Symposia
LGBQT+
Matthew F. Thompson, M.S.
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Jeremy Luk, PhD
Clinical Psychologist
National Institutes of Health
Bethesda, Maryland
Jessica LaCroix, PhD
Research Assistant Professor
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Sarah Carter, Ph.D.
Research Assistant Professor
Uniformed Services University of the Health Sciences
Bethesda, MD
Kanchana Perera, MS
Data Manager/Biostatistician
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Joshua Gray, PhD
Assistant Professor
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Marjan Ghahramanlou-Holloway, PhD
Professor
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Background: Risk for suicide remains elevated for those who identify as sexual minorities within military treatment settings, despite the repeal of Don’t Ask Don’t Tell. A recent publication, comparing demographic and clinical characteristics of lesbian, gay, and bisexual (LGB) with heterosexual participants enrolled in a clinical trial, found lower family support, higher perceived burdensomeness, and greater difficulties in controlling suicidal thoughts for LGB participants relative to heterosexual participants. Given these baseline differences, further research is needed to understand how LGB persons may respond to suicide-focused care over time in the context of clinical research.
Objective: The purpose of this study was twofold: (1) to evaluate treatment dosage received by LGB participants enrolled in a clinical trial (therapy duration and number of session); and (2) to determine whether sexual orientation moderated the link between treatment condition and five suicide risk outcomes (perceived burdensomeness, thwarted belongingness, and frequency, duration, and controllability of suicidal thoughts) at three months post-treatment.
Method: Secondary analyses were performed on baseline and 3-month follow-up data collected from 209 participants in a multisite randomized controlled trial of Post-Admission Cognitive Therapy (PACT). Treatment condition (experimental and control) and sexual orientation (LGB n = 39, heterosexual n = 170) served as predictors in five distinct regression models with suicide risk outcomes. Each model was adjusted for the corresponding baseline suicide risk index, and Bayesian analyses were subsequently performed.
Results: Treatment dosage did not differ by sexual orientation. In each of the models, there were no main effects of sexual orientation or treatment condition. Additionally, sexual orientation was not a moderator in any of the models using each of the five suicide risk factors. Bayesian analyses indicated evidence for the null hypotheses (B.F. range = 4.75-5.89).
Conclusions: Despite observed baseline differences, LGB participants had similar outcomes on five suicide risk factors when compared with heterosexual participants at 3-months post-discharge, in the context of a cognitive behavioral intervention for suicide risk within a military setting. Iterations of cognitive therapy with flexibility to address minority stressors may ameliorate some risk factors for LGB participants. Future research should expand our understanding of unique treatment needs and trajectories.