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辩证行为治疗计划中性少数和性别少数青少年的临床结果
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辩证行为治疗计划中性少数和性别少数青少年的临床结果
Clinical outcomes for sexual and gender minority adolescents in a dialectical behaviour therapy programme
——原载《行为与认知心理治疗》2024年第52卷第4期——
<Behavioural and Cognitive Psychotherapy> Volume 19, Issue 4, 2024
【摘要】背景：性少数和性别少数 (SGM) 青少年的自残和自杀风险增加，并且在获得心理健康支持方面遇到障碍。辩证行为疗法 (DBT) 是治疗青少年群体自残和情绪失调的有效方法，但很少有研究发表DBT对SGM年轻人的影响。目的：本研究旨在调查英国国家和专科CAMHS、DBT服务中SGM青少年及其顺性别和异性恋同龄人的治疗结果和完成情况。方法：检查性别和性别认同组别的治疗完成情况以及治疗前和治疗期间退出的情况，以及治疗结束时情绪失调、自残、住院床位、急诊就诊、边缘性人格障碍、抑郁和焦虑症状的变化。结果：即使考虑到SGM青少年自残风险增加，他们在该服务中所占比例仍然过高。在性取向和性别认同组之间，治疗完成情况没有发现统计学上显着差异，尽管有模式表明治疗吸收率和完成率可能较低，值得进一步研究。治疗完成者的临床结果显示，除少数例外外，每个组在DBT结束时都有所改善。讨论：这些结果来自相对较小的子样本，无法按出生时指定的性别分开。应暂时将研究结果视为效果大小的早期迹象，以指导未来的研究。这项研究表明，DBT可能是高度专业化的治疗环境中对SGM青少年的有效治疗方法。
【关键词】青少年、辩证行为疗法、情绪失调、性多元群体、自残
[Abstract] Background: Sexuality and gender minoritised (SGM) adolescents are at increased risk of self-injury and suicide, and experience barriers to accessing mental health support. Dialectical behaviour therapy (DBT) is an effective treatment for self-injury and emotion dysregulation in adolescent populations, but few studies have published outcomes of DBT for SGM young people. Aims: This study aimed to investigate treatment outcomes and completion for SGM adolescents and their cisgender and heterosexual peers, in the National & Specialist CAMHS, DBT service (UK). Method: Treatment completion, and opting out before and during treatment were examined for sexual and gender identity groups, as well as changes by the end of treatment in emotion dysregulation, self-injury, in-patient bed-days, emergency department attendances, and borderline personality disorder, depression and anxiety symptoms. Results: SGM adolescents were over-represented in this service, even after considering their increased risk for self-injury. No statistically significant differences were found for treatment completion between the sexual orientation and gender identity groups, although there were patterns indicating possible lower treatment uptake and completion that warrant further investigation. Clinical outcomes for treatment-completers showed improvement by the end of DBT for each group, with few exceptions. Discussion: These results are from relatively small subsamples, and it was not possible to separate by sex assigned at birth. Findings should be treated tentatively and as early indications of effect sizes to inform future studies. This study suggests that DBT could be a useful treatment for SGM adolescents in a highly specialist treatment setting.
[Key words] Adolescents, DBT, Emotion dysregulation, LGBTQ+, Self-injury
论文原文：J. Camp, G. Durante, A. Cooper, P. Smith and K. A. Rimes (2024). Clinical outcomes for sexual and gender minority adolescents in a dialectical behaviour therapy programme. Behavioural and Cognitive Psychotherapy, Volume 52, Issue 4, Pages 337-355.
https://doi.org/10.1017/S135246582400016X
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