Women's health: Review and research agenda as we approach the 21st century.

This article reviews past research and projects future research directions regarding women's health. Sex differences in mortality and morbidity, along with evidence that the quality and quantity of these differences are changing, are examined. Over the past decade, concurrent with dramatic changes in lifestyle and social roles for women, mortality rates have shifted, resulting in a decreasing advantage for women. Explaining the consequences of these dynamic changes requires understanding the health effects of such variables as perceived control, the experience of life roles, perceived and actual social support, and redefinition of gender roles. The future portends additional changes that will significantly affect women's health. In establishing an explicit psychological research agenda on women's health, (a) general recommendations for research are provided and (b) important issues that have not yet received a great deal of research attention (e.g., women and acquired immune deficiency syndrome [AIDS], psychopharmacology, reproductive technologies) are highlighted. This article expands the current discourse in health psychology and raises a number of issues for serious consideration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Women's mental health: some directions for research

Some key issues regarding gender differences in the prevalence of mental disorders, the course of mental illness, and the use of services are reviewed, along with their diagnosis and psychopharmacologic treatment. Implications for clinical practice are examined, as are directions for future research that will ensure the presence of women's mental health as a major element in the national agenda on women's health.     

The challenge of double jeopardy: Toward a mental health agenda for aging women.

The elderly may be considered a group at risk with regard to mental health and the mental health system. Aging women experience a double jeopardy arising from social, economic, and psychological conditions surrounding age and gender—in particular, poverty, widowhood, and the dynamics of family caregiving. This double jeopardy translates into a vulnerability within the mental health system that is seen in issues of service utilization, therapist–client interactions, and diagnosis, most notably in diagnoses of Alzheimer's disease, alcohol and drug misuse, and depression. The failure of the mental health system to consider elderly individuals as psychological survivors further suggests an implicit assumption that mental decline is a normative part of the aging process. Recommendations for change include addressing gender and age interactions in mental health policy and in psychological research, training, and practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unmet needs of older women in a clinic population: The discovery of possible long-term sequelae of domestic violence.

The effects of prior domestic violence may significantly affect older women who seek mental health services. In two community mental health centers, older women frequently presented with depressive and anxious symptoms, poor family relationships, multiple health problems, alcohol dependence (in themselves, their former spouses, and their children), and economic difficulties. Increased media attention to domestic violence often preceded first-time disclosure of abuse within their marriages, which often had occurred years ago. Peers and family members rarely provided adequate support. Practitioners should assess for prior abuse, and treatment must address the full spectrum of these clients' needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Poverty and women's mental health.

The positive association between poverty and mental health problems is one of the most well established in all of psychiatric epidemiology. Research has documented consistently that low income and low socioeconomic status are associated with high rates of mental disorder. With the prevalence of poverty itself now on the rise in our country, particularly among women, children and those from minority groups, increased attention must be paid to the mental health risks that accompany poverty. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental disorder and violent behavior: Perceptions and evidence.

Throughout history and in all known societies, people have believed that mental disorder and violence were somehow related. The consensus of modern scholarly opinion, however, has been that no such relationship exists. Recent epidemiological studies cast doubt on this no-relationship position. Evidence now indicates that mental disorder may be a consistent, albeit modest, risk factor for the occurrence of violence. Denying that mental disorder and violence may be in any way associated is disingenuous and ultimately counterproductive. Dire implications for mental patient advocacy, for mental health law, and for the provision of mental health treatment need not follow from candidly acknowledging the possibility of a limited connection between disorder and violence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The women's mental health research agenda: Violence against women.

The focus of this article is violence against women: scope, impact, community response, clinical treatment, and prevention. Conclusions include the following: (a) Nationally representative data on the scope of violence are lacking. (b) The mental health implications of violence are not currently addressed by the practices of mental health professionals. (c) Discontinuity exists between clinical understanding of the impact of violence and empirical treatment research. (d) Victim services are proceeding in program development without direction from empirical data. (e) Prevention efforts have been isolated from the social context in which violence against women occurs. Nine directions for future research are highlighted that intersect with the stated priorities of the National Institute of Mental Health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Workplace violence: Prevention, response, and recovery.

Describes a model of collaboration between business leaders and mental health clinicians in developing programs and strategies to prevent violence, handle acute crises, and cope with recovery and rebuilding in the aftermath of a workplace violence incident. Sections address the following: (1) demographics, costs, and risk factors and warning signs of workplace violence; (2) workplace violence prevention policies, including hiring, discipline, and termination practices; (3) responses to emergencies, such as potentially dangerous situations, violent episodes, and guns or weapons in the workplace; and (4) strategies for recovery following workplace violence that involve mental health and law enforcement mobilization, dealing with the media, assisting employees and families, legal issues, identification and treatment of posttraumatic stress disorder (PTSD), and follow-up procedures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"I only read about myself on bathroom walls": the need for research on the mental health of lesbians and gay men

The very recent history of pathologizing homosexuality still has a strong impact on the public in general and mental health professionals in particular. In contrast to the early research on sexual reorientation of lesbians and gay men, there is relatively little empirical research on the mental health issues of lesbians and gay men. Whether researchers choose to define sexual orientation by sexual behavior, self-definition, or membership in lesbian and gay community groups will have an impact on the results. Research on mental health issues that include lesbians, gay men, and heterosexual women and men would allow an examination of the relative salience of gender versus sexual orientation. Finally, the experiences of lesbians and gay men in society may place them at increased risk for some mental health problems and may protect them from other mental health problems.     

Women, psychology, and public policy: Selected issues.

Asserts that the dramatic changes in women's work and family roles in recent decades have profound implications for employment and family policy. It is argued that the market forces used by economists to adjust salary levels do not counteract the forces that devalue women's contributions to the economy. Depressed wages and a benefit structure based on earnings increases the likelihood of poverty of women. Many employment issues, such as the assumption that workers and family members are physically and mentally able-bodied, disabled women's employment status, and the relationships among women's physical and mental health status and work and family roles, require psychological research. The slowness of public policies to reflect women's changing roles is discussed, and tools for meeting the challenges of change, including science and technology and educational equity, are presented. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transgender and gender variant populations with mental illness: Implications for clinical care.

There is a scarcity of literature on clinical care for transgender and gender variant populations with serious mental illness. At times, gender identity issues among individuals with serious mental illness have been labeled as delusions that should not be reinforced by providers. However, there are significant limitations to attributing gender variance among populations with mental illness solely to a psychotic process. The following case study research demonstrates the variation in gender identity issues among individuals with serious mental illness. These individuals may experience gender dysphoria exclusively in the context of acute psychosis or may have gender identity issues that are distinct from the mental illness. Denial of an individual's gender variant presentation by treatment staff may heighten distress, thus interfering with a collaborative treatment alliance while posing additional barriers to recovery from mental illness. Implications and applications for clinical training and further research will be presented in order to promote awareness and competent care of gender issues when co-occurring with mental illness. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The science and politics of comparing women and men.

This article considers scientific evidence relevant to 4 claims that are often made about the findings of research that has compared the sexes. These claims are that the sex-related differences demonstrated by empirical research are small, unusually unstable across studies, very often artifactual, and inconsistent with the content of gender stereotypes. The empirical status of these claims has been seriously weakened by the findings of numerous quantitative syntheses of research that have compared female and male behavior. This weakening of the evidence has jeopardized the feminist political agenda of using empirical research to disconfirm gender stereotypes to raise women's status. Consequently, comparing the sexes has become increasingly controversial among psychologists. To deal responsibly with the issues that have been raised, psychologists should consider the role that their research plays in discourse on the status of women in society. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Women's oral health issues: an exploration of the literature

As interest in women's health issues grows, there is increasing concern that today's practice of medicine may not meet the health needs of women. A primary reason is the gender bias that has been inherent in medical education, research and clinical practice. The prevailing medical viewpoint has often been that the male body is considered to be the norm and that the female body exactly the same except for the reproductive function. This attitude has led to a lack of interest in researching gender differences and a consequent lack of knowledge of women's health issues. Fortunately, there is a movement for change. The Women's Health Interschool Curriculum Committee was formed in January 1992 to develop curricula concerning women's health and examine bias that may exist in existing curricula. The Canadian Women's Health Network has been growing across the country and there have been calls to create a new specialty in women's health. According to Angell, this proposal for a new specialty was provocatively debated in the Journal of Women's Health, which started publication in 1992. There is also a growing concern on how to conduct better research to address women's health needs. As more attention is paid to women's health issues, what will happen in the area of oral health? In health care, it would seem that the mouth has become completely separated from the rest of the body. Health conferences rarely have any oral health content at all. To correct this problem, there must be an increase in general awareness of the importance of oral health as it relates to the overall health of both women and men. Good oral health is more than just decay-free teeth. Oral health encompasses the teeth, the supporting periodontal structures, soft tissues of the mouth and oral pharynx area, temporomandibular joints and muscles of mastication. The mouth is a gateway to the body and will also reflect many systemic health problems, such as diabetes, leukemia and lupus. The second step would be the recognition that women may have different oral health needs and issues than men. The common view may be that teeth are gender free, but how can this be when teeth exist in a body, and that body is male or female? For many years, the primary acknowledged difference between men and women's oral health was pregnancy gingivitis. Like medicine, dentistry must re-examine the viewpoint that women's oral health differs from men's only as it is influenced by reproductive processes. There are many areas where women's oral health may differ from that of men. This paper will explore the literature for potential women's oral health issues in the areas of oral hygiene behaviours, esthetics, eating disorders, temporomandibular disorders, and hormonal influences on periodontal health.     

Molecular basis of drug interaction with L-type Ca2+ channels

This article seeks to identify mental health issues in regard to violence among Hispanics and Latinos relative to other groups in the United States. A review of the literature provides prevalence and incidence rates, population and demographic information, and unique issues in regard to violence for Latinos and Latinas, including in the areas of battering and wife abuse, child and sexual abuse, sexual harassment, and the complicating effects of racial-ethnic discrimination. Aspects of cultural ideology, including the social construction of gender and its relevance to violence, are discussed, as are theoretical explorations of the impact of violence on familism, a major Hispanic cultural value. Finally, therapeutic implications for clinicians are explored, structured by the American Psychological Association (1993).     

Emotional disorders in primary care.

Individuals with emotional disorders are more likely to use primary medical care than specialty mental health services, but these disorders are likely to be undetected or inadequately treated. Recognition of the importance of primary medical care for the treatment of mental disorder has resulted in pressing new research priorities. One set of issues concerns the adequacy of existing nosological systems for conceptualizing emotional disorder in primary care and identifying need for treatment. Another concerns the difficulties translating efficacious treatment into effective strategies that can be integrated into the competing demands of primary medical care. Psychologists have played only a limited role in defining and addressing emerging questions. Irreversible changes in mental health services have created the need for the development of a psychosocial perspective for what would otherwise be defined as narrowly biomedical issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal investigation of interpersonal violence in relation to mental health and substance use.

The authors examined longitudinally the mental health status of women as a function of different types and combinations of exposure to interpersonal violence. A structured telephone interview was administered to a household probability sample of 4,008 women (18-89 years of age), who were then recontacted for 1- and 2-year follow-up interviews. Interviews assessed lifetime violence history (i.e., sexual assault, physical assault, witnessed serious injury or violent death), past-year mental health functioning (i.e., posttraumatic stress disorder [PTSD], depression, and substance use problems), and new instances of violence occurring after the baseline interview. Results indicate that (a) lifetime violence exposure was associated with increased risk of PTSD, depression, and substance use problems; (b) odds of PTSD, depression, and substance use problems increased incrementally with the number of different types of violence experienced; (c) relations were fairly stable over a 2-year period; and (d) new incidents of violence between the baseline and follow-up interviews were associated with heightened risk of PTSD and substance use problems. Greater understanding of the cumulative impact of violence exposure will inform service provision for individuals at high risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The major mental disorders: New evidence requires new policy and practice.

Reviews research and argues that new mental health policy and programs are needed to deal with the major mental disorders (schizophrenia, major depression, and bipolar disorder). Data show that many of the persons who are afflicted with these disorders continue to suffer throughout their adult lives, despite treatment. Not only do these individuals present all of the symptoms and social impairments usually associated with the major disorders, they are also at increased risk for premature death, substance abuse/dependence, criminality, violence, homelessness, and infectious disease. Two findings suggest that prevention may be possible: (1) many of the children at risk for the major mental disorders can be identified by their family history of mental disorder; and (2) non-genetic factors, biological and/or psychosocial, can limit the expression of the hereditary factors associated with each of these disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)