Psychological consequences of positive results in cervical cancer screening

Abstract

This study was carried out to assess the psychological impact of abnormal cervical smear results. Existing literature contain only uncontrolled studies or controlled studies with non-standardised measures. Subjects were recruited from women attending two general practices for routine cervical smears over a six month period. A comparison was made between women with positive results who were referred for colposcopy, with mild abnormalities who were asked to return for a repeat smear in six months, or negative smear results. Psychometric assessment by postal questionnaire was carried out one week after receiving the result. The measures used were the 28-item General Health Questionnaire (GHQ-28), Spielberger State Anxiety (STAI), and a measure designed specifically for use in the study, the Cervical Screening Questionnaire (CSQ). Results indicated that women with positive smear test results who were referred for colposcopy had significantly higher scores on GHQ (p<.01) STAI-S (p<.05) and CSQ (p<.001) than women with mild abnormalities or negative results. Significant differences between the groups with mild abnormalities and negative results were found on the CSQ (p<.05). These findings suggest that positive results on cervical screening are associated with a significant psychological impact including a range of specific concerns about gynaecological health and cancer, increased anxiety and impaired well-being. Even mildly abnormal results, which involve a recommendation for early repeat screening, cause raised concern about cancer for the recipients. The procedures for providing smear results should be organised to minimise the level of distress.     

The Genogram

No abstract available for this article.     

Assisting Older Women in Combatting Ageist Stereotypes and Improving Attitudes Toward Aging

Ageism is a pervasive force in society that poses a significant threat to the well-being of older women. This article integrates theory, research and practice in an examination of ageism as it relates to therapy with older women. The authors review common stereotypes of older women, and discuss the pervasiveness of these stereotypes using a terror management explanatory framework. Particular attention is also paid to the effects of ageist stereotypes on older women, with especial emphasis on stereotype threat and self-stereotyping concepts. The authors argue that geriatric rehabilitation settings may enhance vulnerability to these negative effects. Finally, strategies for older women to combat ageist stereotypes and develop positive attitudes toward aging are discussed. Implications for therapeutic practice to help older women maintain a satisfying quality of life, despite these stereotypes, are presented throughout the article. The authors recommend interventions embedded in feminist theory, positive psychology, and humanistic and cognitive–behavioral therapies.     

Psychological Well-Being and the Metabolic Syndrome in African and Caucasian Women in South Africa

This study explored the association between comprehensive psychological well-being and the metabolic syndrome (MS), as well as whether women without MS markers differ significantly from women with MS (three or more markers) on specific facets of psychological well-being. African (N=102) and Caucasian (N=115) women completed self-report questionnaires on psychological well-being, and biological markers for MS were determined. Results indicated a significant association between comprehensive psychological well-being and the MS in Caucasian women, but not in the case of African women. Caucasian women without MS had higher levels of perceived support from friends and family, environmental mastery, purpose in life, sense of coherence, affect balance and positive relationships than those with MS. African women without MS had higher levels of positive relationships and an optimistic explanatory style, but lower levels of perceived support from family. Further research is indicated.     

Islamic identity re‐covered: Muslim women after September 11th

For women, hijab is a prominent and oftentimes controversial physical marker of their social identity as Muslims. This study explores the perceptions of Muslim women living in Houston regarding the hijab and how these perceptions were partially shaped by media portrayals of Muslim women overseas after the September 11th tragedy. The effects of these perceptions on women's decisions to wear the hijab after September 11th were also examined. Using a convenience sample of 67 women, semi‐structured interviews were conducted. Results suggest that American Muslim women were more likely to talk about hijab in terms of identity than immigrant Muslim women, and to believe that by wearing hijab they could help portray a more positive image of Muslims in the United States.     

Young women’s construction of their post-cancer fertility

Younger women diagnosed with cancer often face compromised fertility as a result of their treatment. However, previous research has adopted a biomedical model of fertility and utilised hypothetico-deductive research methods which have not allowed for full exploration of women’s subjectivity. This study explored younger women’s construction of their fertility post-cancer, and their discussions of fertility with healthcare professionals, from a social constructionist epistemology. Semi-structured one-to-one interviews were conducted with eight women aged 18–26, across a variety of cancer types. Foucaultian Discourse Analysis identified three subject positions associated with fertility concerns: ‘Inadequate woman: Accepting the motherhood mandate’; ‘Adequate woman: Resisting the motherhood mandate’; and ‘Survival of the fittest: Woman as genetically defective’. Implications of these subject positions included feelings of inadequacy, fear and devastation; feeling undesirable to romantic partners; and concern about passing on cancer-positive genes. In describing healthcare professional interactions, women adopted positions of ‘Satisfied patient’; ‘Passive recipient patient’; or ‘Resisting the passive patient position’. Accounts of inadequate information provision were associated with anger and frustration, whereas feeling adequately informed was associated with satisfaction at making decisions about fertility preservation. These results suggest that fertility is of importance to young women cancer survivors, and that compromised fertility can negatively impact subjectivity.     

An evaluation of the accuracy of self-reports for predicting menstrual onset

Abstract

The self-reported predicted and actual day of menstrual onset were compared for 107 female volunteers. The differences between predicted and actual day of menstrual onset were compared by categorizing women into the ovulatory, premenstrual, and menstrual phases separately based on their predicted and actual days of menstrual onset. A main effect for phase suggested that menstrual women were less accurate in predicting menstrual onset. Thus, the degree of inaccuracy differed by phase and varied as a function of whether predicted or actual menstrual onset date was used to assign women to phases. These data provide a more precise indication of the degree of unreliability of self-reports and suggest a phase-accuracy connection which may be influenced by a number of factors, particularly recall of last menstrual onset.     

Conceptualizations of Social Class in Afrtican American Women:

This article addresses the multiple definitions of social class in African American people and how the therapist's understanding of these definitions is important in therapeutic interventions with African American women. The article discusses: (a) the traditional ways in which social class has been defined in social science and the limits of these conceptualizations; (b) the multiple definitions of class within the African American community; and (c) treatment concerns for African American women based on class issues. Clinicians working with African American and other women who vary by class should be able to assess how class variables influence their therapeutic interventions with these women.     

Feminism's Third Wave

Summary

“Third wave” feminists, raised in the wake of an established feminist movement as well as a strong anti-feminist backlash, are beginning to define their own feminist agenda. “Third wave” feminists are exploring the contradictions in their lived experience as feminists, and examining the inter section of feminism with their other identities. Young feminists' self-expression has been characterized (by feminists and non-feminists) as “self-obsessed” and “divorced from matters of public purpose” (Bellafante, 1998, p. 57 & 60). In this essay, we provide an alternative view of “third wave” expression, seeing young feminists' honesty in their struggles with various identities as a resurgence of grass roots activism; a return to “the personal.” In this essay, we call for an intergenerational dialogue between second and third wave feminists, and encourage feminist therapists to support and validate young feminists.     

Womanist Therapy with African American Women with Disabilities

Abstract

African American women are at increased risk for disabilities. There is very little information available, however, regarding psychological interventions with African American women with disabilities. The purpose of this article is to discuss psychological intervention in working with African American women with acquired disabilities from a womanist perspective. Themes and interventions will be discussed. Recommendations for working with African American women with disabilities in a therapeutic context will be offered.