Russon Jody, Abbott Caroline H, Jin Bora, Rivers Alannah Shelby, Winston-Lindeboom Payne, Kobak Roger, Diamond Guy S
Virginia Polytechnic and State University, Blacksburg, Virginia, USA.
VA Boston Healthcare System, Boston, Massachusetts, USA.
Suicide Life Threat Behav. 2023 Dec;53(6):958-967. doi: 10.1111/sltb.12995. Epub 2023 Sep 21.
Lesbian, gay, bisexual, and questioning (LGBQ) adolescents are particularly at risk for suicidal ideation; however, little clinical research is focused on treating this population. Attachment-based family therapy (ABFT) is among the few empirically supported youth suicide treatments adapted for LGBQ adolescents. The purpose of this exploratory study is to determine the differential treatment effects and rates of change for LGBQ and heterosexual adolescents with depression and suicidal ideation receiving either ABFT or family enhanced nondirective supportive therapy (FE-NST).
The sample included 129 adolescents (31% LGBQ), ages 12-18 randomized to the two treatment groups. Multilevel modeling was used to examine individual changes in depression and suicidal ideation over the 16-week treatment.
Results revealed that LGBQ adolescents in the ABFT condition showed a greater rate of reduction in depressive symptoms over treatment, slope = -0.94, p < 0.001, than did LGBQ adolescents in the NST condition, slope = -0.41, p = 0.12. Heterosexual adolescents showed symptom reduction in both treatment conditions (ABFT slope = -0.47, p < 0.001; NST slope = -0.79, t (113) = -7.48, p < 0.001). Changes in suicidal ideation were found across time, but not across conditions.
LGBQ adolescents in the ABFT condition had a sharper decrease in depressive symptoms and better outcomes at week 16.
女同性恋、男同性恋、双性恋及性取向存疑(LGBQ)的青少年尤其容易产生自杀念头;然而,针对这一群体进行治疗的临床研究却很少。基于依恋的家庭治疗(ABFT)是为数不多的经实证支持的、适用于LGBQ青少年的青少年自杀治疗方法之一。这项探索性研究的目的是确定接受ABFT或家庭强化非指导性支持治疗(FE-NST)的患有抑郁症和自杀念头的LGBQ青少年与异性恋青少年的差异治疗效果和变化率。
样本包括129名年龄在12至18岁之间的青少年(31%为LGBQ),他们被随机分配到两个治疗组。采用多层次模型来检验在16周治疗期间抑郁和自杀念头的个体变化。
结果显示,接受ABFT治疗的LGBQ青少年在治疗过程中抑郁症状的减轻率更高,斜率为-0.94,p < 0.001,高于接受NST治疗的LGBQ青少年,斜率为-0.41,p = 0.12。异性恋青少年在两种治疗条件下症状均有所减轻(ABFT斜率为-0.47,p < 0.001;NST斜率为-0.79,t(113) = -7.48,p < 0.001)。自杀念头随时间变化,但在不同治疗条件之间没有差异。
接受ABFT治疗的LGBQ青少年在第16周时抑郁症状下降更明显,治疗效果更好。