Symposia
Disaster Mental Health
Patricia Cavazos-Rehg, Ph.D.
Washington University in St. Louis
St. Louis, Missouri
Hannah Szlyk, LCSW, PhD
Research Coordinator
Washington University School of Medicine
St. Louis, Missouri
Erin Kasson, MS, MSW
Senior Clinical Research Coordinator
Washington University School of Medicine
St. Louis, Missouri
Xiao Li, MS
Senior Statistical Data Analyst
Washington University School of Medicine
St. Louis, Missouri
Eating disorders (ED) include high-risk behaviors that can cause severe organ damage and result in other life-threatening consequences. Young people are the age group at greatest risk of developing EDs and youth who identify as sexual and gender minorities (SGM) may experience body image concerns and EDs at higher rates than non-SGM youth. During the COVID-19 pandemic, weekly emergency department visits for EDs among adolescents have doubled. Thus, digital tools are timely strategies to widely disseminate cognitive behavioral therapy (CBT) for EDs, to address barriers to in-person ED treatment and to reach youth in need of support and early intervention. Yet, few CBT-based digital interventions for ED are developed for adolescents or tailored for SGM youth. In response to this need, the current investigation examined differences in baseline survey responses by SGM and non-SGM youth who agreed to participate in a pilot randomized controlled trial (RCT) for a CBT-based digital intervention for EDs. Youth were recruited from social media and assented to participate in the study. Teens aged 14-17 years old who screened positive for ED symptoms or at high risk for an ED were eligible to participate. The two-month intervention could be accessed by computer or mobile phone. Participants were surveyed to assess current ED symptoms, comorbid anxiety and depression symptoms, mental health history, and help-seeking for EDs. At the time of the study, 92 youth had completed the baseline survey. Over 41% of youth reported to be 17 years old (n=38), the majority screened positive for symptoms of a clinical/subclinical ED (n=60, 65.2%), and nearly half of participants identified as non-Hispanic White (n=44, 48.4%). Sixty-two participants identified as SGM and 30 identified as non-SGM. SGM participants reported more moderate to severe symptoms of depression (p< 0.01), more symptoms of social anxiety (p< .05), more lifetime suicide attempts (p< .001), and more help-seeking for EDs within the past 30 days (p< .05) than their non-SGM peers. No significant differences by ED symptoms were found. Our findings suggest that SGM youth seek out help for ED more than non-SGM peers and that CBT-based digital interventions are of interest to SGM youth. In preparation for future intervention trials, the research team may ensure that modules are SGM-affirmative. Lastly, the research team may consider including intervention content on mental health management and suicide risk prevention, as these issues are often co-occurring with ED and occur at very high rates among SGM youth.