title: Examining sexual orientation disparities in alcohol misuse among women veterans.
abstract: BACKGROUND
  Alcohol misuse is a significant health concern among women veterans, especially among lesbian and bisexual veterans. Mediators that might explain alcohol disparities between heterosexual and sexual minority veterans have not yet been identified.
  
  
  OBJECTIVE
  To examine the role of civilian and military traumas and mental health symptoms (i.e., depression, post-traumatic stress disorder) in explaining sexual orientation disparities in alcohol misuse between sexual minority and heterosexual women veterans across the U.S.
  
  
  METHODS
  Women veterans were recruited using Internet methods to participate in an online, anonymous, national survey (N=699, 37% lesbian or bisexual) from February to May 2013. Path analysis was used to examine a model wherein sexual orientation both directly and indirectly predicted alcohol misuse through trauma exposures and mental health symptoms. Data were analyzed in November 2013.
  
  
  RESULTS
  Findings indicated significant disparities in alcohol misuse among women veterans by sexual orientation, with indirect effects via childhood trauma, physical victimization in adulthood both during the military and as a civilian, and depressive and post-traumatic stress disorder symptoms.
  
  
  CONCLUSIONS
  Lesbian and bisexual women veterans reported higher rates of some trauma exposures and mental health symptoms than their heterosexual counterparts, partly accounting for their higher rates of alcohol misuse. Interventions that attend to both victimization and drinking among this population are needed, as well as future research that addresses other factors influencing alcohol misuse.
authors.affiliation: Mental Illness Research, Education, and Clinical Center, Seattle, Washington; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, Seattle, Washington. Electronic address: klehavot@uw.edu.
authors.forename: Keren
authors.initials: K
authors.lastname: Lehavot
authors.affiliation: Mental Illness Research, Education, and Clinical Center, Seattle, Washington; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, Seattle, Washington.
authors.forename: Kendall C
authors.initials: KC
authors.lastname: Browne
authors.affiliation: Mental Illness Research, Education, and Clinical Center, Seattle, Washington; Center of Excellence in Substance Abuse Treatment and Education, Veterans Affairs Puget Sound Health Care System, Seattle, Washington; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, Seattle, Washington.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Simpson
mesh_terms: D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology; D001727:Bisexuality / Q000523:psychology / Q000706:statistics & numerical data; D003863:Depression / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D020010:Heterosexuality / Q000523:psychology / Q000706:statistics & numerical data; D018452:Homosexuality, Female / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*