Tag Archive for: adolescents

blue and pink chalk transgender symbol

New study looks at potential predictors of mental health in transgender adolescents

blue and pink chalk transgender symbol

Autism and autism-related traits, common in transgender populations, are associated with greater mental health burden in transgender adolescents, according to a new study published in the Journal of Clinical Child and Adolescent Psychology.

Autism and autism-related traits, common in transgender populations, are associated with greater mental health burden in transgender adolescents, according to a new study published in the Journal of Clinical Child and Adolescent Psychology.

The study, led by John Strang, Psy.D., director of the Gender and Autism Program (GAP) at Children’s National Hospital, found that autistic transgender adolescents experienced significantly greater emotional distress compared to both autistic cisgender and non-autistic transgender adolescents.

The research team notes that given the mental health risks transgender youth often face, characterization of attributes that predispose certain gender-diverse youth to mental health challenges may be useful in clinical settings. For example, this information may be helpful in screening transgender young people to identify those who may benefit from specific supports, such as accommodations for organization and planning skills (executive function skills) which are needed to navigate the multiple steps of gender transition.

“To date, the primary focus of transgender youth mental health research has been environmental drivers of wellbeing and distress. Specifically, rejection and stigma are established predictors of poorer mental health in transgender adolescents,” Dr. Strang said. “This current study takes a new direction by examining cognitive and neurodevelopmental factors as additional potential predictors of emotional distress in transgender youth.”

In addition to well-established LGBT stigma-related predictors of transgender youth mental health challenges, this study found cognitive and autism-related factors associated with increased transgender youth distress. Specifically, problems with executive function and the impact of executive function problems on a young person navigating their gender transition were associated with greater suicidality. Social symptoms of autism and executive function problems impacting gender transition were associated with greater emotional internalizing symptoms.

More than 90 adolescents ages 13 through 21 were part of the study. Participants were evenly divided between autistic-transgender, autistic-cisgender and non-autistic-transgender groups. Thirteen transgender adolescents were found to be at the margin of autism spectrum disorder (ASD) diagnosis and included within a larger “broad-ASD” grouping for analyses. To evaluate the groups psychologically and neuropsychologically, the study included comprehensive gold-standard assessment of autism and autistic symptoms for all participants as well as evaluation of mental health, IQ, gender dysphoria, LGBT-related perceived stigma, executive function planning skills, and executive function-related barriers to achieving gender transition.

Children’s National GAP is the first clinical and research initiative founded to address the needs of the many transgender youth who are autistic, or more broadly, neurodiverse. Findings from this current study and the growing body of research on co-occurring autism and gender diversity help inform the GAP’s evaluation and support programs for neurodiverse gender diverse youth.

Maureen Monaghan

Using text messages and telemedicine to improve diabetes self-management

Maureen Monaghan

Maureen Monaghan, Ph.D., C.D.E., clinical psychologist and certified diabetes educator in the Childhood and Adolescent Diabetes Program at Children’s National Health System, awarded nearly $1.6 million grant from American Diabetes Association.

Adolescents and young adults ages 17-22 with Type 1 diabetes are at high risk for negative health outcomes. If fact, some studies show that less than 20 percent of patients in this population meet targets for glycemic control, and visits to the Emergency Department for acute complications like diabetic ketoacidosis peak around the same age.

The American Diabetes Association (ADA) awarded Maureen Monaghan, Ph.D., C.D.E., clinical psychologist and certified diabetes educator in the Childhood and Adolescent Diabetes Program at Children’s National Health System, nearly $1.6 million to evaluate an innovative behavioral intervention to improve patient-provider communication, teach and help patients maintain self-care and self-advocacy skills and ultimately prepare young adults for transition into adult diabetes care, limiting the negative adverse outcomes that are commonly seen in adulthood.

Dr. Monaghan is the first psychologist funded through the ADA’s Pathway to Stop Diabetes program, which awards six annual research grants designed to spur breakthroughs in fundamental diabetes science, technology, diabetes care and potential cures. Dr. Monaghan received the Accelerator Award, given to diabetes researchers early in their careers, which will assist her in leading a behavioral science project titled, “Improving Health Communication During the Transition from Pediatric to Adult Diabetes Care.”

“Behavior is such a key component in diabetes care, and it’s wonderful that the American Diabetes Association is invested in promoting healthy behaviors,” says Dr. Monaghan. “I’m excited to address psychosocial complications of diabetes and take a closer look at how supporting positive health behavior during adolescence and young adulthood can lead to a reduction in medical complications down the road.”

During the five year study, Dr. Monaghan will recruit patients ages 17-22 and follow their care at Children’s National through their first visit with an adult endocrinologist. Her team will assess participants’ ability to communicate with providers, including their willingness to disclose diabetes-related concerns, share potentially risky behaviors like drinking alcohol and take proactive steps to monitor and regularly review glucose data.

“The period of transition from pediatric to adult diabetes care represents a particularly risky time. Patients are going through major life changes, such as starting new jobs, attending college, moving out of their parents’ homes and ultimately managing care more independently,” says Dr. Monaghan. “Behavioral intervention can be effective at any age, but we are hopeful that we can substantially help youth during this time of transition when they are losing many of their safety nets.”

Study leaders will help participants download glucose device management tools onto their smartphones and explain how to upload information from patients’ diabetes devices into the system. Participants will then learn how to review the data and quickly spot issues for intervention or follow-up with their health care provider.

Patients also will participate in behavioral telemedicine visits from the convenience of their own homes, and receive text messages giving them reminders about self-care and educational information, such as “Going out with your friends tonight? Make sure you check your glucose level before you drive.”

At the study’s conclusion, Dr. Monaghan anticipates seeing improvements in psychosocial indicators, mood and transition readiness, as well as improved diabetes self-management and engagement in adult medicine.