The Mediating Role of Disengaged Coping in the Relationship Between Adverse Childhood Experiences and Substance Use Among Sexual Minority Adults

Adverse childhood experiences (ACEs) are strongly linked to negative long-term health outcomes. Sexual minority (SM) individuals face disproportionate exposure to ACEs and their consequences compared to heterosexual peers. However, the mechanisms connecting ACEs to these outcomes remain poorly understood. Emerging evidence suggests coping styles may play a critical role, yet the interplay between general ACEs, SM-specific ACEs, coping styles, and health outcomes is underexplored. To address these gaps, a cross-sectional survey of 530 SM adults (265 men, 265 women) in the United States examined the relationships among ACEs, coping styles, and substance use. Structural equation modeling revealed weak but significant positive associations between ACEs and both adaptive and support-based coping styles, alongside a stronger positive relationship between ACEs and disengaged coping. While adaptive coping showed no significant link to substance use, support coping showed a small inverse association and disengaged coping a moderately strong positive association with substance use. Mediation analysis further indicated that disengaged coping partially mediated the observed relationship between ACEs and substance use. These findings highlight disengaged coping as a potential mechanism linking ACEs to substance use among SM individuals. Interventions targeting disengaged coping may mitigate the harmful effects of ACEs on health behaviors in this population. Future research should explore the development of coping styles and design strategies to promote adaptive coping in SM individuals, addressing a critical gap in health disparity research.