Investigating Impulsivity as a Moderator of the Association Between Sexual Abuse and Alcohol Misuse Across Individuals from Different Countries, Gender Identities, and Sexual Orientations

This study examined how impulsivity moderates the relationship between sexual abuse and alcohol misuse in a large international sample. Participants (N = 64,472) completed the Alcohol Use Disorders Identification Test (AUDIT), the UPPS-P Impulsive Behavior Scale, and sexual abuse measures through the International Sex Survey. Structural equation models tested associations between childhood sexual abuse (CSA), adolescent/adult sexual abuse (AASA), and combined exposure with alcohol misuse, and explored moderation by impulsivity across gender identity, sexual orientation, and country. AASA and CSA + AASA were positively associated with alcohol misuse, while CSA alone showed mixed associations across groups. Urgency and premeditation facets of impulsivity moderated these associations, particularly among sexual and gender minority individuals. Country-level differences suggested cultural and contextual variation in how impulsivity interacts with trauma to influence alcohol use. Findings underscore the need for targeted, culturally responsive interventions addressing impulsivity in the aftermath of sexual trauma.