Leonhardt André, Fuchs Martin, Kohlboeck Gabriele, Bachler-Ortner Nora, Haid-Stecher Nina, Gander Manuela, Sevecke Kathrin
Institute of Psychology, University of Innsbruck, Universitätsstraße 15, 6020, Innsbruck, Austria.
Department for Child and Adolescent Psychiatry, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Arch Sex Behav. 2025 Aug 20. doi: 10.1007/s10508-025-03221-3.
Gender dysphoric adolescents presenting to specialized gender identity services experience varying degrees of co-occurring mental health problems. However, few studies have examined how these symptoms may cluster into distinct patterns of psychological distress. This study examined subgroup differences in psychopathological characteristics in a clinical sample of 102 adolescents (74.5% natal females, M age = 16.08 years, SD = 1.54) with gender dysphoria. We used hierarchical cluster analysis to identify subgroups within our sample based on self-report measures on gender dysphoria, general psychopathology, body image, childhood trauma, levels of personality functioning, identity development, and items on perceived social support. This exploratory approach revealed three subgroups with distinct distress profiles. A "Low-Distress" cluster (29%) showed minimal psychopathological symptoms, with scores below clinical cut-offs on most measures and high levels of social support. A "Moderate-Distress" cluster (48%) showed significant internalizing psychopathology, moderate exposure to emotional maltreatment, and low to moderate impairment in personality functioning, but high levels of social support. A "High-Distress" cluster (23%) showed severe internalizing and externalizing psychopathology, high levels of childhood trauma on most subscales, severe impairments in personality functioning and identity development and low levels of social support. All clusters reported clinically significant gender dysphoria and poor body image. These findings highlight significant differences in distress profiles in this clinical sample and provide a basis for future research to validate this subgroup typology, examine their developmental trajectories, and inform individualized treatment approaches for adolescents with gender dysphoria.
前来专门的性别认同服务机构就诊的性别焦虑青少年存在不同程度的共病心理健康问题。然而，很少有研究探讨这些症状如何可能聚集成不同的心理困扰模式。本研究调查了102名患有性别焦虑的青少年（74.5%为出生时被认定的女性，平均年龄 = 16.08岁，标准差 = 1.54）临床样本中心理病理特征的亚组差异。我们使用层次聚类分析，根据关于性别焦虑、一般心理病理学、身体意象、童年创伤、人格功能水平、身份发展以及感知到的社会支持项目的自我报告测量，在我们的样本中识别亚组。这种探索性方法揭示了三个具有不同困扰特征的亚组。一个“低困扰”亚组（29%）表现出最小的心理病理症状，在大多数测量指标上得分低于临床临界值且社会支持水平高。一个“中度困扰”亚组（48%）表现出显著的内化心理病理学、中度暴露于情感虐待以及人格功能低至中度受损，但社会支持水平高。一个“高困扰”亚组（23%）表现出严重的内化和外化心理病理学、在大多数子量表上童年创伤水平高、人格功能和身份发展严重受损以及社会支持水平低。所有亚组都报告了临床上显著的性别焦虑和不良身体意象。这些发现突出了该临床样本中困扰特征的显著差异，并为未来研究验证这种亚组类型学、检查其发展轨迹以及为患有性别焦虑的青少年提供个性化治疗方法提供了基础。
