Cognitive-Behavioral Therapy for Young Adult Lesbian, Gay and Bisexual: Transdiagnostic Minority Stress Approach

Not Applicable

Completed

• Conditions: Alcohol Abuse; Depression, Anxiety; Unsafe Sex; Sexual Compulsivity
• Interventions: Behavioral: ESTEEM (Effective Sikills to Empower Effective Men)

• Registration Number: NCT03980873
• Lead Sponsor: University of the Basque Country (UPV/EHU)

Brief Summary

Background: LGB people experience a large number of anxiety and mood disorders, and risk behaviors than heterosexual (Marshall et al., 2011). The evidence points to the importance played by the stress of minorities in the development of such problems (Bränstrom, Hatzenbuehler, Pachankis and Link, 2016).

Objective: The present study aims to adapt and analyze the efficacy of the ESTEEM program designed for this population (Burton, Wang and Pachankis, in press) in: 1) the reduction of psychopathological symptoms, abusive alcohol consumption and risky sexual behavior, 2 ) the decrease in the level of stress, anxiety for rejection, internalized homophobia and level of concealment, and finally, 3) the improvement of assertiveness levels. The effect of the variables social support, emotional regulation strategies and rumination will be analyzed.

Method: A quasi-experimental design will be used, where the LGB people (n = 63, 18\<) will be assigned to the experimental group (immediate treatment), or to the control group (three-month waitlist). At baseline, 3-month, 6-month and 12-month assessments, participants completed self-reports of mental health and minority stress.

Results: It is expected that after treatment, LGB people mental health will be improved, as well as, minority stress will be reduced.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2019-06-04
• Study First Submitted QC: 2019-06-07
• Study First Posted: 2019-06-10
• Study Start: 2020-09-20
• Primary Completion: 2023-05-01
• Study Completion: 2023-05-01
• Status Verified: 2023-07
• Last Update Submitted: 2023-07-31
• Last Update Posted: 2023-08-01

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 63

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Experimental	ESTEEM (Effective Sikills to Empower Effective Men)	An experimental group. The psychological treatment includes 10 sessions of cognitive-behavioural treatment ESTEEM (Effective Skills to Empower Effective Men) is a 10-session intervention based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders

Primary Outcome Measures

Name	Time	Method
Change of Sexual Compulsivity Scale (SCS) from baseline to 16 months	baseline (week 0), end of treatment (week 10), and during the maintenance phase	The SCS contains 10 items (e.g., "my desires to have sex have disrupted my daily life"), rated from 1 (not at all like me) to 4 (very much like me). Item responses are summed to derive an overall score (range 10-40). The SCS has high reliability and validity across multiple studies (Hook, Hook, Davis, Worthington, \& Penberthy, 2010). A score of 24 or higher is frequently used to distinguish problematic sexual compulsivity (e.g., Grov, Parsons, \& Bimbi, 2010; Ventuneac, Rendina, Grov, Mustanski, \& Parsons, 2015).
Symptom Assessment-45 Questionnaire from baseline to 16 months	baseline (week 0), end of treatment (week 10), and during the maintenance phase	Is an inventory developed to assess the intensity of symptoms inventoried during the last weeks. Each of the 45 items that is integrated in the self-report questionnaire is answered in a likert scale from 0 (nothing) to 4 (a lot), depending on the intensity with which the subject has lived in the last weeks the discomfort that each one explores. It is evaluated and interpreted in function of 10 primary dimensions (somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychotic and diverse symptoms and three global indexes of psychological disorders). The application does not require more than 15 minutes.
Change of Safer Sex Self-Efficacy Questionnaire (SSSE) from baseline to 16 months	baseline (week 0), end of treatment (week 10), and during the maintenance phase	The 13-item SSSE assesses self-efficacy for condom use in various situations (e.g., "When you really need affection," "When your partner says he/she does not want to use a condom") in response to the prompt, "How confident are you that you could avoid having anal sex without a condom?" using a scale ranging from 1 (not at all tempted) to 5 (extremely tempted). The SSSE predicts condomless anal intercourse among men who have sex with men (MSM; Rendina, 2014).

Secondary Outcome Measures

Name	Time	Method
Change of Measure of Gay-Related Stress (MOGS) from baseline to 16 months	baseline (week 0), end of treatment (week 10), and during the maintenance phase	The MOGS contains 56 stressors related to being gay, which participants rated in terms of the negative and positive impact each stressor had if it occurred in the past 12 months along a scale ranging from -3 (extremely negative) to 3 (extremely positive).; The negative impact of gay-related stress predicts depressive symptoms over-and-above general life stress (Lewis et al., 2003).
Change of Internalized Homophobia Scale (IHP) from baseline to 16 months	baseline (week 0), end of treatment (week 10), and during the maintenance phase	The IHP assesses how troubled gay and bisexual men are about their sexual identities over the past year. Participants rate nine items using a scale from 1 (never) to 4 (often). The IHP is associated with general mental and sexual health problems in a sample of adult gay men (Meyer, 1995).
Change of Gay-related Rejection Sensitivity Scale (GRSS) from baseline to 16 months	baseline (week 0), end of treatment (week 10), and during the maintenance phase	The GRSS assesses the degree to which gay and bisexual men would be anxious about being rejected in each of 14 vignettes because of their sexual orientation, from 1 (very unconcerned) to 6 (very concerned), and the degree to which they would expect such rejection from 1 (very unlikely) to 6 (very likely). Previous uses of this scale have yielded associations with depression, social anxiety, substance use, and sexual compulsivity (Feinstein, Goldfried, \& Davila, 2012; Pachan kis et al., 2015).
Change of Sexual Orientation Concealment Scale (SOCS) from baseline to 16 months	baseline (week 0), end of treatment (week 10), and during the maintenance phase	In the SOCS, participants indicate the degree to which they are "out of the closet" to five domains of people: family; gay, lesbian, and bisexual friends; straight friends; co-workers; and health care providers, using a scale from 1 (out to all) to 4 (out to none). The SOCS has shown significant positive associations with internalized homophobia and negative associations with gay community connectedness (Frost \& Meyer, 2009).

Trial Locations

Locations (1)

Universidad del País Vasco; 🇪🇸 San Sebastián, Guipuzcoa, Spain