Isbășoiu Andreea Bogdana, Sava Florin Alin, Larsen Torill M B, Anderssen Norman, Rotaru Tudor-Stefan, Rusu Andrei, Sălăgean Nastasia, Tulbure Bogdan Tudor
Department of Psychology, West University of Timisoara, Timisoara, Romania.
Department of Psychology and Educational Sciences, Transilvania University of Brasov, Brasov, Romania.
JMIR Form Res. 2024 May 15;8:e56198. doi: 10.2196/56198.
Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people are at higher risk of mental health problems due to widespread hetero- and cisnormativity, including negative public attitudes toward the LGBTQ+ community. In addition to combating social exclusion at the societal level, strengthening the coping abilities of young LGBTQ+ people is an important goal.
In this transdiagnostic feasibility study, we tested a 6-week internet intervention program designed to increase the ability of nonclinical LGBTQ+ participants to cope with adverse events in their daily lives. The program was based on acceptance and commitment therapy principles.
The program consists of 6 web-based modules and low-intensity assistance for homework provided by a single care provider asynchronously. The design was a single-group assignment of 15 self-identified LGB community members who agreed to participate in an open trial with a single group (pre- and postintervention design).
Before starting the program, participants found the intervention credible and expressed high satisfaction at the end of the intervention. Treatment adherence, operationalized by the percentage of completed homework assignments (32/36, 88%) was also high. When we compared participants' pre- and postintervention scores, we found a significant decrease in clinical symptoms of depression (Cohen d=0.44, 90% CI 0.09-0.80), social phobia (d=0.39, 90% CI 0.07-0.72), and posttraumatic stress disorder (d=0.30, 90% CI 0.04-0.55). There was also a significant improvement in the level of self-acceptance and behavioral effectiveness (d=0.64, 90% CI 0.28-0.99) and a significant decrease in the tendency to avoid negative internal experiences (d=0.38, 90% CI 0.09-0.66). The level of general anxiety disorder (P=.11; d=0.29, 90% CI -0.10 to 0.68) and alcohol consumption (P=.35; d=-0.06, 90% CI -0.31 to 0.19) were the only 2 outcomes for which the results were not statistically significant.
The proposed web-based acceptance and commitment therapy program, designed to help LGBTQ+ participants better manage emotional difficulties and become more resilient, represents a promising therapeutic tool. The program could be further tested with more participants to ensure its efficacy and effectiveness.
ClinicalTrials.gov NCT05514964; https://clinicaltrials.gov/study/NCT05514964.
女同性恋、男同性恋、双性恋、跨性别者和酷儿（LGBTQ+）群体由于普遍存在的异性恋规范和顺性别规范，包括公众对LGBTQ+群体的负面态度，面临更高的心理健康问题风险。除了在社会层面打击社会排斥外，增强年轻LGBTQ+群体的应对能力是一个重要目标。
在这项跨诊断可行性研究中，我们测试了一个为期6周的网络干预项目，该项目旨在提高非临床LGBTQ+参与者应对日常生活中不良事件的能力。该项目基于接纳与承诺疗法原则。
该项目由6个基于网络的模块以及由单一护理提供者异步提供的低强度家庭作业辅导组成。设计为对15名自我认同为LGB群体的成员进行单组分配，他们同意参与一项单组开放试验（干预前和干预后设计）。
在开始该项目之前，参与者认为该干预可信，并在干预结束时表示高度满意。以完成的家庭作业任务百分比（32/36，88%）衡量的治疗依从性也很高。当我们比较参与者干预前和干预后的分数时，我们发现抑郁的临床症状（科恩d=0.44，90%置信区间0.09 - 0.80）、社交恐惧症（d=0.39，90%置信区间0.07 - 0.72）和创伤后应激障碍（d=0.30，90%置信区间0.04 - 0.55）有显著下降。自我接纳水平和行为效能（d=0.64，90%置信区间0.28 - 0.99）也有显著改善，避免负面内心体验的倾向（d=0.38，90%置信区间0.09 - 0.66）有显著下降。广泛性焦虑障碍水平（P = 0.11；d=0.29，90%置信区间 - 0.10至0.68）和酒精消费（P = 0.35；d=-0.06，90%置信区间 - 0.31至0.19）是仅有的两个结果在统计学上不显著的指标。
所提出的基于网络的接纳与承诺疗法项目，旨在帮助LGBTQ+参与者更好地管理情绪困扰并变得更有复原力，是一种有前景的治疗工具。该项目可以用更多参与者进一步测试以确保其有效性和效能。
ClinicalTrials.gov NCT05514964；https://clinicaltrials.gov/study/NCT05514964 。
