An ecological momentary assessment study of predictors for alcohol outcomes in transgender and gender diverse youth
Bibliographic record
Abstract
BACKGROUND AND AIMS: This study examined how gender minority stressors and resilience experienced by transgender and gender diverse (TGD) youth relate to daily and momentary occurrences of alcohol use risk processes (e.g., alcohol craving, drinking motives, and distress), alcohol use, and alcohol-related harms. The feasibility of ecological momentary assessment (EMA) was evaluated. METHODS: Forty TGD youth (mean 22.42 years [SD = 3.03]; range 18-29) completed a baseline interview followed by 21 days of EMA. Daily morning surveys assessed stressors and resilience, alcohol risk processes, use and harms experienced "yesterday" and twice-daily random surveys assessed most of these experiences in the "past 30 min" or "right now." RESULTS: Using multilevel models, at the daily (within-person) level, gender minority stressors were significantly related to increased alcohol use (incidence rate ratio (IRR) = 1.16, 95% confidence interval [CI]: 1.03-1.32), drinking to cope (B = 0.16, 95% CI: 0.06-0.26), psychological distress (B = 0.19, 95% CI: 0.03-0.35) and alcohol craving (B = 0.05, 95% CI: 0.01-0.10), but not alcohol harms or negative affect. At the momentary (within-person) level, gender minority stress was associated with increased drinking to cope (B = 0.76, 95% CI: 0.51-1.01), alcohol craving (B = 0.43, 95% CI: 0.31-0.55), and negative affect (B = 2.17, 95% CI: 1.31-3.02). Daily resilience was also associated with increased alcohol use (IRR = 1.32, 95% CI: 1.15-1.52), but not craving or negative affect. Momentary resilience was associated with reduced drinking to cope (B = -0.56, 95% CI: -0.88, -0.23) and negative affect (B = -0.52, 95% CI: -0.81, -0.23), but not craving. Adherence rates and participants' ratings about study acceptability were favorable. CONCLUSIONS: Gender minority stressors are a risk factor for same-day alcohol use. Resilience factors may be associated with increased alcohol use through other mechanisms (e.g., drinking for social or conformity reasons). Interventions to reduce TGD youth's alcohol use should address gender minority stressors and support TGD youth to cope with these stressors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".