Psychopathology In Women Research Articles

2280 – Oestrogen related features and gynaecological service use in delusional disorder

Introduction Oestrogens may be a protective factor in psychosis. Women with schizophrenia have a later age of menarche, fewer pregnancies and earlier age of menopause. However, little information is available focusing on delusional disorder (DD). Objectives To evaluate gynaecological variables and psychopathology in women with DD. Aim To investigate the relationship between age of menarche and onset, and psychopathology in DD. Methods Forty-five outpatients with DD (DSM-IV-TR) were recruited at the Hospital Clinic of Barcelona, from 2008 to 2012. Twenty-five females underwent a demographic and gynaecological questionnaire. HRSD-17 for depression, PANSS for psychopathology, PSP for functionality and C-SSRS for suicide were assessed. The sample was divided into two groups according to the age of menarche: 12 years or less and more than 12. Results Mean age of menarche (SD) was 12.6(1.4) years, mean age of menopause 49.1(3.15), mean age at onset of DD was 49.9(12.58). 33.3% of the sample did not receive gynaecological service in the last 3 years. The group with the earliest age of menarche was older [67.33(11.67) vs.56(9.6); p=0.026], presented an earlier age of menopause [46.80(2.84) vs.50.71(2.29) p=0.018] and latest onset of DD (53.50(14.32) vs.47.44(11.5); p=NS], than those with later age of menarche. No differences were found regarding psychopathology, suicidal behaviour or functionality. Conclusions Although a small sample size, this is the first study to specifically examine gynaecological variables in DD. A low compliance rate in gynaecological service use was found. An earlier age of menarche was associated to an earlier age of onset of DD.

Mother–infant bonding impairment across the first 6 months postpartum: the primacy of psychopathology in women with childhood abuse and neglect histories

Our goal was to examine the trajectory of bonding impairment across the first 6months postpartum in the context of maternal risk, including maternal history of childhood abuse and neglect and postpartum psychopathology, and to test the association between self-reported bonding impairment and observed positive parenting behaviors. In a sample of women with childhood abuse and neglect histories (CA+, n = 97) and a healthy control comparison group (CA-, n = 53), participants completed questionnaires related to bonding with their infants at 6weeks, 4months, and 6months postpartum and psychopathology at 6months postpartum. In addition, during a 6-month postpartum home visit, mothers and infants participated in a dyadic play interaction subsequently coded for positive parenting behaviors by blinded coders. We found that all women, independent of risk status, increased in bonding with their infant over the first 6months postpartum; however, women with postpartum psychopathology (depression and posttraumatic stress disorder [PTSD]) showed consistently greater bonding impairment scores at all timepoints. Moreover, we found that, at the 6-month assessment, bonding impairment and observed parenting behaviors were significantly associated. These results highlight the adverse effects of maternal postpartum depression and PTSD on mother-infant bonding in early postpartum in women with child abuse and neglect histories. These findings also shed light on the critical need for early detection and effective treatment of postpartum mental illness in order to prevent problematic parenting and the development of disturbed mother-infant relationships. Results support the use of the Postpartum Bonding Questionnaire as a tool to assess parenting quality by its demonstrated association with observed parenting behaviors.

Co-morbidity of substance use disorder and psychopathology in women who use methamphetamine during pregnancy in the US and New Zealand

BackgroundMethamphetamine (MA) abuse is a worldwide problem. Little is known about the co-morbidity of substance use disorders (SUD) and other psychiatric disorders of mothers who use MA prenatally. The Infant Development, Environment and Lifestyle (IDEAL) Study is a prospective, investigation of prenatal MA use and child outcome in the United States (US) and New Zealand (NZ). This study examined prenatal MA use and the co-morbidity of SUD and psychiatric disorders at 1-month postpartum. MethodMothers who used MA (US=127, NZ=97) were compared to a matched comparison group (US=193, NZ=110). The Substance Abuse Subtle Screening Inventory-3 was used to measure the probability of a SUD. The Brief Symptom Inventory (BSI) was used to measure the likelihood of a positive diagnosis of a psychiatric disorder. ResultsIn the US and NZ, MA groups had lower SES, increased single parenting, delayed prenatal care, and increased polydrug use. In the US only, MA mothers had lower income than the comparison group. MA users were 10 times more likely to have a SUD and twice as likely to meet BSI criteria for a diagnosable psychiatric disorder. In NZ, but not the US, MA users were five times more likely to have co-morbidity of both. This disparity may be due to higher quantities of prenatal alcohol use associated with increased psychiatric symptoms. ConclusionThese findings suggest that addressing both substance abuse and psychiatric disorders in mothers who use MA may be required to effectively treat maternal MA use.

Emotion Regulation and Psychopathology: The Role of Gender

This review addresses three questions regarding the relationships among gender, emotion regulation, and psychopathology: (a) are there gender differences in emotion regulation strategies, (b) are emotion regulation strategies similarly related to psychopathology in men and women, and (c) do gender differences in emotion regulation strategies account for gender differences in psychopathology? Women report using most emotion regulation strategies more than men do, and emotion regulation strategies are similarly related to psychopathology in women and men. More rumination in women compared to men partially accounts for greater depression and anxiety in women compared to men, while a greater tendency to use alcohol to cope partially accounts for more alcohol misuse in men compared to women. The literature on emotion regulation is likely missing vital information on how men regulate their emotions. I discuss lessons learned and questions raised about the relationships between gender differences in emotion regulation and gender differences in psychopathology.

Risk factors associated with postpartum psychopathology in women with bipolar disorder

Risk factors associated with postpartum psychopathology in women with bipolar disorder

Hormonal contraception and mental health: results of a population-based study

The effects of oral contraceptives (OCs) on mental health are not clear, and no study has been focused on the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) on mental health. The aim of this study was to analyse the association between the use of OCs and the LNG-IUS and psychological well-being and psychopathology. The associations between the current use of OCs and the LNG-IUS, and their duration versus mood symptoms [Beck Depression Inventory (BDI)], psychological well-being [(General Health Questionnaire-12 (GHQ-12)] and recent psychiatric diagnoses [(Composite International Diagnostic Interview (CIDI)] were examined among women who participated in the Finnish-population-based Health 2000 study. Analyses were performed on the 30- to 54-year-old sample (n = 2310); some of the analyses were extended to include the younger age group (18- to 54-year-old sample; n = 3223). Overall, hormonal contraception was well tolerated with few significant effects on psychological well-being. The length of OC use was inversely associated with some BDI items ('dissatisfaction, irritability, lost interest in people, earlier waking and lost interest in sex'), and directly associated with 'worries about one's health' (BDI) and with a current diagnosis of 'alcohol dependence' (CIDI). The current use of the LNG-IUS was inversely associated with 'earlier waking' (BDI) and with 'impaired concentration' (GHQ), while the length of LNG-IUS use was inversely associated with 'strain' (GHQ). The influence of hormonal birth control on mental health is modest and mainly favourable. The length of current OC use seems to have some beneficial effects on mood although the longer the duration of use, the greater the association with a diagnosis of alcohol dependence. Knowledge of the use of hormonal contraception might be of value when assessing psychopathology in women. The cross-sectional design, with partly retrospective data collection, precludes any causal conclusions.

Mediators between perfectionism and eating disorder psychopathology: Shape and weight overvaluation and conditional goal‐setting

To examine mediators of the relationship between perfectionism and eating disorder (ED) psychopathology in a clinical sample. Participants were 201 women with a DSM-IV diagnosed ED consecutively referred to a specialist outpatient treatment clinic. Participants completed measures of perfectionism, ED psychopathology, shape and weight overvaluation, and conditional goal-setting (CGS). Evaluation of a multivariate mediator model using Baron and Kenny's (1986) four-step mediation methodology showed that shape and weight overvaluation and CGS significantly and uniquely mediated the relation between self-oriented perfectionism (SOP) and restraint, eating concern, shape concern, and weight concern. The mediator model furthered the proportion of explained variance in outcomes beyond the direct effects model by 28-49%. The findings support the conclusion that the relationship between SOP and ED psychopathology in women with a clinically diagnosed ED is mediated by shape and weight overvaluation and CGS.

Appetite-regulating hormones cortisol and peptide YY are associated with disordered eating psychopathology, independent of body mass index

Disordered eating occurs in women at both weight extremes of anorexia nervosa (AN) and obesity. Cortisol, peptide YY (PYY), leptin, and ghrelin are hormones involved in appetite and feeding behavior that vary with weight and body fat. Abnormal levels of these hormones have been reported in women with AN, functional hypothalamic amenorrhea (HA), and obesity. The relationship between appetite-regulating hormones and disordered eating psychopathology is unknown. We therefore studied the relationship between orexigenic and anorexigenic hormones and disordered eating psychopathology in women across a range of weights. A cross-sectional study of 65 women, 18-45 years: 16 with AN, 12 normal-weight with HA, 17 overweight or obese, and 20 normal-weight in good health. Two validated measures of disordered eating psychopathology, the Eating Disorders Examination-Questionnaire (EDE-Q) and Eating Disorders Inventory-2 (EDI-2), were administered. Fasting PYY, leptin, and ghrelin levels were measured; cortisol levels were pooled from serum samples obtained every 20 min from 2000 to 0800 h. Cortisol and PYY levels were positively associated with disordered eating psychopathology including restraint, eating concerns, and body image disturbance, independent of body mass index (BMI). Although leptin levels were negatively associated with disordered eating psychopathology, these relationships were not significant after controlling for BMI. Ghrelin levels were generally not associated with EDE-Q or EDI-2 scores. Higher levels of cortisol and PYY are associated with disordered eating psychopathology independent of BMI in women across the weight spectrum, suggesting that abnormalities in appetite regulation may be associated with specific eating disorder pathologies.

Peripheral oxytocin is associated with reduced symptom severity in schizophrenia

Background Emerging evidence from clinical trials suggests that oral estrogen and intranasal oxytocin might reduce symptom severity in schizophrenia. Whether increases in endogenous hormones are similarly associated with improved symptoms is unknown. We investigated the effects of menstrual cycle phase and related fluctuations in peripheral hormone levels on clinical symptoms in women with chronic schizophrenia. Method Twenty-three women with schizophrenia were administered the Positive and Negative Syndrome Scale (PANSS), a measure of clinical symptom severity, at two menstrual cycle phases: 1) early follicular (Days 2–4; low estrogen/progesterone) and 2) midluteal (Days 20–22; high estrogen/progesterone). Twenty-seven males with schizophrenia and 58 controls (31 female) completed testing at comparable intervals. Men were included to examine whether the relationships between clinical symptoms and hormone levels in women generalize to men. Plasma hormone assays of estrogen, oxytocin, progesterone, and testosterone were obtained. Results Female patients showed less severe symptoms during the midluteal versus early follicular phase ( p's < 0.01). Oxytocin did not fluctuate across phases, but in female patients ( p's < 0.01) higher oxytocin levels were associated with less severe positive symptoms and overall psychopathology. In both sexes, higher oxytocin levels were associated with more prosocial behaviors ( p < 0.05). Conclusion Consistent with previous findings in acutely ill patients, our results suggest that clinical symptoms vary across the menstrual cycle in patients with chronic schizophrenia. Similar to recent findings regarding benefits of intranasal oxytocin, these new findings indicate that high levels of endogenous oxytocin might improve positive symptom severity and general psychopathology in women and social behaviors in both sexes.

The Kore Complex: on a Woman’s Inheritance of Her Mother’s Failed Oedipus Complex

The Greek myth of Kore/Persephone captures a particular psychopathology of women who are torn between a deadened and often asexual husband (Hades) and an ongoing close relationship with a caretaking mother (Demeter). Psychoanalytic work often reveals that these women live in the shadow of their mothers’ failed oedipal complex. Their identificatory preoccupation with maternal object preservation disrupted or distorted their oedipal development, and ever since continues to serve as a defense against sexual strivings. Thus, these women are trapped in a Kore complex: as maiden caretakers, they remain attached to and torn between a “grain mother” and a grandfather transference object.

Adjunctive transdermal oestradiol improves positive symptoms and general psychopathology in women with schizophrenia

Adjunctive transdermal oestradiol improves positive symptoms and general psychopathology in women with schizophrenia

Depressive symptoms predict smoking status among pregnant women

The current study assessed self-reported psychopathology in women who spontaneously quit or continued smoking after learning that they are pregnant and examined whether any potential differences remained after control for confounding variables. All participants (77 smokers and 50 spontaneous quitters) completed 3 assessments of psychological functioning prior to enrollment in either smoking cessation or relapse prevention studies. Assessments included the Brief Symptom Inventory (BSI); the Beck Depression Inventory (BDI); and the Adult Self-Report (ASR). Smokers and spontaneous quitters differed on sociodemographic and smoking characteristics. In terms of psychological functioning, smokers reported significantly more depression/anxiety symptoms and withdrawn behavior than spontaneous quitters on the BSI and the ASR. Higher depression scores on the BSI were associated with increased odds of continued smoking, even after controlling for sociodemographic and smoking variables in multivariate analyses. These results suggest that depressive symptoms may be an independent contributor to the problem of continued smoking during pregnancy, which may have implications for smoking-cessation interventions among pregnant women.

The dynamic relationship of parental personality traits with the personality and psychopathology traits of anorectic and bulimic daughters

Objective Parenting and family dynamics influence the emergence, development, and maintenance of eating disorders (EDs). Although family interventions are relevant for therapeutic programs, knowledge of the relationship between parental personality traits and the eating psychopathology of daughters is scarce. This study explored the personality and psychopathology of women with EDs and correlated them with parental personality traits. Method The personality and eating psychopathology traits of 38 restricter anorectics, 30 bingeing/purging anorectics, 37 bulimics, and their parents' personality traits (87 fathers and 97 mothers) were measured with the Temperament and Character Inventory, the Clinical Global Impression Scale, the Eating Disorders Inventory-2, and the Beck Depression Inventory. The results were compared with matched controls (54 women, 50 fathers, 54 mothers). Personality and psychopathology were correlated with multiple regression. Results Women with ED displayed high harm avoidance and low self-directedness, whereas restricter anorectic women had high persistence. Low persistence was common in fathers of daughters across all EDs. Fathers of restricter anorectics were highly harm avoidant. Fathers of both anorectic subtypes and mothers of bulimic women displayed low self-directedness. Parental personality traits were linearly correlated with their daughter's personality and psychopathology, but the correlation differed among EDs. Conclusion Parents of eating-disordered participants displayed personality characteristics that differed from controls and, among ED subgroups, these differences were related to their daughter's personality and psychopathology. The linear correlation did not fully explain the relationship of the parental personality traits to the presence of their daughter's ED, suggesting that a more complex personality-based family dynamic is involved. A Temperament and Character Inventory profile of the entire family may be used in the planning of family treatment.

Disaster-Related Mental Health Needs of Women and Children

Since the events of September 11, 2001 and Hurricane Katrina, the world has become more acutely aware of disasters and their sequelae, and efforts have been made to improve preparedness-related skills of healthcare professionals. One area that requires more skill building concerns the ability to deal with mental health-related needs. Although the appearance of postdisaster psychological symptoms in adults varies, the incidence of psychopathology in women and children is high after disasters. Children are disproportionately affected by disasters, and their special needs have only recently begun to be understood and considered in disaster-related planning. Categories of psychological effects include distress symptoms, risk behaviors, and psychiatric disorders. These issues require ongoing care, not single interventions. This article describes how maternal child health nurses can develop and use the requisite skills to effectively assist families to optimize their mental health status and prevent sequelae after a disaster.

Obesity and psychopathology in women: a three decade prospective study

To evaluate prospective associations between elevations in body mass index (BMI) at average age 27 and generalized anxiety disorder (GAD) and major depressive disorder (MDD) at average age 59 in a community sample of women. Three waves of data collected over three decades were drawn from mothers in the Children in the Community (CIC) Study. Binary logistic regression was used to estimate predictive effects of two BMI cutpoints (> or =30 and > or =25) on GAD and MDD independent of other risks for psychopathology. The 544 mothers who were interviewed in the original wave of the CIC Study in 1975 and in the first and most recent follow-up waves in 1983 and 2002-2005. Information about height and weight was obtained by self-report in face-to-face interviews. GAD and MDD were assessed by structured interview covering DSM-IV diagnostic criteria. Other potential risk factors examined included age, race, education, prior depressive symptoms and marital status, chronic disease, social support and financial strain concurrent with GAD and MDD. A baseline BMI > or =30 significantly increased the odds for subsequent GAD and MDD by 6.27 and 5.25 times, respectively, after adjusting for other significant risk factors. Odds of GAD also increased significantly given a baseline BMI > or =25 (by 2.44 times); however this association was not independent of other significant risk factors. Predictive associations between a baseline BMI > or =30 and MDD were not attenuated by attained BMI assessed at outcome. Findings extend existing evidence of the mental health consequences of obesity in a representative sample of mothers, and suggest that obesity may have long-term implications for mental distress in women at a clinical level over the adult years.

Estrogen, menstrual cycle phases, and psychopathology in women suffering from schizophrenia

Estrogen has been hypothesized to have a protective and antipsychotic-like effect in women at risk for schizophrenia. The aim of the present study was to evaluate the association between menstrual cycle and/or estrogen levels and psychotic symptoms in a sample of women with schizophrenia. One hundred and twenty-five premenopausal women with schizophrenia and regular menses were examined. The levels of 17beta-estradiol and other hormones of the gonadal axis were assessed in the follicular, peri-ovulatory, and luteal phases of the menstrual cycle. The effects of the menstrual cycle phase and/or the estradiol level on the Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS) scores were calculated by means of regression analyses. Significant improvement in psychotic, but not depressive, symptoms was observed during the luteal phase, compared with other days of the menstrual cycle. The present findings indicate that estradiol may have specific antipsychotic-like effects on the symptoms of schizophrenia. Thus further investigation into the therapeutic effect of estrogen may be worthwhile.

Inferior frontal white matter microstructure and patterns of psychopathology in women with borderline personality disorder and comorbid attention-deficit hyperactivity disorder

Background:Inferior frontal white matter circuits are likely to be relevant to dysfunctional affect regulation, aggression, dissociative symptoms, neuropsychological functioning and psychopathology in women with borderline personality disorder (BPD) and comorbid attention-deficit hyperactivity disorder (ADHD). Methods:20 women with BPD and comorbid ADHD and 20 healthy women were investigated, and groups were matched for age, education and premorbid intelligence. Mean diffusivity and fractional anisotropy were measured bilaterally in the inferior frontal white matter by diffusion tensor imaging (DTI). Conflict resolution was assessed by the Attention Network Test, sustained vigilance by the Degraded-Stimulus Continuous Performance Test. Results:Among women with BPD and comorbid ADHD, increased mean diffusivity in inferior frontal white matter was associated with higher levels of dysfunctional affect regulation, anger–hostility, dissociative symptoms, and general psychopathology (p<.05, uncorrected). Poor conflict resolution during the attention task was positively associated with anger–hostility, psychopathology, dissociation and the number of ADHD-symptoms, but not related to DTI variables. Both groups did not differ significantly with respect to DTI variables or neuropsychological performance. In the BPD group, a lifetime history of major depression or a current eating disorder were associated with impaired inferior frontal white matter integrity, while a history of sexual abuse or a current posttraumatic stress disorder were not. Conclusions:Inferior frontal white matter microstructural abnormalities may be linked to key aspects of psychopathology in women with BPD and comorbid ADHD and add to alterations in orbitofrontal and limbic areas. The relationship between neuropsychological functioning and white matter structure remains unclear.

A Review of Psychological Outcomes and Suicide in Aesthetic Breast Augmentation

Aesthetic surgery is an essential component of plastic surgery and has become increasingly popular in American society. In 2002, 1.8 million surgical cosmetic procedures were performed in the United States, representing a 294 percent increase from 1992. The 1992 U.S. Food and Drug Administration moratorium on silicone breast implants arose in response to numerous reports of connective tissue disease associated with silicone gel breast augmentation and has led to a decade-long battle over the safety of silicone breast implants that continues today. Numerous scientific and epidemiologic studies of the past decade have established that there is no association between silicone breast prostheses and systemic disease. Recently, a new front has opened in the conflict regarding the safety of breast augmentation: the psychological impact of breast augmentation. Quality studies assessing the psychological characteristics of breast augmentation patients and the psychological impact of breast augmentation surgery are few and most studies are flawed in their methods. Recent reports have provided corroborating evidence to support the psychological benefits of cosmetic surgery and breast augmentation. New reports citing an increased risk for suicide among women with breast implants have brought renewed concerns but are unable to demonstrate a cause-and-effect relationship between breast implants and suicide. The present challenge is to determine whether the increased risk reported in epidemiologic studies is falsely associated with breast implants or whether it represents underlying risk factors or psychopathology in women undergoing breast augmentation that puts them at increased risk for suicide. The purpose of this article is to review the literature regarding the psychological impact of breast augmentation and assesses current scientific findings, with emphasis on the validity of suicide risk in breast augmentation patients.

A Descriptive Study on Psychopathology of Women in Turkey: Implications for Education Reform

A Descriptive Study on Psychopathology of Women in Turkey: Implications for Education Reform

Psychopathology in Women Arrested for Domestic Violence

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.