Disclosures: The authors report no relevant financial disclosures.
December 08, 2020
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Gay, lesbian, bisexual individuals have higher rates of adverse childhood experiences

Disclosures: The authors report no relevant financial disclosures.
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Gay, lesbian and bisexual individuals had more adverse childhood experiences than their heterosexual counterparts in the United States, according to study results published in Journal of Clinical Psychiatry.

Further, these individuals were at higher risk for comorbid substance use and mental health disorders.

“Our study is the first nationally representative study to investigate the relationships among sexual orientation, adverse childhood experiences (eg, physical abuse) and comorbid substance use and mental health disorders (eg, alcohol use disorder and mood disorder) in the U.S.,” Sean Esteban McCabe, PhD, of the Center for the Study of Drugs, Alcohol, Smoking and Health at the University of Michigan School of Nursing, told Healio Psychiatry.

Sean Esteban McCabe
Sean Esteban McCabe

The investigators sought to evaluate the links between adverse childhood experiences and comorbid DSM-5 substance use and mental health disorders among individuals who identified as lesbian/gay, bisexual, unsure, discordant heterosexual and concordant heterosexual. They analyzed data collected in households via structured diagnostic face-to-face interviews of 36,309 U.S. adults aged 18 years or older who were included in the 2012 to 2013 National Epidemiologic Survey on Alcohol and Related Conditions-III.

Results showed the highest prevalence of adverse sexual experiences and comorbid substance use and mental health disorders among gay, lesbian and bisexual individuals, especially bisexual women. A total of 43.8% of bisexual women reported four or more adverse childhood experiences, and 38% of bisexual women reported comorbid mental health and substance use disorders. According to results of multivariable regression analyses, adverse childhood experiences, comorbid substance use and mental health disorder had a curvilinear relationship. Further, gay, lesbian and bisexual individuals had a higher adverse childhood experience mean vs. concordant heterosexual participants. Most individuals in this population with high levels of adverse childhood experiences had comorbid substance use and mental health disorders.

“Our study provides compelling evidence that sexual minorities are exposed to more adverse childhood experiences and are at greater risk for comorbid substance use and mental health disorders than heterosexuals in the U.S.,” McCabe said. “The findings highlight the importance of screening for adverse childhood experiences in clinical settings. Clinicians working with patients exposed to high levels of adverse childhood experiences are recommended to evaluate for comorbid substance use and mental health disorders, especially among sexual minorities. The findings also reinforce the importance of effective trauma-informed interventions to treat comorbidities in patients exposed to multiple adverse childhood experiences so they can thrive in life.”