title: LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: A randomized controlled trial of a transdiagnostic minority stress approach.
abstract: OBJECTIVE
  We tested the preliminary efficacy of a transdiagnostic cognitive-behavioral treatment adapted to improve depression, anxiety, and co-occurring health risks (i.e., alcohol use, sexual compulsivity, condomless sex) among young adult gay and bisexual men. Treatment adaptations focused on reducing minority stress processes that underlie sexual orientation-related mental health disparities.
  
  
  METHODS
  Young gay and bisexual men (n = 63; M age = 25.94) were randomized to immediate treatment or a 3-month waitlist. At baseline, 3-month, and 6-month assessments, participants completed self-reports of mental health and minority stress and an interview of past-90-day risk behavior.
  
  
  RESULTS
  Compared to waitlist, treatment significantly reduced depressive symptoms (b = -2.43, 95% CI: -4.90, 0.35, p < .001), alcohol use problems (b = -3.79, 95% CI: -5.94, -1.64, p < .001), sexual compulsivity (b = -5.09, 95% CI: -8.78, -1.40, p < .001), and past-90-day condomless sex with casual partners (b = -1.09, 95% CI: -1.80, -0.37, p < .001), and improved condom use self-efficacy (b = 10.08, 95% CI: 3.86, 16.30, p < .001). The treatment yielded moderate and marginally significant greater improvements than waitlist in anxiety symptoms (b = -2.14, 95% CI: -4.61, 0.34, p = .09) and past-90-day heavy drinking (b = -0.32, 95% CI: -0.71, 0.07, p = .09). Effects were generally maintained at follow-up. Minority stress processes showed small improvements in the expected direction.
  
  
  CONCLUSIONS
  This study demonstrated preliminary support for the first intervention adapted to address gay and bisexual men's co-occurring health problems at their source in minority stress. If found to be efficacious compared to standard evidence-based treatments, the treatment will possess substantial potential for helping clinicians translate LGB-affirmative treatment guidelines into evidence-based practice. (PsycINFO Database Record
authors.affiliation: Department of Chronic Disease Epidemiology, Social and Behavioral Sciences Division, Yale School of Public Health, Yale University.
authors.forename: John E
authors.initials: JE
authors.lastname: Pachankis
authors.affiliation: Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Hatzenbuehler
authors.affiliation: Center for HIV/AIDS Educational Studies & Training (CHEST).
authors.forename: H Jonathon
authors.initials: HJ
authors.lastname: Rendina
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Safren
authors.affiliation: Center for HIV/AIDS Educational Studies & Training (CHEST).
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Parsons
mesh_terms: D000293:Adolescent; D000328:Adult; D001727:Bisexuality / Q000523:psychology* / Q000706:statistics & numerical data; D015928:Cognitive Behavioral Therapy; D005500:Follow-Up Studies; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008913:Minority Groups / Q000523:psychology* / Q000706:statistics & numerical data; D012309:Risk-Taking; D057566:Self Report; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult