OBJECTIVE To identify scalable interventions for improving sexual minority mental health and health-risk behavior, this study tested the efficacy of two self-guided online writing interventions-expressive writing and self-affirmation. To reach sexual minority young adults living in high-stigma, low-resource settings, we developed and tested these interventions in Appalachian Tennessee. METHOD In consultation with sexual minority young adults (n = 10) and stakeholders (n = 10) living in Appalachian Tennessee, we adapted these two writing interventions that we then delivered to 108 local sexual minority young adults (Mage = 23.68, SD = 3.11). Participants, representing diverse sexual and gender identities and socioeconomic backgrounds, were randomly assigned to participate in a 3-session expressive writing intervention, self-affirmation intervention, or neutral control. Participants completed mental health and health-risk behavior measures at baseline, postintervention, and 3-month follow-up. RESULTS Compared to the neutral control, expressive writing exerted 3-month improvements in depressive symptoms (d = 0.48) and general psychological distress (d = 0.36) whereas self-affirmation exerted improvement in suicidal ideation (d = 0.62) and drug abuse (d = 0.59). Participants who were exposed to greater contextual minority stressors common in rural regions (i.e., discrimination and victimization) experienced significantly greater 3-month reductions in depression from expressive writing and self-affirmation compared to control. Those who experienced greater discrimination also experienced significantly greater 3-month reductions in suicidality from self-affirmation compared to control. CONCLUSION Brief writing interventions exert significant impact on the mental health of young adult sexual minorities, especially those exposed to minority stress. Future research can consider strategies for population-level implementation, especially in high-stigma, low-resource settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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LGBTQ 青年心理和行为健康的简短在线干预：一项在高污名、低资源背景下的随机对照试验。

目的为了确定可扩展的干预措施以改善性少数群体的心理健康和健康风险行为，本研究测试了两种自我指导的在线写作干预措施——表达性写作和自我肯定的有效性。为了接触生活在高污名、低资源环境中的性少数年轻人，我们在阿巴拉契亚田纳西州开发并测试了这些干预措施。方法 在与居住在阿巴拉契亚田纳西州的性少数青年 (n = 10) 和利益相关者 (n = 10) 协商后，我们调整了这两种写作干预措施，然后将其交付给 108 名当地性少数青年 (Mage = 23.68, SD = 3.11 ）。代表不同性和性别身份以及社会经济背景的参与者被随机分配参加 3 次表达性写作干预、自我肯定干预、或中性控制。参与者在基线、干预后和 3 个月的随访中完成了心理健康和健康风险行为测量。结果 与中性对照相比，表达性写作在抑郁症状 (d = 0.48) 和一般心理困扰 (d = 0.36) 方面有 3 个月的改善，而自我肯定在自杀意念 (d = 0.62) 和药物滥用 (d = 0.59）。与对照组相比，暴露于农村地区常见的更大背景少数族裔压力源（即歧视和受害）的参与者在 3 个月内因表达性写作和自我肯定而出现的抑郁症状显着减少。与对照组相比，那些遭受更大歧视的人在 3 个月内因自我肯定而导致的自杀倾向显着减少。结论 简短的写作干预对年轻的性少数群体的心理健康产生重大影响，尤其是那些暴露于少数群体压力的人。未来的研究可以考虑人口层面的实施策略，特别是在高污名、低资源环境中。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。