The Relationship between Adverse Childhood Events and Alcohol/Substance Use: The Role of Minority Stress and PTSD in Sexual Minorities

Sexual minorities report higher levels of adverse childhood experiences, posttraumatic stress disorder, and substance use. This study aimed to understand the indirect effects of the relationship between adverse childhood experiences and adult health risks. Three hundred forty-three sexual minorities (mostly bisexual 48%; cisgender 48%; white 89%; and had at least a bachelor's degree 74%) were recruited through Amazon MTurk and surveyed on SurveyMonkey. The questionnaires included demographic questions, adverse childhood events prior to the age of 18 as measured by the Revised Adverse Childhood Experience Scale, posttraumatic stress disorder (PTSD) symptoms as measured by the Post Traumatic Stress Checklist for the DSM-5 (PCL-5), minority stress as measured by the Minority Stress Scale, alcohol use as measured by the Alcohol Use Disorder Identification Test (AUDIT), and substance use as measured by an adaptation of the AUDIT. We found that ACEs predicted substance use and alcohol use through minority stress and PTSD. When looking at the relationships between ACEs and negative mental health outcomes, such as substance use/alcohol use we must consider the roles of minority stress and PTSD.