The Mediating Role of Psychological Distress in the Association between Harassment and Alcohol Use among Lesbian, Gay, and Bisexual Military Personnel

Abstract

Background

The purpose of this study was to examine the mediating role of psychological distress on the associations between two forms of harassment, military sexual trauma (MST) and sexual orientation-based discrimination (SOBD), and alcohol use in a sample of lesbian, gay, and bisexual (LGB) military personnel. Methods: Data were analyzed from 254 LGB military service members in the United States. Bivariate associations were examined between MST, SOBD, anxiety and depression, distress in response to stressful military events, and alcohol use. A latent psychological distress factor was estimated using anxiety and depression, and distress in response to stressful military events. Path analyses were used to estimate the direct effects of MST and SOBD on alcohol use and the indirect effects of MST and SOBD on alcohol use through psychological distress. Results: All bivariate associations were positive and significant between MST, SOBD, anxiety and depression, distress in response to military events, and alcohol use. In multivariable analyses, after adjusting for demographic covariates, a significant indirect effect was observed for SOBD on alcohol use through psychological distress. MST was not directly or indirectly associated with alcohol use when SOBD was included in the path model. Conclusion: Overall, findings suggest SOBD is associated with poorer mental health, which in turn places LGB military personnel at greater risk of alcohol use and associated problems. These results affirm the need for interventions that reduce SOBD in the military and suggest that these interventions will have a positive impact on the health of LGB military personnel.

Keywords:

• LGB
• military
• harassment
• mental health
• alcohol

Acknowledgements

The authors would like to acknowledge the entire team of CHEST staff, interns, volunteers, and recruiters, with special thanks to Christian Grov, PhD and John Pachankis, PhD, Matthew Wachman, Aaron Belkin, PhD, Andrew Jenkins, Grace Macalino, PhD, Admiral Steinman, Katie Miller, Ron Nalley, Jeff Meuller, Maj USAF, OutServe-SLDN, and our participants who volunteered their time. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Disclosure statement

The authors report no conflict of interest.

Data availability statement

The data that support the findings of this study are available from the corresponding author, RM, upon reasonable request.

Additional information

Funding

Funding for this project was provided through collaboration between the Palm Center and the Center for HIV Educational Studies and Training (CHEST) at Hunter College, City University of New York (CUNY).