The Meaning and Impact of Partner's Accompaniment on Women's Adjustment to Abortion1

The present study examined the meaning of accompaniment to an abortion clinic by a male partner and explored the effects of accompaniment on women's immediate and three-week post-abortion psychological distress. A comparison of accompanied and unaccompanied women revealed few differences in demographic or psychological characteristics, although accompanied women perceived greater levels of social support from their partners and reported that they were in more committed relationships. The effects of accompaniment on women's post-abortion distress were neither universally positive nor universally negative, but depended on the personal characteristics of the women involved. Consistent with Conservation of Resources Theory (Hobfoll, 1988), accompaniment was more beneficial for women who were high in personal coping resources than for women low in these resources.     

Being marked as different: The emotional politics of experiences of depression and migrant belongings

This article asks the question: “What does it mean to think about ‘home’ and ‘belonging’ when migratory experience is enmeshed with the story of depression?”. The article focuses on the personal story of a woman who migrated from the United States (US) to Australia, and whose sense of disconnection and displacement in relation to everyday life is embedded within a narrative of depression. Our discussion of her twin narratives of emotional distress and migration is located within theoretical debates about depression, migration and the constitution of subjectivity. In particular, we draw on psychoanalytical approaches to subjectivity to argue that her emotional distress and the medical diagnosis of depression together represent a form of ‘experienc[ing] oneself as a subject’ (Butler, 2005), and function as a precondition to her narrative of migration. Ultimately, we conclude, the woman's intertwined narratives of depression and migration operate simultaneously to provide retroactive order to her subjectivity.     

Social-cognitive processes as moderators of a couple-focused group intervention for women with early stage breast cancer.

OBJECTIVE: The purpose was to examine whether social-cognitive variables would moderate the efficacy of a couple-focused group intervention (CG) for women diagnosed with early stage breast cancer. DESIGN: Participants (N = 238) were randomly assigned to 6 sessions of a couple-focused group versus usual care. Intent to treat growth curve modeling analyses indicated that emotional expression and emotional processing moderated CG effects on depression. MAIN OUTCOME MEASURES: The primary outcome measures for this study were psychological distress and psychological well-being. RESULTS: Treatment attrition analyses separating out participants assigned to but not attending CG indicated that emotional expression, emotional processing, and protective buffering moderated the effects of CG among those who attended CG with the most consistent effects noted for emotional processing on indicators of distress and well-being. CONCLUSION: The CG intervention may be more effective for patients who begin the group experience using emotional approach coping strategies to deal with cancer.     

Military Sexual Trauma in Treatment-Seeking Women Veterans

As the number of women serving in the military continues to grow, it is increasingly important to explore the sequelae of military sexual trauma (MST) among female veterans. The current study included 232 female veterans who sought outpatient mental health treatment at an urban Veterans Affairs hospital. The study's aims were to (a) describe and compare the demographic characteristics, health behaviors, and psychological symptoms of female veterans who have experienced MST to those veterans who do not report this experience; and (b) examine the associations between psychological symptoms and health behaviors in this sample, stratified by MST status. Results indicate that treatment-seeking women veterans who reported experiencing MST endorsed more psychological distress compared to those who did not report experiencing MST. In addition, psychological symptoms were associated with engaging in problematic health behaviors, such as binge eating and infrequent physical exercise among both those women who experienced MST and those who did not.     

Maternal distress and women's reentry into family and community life

This paper advances conceptualization of maternal distress following incarceration. We utilized a multiple case study methodology based on interviews with 10 mothers who demonstrated various permutations of "the triple threat" (depression, domestic violence, and substance abuse; Arditti & Few, 2006). Findings suggest that depressive symptomology persisted and worsened for mothers in our study and that maternal distress was indicative not only of women's psychological state, but also a relational and situational construct that embodied women's core experience. Maternal distress was largely characterized by health challenges, dysfunctional intimate relationships, loss related trauma, guilt and worry over children, and economic inadequacy. Further, maternal distress seemed to be intensified by the punitive traumatic context of prison and lessened by rehabilitation opportunities as well as support by kin and probation officers after reentry. Recommendations for clinicians and professionals who work with reentry mothers center around the need to alleviate maternal distress and better address women's emotional and physical health needs during incarceration and reentry.     

Emotional sequelae of abortion: implications for clinical practice

For women in therapy who have had abortions, an exploration of the context and aftermath of each abortion has been suggested. This inquiry should include: characteristics of the woman herself before and at the time of the abortion, the nature of the interpersonal and cultural milieu at the time, characteristics of the medical environment and procedure, and any events subsequent to the abortion that may evoke regrets about the earlier decision.
Whether or not such an inquiry results in the identification of unresolved issues surrounding the abortion, it is likely to enhance one's general understanding of the client. Exploring a woman's decision to have an abortion can bring into relief developmental and family issues, relationship conflicts, and her aspirations for education, work, and family. A woman's approach to establishing and asserting her priorities and values in making difficult personal decisions becomes clear as does her ability to tolerate and resolve the ambivalence inherent in making difficult decisions.
In psychotherapy, it is important to understand and address those aspects of experience that women have difficulty resolving. Hence, the emphasis on categories of experience that may have a negative impact on a woman's emotional well-being after abortion. Nevertheless, the clinician should remember that even women who report negative post-abortion sequelae overwhelmingly report that they feel that the decision was the right one for them. Having ambivalent feelings to resolve does not necessarily mean that one has made a wrong choice, only that one has made an emotionally significant choice with far-reaching personal implications, in a sociocultural environment that reinforces the ambivalence inherent in such decisions.     

The Roles of Cognitive Flexibility and Experiential Avoidance in Explaining Psychological Distress in Survivors of Interpersonal Victimization

The long-term negative psychological consequences associated with interpersonal victimization are significant; however a history of interpersonal victimization alone does not necessarily lead to greater long-term psychological distress. The current study examined the relationship between cognitive flexibility, experiential avoidance, and psychological distress among 92 women who reported a history of interpersonal victimization. The findings indicate that both cognitive flexibility and experiential avoidance are significantly related to posttraumatic stress symptomology and depression in this sample. Preliminary evidence is also presented suggesting experiential avoidance maybe a potential mediator between cognitive flexibility and psychological distress in this sample. The current findings suggest that treatments targeting greater emotional acceptance and mindfulness might be useful approaches in working with survivors of interpersonal victimization.     

Male Partners' Appraisals of Undesired Pregnancy and Abortion: Implications for Women's Adjustment to Abortion

The impact of men's attributions for pregnancy and expectations for coping with abortion on their partner's post-abortion adjustment was examined. Men's and women's attributions and coping expectations were assessed in a sample of 73 couples prior to obtaining a first-trimester abortion of an undesired pregnancy. Women's depression was assessed 30 minutes post-abortion. Partners did not differ in their coping expectations or attributions of the pregnancy to chance, situation, another person, or their own behavior, but men blamed the pregnancy more on their own character than did their partners. Male partner's coping expectancies affected women's adjustment only if the women themselves had low coping expectancies. Among women with low coping expectancies, those accompanied by partners who also had low coping expectancies were the most depressed. Men's attributions were unrelated to their partner's adjustment.     

L’indépendance émotionnelle à la mère et au père en lien avec la détresse psychologique chez les jeunes femmes

Women aged from 18 to 25 years old are a group particularly at risk to experience elevated psychological distress. However, only a few studies have documented developmental factors associated with this variable for this population, especially in regard to emotional independence to mother's and father's individuation. The aim of the study is to explore the association between emotional independence to each parent, referring to the underlying emotional aspect related to the distance toward each parent, and psychological distress. The sample includes 1716 French-Canadian college women aged from 18 to 25 who completed an online survey. Results confirm the high prevalence of psychological distress among this population. Emotional independence to mothers and fathers are found to be moderately correlated. However, the mean emotional independence to mothers is significantly lower than the emotional independence to fathers. The results also suggest that low emotional independence, even to only one of parents is associated with higher levels of distress among young women. In contrast, levels of middle and high emotional independence from both parents are associated with lower levels of distress. The findings support the association between emotional independence to each parent and psychological distress. Empirically, further studies should distinguish between mother's and father's emotional independence. Clinically, these results emphasize the need to works patient's emotional independence to both parents.     

Coping and Emotional Distress in Primary and Recurrent Breast Cancer Patients

The purpose of this study was to explore the emotional distress and coping strategies among women with primary as against recurrent (local or metastatic) breast cancer. The study sample consisted of 80 women, all 1 year postdiagnosis of primary or recurrent breast cancer. All women completed a demographic questionnaire, the Emotional Symptoms Checklist (SCL-90R) and the Ways of Coping Questionnaire (WCQ). Patients with recurrence reported higher levels of depression and anxiety as well as a higher global severity index (GSI). This group used significantly fewer problem-solving and positive-focus strategies. Emotion-focused coping predicted depression and the GSI, but only positive attitude predicted the level of anxiety. The state of disease was a major predictor of emotional symptoms, and to a lesser extent of the coping strategies used. Although emotion-focused coping had a deleterious effect on emotional well-being, our study highlighted the importance and relevance of positive attitude for reducing emotional distress in general and level of anxiety in particular. Promotion of positive-focus coping strategies should thus be a key element in psychological interventions with cancer patients.     

Abortion as stigma: cognitive and emotional implications of concealment.

This study examined the stigma of abortion and psychological implications of concealment among 442 women followed for 2 years from the day of their abortion. As predicted, women who felt stigmatized by abortion were more likely to feel a need to keep it a secret from family and friends. Secrecy was related positively to suppressing thoughts of the abortion and negatively to disclosing abortion-related emotions to others. Greater thought suppression was associated with experiencing more intrusive thoughts of the abortion. Both suppression and intrusive thoughts, in turn, were positively related to increases in psychological distress over time. Emotional disclosure moderated the association between intrusive thoughts and distress. Disclosure was associated with decreases in distress among women experiencing intrusive thoughts of their abortion, but was unrelated to distress among women not experiencing intrusive thoughts.     

Why We Should Avoid the use of the Term “Post-Abortion Syndrome”: Commentary on Boulind and Edwards (2008)

Boulind and Edwards (2008) present a case study of Grace, a women suffering, in their words, from post-abortion syndrome (PAS). In this commentary I argue that while Boulind and Edwards' (2008) report is useful in terms of documenting the therapeutic processes engaged in, they would have been better served in not hanging the distress experienced by Grace on the diagnostic category of post-abortion syndrome. Reasons for this are that: PAS is not a recognised category of diagnosis, despite having been initially proposed in 1981; applying a PTSD framework to abortion is questionable; PAS focuses attention on the abortion itself in isolation from the fact that abortion occurs in the context of severely problematic pregnancies and other important socio-cultural stressors; PAS, in the very manner in which it is formulated, invokes to a very complex politics of the foetus. Boulind and Edwards (2008) are careful in their documentation of the complexities of the case, and thus their use of PAS is unfortunate.     

Trauma narratives and emotional processing

The present study examined the relations between indicators of emotional processing (e.g. trauma narratives), posttraumatic stress symptoms, and psychological distress in two military samples (N = 120) exposed to significant training accidents. Trauma narratives were collected at 2-3 weeks, while outcome measures (e.g. IES-15, PTSS-10, and GHQ-30) were collected at 2-3 weeks, and 4 months after the accidents. Emotional processing was indexed by the content of positive and negative emotional expressions in the trauma narratives. The results showed that positive emotional expressions were associated with lower levels of psychological distress, whereas negative emotional expressions were linked to trauma specific symptoms and psychological distress at 2-3 weeks. Negative emotional expressions explained between 6-8% of the variance in trauma specific symptoms at 2-3 weeks, and 11% of the variance in psychological distress symptoms at 4 months after the traumatic event.     

The impact of psychological distress on absence from work

The aims of this study were to examine the impact of psychological distress on absence from work; to compare psychological distress and job satisfaction as predictors of absence; and to compare the relative effects of 2 components of psychological distress, depression and anxiety, on absence. Organizational records of absence over a 3-year period were obtained for 323 health service staff in the United Kingdom, who also completed self-report measures of psychological distress and job satisfaction at the beginning of the study and 2 years later. Psychological distress, particularly depression, was found to predict absence, with higher levels of distress predicting a greater number of days and number of times absent. Job satisfaction and psychological distress independently predicted levels of absence. The psychological distress-absence relationship was not moderated by demographic variables.     

Bridging the Divide

Abstract

Women who consider themselves traditional or conservative in the context of religious practice often experience tremendous conflicts regarding the integration of same-sex emotional and sexual feelings with their religion and spirituality. Current religious teachings about homosexuality make this combination difficult as only heterosexual sexuality within marriage is permitted in most orthodox faiths. Further, the way that spirituality and sexuality are conceptualized as opposing dichotomous categories (e.g., body vs. soul) presents women with a framework where integration does not seem possible. Observant women who come to psychotherapy often experience tremendous distress, guilt, depression, and even suicidality due to the conflict between their sexual feelings and religious doctrine. Relieving the distress, and resolving the conflicts while honoring the emotional complexity of sexual feelings, spirituality, and religious orthodoxy can present tremendous dilemmas for the practitioner as well as the client. Using the example of psychotherapy of an Orthodox Jewish woman who integrated same-sex desire into her life, this article describes psychotherapy process and alternative ways of viewing spirituality and sexuality that permit possible resolutions for clients.     

Psychological and relationship changes of couples undergoing an infertility investigation: Some implications for counsellors

The emotional and psychological aspects of the experience of infertility have been largely ignored by researchers. A study was accordingly undertaken of 43 infertile couples who were undergoing medical investigation of their fertility problems. Preliminary analysis of the data suggests that the infertility investigation was most stressful for the participants at the time of the initial medical interview, and that distress was greater for those who were themselves identified as having an organic fertility problem. A substantial number of the men and women involved indicated a need for the provision of psychological counselling services. The nature of the most appropriate forms of such help is explored.     

Postconcussion Symptoms

Research pertaining to the self-report of symptoms after traumatic brain injury was reviewed. Cognitive, emotional, and motivational factors have more relevance than demographic (except for female sex) and personality factors. Specific neuropsychological deficits in attention and memory have been found in the early stages after head injury of even mild severity. This is unlikely to be the only factor affecting symptom persistence. Exaggeration of cognitive dysfunction occurs in some cases, but appears unrelated to symptom overreport. Increased emotional distress typically accompanies symptom persistence. The psychological reaction of preoccupation with symptoms and emotional distress is not unique to concussion, but also occurs after severe head injury and back injury and relates more to the personal interpretation of the effect of the trauma than to objective indicators of brain injury severity.     

Maternal Childhood Sexual Trauma and Early Parenting: Prenatal and Postnatal Associations

Existing research suggests that approximately 19% of females experience childhood sexual trauma (CST). Little is known, however, about the parenting behaviour of mothers who have experienced CST. Using propensity‐matched controls, the present study examines prenatal psychosocial distress, postnatal depressive symptomatology, and caregiving behaviours of women reporting CST at or before the age of 14. Data for these analyses were obtained from mother reports and from observational protocols from a longitudinal study of low‐income, rural families. Propensity score methodology was used to create a contrast group matched on family of origin variables in an effort to isolate and examine the long‐term associations of CST beyond the effects of other childhood adversities such as poverty. Study findings provide evidence that women with CST histories report greater prenatal psychosocial distress compared to women without trauma histories. Findings further provide evidence for a spillover process from prenatal distress to the broader caregiving system including less sensitive parenting through postnatal depressive symptoms for women with CST histories. These results highlight the importance of screening for CST and psychosocial distress and depression prenatally. Interventions for women with CST histories and directions for future study are proposed. Copyright © 2016 John Wiley & Sons, Ltd.     

When does partner devaluation predict emotional distress? Prospective moderating effects of reassurance-seeking and self-esteem

Coyne's (1976b) interpersonal theory of depression asserts that devaluation and rejection by relationship partners may exacerbate depressive symptoms. We tested this assertion empirically and investigated two theoretically based moderators of this effect: reassurance-seeking and self-esteem level. Dating women (N= 134) completed measures of depression, reassurance-seeking, and self-esteem at Time 1 and a measure of depression at Time 2 six weeks later. Male partners completed a measure of devaluation of the women. Partner devaluation was not associated with increased emotional distress for women across the entire sample. However, significant moderating effects of both reassurance-seeking and self-esteem level were found. Partner devaluation predicted increased emotional distress among women who reported high levels of reassurance-seeking and among women who reported low levels of self-esteem. Results are discussed in terms of convergence with Coyne's theory.     

The Moderating Effects of Mindfulness on Psychological Distress and Emotional Eating Behaviour

Current evidence and theory suggests that emotional eating resulting from attempts to manage psychological distress, such as anxiety, depression, and stress, is considered to be a major contributor to obesity. Mindfulness has been shown to be related to disordered eating behaviours. Employing a non‐clinical sample of 42 males and 115 females, the present study investigated the contribution of mindfulness as a potential moderator between psychological distress and engagement in emotional eating, while controlling for the effects of gender and general nutrition knowledge. Consistent with predictions, psychological distress was positively associated with engagement in emotional eating, while mindfulness was found to share an inverse relationship. Moreover, after controlling for gender and general nutrition knowledge, the interaction between psychological distress and mindfulness was found to significantly predict the tendency to engage in emotional eating over and above the individual effects of these variables. The findings from the current study add to the current literature supporting the use of mindfulness‐based interventions for treatment of emotional eating practices in individuals experiencing anxiety, stress, and lower levels of depression.