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Gender

Rates and Risks for Prolonged Grief Disorder in a Sample of Orphaned and Widowed Genocide Survivors

Citation:

Schaal, Susanne, Nadja Jacob, Jean-Pierre Dusingizemungu, and Thomas Elbert. 2010. "Rates and Risks for Prolonged Grief Disorder in a Sample of Orphaned and Widowed Genocide Survivors." BMC Psychiatry 10 (55): 1-9.

Authors: Susanne Schaal, Nadja Jacob, Jean-Pierre Dusingizemungu, Thomas Elbert

Abstract:

Background: The concept of Prolonged Grief Disorder (PGD) has been defined in recent years by Prigerson and co-workers, who have developed and empirically tested consensus and diagnostic criteria for PGD. Using these most recent criteria defining PGD, the aim of this study was to determine rates of and risks for PGD in survivors of the 1994 Rwandan genocide who had lost a parent and/or the husband before, during or after the 1994 events. 

Methods: The PG-13 was administered to 206 orphans or half orphans and to 194 widows. A regression analysis was carried out to examine risk factors of PGD. 

Results: 8.0% (= 32) of the sample met criteria for PGD with an average of 12 years post-loss. All but one person had faced multiple losses and the majority indicated that their grief-related loss was due to violent death (70%). Grief was predicted mainly by time since the loss, by the violent nature of the loss, the severity of symptoms of posttraumatic stress disorder (PTSD) and the importance given to religious/spiritual beliefs. By contrast, gender, age at the time of bereavement, bereavement status (widow versus orphan), the number of different types of losses reported and participation in the funeral ceremony did not impact the severity of prolonged grief reactions. 

Conclusions: A significant portion of the interviewed sample continues to experience grief over interpersonal losses and unresolved grief may endure over time if not addressed by clinical intervention. Severity of grief reactions may be associated with a set of distinct risk factors. Subjects who lose someone through violent death seem to be at special risk as they have to deal with the loss experience as such and the traumatic aspects of the loss. Symptoms of PTSD may hinder the completion of the mourning process. Religious beliefs may facilitate the mourning process and help to find meaning in the loss. These aspects need to be considered in the treatment of PGD.

Keywords: mental health, posttraumatic stress disorder, genocide, widows

Topics: Armed Conflict, Ethnic/Communal Wars, Gender, Women, Health, Mental Health, PTSD, Trauma Regions: Africa, Central Africa, East Africa Countries: Rwanda

Year: 2010

"How Can I Feel for Others When I Myself Am Beaten?" The Impact of the Armed Conflict on Women in Israel

Citation:

Sachs, Dalia,  Amalia Sa’ar, and Sarai Aharoni. 2007. "‘How Can I Feel for Others When I Myself Am Beaten?’ The Impact of the Armed Conflict on Women in Israel." Sex Roles 57 (7): 593-606.

Authors: Dalia Sachs, Amalia Sa'ar, Sarai Aharoni

Abstract:

This research presents an initial documentation of Israeli women’s sense of insecurity during the Second Intifada (2001–2005). Drawing on feminist security theory and the intersectional approach to gender, we hypothesized that women’s familiar tendency to develop high levels of stress following political violence would be related to previous sexual and domestic victimization, to economic distress and ethnic discrimination among minority women, and to the cultural role of care workers among women of all socio-economic backgrounds. A sample of 552 women self-completed a cluster of questionnaires addressing a broad array of topics, and results confirmed most of the research hypotheses. The discussion highlights the multiple articulations of gender, militarism, and security and their possible implications for policies of conflict resolution.

Keywords: feminist security theory, Israel, militarism, women's stress and wellbeing

Topics: Feminisms, Gender, Women, Health, Mental Health, Military Forces & Armed Groups, Militarism, Security Regions: MENA, Asia, Middle East Countries: Israel

Year: 2007

Psychological Effects of War Trauma and Abuse on Older Cambodian Refugee Women

Citation:

Rozée, Patricia D., and Gretchen Van Boemel. 1990. "The Psychological Effects of War Trauma and Abuse on Older Cambodian Refugee Women." Women & Therapy 8 (4): 23-50.

Authors: Patricia D. Rozée, Gretchen Van Boemel

Abstract:

The paper discusses the life experiences of a group of older women about whom little is known: Cambodian refugees. Interview data demonstrate the superiority of environmental stress theories over psychodynamic theory in explaining non-organic blindness among this population. Subjective visual acuity was significantly related to years of servitude/internment (including forced labor, starvation, physical and sexual abuse and execution of loved ones) in communist camps during and after the fall of Cambodia in 1975. Onset of visual loss following these traumas, preceded by healthy pre-trauma functioning, suggests environmental rather than intrapsychic etiology. Physical and psychological abuse of Cambodian women during and after the fall of Cambodia is examined in depth. Suggestions for culturally-relevant interventions are discussed.

Keywords: trauma, female refugees, mental health, sexual abuse

Topics: Displacement & Migration, Refugees, Gender, Women, Health, Mental Health, Trauma, Sexual Violence, Sexual Exploitation and Abuse Regions: Asia, Southeast Asia Countries: Cambodia

Year: 1990

Needs of Female Patients in a Veterans Psychiatric Hospital

Citation:

Rothman, Gene H. 1984. "Needs of Female Patients in a Veterans Psychiatric Hospital." Social Work 29 (4): 380-385.

Author: Gene H. Rothman

Abstract:

The article elaborates a study, which examined the psychiatric and medical care of female veterans. This article presents findings of a survey of 69 female patients at a Veterans Administration (VA) psychiatric facility. The purpose of the study was to assess the satisfaction with present health and mental health services and the possible need for additional services for females. The study was conducted by a Task Force on the Status of Female Veterans at the facility under the auspices of the hospital director. At a later time, the VA national administration independently called attention to the "special needs and concerns of women veteran patients" in a "Professional Services Letter," which noted that because of the high proportion of male veterans, VA health care programs are typically oriented to male health needs. There are several reasons why female veterans are important to the field of social work at the present time. First, health care for veterans is a major component of the national health care system, and female veterans are an increasing proportion of such patients. Until 1967, law to 2 percent of enlisted strength limited female participation in the armed forces.

Keywords: female veterans, mental health, sexual assault

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Sexual Violence, Sexual Exploitation and Abuse Regions: Americas, North America Countries: United States of America

Year: 1984

Gender Differences in Subjective Distress Attributable to Anticipation of Combat among US Army Soldiers Deployed to the Persian Gulf during Operation Desert Storm

Citation:

Rosen, Leora N., Kathleen Wright, David Marlowe, Paul Bartone, and Robert K. Gifford. 1999. "Gender Differences in Subjective Distress Attributable to Anticipation of Combat among U.S. Army Soldiers Deployed to the Persian Gulf during Operation Desert Storm." Military Medicine 164 (11): 753-757.

Authors: Leora N. Rosen, Kathleen Wright, David Marlowe, Paul Bartone, Robert K. Gifford

Abstract:

Compared the perceptions of stress, cohesion, and psychological well-being among army soldiers deployed to the Persian Gulf during Operation Desert Storm. 856 male and 169 female soldiers (mean age 26.3–28.9 yrs) across 48 combat support and combat service support companies were administered surveys on-site concerning anticipation of combat, operational stress, personal stress, and bonding with peers, leaders, and subordinates. Administered tests included the Brief Symptom Inventory (L. R. Derogatis and N. Melisaratos, 1983) and the Measure of Personality Hardiness (S. C. Kobasa, 1979). Results show that females scored higher than males on all 3 stress measures and scored lower in bonding with leaders and subordinates. Anticipation of combat was the most significant discriminator between sexes, and was a significant predictor of increased psychological symptoms for both sexes. Hardiness scores were similar for both sexes, but anticipation of combat had a greater effect on the psychological symptoms of females compared with males.

Keywords: female soldiers, mental health

Topics: Armed Conflict, Combatants, Female Combatants, Male Combatants, Gender, Women, Men, Health, Mental Health, Military Forces & Armed Groups, Militaries Regions: Americas, North America Countries: United States of America

Year: 1999

Women in Novel Occupational Roles: Mental Health Trends in the UK Armed Forces

Citation:

Rona, Roberto J., Nicola T. Fear, Lisa Hull and Simon Wessely. 2007. "Women in Novel Occupational Roles: Mental Health Trends in the UK Armed Forces." International Journal of Epidemiology 36 (2): 319-26.

Authors: Roberto J. Rona, Nicola T. Fear, Lisa Hull, Simon Wessely

Abstract:

Background: There is uncertainty about whether women in the military have more psychological symptoms than men and whether psychological symptoms have increased over time. The aims of this study were to assess changes in psychological symptoms in military women over time, to compare them with men, and assess the effect of deployment.

Methods: Two cross-sectional studies based on random samples of the Armed Forces were used to assess the effects of deployment to the Gulf and Iraq Wars. We selected for the analyses all the women and a 20% random sample of men who completed a questionnaire stratified by rank. We assessed psychological distress, number of symptoms, post-traumatic stress reaction (PTSR), chronic fatigue and alcohol misuse.

Results: There has been an increase in psychological symptoms, including alcohol misuse, in those not deployed to the Gulf or Iraq Wars, especially in women. The odds ratios for PTSR [5.82 (95% CI: 1.27–26.71)], multiple symptoms [8.49 (1.97–36.65)] and alcohol misuse [6.20 (2.09–18.37)] were higher in women than in men in the non-deployed samples. Psychological distress and chronic fatigue was more common in women, and alcohol misuse, was more common in men. In women, psychological symptoms were positively associated with deployment in the Gulf War, but not the Iraq War.

Conclusion: Psychological symptoms in the Armed Forces have increased over time regardless of gender, in those not deployed. The association between gender and psychological symptoms has not changed over time. The deployment effect in women is similar to that described in men. 

Topics: Armed Conflict, Combatants, Female Combatants, Gender, Women, Health, Mental Health, Trauma Regions: Europe Countries: United Kingdom

Year: 2007

Somali and Oromo Refugee Women: Trauma and Associated Factors

Citation:

Robertson, Cheryl L., Linda Halcon, Kay Savik, David Johnson, Marline Spring, James Butcher, Joseph Westermeyer, and James Jaranson. 2006. "Somali and Oromo Refugee Women: Trauma and Associated Factors." Journal of Advanced Nursing 56 (6): 577-87.

Authors: Cheryl L. Robertson, Linda Halcon, Kay Savik, David Johnson, Marline Spring, James Butcher, Joseph Westermeyer, James Jaranson

Abstract:

Aim: This paper reports a study identifying the demographic characteristics, self-reported trauma and torture prevalence, and association of trauma experience and health and social problems among Somali and Oromo women refugees.

Background: Nearly all refugees have experienced losses, and many have suffered multiple traumatic experiences, including torture. Their vulnerability to isolation is exacerbated by poverty, grief, and lack of education, literacy, and skills in the language of the receiving country.

Method: Using data from a cross-sectional population-based survey, conducted from July 1999 to September 2001, with 1134 Somali and Oromo refugees living in the United States of America, a sub-sample of female participants with clearly identified parenting status (n = 458) were analysed. Measures included demographics, history of trauma and torture, scales for physical, psychological, and social problems, and a post-traumatic stress symptom checklist.

Finding: Results indicated high overall trauma and torture exposure, and associated physical, social and psychological problems. Women with large families reported statistically significantly higher counts of reported trauma (mean 30, P < 0·001) and torture (mean 3, P < 0·001), and more associated problems (P < 0·001) than the other two groups. Women who reported higher levels of trauma and torture were also older (P < 0·001), had more family responsibilities, had less formal education (P < 0·001) and were less likely to speak English (P < 0·001).

Conclusion: These findings suggest a need for nurses, and especially public health nurses who work with refugee and immigrant populations in the community, to develop a more comprehensive understanding of the range of refugee women's experiences and the continuum of needs post-migration, particularly among older women with large family responsibilities. Nurses, with their holistic framework, are ideally suited to partner with refugee women to expand their health agenda beyond the biomedical model to promote healing and reconnection with families and communities.

Keywords: female refugees, trauma, torture, posttraumatic stress disorder, mental health

Topics: Age, Displacement & Migration, Refugees, Gender, Women, Gender-Based Violence, Health, Mental Health, PTSD, Trauma, Torture Regions: Africa, East Africa Countries: Somalia

Year: 2006

Post-Traumatic Stress Disorder in Asylum Seekers and Refugees from Chechnya, Afghanistan, and West Africa: Gender Differences in Symptomatology and Coping

Citation:

Renner, Walter, and Ingrid Salem. 2009. "Post-Traumatic Stress in Asylum Seekers and Refugees from Chechnya, Afghanistan, and West Africa: Gender Differences in Symptomatology and Coping." International Journal of Social Psychiatry 55 (2): 99-108.

Authors: Walter Renner, Ingrid Salem

Abstract:

Background: Internationally, a high number of refugees are in need of help as a consequence of post-traumatic stress or acculturation problems.

Aims: The present study investigated the gender-specific requirements for such interventions taking clinical symptoms as well as coping strategies into account. 

Methods: Five psychometric instruments assessing anxiety, depression, posttraumatic stress, somatic symptoms, and social adaptation were administered and semi-structured interviews with n = 150 asylum seekers and refugees from Chechnya, Afghanistan, and West Africa were conducted.

Results: On the level of total test scores, women reported significantly more somatic symptoms than men but there were no further gender differences. On the item level of the questionnaires as well as with respect to the categories obtained from the interview data, marked gender differences were found. Women, as compared to men, reported more somatic symptoms, emotional outbursts, and loss of sexual interest, while men reported detachment. For women, typical coping strategies were concentrating on their children and various indoor activities, while men preferred looking for work and socializing. 

Conclusion: Social psychiatric interventions should take gender-specific symptoms and coping strategies into account. For asylum seekers and refugees, same gender client-therapist dyads and groups are highly recommended.

Keywords: posttraumatic stress disorder, female refugees, male refugees, mental health, anxiety, depression

Topics: Displacement & Migration, Refugees, Gender, Health, Mental Health, PTSD, Trauma Regions: Africa, West Africa, Asia, South Asia, Europe Countries: Afghanistan, Russian Federation

Year: 2009

Role of Peritraumatic Dissociation and Gender in the Association Between Trauma and Mental Health in a Palestinian Community Sample

Citation:

Punamäki, Raija-Leena, Ivan H. Komproe, Samir Qouta, Mustafa Elmasri, and Joop T.V.M. de Jong. 2005. "The Role of Peritraumatic Dissociation and Gender in the Association Between Trauma and Mental Health in a Palestinian Community Sample." The American Journal of Psychiatry 162 (3): 545-51.

Authors: Raija-Leena Punamäki, Ivan H. Komproe, Samir Qouta, Mustafa Elmasri, Joop T.V.M. de Jong

Abstract:

Objective: This research focused on gender-specific trauma exposure and mental health symptoms among Palestinians living in conditions of military violence. It also examined the gender-specific role of peritraumatic dissociation in moderating the association between lifetime trauma and mental health.

Method: A random sample of 311 Palestinian women and 274 men ages 16–60 years from the Gaza Strip participated. The subjects were asked about lifetime trauma and peritraumatic dissociation during their most severe traumatic experience. Mental health was indicated by total scores and diagnostic variables of posttraumatic stress disorder (PTSD), anxiety, mood (depression), and somatization disorders. Symptoms of hostility were assessed as a total score.

Results: The women reported a lower level of lifetime trauma than the men, but exposure to trauma was associated with PTSD among both genders. Exposure to lifetime trauma was further associated with anxiety, mood, and somatoform disorders only among women but not among men. No gender differences were found in the level of peritraumatic dissociation. Analyses on moderating effects showed that peritraumatic dissociation made both men and women more vulnerable to symptoms of hostility and men to depressive symptoms when they were exposed to lifetime trauma.

Conclusions: The results are consistent with previous studies in more peaceful conditions: men experience more traumatic events, whereas exposure is associated with more severe psychiatric disorders among women. Peritraumatic dissociation as an acute response to trauma constituted a risk for mental health symptoms in both genders.

Keywords: trauma, mental health, anxiety, depression, posttraumatic stress disorder, military occupation, female civilians, male civilians

Topics: Gender, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Militaries, Violence Regions: MENA, Asia, Middle East Countries: Palestine / Occupied Palestinian Territories

Year: 2005

Stress Among Palestinian Women under Military Occupation; Women's Appraisal of Stressors, Their Coping Modes, and Their Mental Health

Citation:

Punamäki, Raija-Leena. 1986. "Stress Among Palestinian Women under Military Occupation; Women's Appraisal of Stressors, Their Coping Modes, and Their Mental Health." International Journal of Psychology 21 (1-4): 445-62.

Author: Raija-Leena Punamäki

Abstract:

Psychological responses and mental health of 174 Palestinian women living in the occupied West-Bank and the Gaza Strip were studied through a stress model. Thirty-five Palestinian women living in Israel proper who had not been exposed to military occupation were interviewed as a comparison group. The stress process studied consists of women's appraisal of threat and the importance of the stressors in their lives, the estimation of their own resources to cope with stress, actual coping modes, and mental health outcomes. Women living under military occupation tended to appraise their environment as highly threatening and their experiences as strain-producing. At the same time they believed they had sufficient assets, especially collective and ideological resources, to deal with the stressors. This tendency was particularly evident among victims of political violence. Women strongly exposed to hardships of military occupation tended to employ more social and political activity and less inactive and accommodative coping modes than did less traumatized women. Exposure to stressful events, characteristic to military occupation and armed conflict, tended to deteriorate women's mental health. as indicated by severe anxiety, depression, hostile feelings and psychiatric symptoms, and also deteriorating their general health. Multiple regression analysis of the data pertaining to the stress process indicated not only the existence of objective stressors but also the appraisal of their harmfulness, the coping modes as well as vulnerability-protective factors which determine the outcomes of the stress process. A good economic situation, sufficient social support, and religious commitment functioned as protective factors in stress process, i.e., they were able to diminish the impact of exposure to stressors on women's mental health. In the case of the Palestinian women the hardships due to military occupation and national struggle initiated a different stress process than did the daily life difficulties. This indicates that in studies on psychological functioning in a political and armed conflict, the collective level of coping, values, norms, ideology as well as the concrete political aims of the society should be included in analysis and interpretation.

Keywords: military occupation, mental health, depression, anxiety, female civilians

Topics: Armed Conflict, Gender, Women, Health, Mental Health, Trauma, Military Forces & Armed Groups, Militarization Regions: MENA, Asia, Middle East Countries: Palestine / Occupied Palestinian Territories

Year: 1986

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