Understanding the impact of prior depression on stress generation: Examining the roles of current depressive symptoms and interpersonal behaviours

Stress generation is a process in which individuals contribute to stressful life events. While research has supported an association between current depression and stress generation, it has been noted that individuals with prior depression tend to contribute to stressors even when they are no longer experiencing a depressive episode. The aim of the study is to elucidate the pathways through which prior major depression predicts interpersonal stress generation in women. Specifically, we examined current subsyndromal depressive symptoms and problematic interpersonal behaviours as potential mediators. Fifty‐one college women were followed prospectively for 6 weeks. Participants were interviewed to assess current and past depression as well as stressful life events they experienced over the 6‐week period. The findings suggest that prior major depression continues to have an impact even after the episode has ended, as the disorder continues to contribute to stress generation through residual depressive symptoms.     

The Butterfly Dilemma: Asian Women,Whiteness, and Heterosexual Relationships

Critical Whiteness theory explores Whiteness as a form of power and privilege that originated in Western countries and has been dispersed globally. Its form is particular to location and its interaction with race, ethnicity, nationality, class, and gender. Two ways it has operated historically is through making the norms of Whiteness universal and the marker of reason and rationality. This article examines Whiteness through two lenses, the colonial-era opera, Madame Butterfly, and three recent therapy case studies involving White American husbands and Asian immigrant wives. Although the women in these therapy cases have emigrated from different Asian countries and cultures, the treatment toward them suggests that colonial-era images and stereotypes of Asian women still resonate in contemporary White American culture and are impervious to national or cultural boundaries. A comparison of the opera’s themes with those of the therapy cases suggest how historical and social constructions of Whiteness continue to promote inequality in heterosexual relationships comprised of White American males and Asian females. Feminist, multicultural analyses of the therapy cases are provided to highlight more egalitarian treatment of the women in therapy, in their families, and in the broader society. The intersectionality of gender with ethnicity and culture is discussed for these Asian women who experience the homogenization of their identities in spite of having immigrated to the U.S. from distinct cultures.     

Breaking the cycle of violence: an examination of factors relevant to treatment follow-through

To examine differences between a group of battered mothers who followed through with treatment recommended for their children and those who did not, 10 women from each of two comparable women's shelters who followed through with recommended therapy for their children were compared with 10 women from each shelter who did not follow through, in regard to age, years of education, job history, economic status, and prior exposure to therapy. Analysis indicated that women who followed through had significantly more years of education than those women who did not follow-through. Furthermore, women who followed-through were significantly more likely to have had prior experience in counseling or therapy as were their mates. Implications, including education of mothers about the emotional needs of their children by peers, staff, or liaison workers from mental health agencies as a positive means of curtailing transmission of violent patterns from parents to children, are discussed.     

Traumatic stress and psychological adjustment in treatment-seeking women sexually abused in childhood: A follow-up

The objective of this study was to assess post-traumatic stress disorder (PTSD), psychological distress, and risk factors among women sexually abused in childhood (CSA) after six months in therapy. Thirty in-treatment CSA survivors reported their abuse history and filled out several questionnaires. Comparisons were made to a non-CSA in-treatment sample. Although, 50% of the CSA women still had PTSD, there was a remarkable decrease in PTSD symptoms (Cohen's d = 1.06). A considerable change in self-worth and in attachment styles was found. It was concluded that CSA survivors benefit much from 6 months of weekly treatment. However, it is recommended that treatment should continue for a still longer period.     

Preliminary evidence that acute and chronic daily psychological stress affect sexual arousal in sexually functional women

It is assumed that psychological stress may inhibit sexual arousal in women. Research on the effect of (acute and chronic) psychological stressors on genital and subjective sexual arousal, however, is scarce. To investigate whether psychological stressors indeed inhibit sexual responding, sexually functional women were randomly assigned to an experimental condition (n=30) in which acute psychological stress was induced by a frustrating computer task or a control condition (n=29). After the acute psychological stress or control induction women were exposed to an erotic stimulus. Genital sexual arousal was assessed using vaginal photoplethysmography. Self-report ratings of subjective sexual arousal were collected after the erotic stimulus. Furthermore, women were post hoc divided into a 'low' and a 'high' chronic stress group, based on their pre-assessment scores on a chronic daily stress questionnaire. As predicted, it was found that women in the acute stress condition responded with lower levels of genital and subjective sexual arousal to an erotic stimulus than women in the control condition. In addition, women with high levels of chronic stress responded with lower levels of genital sexual arousal to an erotic stimulus than women with low levels of chronic stress. Chronic stress did not affect the level of subjective sexual arousal.     

Gender Differences in Depression

From early adolescence through adulthood, women are twice as likely as men to experience depression. Many different explanations for this gender difference in depression have been offered, but none seems to fully explain it. Recent research has focused on gender differences in stress responses, and in exposure to certain stressors. I review this research and describe how gender differences in stress experiences and stress reactivity may interact to create women's greater vulnerability to depression.     

Fifth Province re-versings: the social construction of women lone parents' inequality and poverty

In this paper a systemic orientation is proposed which formulates theories and practices in relation to the social construction of women's inequality and poverty. A central hypothesis is that discursive interactions at the macro- and micro-social levels generate much female inequality and relationships of power. Therefore, the paper posits that women's inequality is partially constructed in and through social discourse at the public level (for example, politics and the media) and as such it is argued that these issues need to be entered into discussions within and around therapy. Finally, through a Fifth Province Approach some strategies for resisting power practices are presented. Reflexivity will be attempted in the feedback or re-versings of women clients living in poverty on the process of therapy.     

Differentiating the impact of episodic and chronic stressors on hypothalamic-pituitary-adrenocortical axis regulation in young women.

OBJECTIVE: The goal of this study was to examine the impact of episodic stress and chronic interpersonal stress on indices of HPA regulation. To explore the potential downstream consequences of altered HPA dynamics, the authors also assessed indicators of metabolic control and systemic inflammation. DESIGN: One hundred four medically healthy women between the ages of 15 and 19 participated. Following an in-depth interview of life stress, a sample of blood was drawn through antecubital venipuncture. Over the course of the next 2 days, participants gathered salivary cortisol samples. MAIN OUTCOME MEASURES: Cortisol morning response, cortisol daily output, glucocorticoid receptor (GR) mRNA, C-reactive protein (CRP), insulin, and glucose. RESULTS: The simple presence of episodic stress or chronic interpersonal stress was not reliably associated with cortisol output, GR mRNA, insulin, or glucose. When women were exposed to an episodic stressor in the midst of chronic stress they showed increased cortisol output and reduced expression of GR mRNA. By contrast, when women had low levels of chronic stress, episodic events were associated with decreased cortisol output and increased GR mRNA. Episodic and chronic stress also interacted to predict CRP, but not insulin or glucose. CONCLUSIONS: The impact of episodic stress is accentuated in the midst of chronic interpersonal stress and diminished in its absence. Simultaneous exposure to episodic and chronic stress may create wear and tear on the body, whereas exposure to episodic stress in the context of a supportive environment may toughen the body, protecting it against subsequent stressors.     

Re-Membering Spirituality

Ritual has been used as a therapeutic tool within family therapy for nearly two decades. Our understanding of ritual has been drawn from studies of cultures in which all life was viewed as sacred. However, common use of ritual in therapy lifts ritual out of its sacred context and secularizes it. Blending some of the key thinking in feminist theology with feminist psychology can help women reconnect with a perspective on the sacred that is empowering. Reimbuing ritual with the sacred and expanding its use in therapy make it a powerful healing process for women.     

Cognitive therapy with battered women

Violence toward women by their male partners occurs so frequently that it must be considered seriously by every psychotherapist treating women clients. The paper addresses cognitive therapy with women when there has been a history of domestic violence toward them regardless of whether the danger is imminent and regardless of whether they initially identify battering as the presenting problem. Some cognitions which a woman may hold prior to the onset of abuse may contribute to an increased vulnerability once the violence occurs. A second category of cognitions develops through the battering experience itself, including perceptions of severity of abuse, attributions about the cause of the violence, and attributions about the solution to the problem. Working effectively with battered women requires not only an understanding of the dysfunctional cognitions that they may hold, but also a recognition of the dysfunctional cognitions to which therapists ascribe. It is important for a battered woman to accept responsibility for control of a solution to her victimization, not because the responsibility of the cause is hers, but because it represents empowerment over her own life. A third category of cognitions includes the negative psychological effects of violence. It is imperative to keep as the primary goal of intervention that of safety. Although dysfunctional cognitions may be important to alter, it is necessary never to lose sight of the real dangers the battered woman faces.     

Stress and health among women and men in a Swedish telecom company

The aim of the study was to investigate gender differences at managerial and nonmanagerial level in perceived stress and control and the relationship to health problems. Questionnaires were collected from 281 women and men at both managerial and nonmanagerial level in a sales department in a large Swedish telecom company. Items describing sources of stress were selected from Dallner, Gamberale, Olsson, and Örelius (1999) and developed through a group interview. The results showed only minor differences in perceived stress and no differences in perceived control when comparing men and women working at the same level in the organization. Instead the differences in perceived stress and control were found between managers and nonmanagers. In addition, the study showed both differences and similarities in explaining health symptoms for women and men at the same organizational level. Similarities were found at a nonmanagerial level but at a managerial level health problems were not predicted by the same factors for women and men. The need to consider organizational level in future studies about stress and gender is addressed.     

Chronic stress,acute stress,and depressive symptoms

Although life events continue to be the major focus of stress research, recent studies suggest that chronic stress should be a more central focus. An evaluation of this issue is presented using data from a large community survey of married men (n = 819) and women (n = 936). Results show that chronic stresses are more strongly related to depressive symptoms than acute stresses in all but one life domain. The interaction patterns exhibited by chronic and acute stresses are predominantly associated with lower levels of depression than those predicted by a main effects model. This pattern suggests that chronic stresses may reduce the emotional effects of acute stresses. Although the processes through which this effect occurs are not clear, it is suggested that anticipation and reappraisal reduce the stressfulness of an event by making its meaning more benign. Implications for future research on chronic and acute stress effects are discussed.     

Interoceptive exposure therapy combined with trauma-related exposure therapy for post-traumatic stress disorder: a case report

Trauma-related exposure therapy is a useful but not universally effective treatment for post-traumatic stress disorder. Anxiety sensitivity may play an important role in this disorder, as it does in panic disorder. Studies have shown that interoceptive exposure therapy reduces anxiety sensitivity in panic disorder. The present case study was a preliminary investigation of the merits of including interoceptive exposure therapy in the treatment of post-traumatic stress disorder, in order to improve treatment outcome for a patient who had no history of panic disorder or panic attacks. Interoceptive exposure therapy (4 sessions) was one component of treatment, combined with trauma-related exposure therapy (4 sessions of imaginal exposure followed by 4 sessions of in vivo exposure). Treatment outcome was assessed with the Clinician-Administered Post-traumatic Stress Disorder Scale, a self-report measure of post-traumatic stress disorder symptoms, and measures of symptoms and cognitions commonly associated with post-traumatic stress disorder. Scores on all outcome measures decreased over the course of treatment, with gains maintained at 1- and 3-month follow-up. Symptoms of anxiety sensitivity and post-traumatic stress disorder decreased during interoceptive exposure therapy. The results indicate that interoceptive exposure therapy is a promising adjunctive intervention for post-traumatic stress disorder. Further research is needed into the merits of combining interoceptive exposure therapy and trauma-related exposure therapy as a means of boosting treatment efficacy.     

Type A behavior and parenting stress in mothers with young children

Type A Behavior Pattern (TABP) is characterized by competitiveness, a sense of time-urgency, impatience, and aggression/hostility and it has been associated with coronary heart disease and occupational stress in men. Recently, research had begun to examine TABP in women. However, the majority of studies focus on women as student or employee and not in the role of mother. Thus, although women spend a significant proportion of their adult lives bearing and raising children, little is known about TABP relationships in these roles. Further, the parenting adjustment literature amply describes the stressful nature of parenting a young child but with little attention paid to the relationship between maternal individual characteristics and parenting stress. This study investigated maternal adjustment and TABP in order to provide a clearer picture of Type A women as mothers as well as to expand information on individual characteristics which contribute to or mediate a woman’s adjustment to motherhood. Because of its presumed relationship to TABP and stress, maternal employment status was a control variable. One hundred twenty-six women with children between the ages of 9–24 months completed questionnaires reporting maternal stress, maternal perceptions of her child and somatic complaints. TABP was assessed by two measures, the Framingham Type A Scale (FTAS) and a recent measure, the Adolescent/Adult Type A Behavior Scale (AATABS), which yields factor scores as well as a global TABP rating. Overall, Type A women reported higher levels of child-related stress and personal stress than Type B women. Certain factors such as Hurry, Control, and Hostility were also associated with stress indices. There was qualified support for a relationship between the TABP factor, Hurry, and self-reported somatic complaints. Directions for future research are discussed.     

Type A behavior and parenting stress in mothers with young children

Type A Behavior Pattern (TABP) is characterized by competitiveness, a sense of time-urgency, impatience, and aggression/hostility and it has been associated with coronary heart disease and occupational stress in men. Recently, research had begun to examine TABP in women. However, the majority of studies focus on women as student or employee and not in the role of mother. Thus, although women spend a significant proportion of their adult lives bearing and raising children, little is known about TABP relationships in these roles. Further, the parenting adjustment literature amply describes the stressful nature of parenting a young child but with little attention paid to the relationship between maternal individual characteristics and parenting stress. This study investigated maternal adjustment and TABP in order to provide a clearer picture of Type A women as mothers as well as to expand information on individual characteristics which contribute to or mediate a woman’s adjustment to motherhood. Because of its presumed relationship to TABP and stress, maternal employment status was a control variable. One hundred twenty-six women with children between the ages of 9–24 months completed questionnaires reporting maternal stress, maternal perceptions of her child and somatic complaints. TABP was assessed by two measures, the Framingham Type A Scale (FTAS) and a recent measure, the Adolescent/Adult Type A Behavior Scale (AATABS), which yields factor scores as well as a global TABP rating. Overall, Type A women reported higher levels of child-related stress and personal stress than Type B women. Certain factors such as Hurry, Control, and Hostility were also associated with stress indices. There was qualified support for a relationship between the TABP factor, Hurry, and self-reported somatic complaints. Directions for future research are discussed.     

Intimate partner violence exposure predicts PTSD treatment engagement and outcome in cognitive processing therapy

Intimate partner violence (IPV) exposure was examined as a predictor of treatment engagement (i.e., starting and completing therapy) and treatment outcome in 150 women taking part in a dismantling study of cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD; Resick et al., 2008). Results indicate that women in a current intimate relationship with recent IPV (i.e., past year) were less likely to begin treatment relative to women who reported past IPV only or no history of IPV. For women who began treatment, IPV exposure was not predictive of whether or not they completed treatment. Among women who began treatment, the frequency of IPV was associated with treatment outcome such that women who experienced more frequent IPV exhibited larger reductions in PTSD and depression symptoms over the course of treatment, but experienced similar levels of PTSD and depression severity at the 6-month follow-up. Findings highlight the importance of targeting treatment engagement among women who report recent IPV and suggest that women who have experienced frequent IPV respond well to CPT treatment in spite of their IPV experiences.     

Guest referees for 17(4)

Background and objectives: Although intimate partner violence (IPV) has demonstrated strong associations with anxiety and posttraumatic stress, these constructs have rarely been examined simultaneously in IPV research. Gaps in knowledge remain as to their differential associations to substance use problems among IPV-victimized women. Design: A sample of 143 community women self-reported on their current IPV victimization, mental health and substance use problems. Method: Hierarchical entry multiple regressions were used to test for the direct and indirect effects of psychological, physical, and sexual IPV to alcohol and drug problems through anxiety and posttraumatic stress. Results: Higher anxiety symptom severity and higher physical IPV severity were associated with greater alcohol and drug problems. Higher posttraumatic stress symptom severity was associated with greater alcohol and drug problems. Mediation analyses indicated (i) significant indirect pathways of IPV types to alcohol problems through posttraumatic stress symptom severity controlling for anxiety symptom severity and (ii) significant indirect pathways of IPV types to drug problems through anxiety symptom severity controlling for posttraumatic stress symptom severity. Conclusions: In examining the indirect pathways of psychological, physical, and sexual IPV to substance use problems this study highlights that anxiety and posttraumatic stress symptom severity have unique effects on alcohol and drug problems among IPV-victimized women.     

Emotional Constriction and Risk for Posttraumatic Stress: The Roles of Trauma History and Gender

Research suggests there are qualitative differences in emotionality across gender, with men being more emotionally constrictive than women. Constrictive emotionality has consistently been linked to posttraumatic stress disorder (PTSD) and because men are generally more emotionally constrictive, one could infer they are at increased risk for PTSD. However, research demonstrates that twice as many women are diagnosed with PTSD than men. In an undergraduate sample, men reported significantly greater emotional constriction, but significantly less posttraumatic stress severity in comparison to women. The gender differences in emotional constriction disappeared in a subsample of students who endorsed experiencing an upsetting event. Emotional constriction mediated the relationship between trauma and posttraumatic stress severity, although it was a stronger mediator for women than men.     

Anxiety and the blues after breast cancer: how common are they?

A number of myths exist concerning the psychological impact of breast cancer. Primary among these is the belief that women with breast cancer have greater emotional disability than individuals with other diseases or the population at large. While research has shown that women cope remarkably well with a diagnosis of breast cancer, an understanding of the key periods of anxiety and primary stressors is crucial to the overall psychological and medical management plan. While psychopharmacologic therapy may be indicated for women with breast cancer, it is rarely sufficient and should be combined with effective psychosocial interventions such as group therapy.     

Stress management: a randomized study of cognitive behavioural therapy and yoga

In this study, a stress management program based on cognitive behavioural therapy principles was compared with a Kundaliniyoga program. A study sample of 26 women and 7 men from a large Swedish company were divided randomly into 2 groups for each of the different forms of intervention; a total of 4 groups. The groups were instructed by trained group leaders and 10 sessions were held with each of groups, over a period of 4 months. Psychological (self-rated stress and stress behaviour, anger, exhaustion, quality of life) and physiological (blood pressure, heart rate, urinary catecholamines, salivary cortisol) measurements obtained before and after treatment showed significant improvements on most of the variables in both groups as well as medium-to-high effect sizes. However, no significant difference was found between the 2 programs. The results indicate that both cognitive behaviour therapy and yoga are promising stress management techniques.