Abstract
ObjectiveThis study tested the efficacy of AFFIRM, a brief affirmative cognitive-behavioural group intervention tailored to reduce psychosocial distress and improve coping among sexual and gender minority adolescents and young adults (SGMY).MethodSGMY (n = 138; M age = 22.44) were allocated to immediate 8-week AFFIRM intervention delivered at 12 community-based organisations or an 8-week waitlisted control. At baseline, post-intervention or post-waitlist, participants completed self-reported assessments of depression, hope, coping, and stress appraisal. Implementation outcomes of feasibility and acceptability were also assessed.ResultsCompared to waitlist, SGMY in the intervention condition significantly reduced their depressive symptoms (b = − 5.79, p = .001) as well as increased reports of hope (agency: b = 0.84, p = .001; pathway: b = 0.79, p = .001), and coping by emotional support (b = 0.59, p < .001), instrumental support (b = 0.67, p < .001), positive framing (b = 0.59, p < .001), humour (b = 0.36, p = .014), planning (b = 0.49, p < .001) as well as reflective coping (b = 0.27, p = .009). Intervention participants were also less likely to perceive stress as a threat (b = − 0.43, p = .001), and more likely to perceive stress as challenge (b = 0.67, p < .001) and have the resources to deal with that stress (b = 0.38, p = .016) in comparison to waitlisted control participants. All outcomes had medium to large effect sizes. AFFIRM participants reported low attrition (8.5%) and high levels of engagement and acceptability (e.g. 99% agreed intervention was relevant to their lives). Over 63% of the community organizations that participated in the training hosted AFFIRM at least once during the study.ConclusionsResults demonstrate efficacy for the community-based implementation of an affirmative clinical intervention designed for SGMY to address depression and foster coping with universal and minority stressors.
Highlights
Sexual and gender minority adolescents and young adults, hereafter referred to as sexual and gender minority youth (SGMY) experience significant mental health disparities and psychological distress compared to theirCraig et al BMC Psychol (2021) 9:94 cisgender, heterosexual counterparts [1]
Results demonstrate efficacy for the community-based implementation of an affirmative clinical intervention designed for SGMY to address depression and foster coping with universal and minority stressors
The CDC Youth Risk Behaviour Survey found that over 60 percent of sexual minority youth did not engage in their typical activities due to sadness and hopelessness and were four times as likely to attempt suicide compared to heterosexual youth [3]
Summary
Sexual and gender minority adolescents and young adults, hereafter referred to as sexual and gender minority youth (SGMY) experience significant mental health disparities and psychological distress compared to theirCraig et al BMC Psychol (2021) 9:94 cisgender, heterosexual counterparts [1]. The CDC Youth Risk Behaviour Survey found that over 60 percent of sexual minority youth did not engage in their typical activities due to sadness and hopelessness and were four times as likely to attempt suicide compared to heterosexual youth [3]. According to a recent metanalysis, sexual minority youth have three times the odds of developing a depressive disorder or symptoms compared to their peers [4]. In studies with transgender or gender diverse populations, over 40% attempt suicide during adolescence or young adulthood [5] and 49–62% of youth meet criteria for a depressive disorder [6]. A national investigation found that sexual and gender minority college students (N = 72,815) were twice as likely to report depression that significantly impacts functioning and three times more likely to have suicidal ideation compared to their heterosexual and non-transgender peers [7]
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