress, nicotine use, alcohol consumption, drug use, substance use, within-day variation, maltreatment, real-time monitoring
- MeSH terms
- Sexual and Gender Minorities, Ecological Momentary Assessment, Adolescent, Adult, Alcohol Drinking, Female, Humans, Male, Middle Aged, Prejudice, Stress, Psychological, Substance-Related Disorders, Young Adult
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