(PS6-7) Anxiety and Stress Outcomes of Sexual and Gender Minority Patients in a DBT Partial Hospital Program

Abstract Text:

Background: Sexual and gender minority (SGM) patients experience higher levels of anxiety and stress compared to their cisgender-heterosexual counterparts (Dolezal et al., 2023; Helminen et al., 2022), which may be due to the unique identity-based stressors (e.g., discrimination, stigma, systematic invalidation) they face (Pinciotti et al., 2022). Dialectical Behavior Therapy (DBT; Linehan, 1993) can help teach patients change and acceptance-based skills to address both universal and identity-based stressors and resulting mental health symptoms (Lee et al., 2021; Skerven et al., 2019), including anxiety and stress (Andrade et al., 2024; Malivoire, 2019). This study aimed to examine if a 20-day DBT partial hospital program (PHP) could potentially influence anxiety and stress levels in SGM patients compared to non-SGM patients.

Methods: Data came from 390 patients (62.9% White; M = 17.5 years) in a four-week DBT PHP. The majority of patients identify as a sexual and/or gender minority (57.5%). Participants completed the 21-item Depression, Anxiety and Stress Scale (DASS-21) at intake and discharge, where only the Anxiety and Stress subscales were examined. We conducted independent two-sample t-tests to compare the average anxiety and stress scores between SGM and non-SGM groups and estimated their anxiety and stress change scores by subtracting their admission score from their post treatment score.

Results: SGM patients had significantly higher anxiety (M = 8.90) and stress (M = 10.80) scores compared to cisgender-heterosexual patients (anxiety: M = 7.30, p = .003; stress: M = 9.55, p = .012) at admission. At discharge, SGM patients also had significantly higher stress scores (M = 8.38) than their cisgender-heterosexual counterparts (M = 6.70; p = .001), but did not have significantly different anxiety scores. When examining pre-post outcomes, SGM patients had reductions in their anxiety levels (-6.39), but no observed changes in their levels of stress.

Discussion: SGM patients had higher stress scores compared to cisgender-heterosexual patients at admission and discharge. Although SGM patients had higher anxiety at admission, there was not a significant difference in post-treatment anxiety compared to the cisgender-heterosexual group. While anxiety for SGM patients decreased over time, stress did not. Although the DBT PHP was helpful in reducing anxiety for SGM patients, stress might be a more pervasive challenge as they may experience ongoing identity-based stressors outside of treatment (Cardona et al., 2022). These patients may require tailored treatment adaptations to address SGM-specific needs to help them generalize their skills more effectively in managing unique environmental stressors, such as identity-related stressors (Camp et al., 2024; Skerven et al., 2019). These findings can help support DBT’s effectiveness in reducing anxiety for both SGM patients and the general population. Future research should examine how environmental stressors, including discrimination and invalidation, impact stress to better understand whether interpersonal and identity-based stressors play a role in reducing SGM patients’ stress.