Sharon C Wilsnack

• M.A., Ph.D., Harvard University
• Professor at University of North Dakota

Adjusting for demographics and standard drinking measures, High Intensity Drinking (HID), indexed by the maximum quantity consumed in a single day in the past 12 months, may be valuable in predicting alcohol dependence other harms across high and low income societies. The data consisted of 17 surveys of adult (15,460 current drinkers; 71% of total...

Objective: In the present study, we sought to identify trajectories of symptoms of potential alcohol dependence (AD) among adult sexual minority women (SMW). Theoretical correlates were examined in relation to the empirically identified trajectories. Method: Data were collected at three time points between 2000 and 2012 from SMW drinkers (n = 43...

Background: Two decades ago, there was almost no research on alcohol use among sexual minority women (SMW, e.g., lesbian, bisexual). Since then, a growing body of scientific literature documents substantial sexual orientation-related disparities in alcohol use and alcohol-related problems. Research has identified multiple risk factors associated wi...

Background: The aim of this study was to examine how gender, age and education, regional prevalence of male and female risky drinking and country-level economic gender equality are associated with harms from other people’s drinking. Methods: 24,823 adults in 10 countries were surveyed about harms from drinking by people they know and strangers. Cou...

BACKGROUND Large gaps exist in research on alcohol use and intimate partner aggression (IPA) among sexual minority women (SMW; e.g., lesbian, bisexual). Dyadic research with SMW and their partners can illuminate how couple-level factors operate in conjunction with individual-level factors to shape well-being in this understudied and vulnerable popu...

Background Large gaps exist in research on alcohol use and intimate partner aggression (IPA) among sexual minority women (SMW; eg, lesbian, bisexual). Dyadic research with SMW and their partners can illuminate how couple-level factors operate in conjunction with individual-level factors to shape well-being in this understudied and vulnerable popula...

Sexual minority women (SMW; e.g., lesbian, bisexual) are more likely than heterosexual women to be heavy drinkers, with bisexual women showing the highest risk. There is ample literature demonstrating that intimate relationships protect against stress-related health risk behaviors in the general population. However, very little research has focused...

Introduction and aims That physical, emotional and social problems occur not only to drinkers, but also to others they connect with, is increasingly acknowledged. Financial harms from others’ drinking have been seldom studied at the population level, particularly in low- and middle-income countries. Whether financial harm and costs from others’ dri...

Until the 1980s, the limited research on alcohol and other drug (AOD) use among sexual minority women (SMW) focused on alcohol and used samples recruited from gay bars, resulting in inflated estimates of hazardous drinking. Over the past several decades the number of AOD studies with SMW has increased dramatically. To characterize this literature,...

Aims Survey items for measuring harms experienced from others' drinking (AHTO) have been developed primarily to measure type of harm and not severity. However, some type of harms may produce more negative effects than others. We aimed to compare the perceived severity of a comprehensive list of AHTO items to assess consistency in subjective ratings...

Aim: To study caregiver reports of children’s experience of physical harm and exposure to family violence due to others’ drinking in nine societies, assess the relationship of harm with household drinking pattern and evaluate whether gender and education of caregiver affect these relationships. Method: Using data on adult caregivers from the Gender...

Introduction: Drinking behavior differs not only among countries, but also among regions within a country. However, the extent of such variation and the interplay between gender and regional differences in drinking have not been explored and are addressed in this study. Methods: Data stem from 105,061 individuals from 23 countries of the GENACIS da...

Background While research in high‐income countries (HICs) has established high costs associated with alcohol’s harm to others (AHTO) in the workplace, scant attention has been paid to AHTO in the workplace in lower‐ or middle‐income countries (LMICs). Aim To compare estimates and predictors of alcohol’s impacts upon coworkers among workers in 12 c...

Objective: This study examined a range of indicators of alcohol's harm to others (AHTO) among U.S. adults and assessed sociodemographic and alcohol-related risk factors for AHTO. Method: The data came from 8,750 adult men and women in two parallel 2015 U.S. national surveys conducted in English and Spanish. Both surveys used computer-assisted te...

Mental health inequities among bisexual and lesbian women are well-documented. Compared to heterosexual women, both bisexual and lesbian women are more likely to report lifetime depressive disorders, with bisexual women often faring the worst on mental health outcomes. Risk factors for depression, such as victimization in childhood and adulthood, a...

Aims: Multinational studies of drinking and the harms it may cause typically treat countries as homogeneous. Neglecting variation within countries may lead to inaccurate conclusions about drinking behavior, and particularly about harms drinking causes for people other than the drinkers. This study is the first to examine whether drinkers' self-rep...

Aims: Most alcohol research has focused on how drinking harms the drinker. Research on alcohol's harms to others (AHTO) has studied primarily single or small groups of countries. This article describes the methodology of a new multinational study - GENAHTO - of how social and cultural contexts are related to AHTO, from the perspectives of both per...

Both living with children and alcohol consumption are positively associated with intimate partner violence (IPV). We assessed their combined relationship with physical IPV (P-IPV) victimization and perpetration, and explored possible moderating roles of sex and culture. Data included 15 surveys of 13,716 men and 17,832 women in 14 countries from th...

Aims: This study examined transgenerational transmission of risk for female alcohol misuse. Women's perceived similarity to their mother/father in adulthood was examined in terms of its influence on the expected association between perceived maternal alcohol use and female offsprings' trajectories of alcohol misuse. We hypothesized that a daughter...

Background Drinking is a common activity with friends or at home but is associated with harms within both close and extended relationships. This study investigates associations between having a close proximity relationship with a harmful drinker and likelihood of experiencing harms from known others' drinking for men and women in 10 countries. Met...

Introduction This study examined the relationships between experiences of childhood and adulthood victimization and current smoking among heterosexual and sexual minority women (SMW). The main hypothesis was that victimization experiences would predict current smoking status. Further, we hypothesized that the effect of childhood victimization on se...

Using comparable survey data from the GENACIS Project, collected from representative samples of people aged 20 to 70 years old in the U.S. (n = 2,598) and Japan (n = 1,734), this study examined, across these two diverse societies, the gender difference in the association between the early onset of drinking and the development of drinking problems....

Just as binge drinking rates differ for men and women, the predictors and consequences of binge drinking vary by gender as well. This article examines these differences and how binge drinking definitions and research samples and methods may influence findings. It also describes the relationship between age and binge drinking among men and women, an...

Purpose: Given that self-perceptions of mental and physical health are important predictors of health outcomes and well-being, particularly among older adults, this study focuses on associations among age, alcohol consumption, and indicators of both self-rated mental health and self-rated physical health in a sample of sexual minority women (SMW)....

Although marriage tends to be protective against hazardous drinking among women in the general population, few studies have compared drinking rates, levels, or problems based on relationship status among sexual minority women (SMW; lesbian, bisexual). We examined associations between relationship status (committed relationship/cohabiting; committed...

Drinking is associated with a higher rate of violent offending among males and a higher rate of violent victimization among females. Using comparable self-reported data, this study examines between the United States (n = 2,363) and Japan (n = 1,660) whether the gender difference in alcohol-related Intimate Partner Violence (IPV) is explained by alc...

Just as binge drinking rates differ for men and women, the predictors and consequences of binge drinking vary by gender as well. This article examines these differences and how binge drinking definitions and research samples and methods may influence findings. It also describes the relationship between age and binge drinking among men and women, an...

Sexual minority identity (bisexual, lesbian) is a known risk factor for depression in women. This study examined a facet of minority stress prevalent among women-sexual identity mobility-as an identity-related contributor to higher levels of depressive symptoms. We used three waves of data from the Chicago Health and Life Experiences of Women study...

Background: Although sexual minority women (SMW) are at increased risk of hazardous drinking (HD), efforts to validate HD measures have yet to focus on this population. Objectives: Validation of a 13-item Hazardous Drinking Index (HDI) in a large sample of SMW. Methods: Data were from 700 adult SMW (age 18-82) enrolled in the Chicago Health an...

Background To examine changes in men‘s and women’s drinking in Norway over a 20-year period, in order to learn whether such changes have led to gender convergence in alcohol drinking. Methods Repeated cross-sectional studies (in 1984–86, 1995–97, and 2006–08) of a large general population living in a geographically defined area (county) in Norway....

Purpose: The current article examines substance use behavior and associated factors that contribute to risk of substance misuse, such as history of childhood victimization and reports of internalizing symptoms among women from various sexual identity subgroups. Methods: We recruited a convenience sample of 332 community and university student wo...

Clinicians should periodically assess their menopausal patients' alcohol use. Specific health hazards from excessive alcohol consumption, as well as potential benefits of low-level consumption (for cardiovascular disease, bone health, and type 2 diabetes), should be discussed with their patients who drink. The information in this Practice Pearl can...

Although there are wide differences in alcohol use patterns among countries, men are consistently more likely than women to be drinkers and to drink heavily. Studies of alcohol use among sexual minorities (SMs), however, reflect a more complex picture. Such research has found higher rates of alcohol use and alcohol-related problems among SM persons...

Background: Women who terminate pregnancies drink more subsequent to the pregnancy than women who give birth, including women who give birth after seeking to terminate a pregnancy. Methods: Data are from the Turnaway Study, a prospective, longitudinal study of 956 women who sought to terminate pregnancies at 30 U.S. facilities. This paper focuse...

Background: Women of reproductive age who binge drink or have alcohol-related problem symptoms (APS) and who do not use contraception are considered at risk of an alcohol-exposed pregnancy (AEP). In the U.S., efforts to prevent AEPs focus largely on delivering interventions in primary health care settings. While research suggests that these interv...

Abstract: Various harms from others’ drinking have been studied individually and at single points in time. We conducted a US population 15-year trend analysis and extend prior research by studying associations of depression with combinations of four harms – family/marriage difficulties, financial troubles, assault, and vandalism – attributed to par...

We used data from a nationally representative sample to compare substance use outcomes among adult women who identified as mostly heterosexual with those who identified as exclusively (only) heterosexual. We analyzed data from mostly heterosexual women and only heterosexual women in Wave 5 (2001) of the National Study of Health and Life Experiences...

Research finds women who terminate pregnancies are at risk of subsequent problematic alcohol use, but methodological and conceptual problems are common. This study examines the relationship between receiving versus being denied termination and subsequent alcohol use. Data are from a prospective, longitudinal study of US women seeking pregnancy term...

Background: There is little information about pregnancy-related changes in alcohol use and factors contributing to changes among women with unwanted pregnancies. This study describes changes in alcohol use from before pregnancy recognition to during pregnancy and identifies important predictors of alcohol use severity among women with unwanted pre...

Disclosing one’s sexual minority identity, or “coming out,” has varying effects on the mental health of lesbians. Previous research indicates a negative association between disclosure and depression. However, these findings are based on research with White lesbians. To date, there is a paucity of studies that examined how the relationship between d...

Purpose: Substantial research documents sexual-orientation-related mental health disparities, but relatively few studies have explored underlying causes of these disparities. The goals of this article were to (1) understand how differences in sexual identity and victimization experiences influence risk of hazardous drinking and depression, and (2)...

Background Lifetime victimization experiences, including child sexual abuse (CSA), child physical abuse (CPA), adult sexual assault (ASA), and adult physical assault (APA), are associated with health problems. Purpose To examine relationships between cumulative victimization and physical health among heterosexual and lesbian women and determine wh...

Although light-to-moderate drinking among women is associated with reduced risks of some cardiovascular problems, strokes, and weakening of bones, such levels of drinking also are associated with increased risks of breast cancer and liver problems, and heavy drinking increases risks of hypertension and bone fractures and injuries. Women's heavy-dri...

This study examined the influence of demographic characteristics, sexual identity, hazardous drinking, and sexuality/intimacy enhancement alcohol expectancies on rates of risky sexual behaviors in a community sample of women who self-identified as lesbian, mostly lesbian, and bisexual (N = 349). Structured interview data were collected as part of a...

Objective: Sexual-minority women are at heightened risk for a number of mental health problems, including hazardous alcohol consumption, depression, and anxiety. We examined self-medication and impaired-functioning models of the associations among these variables and interpreted results within a life course framework that considered the unique soc...

Childhood abuse and neglect are pervasive problems among girls and young women that have numerous health consequences. Research suggests that sexual minority women are more likely than heterosexual women to report childhood abuse and neglect, but little is known about which sexual minority women are at greatest risk for these early adverse experien...

Childhood abuse and neglect are pervasive problems among girls and young women that have numerous health consequences. Research suggests that sexual minority women are more likely than heterosexual women to report childhood abuse and neglect, but little is known about which sexual minority women are at greatest risk for these early adverse experien...

Childhood sexual abuse (CSA) is a strong predictor of adverse physical and mental health outcomes (Koenig, Doll, O’Leary, & Pequegnat, 2004; Lalor & McElvaney, 2010). Recent research has found that CSA is reported more frequently by lesbians than by heterosexual women (Austin et al., 2008; Balsam, Rothblum, & Beauchaine, 2005; Stoddard, Dibble, & F...

Prenatal alcohol use, a leading preventable cause of birth defects and developmental disabilities, remains a prevalent public health concern in the United States. This study aims to detect the proportion and correlates of prenatal alcohol use in the prenatal care settings in Alabama. Prenatal care settings were chosen because of their potential as...

Gender, Alcohol, and Culture: An International Study (GENACIS) is a collaborative study of gender-related and cultural influences on alcohol use and alcohol-related problems of women and men. Members conduct comparative analyses of data from comparable general population surveys in 38 countries on five continents. This paper presents GENACIS findin...

Most gender-specific studies of the Alcohol Use Disorders Identification Test (AUDIT) have focused on gender differences in thresholds for hazardous drinking. This study examines gender differences in the factor structure of the AUDIT in general-population surveys. General-population surveys from 15 countries provided 27,478 current drinkers' respo...

Wilsnack, R., Kristjanson, A. F., Wilsnack, S. C. & Benson, P. W. (2012). Distress and drinking: Cross-cultural connections and contexts. International Journal of Alcohol and Drug Research, 1(1), 79-94. doi: 10.7895/ijadr.v1i1.37 (http://dx.doi.org/10.7895/ijadr.v1i1.37)Aims: Research on how distress is related to drinking has paid relatively littl...

Most research on sexual orientation and alcohol use in the United States has found higher rates of alcohol use and abuse among gay men and lesbians. Studies from other countries have found smaller or no differences between sexual minority and heterosexual women and men. The present study used general population survey data from 14 countries to exam...

Maternal alcohol consumption during pregnancy and fetal alcohol spectrum disorders (FASDs) represent a significant public health problem. The influence of the male partner's alcohol consumption patterns and the quality of the partner's intimate relationship might be important factors to consider in the design of successful FASD prevention programs....

This study assesses whether severity of physical partner aggression is associated with alcohol consumption at the time of the incident, and whether the relationship between drinking and aggression severity is the same for men and women and across different countries. National or large regional general population surveys were conducted in 13 countri...

This paper examines (i) gender and country differences in negative consequences related to drinking; (ii) relative rates of different consequences; and (iii) country-level predictors of consequences. Multi-level analyses used survey data from the Gender, Alcohol, and Culture: An International Study (GENACIS) collaboration. Measures included 17 nega...

We used an ecological paradigm and multilevel analytic techniques to analyze gender-specific relationships of cohabitation (versus marriage) to drinking in 19 countries (n = 32,922) and to "heavy episodic drinking" (HED) in 17 countries (n = 24,525) in surveys (1996-2004) from Gender, Alcohol, and Culture: An International Study. Cohabitation was a...

Aims: Although research shows that sexual minority women report high rates of lifetime sexual victimization and high rates of hazardous drinking, investigators have yet to explore the relationships between sexual victimization and hazardous drinking in this population. In addition, because the rates of these problems may vary within the sexual min...

There is consensus in the research literature that substance use disparities exist among sexual minority women and men; however, few studies have examined risk factors that may contribute to these disparities. To compare reports of life-time victimization experiences in a US national sample of adult heterosexual and sexual minority women and men an...

To evaluate multinational patterns of gender- and age-specific alcohol consumption. Large general-population surveys of men's and women's drinking behavior (n's > 900) in 35 countries in 1997-2007 used a standardized questionnaire (25 countries) or measures comparable to those in the standardized questionnaire. Data from men and women in three age...

This study (1) examined patterns of correlations between two alcohol consumption measures and 2 drinking-related problem domains in women from 5 different countries; and (2) tested the hypothesis that the correlations between women's alcohol consumption and social criticism of their drinking would be higher in countries where women's drinking is le...

METHODS SAMPLE: The National Study of Health and Life Experiences of Women (NSHLEW) is a multi-wave longitudinal study of U. S. women's drinking behavior and its antecedents and consequences. The NSHLEW interviewed nationally representative samples of U. S. women aged 21 or older in 1981, 1991, and 2001 (Wilsnack et al., 2006). The preliminary anal...

Studies of alcohol use among lesbians have typically used convenience samples with uncertain generalizability or general population samples with small numbers of lesbians. Here we compare rates of high-risk and problem drinking in a large sample of Chicago-area lesbians and a national sample of age- and education-matched urban heterosexual women. D...

This study examined the relationships between childhood and family background variables, including sexual and physical abuse, and subsequent alcohol abuse and psychological distress in adult lesbians. Structural equation modeling was used to evaluate relationships between childhood sexual and physical abuse and parenting variables and latent measur...

Alcohol consumption in Russia is reportedly high for both men and women; most studies of Russian drinking have used questionnaires not designed specifically to measure alcohol consumption or to interview women. This study was designed specifically to measure drinking patterns among pregnant and nonpregnant Russian women. Eight hundred ninety-nine w...

Alcoholl is a major risk factor for mortality and morbidity in the Americas. Overall in the Americas, alcohol consumption levels are higher than the global average while abstention rates for both men and women are consistently lower. In terms of the burden of disease, alcohol caused approximately 323,000 deaths, 6.5 million years of life lost,...

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This paper provides an introduction to a series of articles reporting results from the EU concerted action "Gender, Culture and Alcohol Problems: A Multi-national Study" which examined differences in drinking among women and men in 13 European and two non-European countries. The gender gap in alcohol drinking is one of the few universal gender diff...

Although research on alcohol use among women has increased dramatically during the past several decades, relatively few studies have focused on lesbians, and almost none have included sufficient numbers of older lesbians or lesbians of color to permit comparative analyses. Using data from the Chicago Health and Life Experiences of Women Study (CHLE...

Women's alcohol consumption in the United States has aroused increased public concern, despite a scarcity of evidence of any major increases in women's drinking. To help resolve this apparent inconsistency, we examined patterns of historical and age-related changes in U.S. women's drinking from 1981 to 2001. In national surveys of women in 1981, 19...

Objective: Women's alcohol consumption in the United States has aroused increased public concern, despite a scarcity of evidence of any major increases in women's drinking. To help resolve this apparent inconsistency, we examined patterns of historical and age-related changes in U.S. women's drinking from 1981 to 2001. Method: In national surveys o...

In this chapter we report select findings from a study of lesbians' mental health and alcohol use to illustrate the strengths and limitations of two types of comparison groups of heterosexual women in research with lesbians. Although data from lesbians in this study were collected in Chicago, the issues we highlight have broad application to resear...

Much of the research on suicidality has focused on adolescents and completed suicides, with less attention to types of suicidal behavior (ideation and attempts) that are more common among women. Research has associated women's suicidality with hazardous drinking, adverse childhood experiences, relationship problems, depression, and earlier suicidal...

We evaluated the association of sexual assault history with later social support, operationalized as network size, marital status, presence of a partner, frequency of network contacts, and emotional support from friends and family, from spouse, and from partner. Data came from six independent general population surveys (pooled N = 9,865) whose resu...

We evaluated the association of sexual assault history with later social support, operationalized as network size, marital status, presence of a partner, frequency of network contacts, and emotional support from friends and family, from spouse, and from partner. Data came from six independent general population surveys (pooled N = 9,865) whose resu...

The purpose of this article is to describe patterns of forgetting and remembering childhood sexual abuse (CSA) in a nationally representative sample of US adult women. The respondents were a national probability sample of 711 women, aged 26 years to 54 years, residing in noninstitutional settings in the contiguous 48 states. In a 1996 face-to-face...

The primary research question asked is: After holding alcohol consumption constant, will men and women be at equal risk for a variety of alcohol-related problems? Since women are actually at a higher blood alcohol content at the same consumption levels, a physiological argument would suggest that women are at equal or greater risk for alcohol probl...

General population surveys suggest that the percentage of US women who drink declined slightly during the 1980s. Comparisons of 1981 and 1991 national surveys using the same drinking measures show that fewer women drank heavily in 1991, and women drinkers drank less frequently and had fewer episodes of heavy drinking, although younger drinkers repo...