Perceived Vulnerability When Drinking: Daily-Level Associations with Alcohol Use and Consequences by Sexual Minority Status Among Adolescent Girls and Young Adult Women




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Purpose: Although cross-sectional research on perceived vulnerability (i.e., the likelihood of experiencing consequences if the individual were to engage in a behavior) when drinking suggests that greater perceived vulnerability is associated with less alcohol use and fewer alcohol-related consequences between-persons, there has been minimal research and mixed findings on within-person perceived vulnerability to alcohol-related consequences at the daily-level. Women have been found to experience more alcohol-related consequences compared to men, which may relate to their levels of perceived vulnerability. Additionally, sexual minority girls and women appear to be at increased risk for engaging in greater alcohol use and experiencing more alcohol-related consequences compared to heterosexual women, which may exacerbate their perceived vulnerability. The present study aims to (1) examine daily-level associations between perceived vulnerability and alcohol use and consequences among adolescent girls and young adult women and (2) assess whether sexual minority status moderates the association between perceived vulnerability and alcohol use and consequences at the daily-level. Methods: Participants were recruited as part of a longitudinal ecological momentary assessment (EMA) study conducted in Texas. Participants completed up to two surveys each day (eight surveys per week) in 3-week EMA bursts, which were repeated quarterly across the 12-month study. The sample for the current study included 410 cisgender (i.e., gender identity aligns with sex assigned at birth) adolescent girls and young adult women ages 15 to 25 (M= 20.8) who reported drinking days (44.9% White, Non-Hispanic; 39.8% sexual minority). The analytic sample included 3526 drinking days. Planned Analyses: In each multilevel model, daily-level predictors will be centered-within-person and person-level predictors will be grand-mean-centered. Age, race/ethnicity, weekend/weekday, week in burst, and burst number will be used as covariates in all models. Perceived vulnerability will be used as the predictor for (H1a) alcohol use (i.e., number of drinks) estimated with a mixed effects zero-truncated negative binomial model (count outcome starting at 1) and (H1b) the number of alcohol-related consequences estimated with a mixed-effects zero-inflated negative binomial model (count outcome with excessive zeros). Sexual minority status will be used as a moderator within these models (H2). Hypothesized Results: On drinking days when individuals report greater perceived vulnerability than their average, it is predicted that they will engage in less alcohol use (H1a) and experience fewer negative consequences (H1b). The daily-level associations between perceived vulnerability and alcohol use (H2a) and consequences (H2b) are predicted to be stronger among sexual minority individuals compared to heterosexual individuals. Potential Conclusion: The findings of this study have the potential to increase our understanding of how perceived vulnerability at the daily-level influences drinking among adolescent girls and young adult women, as well as differences based on sexual minority status. These findings could potentially improve the precision and efficacy of in-the-moment preventative interventions by identifying when girls and women are at increased risk of experiencing alcohol-related harm. Furthermore, these findings may inform the need to tailor in-the-moment interventions to target sexual minority girls and women.