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ViewAttendees 4

Symposia

LGBTQ+

Session: Enhancing Sexual Minority Wellbeing via Emotion Regulation: Research Implications and Clinical Insights from Affective and Intervention Science

4 - (SYM 17) Pathways to Improving Syndemic Health of Young Gay and Bisexual Men: emotion Regulation Mediators of Lgbq-affirmative Cognitive-behavioral Therapy

Friday, November 17, 2023
10:30 AM – 12:00 PM PST
Location: Skagit (603), Level 6

    Speaker(s)

  • JB

    Julian Burger, M.S. (he/him/his)

    postdoctoral researcher
    Yale University
    Amsterdam, Noord-Holland, Netherlands

    • Co-author(s)

  • John Pachankis, Ph.D.

    Susan Dwight Bliss Associate Professor of Public Health (Social and Behavioral Sciences)
    Yale School of Public Health
    New Haven, Connecticut




Background: Gay and bisexual men (GBM) disproportionately experience health morbidity relative to the general population. This disparity has been attributed to GBM’s early and ongoing exposure to minority stress. For example, GBM’s experiences of chronic stigmatization have been found to give rise to emotion regulation deficits underlying poor mental (e.g., anxiety, depression) and behavioral (e.g., substance use, HIV-risk) health. To this end, ESTEEM—an LGBQ-affirmative cognitive-behavioral therapy (CBT) intervention—aims to enhance GBM’s insight into the role that minority stress plays in invalidating their emotional experiences and interfering with their emotion regulation abilities. Although ESTEEM has been shown to effectively address GBM’s comorbid health concerns, it is unknown whether these improvements are explained via treatment-related gains in emotion regulation skills.





Methods: To remedy this gap, we analyzed data from a three-arm randomized controlled trial (RCT) comparing the efficacy of ESTEEM to two existing interventions among 254 GBM at 4-, 8-, and 12-month follow-up. Specifically, we employed longitudinal structural equation modeling to examine emotion regulation variables (i.e., difficulties with emotion regulation, rumination, assertiveness) as mediators of ESTEEM’s impact on anxiety, depression, substance use, suicidality, and comorbid diagnoses.





Results: Latent change score models showed that rumination mediated the effect of LGBQ-affirmative treatment on substance use at the 8-month follow-up. Most other indicators of emotion regulation did not mediate the relationship between treatment and outcomes.





Conclusions: Results suggest that rumination serves as a mediator of the impact of LGBQ-affirmative CBT on substance use problems—one of the most consistent outcomes of this intervention. The presentation will discuss how attending to emotion regulation, and other types of mediators (e.g., minority stress), can perhaps strengthen future developments of LGBQ-affirmative CBT.