Suicidal Ideation Severity in Transgender and Cisgender Elevated-Risk Military Service Members at Baseline and Three-Month Follow-Up

Janakiraman, Roshni; Stanley, Ian H.; Duffy, Mary E.; Gai, Anna R.; Hanson, Jetta E.; Gutierrez, Peter M.; Joiner, Thomas E.

doi:10.1080/21635781.2020.1742821

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…This is consistent with previous work finding that TNB individuals with EDs are at greater risk for nonsuicidal self-injury, suicidal ideation and suicide attempts, both when compared to cisgender individuals with EDs and transgender individuals without EDs (Duffy et al, 2019). It is also consistent with a study of U.S. active-duty service members in suicidal crisis (Janakiraman et al, 2020), which found that suicidality resolved well in response to intensive treatment in cisgender but not transgender individuals. Clinically, and albeit quite tentatively, our findings suggest that TNB individuals may benefit from additional mood, anxiety and suicidality-focused interventions over the course of treatment to target their comorbid symptoms.…”

Section: Discussionsupporting

confidence: 92%

“…Several limitations of the current study should be noted. The sample size of TNB patients was relatively small (though larger than a comparable study, i.e., Janakiraman et al, 2020), which limited our ability to detect smaller differences in symptom severity. It is important to recognize that vulnerable and historically excluded populations, such as TNB patients, have been systematically understudied due to many factors, one of which is a tendency to refrain from TNBspecific analysis due to small sample sizes and issues of power.…”

Section: Discussionmentioning

confidence: 89%

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Comparing eating disorder treatment outcomes of transgender and nonbinary individuals with cisgender individuals

Riddle

Robertson

Blalock

et al. 2022

Intl J Eating Disorders

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Objective The purpose of this study was to compare symptom severity of eating disorders (EDs), depression and anxiety at admission and discharge for transgender and nonbinary (TNB) individuals and cisgender adult individuals receiving treatment for EDs at higher levels of care (HLOC), adding to the limited research in this area. Method Participants were 25 TNB individuals and 376 cisgender individuals admitted to a HLOC ED treatment facility. Participants completed the Eating Disorder Examination Questionnaire (EDE‐Q), Patient Health Questionnaire‐9, and Beck Anxiety Inventory at admission and discharge. Results TNB individuals showed significant improvements on EDE‐Q global scores between admission and discharge (Cohen's d = 1.27), and showed similar improvements on the EDE‐Q over the course of treatment (Cohen's d = 0.06) when compared to cisgender individuals. TNB individuals had more severe depression at admission (Cohen's d = 0.61). Although depression improved over the course of treatment for both groups, TNB individuals showed less improvement (Cohen's d = 0.59). Suicidality was higher for TNB individuals on admission and discharge and did not improve significantly over the course of treatment (Cohen's d = 0.38). Discussion This study provides preliminary evidence that TNB and cisgender individuals show similar improvement in ED symptoms during HLOC treatment. However, TNB individuals have more severe depression and less improvement in depression compared to cisgender individuals, without improvement in suicidality. TNB individuals may benefit from care targeting depression and suicidality during ED treatment. Public Significance Statement TNB individuals have increased risk of EDs. Little research addresses how TNB individuals respond to ED treatment, which was traditionally created for cisgender individuals. We present one of the first studies examining ED treatment outcomes for TNB adults. TNB individuals showed improved ED symptoms with treatment, but less improvement in depression and their suicidality remained elevated. This suggests the need for targeted treatment.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 89%

Comparing eating disorder treatment outcomes of transgender and nonbinary individuals with cisgender individuals

Riddle

Robertson

Blalock

et al. 2022

Intl J Eating Disorders

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“…Future studies should seek to conduct more outcome and dissemination research on DBT‐A within this and related minority populations. Clinical scientists should routinely and comprehensively assess both sexual orientation and gender identity; indeed, a wealth of research suggests that transgender and other gender‐expansive minorities experience increased risk of suicidal thoughts and behaviors across the lifespan (Janakiraman et al, 2020). New adaptations to address the unique experiences of sexual and/or gender minorities related to suicide could be developed and tested to see whether larger effects are feasible across multiple settings (Carmel et al, 2014; Dimeff et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Dialectical behavior therapy for adolescents (DBT‐A): Outcomes among sexual minorities at high risk for suicide

Poon

Galione

Grocott

et al. 2022

Suicide & Life Threat Behav

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The alarming rates and pervasiveness of suicidal and self‐destructive behaviors (e.g., non‐suicidal self‐injury) among young sexual minorities represent a major public health concern. We set out to examine whether an empirically driven treatment for suicide and self‐harm, dialectical behavior therapy for adolescents (DBT‐A), provides benefits for adolescents who identify as gay, lesbian, bisexual, or questioning (LGBQ). LGBQ adolescents (n = 16) were compared with non‐LGBQ peers (n = 23). Psychological measures were collected before and after participation in a comprehensive DBT‐A program. LGBQ participants demonstrated significant improvements in emotion regulation, depression, borderline symptoms, and coping strategies; changes were comparable to their heterosexual peers.

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“…This study has several limitations. Despite being larger than previously reported studies, the sample size of TGD individuals remains small (Janakiraman et al, 2020;Riddle et al, 2022). This limited our ability to detect small differences between groups.…”

Section: Discussionmentioning

confidence: 80%

Comparing eating disorder treatment outcomes of transgender and gender diverse adolescents with those of cisgender adolescents

Riddle,

Blalock,

Robertson

et al. 2024

Intl J Eating Disorders

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ObjectiveEating disorder (ED), depression, and anxiety symptoms at admission and discharge were compared, as were admission‐to‐discharge changes, for transgender and gender diverse (TGD), and cisgender adolescents receiving intensive treatment for EDs.MethodParticipants were 44 TGD and 573 cisgender adolescents admitted to a treatment facility. Participants completed the Eating Disorder Examination Questionnaire (EDE‐Q), Patient Health Questionnaire‐9 (PHQ‐9), and Generalized Anxiety Disorder‐7 (GAD‐7) at admission and discharge.ResultsBoth groups had elevated EDE‐Q scores at admission (TGD: M = 3.78, standard deviation [SD] = 1.70; cisgender: M = 3.33, SD = 1.74) that improved by discharge (TGD: M = 2.27, SD = 1.83, Cohen's d = .98; cisgender: M = 2.10, SD = 1.54, Cohen's d = .79); there were no differences in EDE‐Q between groups at admission (p = .09; odds ratio [OR] = 1.18, 95% confidence interval [CI] [.98, 1.44]) or discharge (p = .48; OR = 1.07, 95% CI [.88, 1.30]). On admission, TGD adolescents had higher suicidality, measured by PHQ‐9, item 9 (p < .001; OR = 1.94, 95% CI [1.51, 2.52]), and depression (p < .001; OR = 1.10, 95% CI [1.05, 1.16]) than cisgender participants. Severity decreased over treatment for all measures. Both groups showed similar improvement on suicidality (p = .93; OR = .98, 95% CI [.70,1.36]), depression (p = .42; OR = 1.02, 95% CI [.97, 1.07]), and anxiety (p = .14; OR = 1.05, 95% CI [.99, 1.12]). However, at discharge, suicidality (p = .02; OR = 1.40, 95% CI [1.04, 1.85]), depression (p < .01; OR = 1.06, 95% CI [1.02, 1.11]), and anxiety (p = .02; OR = 1.06, 95% CI [1.01, 1.12]) were higher for TGD adolescents than their cisgender peers.DiscussionAll participants had similar ED symptom severity and improvement. Depression, anxiety, and suicidality remained elevated for TGD adolescents compared to their cisgender peers at discharge, suggesting the need for targeted treatment.Public SignificanceTransgender and gender diverse (TGD) adolescents have increased risk of eating disorders (EDs); few studies examine how they respond to ED treatment. We examine treatment outcomes of TGD adolescents receiving ED treatment compared to their cisgender peers. We measured ED symptoms along with depression, anxiety, and suicidality at the beginning and end of treatment. While TGD adolescents showed similar improvement in ED symptoms, measures of depression, anxiety, and suicidality remained elevated at the time of discharge.

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Suicidal Ideation Severity in Transgender and Cisgender Elevated-Risk Military Service Members at Baseline and Three-Month Follow-Up

Cited by 4 publications

References 26 publications

Comparing eating disorder treatment outcomes of transgender and nonbinary individuals with cisgender individuals

Comparing eating disorder treatment outcomes of transgender and nonbinary individuals with cisgender individuals

Dialectical behavior therapy for adolescents (DBT‐A): Outcomes among sexual minorities at high risk for suicide

Comparing eating disorder treatment outcomes of transgender and gender diverse adolescents with those of cisgender adolescents

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