(PS6-18) Emotion Dysregulation in SGM Individuals: Evidence for the Efficacy of DBT

Abstract Text: Background

Mental health concerns are more prevalent in sexual and gender minority (SGM) than non-SGM individuals. Environmental invalidation, including stigma and discrimination, likely influences this disparity by exacerbating emotion dysregulation. Indeed, emotion dysregulation mediates the relationship between minority stress and mental health outcomes. Emotional suppression (linked to emotional non-acceptance) may be especially relevant for SGM individuals. While DBT is effective for SGM individuals, some symptoms improve less than for straight peers (Oshin et al., 2024). Understanding DBT’s mechanisms is essential to optimize its impact in SGM groups.

This study examines whether (a) levels of baseline total emotion dysregulation and emotional non-acceptance differ between SGM and non-SGM groups, and (b) rate of improvement in these areas differs between groups during DBT. We hypothesize that SGM clients will report higher baseline emotion dysregulation (H1a) and emotional non-acceptance (H1b), with comparable rates of total emotion dysregulation and emotional non-acceptance improvement (H2a, H2b).

Methods
Participants (n = 239) were adult DBT patients at an outpatient practice in Los Angeles. SGM clients accounted for 38.1% (n = 91) and non-SGM accounted for 61.9% (n =148) of the sample. Within the SGM group, 11% identified as gay, 17% bisexual, 5% pansexual, and 5% were unsure, though did not identify as straight. The average age was 31.5 years (SD = 11.3), with 67% women, 30% men, and 3% nonbinary. The DERS-18 was completed prior to treatment and between 2 and 12 months after treatment began.

Results
A mixed linear effects model showed significantly higher DERS-18 total scores in SGM than non-SGM clients at baseline (β = 5.92, SE = 1.59, p < .001). Results supported H1a, showing that SGM individuals initially experience greater emotion dysregulation severity than non-SGM clients. We will examine levels of emotional non-acceptance (H1b) utilizing the same model, to compare baseline levels of DERS-18 emotional non-acceptance subscales for the two groups.

DERS-18 total scores significantly decreased in both groups (β = -0.43, SE = 0.07, p < .001). There was also a significant interaction between time in treatment and SGM status (β = -0.30, SE = 0.11, p < .001). Contrary to H2a, this suggests that emotion dysregulation improved significantly faster in SGM clients. We propose to use a mixed linear effects model to examine whether this interaction extends to DERS-18 emotional non-acceptance.

Conclusion
Results highlight the importance of studying emotion dysregulation in SGM individuals and suggest that DBT may be particularly effective for this group. Consistent with our hypothesis, SGM clients reported higher emotion dysregulation at baseline. Contrary to expectations, SGM clients showed quicker improvement in emotion dysregulation during DBT. Further research might explore mechanisms underlying these improvements, including the role of emotional non-acceptance and other emotion dysregulation facets, to optimize outcomes for SGM individuals.