McDanal Riley, Rubin Alex, Fox Kathryn R, Schleider Jessica L
Stony Brook University.
University of Denver.
Behav Ther. 2022 Mar;53(2):376-391. doi: 10.1016/j.beth.2021.10.004. Epub 2021 Oct 21.
Barriers such as stigma, financial costs, and provider shortages prevent large portions of youth with depression and related difficulties from accessing treatment; lesbian, gay, bisexual, transgender, queer/questioning sexual orientation, or other non-heterosexual identity (LGBTQ+) youth are burdened with additional barriers related to minority stress. Single-session interventions (SSIs) have been found to benefit youth and help reduce depression symptoms, and since many SSIs are brief, cost-free, and accessible online, they may circumvent several access barriers. However, prior to recommending non-community-tailored SSIs as a useful resource for minoritized youths, we first assessed whether LGBTQ+ youth respond as positively to SSIs as do cisgender heterosexual youth. In a subsample of youths recruited via online advertisements from September 2019 to August 2020 (N = 258, 81.4% female-assigned sex at birth, 60.5% LGBTQ+, 47.3% youth of color), we investigated whether changes in hopelessness, agency, and self-hate from before to after completing online self-directed SSIs differed as a function of LGBTQ+ identity. We also quantitatively and qualitatively compared intervention acceptability ratings and feedback across LGBTQ+ and cisgender heterosexual youths. Analyses revealed no significant differences between cisgender LGBQ+, trans and gender diverse, and cisgender heterosexual youths for any intervention outcomes. Likewise, no group differences emerged in intervention acceptability ratings or written program feedback. Self-selection bias and underrepresentation of certain populations, such as American Indian and Alaskan Native youths, may limit generalizability of results. Results suggest that online mental health SSIs are equally acceptable and useful to LGBTQ+ and cisgender heterosexual youth alike, even prior to culturally specific tailoring.
诸如耻辱感、经济成本和医疗服务提供者短缺等障碍，使得很大一部分患有抑郁症及相关问题的青少年无法获得治疗；女同性恋、男同性恋、双性恋、跨性别、酷儿/性取向存疑或其他非异性恋身份（LGBTQ+）的青少年还面临与少数群体压力相关的额外障碍。研究发现，单次干预（SSIs）对青少年有益，并有助于减轻抑郁症状，而且由于许多单次干预简短、免费且可在线获取，它们可能会规避一些获取障碍。然而，在推荐非社区定制的单次干预作为少数族裔青少年的有用资源之前，我们首先评估了LGBTQ+青少年对单次干预的反应是否与顺性别异性恋青少年一样积极。在2019年9月至2020年8月通过在线广告招募的青少年子样本中（N = 258，出生时被指定为女性的占81.4%，LGBTQ+占60.5%，有色人种青少年占47.3%），我们调查了完成在线自主单次干预前后绝望感、能动性和自我厌恶感的变化是否因LGBTQ+身份而异。我们还对LGBTQ+青少年和顺性别异性恋青少年的干预可接受性评分及反馈进行了定量和定性比较。分析显示，对于任何干预结果，顺性别LGBQ+、跨性别和性别多样化青少年与顺性别异性恋青少年之间均无显著差异。同样，在干预可接受性评分或书面项目反馈方面也未出现组间差异。自我选择偏差以及某些人群（如美国印第安人和阿拉斯加原住民青少年）代表性不足，可能会限制研究结果的普遍性。结果表明，即使在进行文化特定调整之前，在线心理健康单次干预对LGBTQ+青少年和顺性别异性恋青少年同样可接受且有用。
