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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The National Centers of Excellence in Women's Health (CoEs) were established in part to provide integrated, comprehensive health care including mental health services to women. The purpose of this study was to identify mental health services currently provided by each of the 19 CoEs throughout the United States and to assess the extent to which these services are targeted to and utilized by rural women. Methods included both website review and semistructured interviews with knowledgeable informants in the CoEs. Center websites varied widely in mental health services mentioned: one CoE described services for nine different types of mental health issues, while one-fourth of the CoEs included no mention of any specific mental health services. Only four websites indicated that rural women were part of the CoE target population. Knowledgeable informant interviews indicated that seven of the CoEs had mental health staff onsite providing mental and behavioral health services. These services most often included treatment for depression and other mood disorders and for stress, as well as counseling for domestic violence issues. None of the CoEs offered mental or behavioral health services specifically targeted to rural women. We conclude that although they have not done so to date, the CoEs would be good sites in which to develop and test mental health outreach services for rural women.
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PMID:Mental health services provided through the National Centers of Excellence in Women's Health: do they reach rural women? 1616 8

The objective of this population-based study was to determine whether traumatic experiences in general, and multiple traumatic experiences in particular, are associated with persistent self-rated depressive symptoms in adult Finnish subjects over 2 years of follow-up. The study sample included 1405 subjects aged 25-64 years. Subjects (n = 217) who were depressed both at baseline in 1999 and on follow-up 2 years later in 2001 (having persistent depressive symptoms) were compared with subjects (n = 987) having no depressive symptoms either at baseline or on follow-up. All six categories of traumatic experiences (wartime experience, natural disaster, life-threatening accident, victim of violent crime, domestic violence and childhood sexual abuse) pertained to the respondents' whole life span. Odds ratios, adjusted for significant covariates, were obtained from multiple logistic regression models that estimated the likelihood of persistent depressive symptoms in different trauma categories. Persistent depressive symptoms had a significant positive graded relationship with the number of traumatic experiences. The adjusted odds of persistent depression was 6.05 (95% CI 1.76-20.7) for men and 6.99 (95% CI 2.69-18.2) for women in those with three or more traumatic experiences compared with those with no such experiences at all. Multiple traumatic experiences substantially increase the likelihood of persistent depressive symptoms. Mental health intervention, as early as possible, may serve to prevent the chronicity of depressive reactions among victims of multiple traumas.
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PMID:Impact of multiple traumatic experiences on the persistence of depressive symptoms--a population-based study. 1619 89

In a longitudinal study of children followed for 8 years into adolescence, the authors investigated how different forms of maltreatment (i.e., harsh parenting, sexual abuse, witnessing domestic violence) in childhood and parenting during adolescence influenced adolescents' shame- and guilt-proneness. Furthermore, the authors examined whether diminished feelings of guilt or heightened feelings of shame were related to delinquent behavior or depression in late adolescence. Results showed that whereas harsh parenting in childhood was related to shame proneness in adolescence, this relationship was mediated by parental rejection in adolescence. Findings confirmed that youth with rejecting parents were more shame-prone and less guilt-prone than other youth. Furthermore, shame-proneness was associated with higher depression when measured 2 years later and guilt-proneness was linked to less delinquent behavior. Results suggest that, as mediators, shame and guilt may provide useful focal points for intervention and prevention efforts in reducing adolescent depression and delinquency.
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PMID:The relation of child maltreatment to shame and guilt among adolescents: psychological routes to depression and delinquency. 1620 35

This paper explores the perceptions of illness causation and health inequalities of Travellers, an ethnic minority group who experience considerable social and health disadvantages in Ireland. In order to allow for subjective meanings to emerge, a qualitative methodology with purposive sampling was employed. Participants in the study were invited to respond to a vignette in a focus group setting. Forty-one Traveller women were recruited to the focus groups through community projects or adult education initiatives. The study not only illustrates the complexity of lay perceptions of ill-health and health inequalities, but raises important questions about the prevalence of depression and of domestic violence in the Travelling community. These Traveller women were very willing to discuss the structural factors that contributed to their health status, attributing ill-health to social and environmental factors, such as accommodation, hardship and discrimination. Further, they broadly rejected behavioural explanations of the heart disease described in the vignette. Traveller women's understandings of health and the factors that determine it are deeply embedded in the social context of their lives and their ethnic identity. These findings are discussed in the context of social identity and ethnicity, and contribute to theoretical debates about the role of that identity in recognising inequality. The study revealed that Traveller women see many shortcomings in health service provision. They need service provision to be culturally sensitive and responsive to their needs.
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PMID:"...it's all the same no matter how much fruit or vegetables or fresh air we get": traveller women's perceptions of illness causation and health inequalities. 1621 42

Somatic complaints of children in primary care settings often go unexplained despite attempts to determine a cause. Recent research has linked violence exposure to stress symptomatology and associated somatic problems. Unknown, however, is whether specific physical symptom complaints can be attributed, at least in part, to violence exposure. Urban African-American 6- and 7-year-old children (N = 268), residing with their biological mothers, recruited before birth, and without prenatal exposure to hard illicit drugs participated. Children and mothers were evaluated in our hospital-based research laboratory, with teacher data collected by mail. Community violence exposure (Things I Have Seen and Heard), stress symptomatology (Levonn), and somatic complaints (teacher-and self-report items) were assessed. Additional data collected included prenatal alcohol exposure, socioeconomic status, domestic violence, maternal age, stress, somatic complaints and psychopathology, and child depression, abuse, and gender. Community violence witnessing and victimization were associated with stress symptoms (r = .26 and .25, respectively, p < .001); violence victimization was related to decreased appetite (r = .16, p < .01), difficulty sleeping (r = .21, p < .001), and stomachache complaints (r = .13, p < .05); witnessed violence was associated with difficulty sleeping (r = .13, p < .05) and headaches (r = .12, p < .05). All associations remained significant after control for confounding. Community violence exposure accounted for 10% of the variance in child stress symptoms, and children who had experienced community violence victimization had a 28% increased risk of appetite problems, a 94% increased risk of sleeping problems, a 57% increased risk of headaches, and a 174% increased risk of stomachaches. Results provide yet another possibility for clinicians to explore when treating these physical symptoms in children.
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PMID:Somatic complaints in children and community violence exposure. 1622 73

A large percentage of HIV-infected pregnant women referred to our HIV Pregnancy Program are economically disadvantaged and underserved. Many of these women experience additional psychosocial stressors that include domestic violence, depression, substance abuse, and pregnancy-related dilemmas. The major challenge we face at the clinic is to provide appropriate interventions in a timely manner to minimize perinatal HIV-1 transmission and optimize maternal and fetal well-being. The medical urgency to ensure optimal patient care has led me to become more detached from our patients. The "humanistic" approach to patient care was an important lesson that I recently re-learned from a 98-year-old artist on World AIDS Day.
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PMID:Vision of life: a lesson learned from a 98-year-old artist on World AIDS Day. 1628 66

One of the main public health problems in the world are alcohol and drug abuse. Health impact of addictions is clearly evidenced by the increasing numbers of suicides, depression, domestic violence, accidents and injuries. The mental and behavioral problems derived by the abuse of alcohol and psychoactive drugs are under reported. From 1991 to 2003 around 13,000 cases for problems due to alcohol abuse were reported annually in Family Medicine services, nearly 4000 cases in specialized services and an average of 20,000 cases were attended in the emergency areas of the social security system in Mexico (IMSS). The data indicates that this health problems are becoming evident in young populations under 25 years old and the trend is increasing. Professional resources that are specialized in the treatment of such behavioral problems are not sufficient and the institution faces an upcoming health threat that demands prevention programs and a more integrated health care programs.
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PMID:[IMSS in numbers. Consumption of alcohol and psyhoactive substances]. 1639

This study examined the prevalence of psychopathology among women arrested for violence and whether the experience of intimate partner violence (IPV) was associated with Axis I psychopathology. Women who were arrested for domestic violence perpetration and court referred to violence intervention programs (N= 103) completed measures of IPV victimization, perpetration, and psychopathology. Results revealed high rates of posttraumatic stress disorder (PTSD), depression, generalized anxiety disorder (GAD), panic disorder, substance use disorders, borderline personality disorder, and antisocial personality disorder. Violence victimization was significantly associated with symptoms of psychopathology. Logistic regression analyses showed that sexual and psychological abuse by partners were associated with the presence of PTSD, depression, and GAD diagnoses. Results highlight the potential importance of the role of violence victimization in psychopathology. Results suggest that Axis I and Axis II psychopathology should routinely be assessed as part of violence intervention programs for women and that intervention programs could be improved by offering adjunct or integrated mental health treatment.
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PMID:Psychopathology in women arrested for domestic violence. 1644 97

Babies who have been abandoned at birth face a lifetime of uncertainty about who they are and which diseases they might be prone to. Mothers who abandon them have to live with guilt, which can result in anxiety and depression. Abandonment is sometimes linked to domestic violence and poverty. In countries such as France and Germany, women can leave a child anonymously in a safe place.
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PMID:Nobody's child. 1653 94

Research indicates that perpetrators of domestic violence have abnormalities in central serotonin and testosterone metabolism, an increased sensitivity to anxiogenic stimuli, and an impaired neuro-connection between their cortex and the amygdala. Clinical evaluations show that perpetrators of domestic violence also have a distinguishing set of behaviors and diagnoses related to anxiety, depression, intermittent explosive disorder, and borderline personality disorder. In this paper we propose a model to understand how the biological abnormalities can potentially explain the behaviors and diagnoses exhibited by the perpetrators. Changes in the perpetrator's neurotransmitters lead to a heightened sensitivity to environmental stimuli, anxiety, and conditioned fear. Lack of cortical input to the amygdala impairs the perpetrator's ability to extinguish anxiety and/or conditioned fear and gives rise to either innate behaviors (e.g., fight, flight, and shut down) or learned fear avoidant behaviors designed to avoid anxiety (e.g., alcohol consumption, self-injurious acts, and obsessive behaviors). Linking conditioned fear and fear avoidance to the behaviors and psychiatric diagnoses will serve to change the way the medical community perceives and treats perpetrators of domestic violence.
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PMID:A model linking biology, behavior and psychiatric diagnoses in perpetrators of domestic violence. 1658 Jan 53


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