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Seager van Dyk I, Sena R, McCord C, Kodish T, DeAntonio M. Affirming LGBTQIA+ Youth in Inpatient Psychiatric Settings. J Am Acad Child Adolesc Psychiatry 2024; 63:296-300. [PMID: 37451313 DOI: 10.1016/j.jaac.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/25/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023]
Abstract
Decades of research show that LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, and others) youth experience higher rates of psychiatric illness and present to mental health settings more often than their heterosexual, cisgender peers. General guidelines for working with LGBTQIA+ youth exist; however, little has been written about the unique challenges facing LGBTQIA+ youth and their families in inpatient psychiatric settings and strategies for ameliorating them. As LGBTQIA+ youth attempt suicide at much higher rates than their peers, inpatient settings see a disproportionate number of these youth. Providing LGBTQIA+ youth with affirming care during their inpatient admission therefore has the potential to shift mental illness trajectories of youth, increase family support, and reduce the number of lives lost to suicide. In this article, we outline specific barriers to affirming care in inpatient child and adolescent psychiatric settings and propose practical strategies that providers can implement to overcome these barriers.
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Affiliation(s)
- Ilana Seager van Dyk
- Yale School of Public Health, New Haven, Connecticut; Massey University, Wellington, New Zealand.
| | - Rhonda Sena
- UCLA Semel Institute, Los Angeles, California
| | - Colleen McCord
- UCLA Resnick Neuropsychiatric Hospital, Los Angeles, California
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Pachankis JE, Soulliard ZA, Layland EK, Behari K, Seager van Dyk I, Eisenstadt BE, Chiaramonte D, Ljótsson B, Särnholm J, Bjureberg J. Guided LGBTQ-affirmative internet cognitive-behavioral therapy for sexual minority youth's mental health: A randomized controlled trial of a minority stress treatment approach. Behav Res Ther 2023; 169:104403. [PMID: 37716019 PMCID: PMC10601985 DOI: 10.1016/j.brat.2023.104403] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/16/2023] [Accepted: 09/04/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE LGBTQ-affirmative cognitive-behavioral therapy (CBT) addresses the adverse impacts of minority stress. However, this treatment has rarely been tested in randomized controlled trials with LGBTQ youth and never using an asynchronous online platform for broad reach. This study examined the feasibility, acceptability, preliminary efficacy, and multi-level stigma moderators of LGBTQ-affirmative internet-based CBT (ICBT). METHOD Participants were 120 LGBTQ youth (ages 16-25; 37.5% transgender or non-binary; 75.8% assigned female at birth; 49.2% non-Latino White) living across 38 U.S. states and reporting depression and/or anxiety symptoms. Participants were randomized to receive 10 sessions of LGBTQ-affirmative ICBT or only complete 10 weekly assessments of mental and behavioral health and minority stress; all completed measures of psychological distress, depression, anxiety, suicidal thoughts, alcohol use, and HIV-transmission-risk behavior at baseline and 4 and 8 months post-baseline; 20 LGBTQ-affirmative ICBT participants completed a qualitative interview regarding intervention acceptability. RESULTS Participants randomized to LGBTQ-affirmative ICBT completed, on average, 6.08 (SD = 3.80) sessions. Participants reported that LGBTQ-affirmative ICBT was helpful and engaging and provided suggestions for enhancing engagement. Although most outcomes decreased over time, between-group comparisons were small and non-significant. LGBTQ-affirmative ICBT was more efficacious in reducing psychological distress than assessment-only for participants in counties high in anti-LGBTQ bias (b = -1.73, p = 0.001, 95% CI [-2.75, -0.70]). Session dosage also significantly predicted reduced depression and anxiety symptoms. CONCLUSIONS LGBTQ-affirmative ICBT represents a feasible and acceptable treatment. Future research can identify more efficacious approaches and modalities for engaging LGBTQ youth, especially those living under stigmatizing conditions, who might benefit most.
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Affiliation(s)
| | | | | | | | | | | | | | - Brjánn Ljótsson
- Division for Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Josefin Särnholm
- Division for Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Johan Bjureberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
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Christensen KA, van Dyk IS, Klaver E. Elevated insomnia symptom severity in university students: The role of sexual orientation and internalizing symptoms. J Am Coll Health 2023:1-7. [PMID: 36595562 PMCID: PMC10315415 DOI: 10.1080/07448481.2022.2145897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/27/2022] [Accepted: 11/04/2022] [Indexed: 06/17/2023]
Abstract
Objectives: Sexual minority (SM) individuals experience a disproportionate health burden relative to their heterosexual peers; however, less is known about their experience of insomnia. Participants: The sample consisted of a subset of students, N = 1543, Mage = 21.25 years, SD = 3.95, in the 2019-2020 Healthy Minds Study. Adjusting for non-response weights, approximately 16.95% of the sample identified as a sexual minority. Methods: Participants completed measures of insomnia (Insomnia Severity Index) and psychopathology symptoms (PHQ-9 for depression and GAD-7 for generalized anxiety). Results: Sexual orientation was significantly positively associated with insomnia severity, such that SM students exhibited higher insomnia symptom severity, B = 1.71, SE = 0.35, p < .001, 95% CI [1.01, 2.40]. Including depression and anxiety symptom severity in the model completely attenuated this effect. Conclusions: Insomnia symptoms in SM students may be understood in the context of internalizing symptoms; however, study design precluded examining causal pathways.
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Affiliation(s)
| | | | - Ellen Klaver
- Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada
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Seager van Dyk I, Clark KA, Dougherty LR, Pachankis JE. Parent responses to their sexual and gender minority children: Implications for parent-focused supportive interventions. Psychology of Sexual Orientation and Gender Diversity 2022. [DOI: 10.1037/sgd0000589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pachankis JE, Soulliard ZA, Seager van Dyk I, Layland EK, Clark KA, Levine DS, Jackson SD. Training in LGBTQ-affirmative cognitive behavioral therapy: A randomized controlled trial across LGBTQ community centers. J Consult Clin Psychol 2022; 90:582-599. [PMID: 35901370 DOI: 10.1037/ccp0000745] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES This randomized controlled trial examined whether an 11-week synchronous (i.e., real-time) online training in lesbian, gay, bisexual, transgender, queer, and other sexual or gender diverse (LGBTQ)-affirmative cognitive behavioral therapy (CBT) could lead to increased uptake of this practice at LGBTQ community centers across 20 U.S. states and internationally. METHOD A total of 121 mental health providers (Mage = 37.74; 78.5% LGBTQ; 60.3% non-Hispanic/Latinx White) were randomized to receive the 11-week training either immediately (n = 61) or after a 4-month wait (n = 60). At baseline and 4 and 8 months after baseline, participants self-reported their LGBTQ-affirmative competency, cultural humility, and knowledge of the minority stress theory and practice skills underlying LGBTQ-affirmative CBT. To objectively assess uptake of LGBTQ-affirmative CBT, participants demonstrated, through simulated practice, how they would respond to two video-based clinical vignettes. RESULTS Compared to wait-list, participants in the immediate training condition reported greater improvements in self-reported cultural competence (d = 1.24), minority stress knowledge (d = 0.78), LGBTQ-affirmative CBT knowledge (d = 0.78), and LGBTQ-affirmative CBT skills familiarity (d = 0.91) and use (d = 0.96); effects persisted 8 months postbaseline. Cultural humility showed no significant difference by condition (d = 0.07). In objectively coded assessments of simulated practice, participants in the training condition demonstrated greater uptake of LGBTQ-affirmative practice skills (d = 0.82). CONCLUSIONS Findings preliminarily suggest that mental health providers can be trained to deliver LGBTQ-affirmative CBT using the low-cost, efficient reach of online training. This training can help disseminate evidence-based mental health care to LGBTQ individuals and support its implementation across practice settings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Christensen KA, van Dyk IS, Southward MW, Vasey MW. Evaluating interactions between emotion regulation strategies through the interpersonal context of female friends. J Clin Psychol 2022; 78:266-282. [PMID: 34260068 PMCID: PMC9434496 DOI: 10.1002/jclp.23214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 05/03/2021] [Accepted: 06/16/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION There is a growing interest in examining how interpersonal relationships may shape associations between emotion regulation (ER) strategies and psychopathology. METHODS We used multilevel modeling to test if respondents' self-reported intrapersonal ER, friends' self-reported intrapersonal ER, and their interaction were associated with psychopathology in a sample of 120 female friend dyads. RESULTS Respondents' use of brooding rumination, expressive suppression, and worry were positively associated with respondent psychopathology. Friend reappraisal moderated the association between respondent reappraisal and respondent psychopathology. Consistent with an interference hypothesis, respondent cognitive reappraisal was only associated with respondent psychopathology when friend cognitive reappraisal was low. Consistent with a compensatory hypothesis, respondent reappraisal was primarily associated with respondent psychopathology when friend repetitive negative thought was high. DISCUSSION Results support the extension of models of ER strategy interactions from intrapersonal to interpersonal contexts. Future research is needed to replicate the interference and compensatory interactions observed in the data.
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Affiliation(s)
- Kara A. Christensen
- Department of Psychology, University of Kansas, 1415 Jayhawk Blvd, Lawrence, KS 66045 USA
| | - Ilana Seager van Dyk
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH 43210 USA
| | | | - Michael W. Vasey
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH 43210 USA
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Pachankis JE, Soulliard ZA, Morris F, Seager van Dyk I. A Model for Adapting Evidence-Based Interventions to Be LGBQ-Affirmative: Putting Minority Stress Principles and Case Conceptualization into Clinical Research and Practice. Cognitive and Behavioral Practice 2022. [DOI: 10.1016/j.cbpra.2021.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Martinez RG, van Dyk IS, Kroll JL, Emerson ND, Bursch B. Recommendations for building telemental health relationships with youth: A systematic review and resource for clinicians. Evid Based Pract Child Adolesc Ment Health 2022; 7:349-362. [PMID: 36248612 PMCID: PMC9562612 DOI: 10.1080/23794925.2021.1970050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Ruben G. Martinez
- Department of Psychiatry & Biobehavioral Sciences, UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA
| | - Ilana Seager van Dyk
- Department of Social & Behavioral Science, Yale School of Public Health, New Haven, CT
| | - Juliet L. Kroll
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TC
| | - Natacha D. Emerson
- Department of Psychiatry & Biobehavioral Sciences, UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA
| | - Brenda Bursch
- Department of Psychiatry & Biobehavioral Sciences, UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA,Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA
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Zullo L, van Dyk IS, Ollen E, Ramos N, Asarnow J, Miranda J. Treatment recommendations and barriers to care for suicidal LGBTQ youth: A quality improvement study. Evid Based Pract Child Adolesc Ment Health 2021; 6:393-409. [PMID: 34901439 PMCID: PMC8659407 DOI: 10.1080/23794925.2021.1950079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Lucas Zullo
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Ilana Seager van Dyk
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT
| | - Elizabeth Ollen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Natalie Ramos
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Joan Asarnow
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Jeanne Miranda
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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Seager van Dyk I, Hahn H, Scott LE, Aldao A, Vine V. Manipulating minority stress: Validation of a novel film-based minority stress induction with lesbian, gay, and bisexual adults. Psychology of Sexual Orientation and Gender Diversity 2021. [DOI: 10.1037/sgd0000509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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van Dyk IS, Shao J, Sohn L, Smiley PA, Olson K, Borelli JL. Responding to Children's Diverse Gender Expression: Validation of a Parent-Report Measure of Gender-Related Conditional Regard. J GLBT Fam Stud 2021; 17:482-500. [PMID: 37693120 PMCID: PMC10489244 DOI: 10.1080/1550428x.2021.1931615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Epidemiological studies suggest that more youth are identifying as gender expansive (e.g., transgender, gender nonconforming) than ever before. However, due to stressors like discrimination, gender minorities remain at significantly higher risk for mental and physical health problems than their cisgender peers. While initial research has shown that parental support of youth's minority gender identities may be protective, further research is needed regarding specific parenting practices and their impact on children. We propose that parental conditional regard-the selective provision of warmth and esteem when children's behavior conforms to parental standards or values - may be a critical component of parenting behaviors that predicts maladaptation in gender expansive children. Across three studies involving parents of cisgender and gender expansive children ages 3-15 (Study 1: N = 601, community sample; Study 2: N = 793, parents of gender expansive and cisgender children; Study 3, same sample as in Study 1), we describe the development of a novel measure of parental conditional regard for gender expression and test its validity and reliability. Finally, we demonstrate that conditional regard for gender expression is distinct from existing conditional regard measures, and is uniquely associated with children's psychopathology.
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Affiliation(s)
| | - Jianmin Shao
- Department of Psychological Science, University of California, Irvine, Irvine, CA, U.S.A
| | - Lucas Sohn
- Department of Psychological Science, University of California, Irvine, Irvine, CA, U.S.A
| | | | - Kristina Olson
- Department of Psychology, University of Washington, Seattle, WA, U.S.A
| | - Jessica L. Borelli
- Department of Psychological Science, University of California, Irvine, Irvine, CA, U.S.A
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Schiltz HK, McVey AJ, van Dyk IS, Adler EJ, Van Hecke AV. Brief Report: Links Between Nonconformity to Gender Norms, Autistic Features, and Internalizing Symptoms in a Non-clinical College Sample. J Autism Dev Disord 2021; 53:1717-1725. [PMID: 33893594 DOI: 10.1007/s10803-021-05033-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
Research shows elevated gender variance among autistic people and more autistic traits among gender diverse people, each of which is related to mental health concerns. Little work has explored broad features of these presentations in a non-clinical sample. College students (n = 174) ages 18-22 years completed questionnaires assessing the broader autism phenotype (BAP), autistic features, nonconformity to gender norms, and internalizing symptoms. Those with more BAP features or autistic communication reported more nonconformity to gender norms. Higher levels of internalizing symptoms were related to more gender nonconformity, BAP, and autistic features. Gender nonconformity marginally moderated the effect of BAP on depression but not anxiety. The BAP, autistic features, and gender nonconformity are important in understanding mental well-being.
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Affiliation(s)
- Hillary K Schiltz
- Department of Psychology, Marquette University, 604 N. 16th St., Milwaukee, WI, 53233, USA.
| | - Alana J McVey
- Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
| | | | - Elyse J Adler
- Department of Psychology, Marquette University, 604 N. 16th St., Milwaukee, WI, 53233, USA
| | - Amy V Van Hecke
- Department of Psychology, Marquette University, 604 N. 16th St., Milwaukee, WI, 53233, USA
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Christensen KA, Seager van Dyk I, Nelson SV, Vasey MW. Using multilevel modeling to characterize interpersonal emotion regulation strategies and psychopathology in female friends. Personality and Individual Differences 2020. [DOI: 10.1016/j.paid.2020.110156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Hahn H, Seager van Dyk I, Ahn WY. Attitudes Toward Gay Men and Lesbian Women Moderate Heterosexual Adults’ Subjective Stress Response to Witnessing Homonegativity. Front Psychol 2020; 10:2948. [PMID: 31998197 PMCID: PMC6965017 DOI: 10.3389/fpsyg.2019.02948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 12/12/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hunter Hahn
- Department of Psychology, The Ohio State University, Columbus, OH, United States
- *Correspondence: Hunter Hahn,
| | - Ilana Seager van Dyk
- Department of Psychology, The Ohio State University, Columbus, OH, United States
| | - Woo-Young Ahn
- Department of Psychology, Seoul National University, Seoul, South Korea
- Woo-Young Ahn,
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