Search

Objective: We examined associations of childhood physical and sexual abuse with risk of intimate partner violence (IPV). We also evaluated the extent to which childhood abuse was associated with self-reported general health status and symptoms of antepartum depression in a cohort of pregnant Peruvian women., Methods: In-person interviews were conducted to collect information regarding history of childhood abuse and IPV from 1,521 women during early pregnancy. Antepartum depressive symptomatology was evaluated using the Patient Health Questionnaire-9. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI)., Results: Any childhood abuse was associated with 2.2-fold increased odds of lifetime IPV (95%CI: 1.72-2.83). Compared with women who reported no childhood abuse, those who reported both, childhood physical and sexual abuse had a 7.14-fold lifetime risk of physical and sexual IPV (95%CI: 4.15-12.26). The odds of experiencing physical and sexual abuse by an intimate partner in the past year was 3.33-fold higher among women with a history of childhood physical and sexual abuse as compared to women who were not abused as children (95%CI 1.60-6.89). Childhood abuse was associated with higher odds of self-reported poor health status during early pregnancy (aOR = 1.32, 95%CI: 1.04-1.68) and with symptoms of antepartum depression (aOR = 2.07, 95%CI: 1.58-2.71)., Conclusion: These data indicate that childhood sexual and physical abuse is associated with IPV, poor general health and depressive symptoms in early pregnancy. The high prevalence of childhood trauma and its enduring effects of on women's health warrant concerted global health efforts in preventing violence.

Background: Latina intimate partner violence (IPV) survivors often face great barriers to depression care. We sought to use a community-based participatory research (CBPR) approach to create and evaluate a community-based depression care program for Latina IPV survivors., Methods: We created a multifaceted, culturally tailored intervention, based on principles of chronic illness management. A promotora provided case management services and led 12 weekly group sessions. Participants completed surveys at baseline and 6 months and participated in open-ended exit interviews., Results: Ten Spanish-speaking Latina women participated in the intervention. The program had excellent attendance, with 100% of women attending at least 10 group sessions, and high satisfaction. We found a large decrease in depression severity (Patient Health Questionnaire [PHQ]-9, 17.3-7.2; p = .001), as well as improvements in depression self-efficacy, self-esteem, and stress., Conclusion: This study offers promising preliminary data to support the use of community-based approaches to reducing depression disparities in Latina IPV survivors.

Background: African Americans are less likely than non-Hispanic Whites to find antidepressants acceptable or seek care for depression., Objective: To develop and pilot test a culturally tailored, community-based, psychoeducational wellness and exercise promotion program to reduce depressive symptoms in African Americans., Methods: Participants were African Americans with moderate depressive symptoms who were interested in exercise but were not exercising regularly. They attended a 6-week psychoeducational group program during which they set personal activity goals and learned depression self-management skills. We conducted pre- and postintervention surveys and postintervention feedback sessions., Results: Twenty-one African Americans participated in the intervention. The program had excellent attendance and satisfaction. We found a large reduction in depressive symptoms, with mean Patient Health Questionnaire-9 (PHQ-9) scores dropping from 14.8 to 7.1 (p < .0001), and increases in exercise and depression self-efficacy and behaviors., Conclusions: This pilot study offers promising preliminary evidence to inform further research on the use of community-based, culturally tailored wellness programs to address depression.

Background: Multi-faceted depression care programs based within the healthcare system have been found to be effective, but may not fully address the needs of African American Intimate Partner Violence (IPV) survivors, many of whom are not seeking depression care in healthcare settings., Objectives: To develop and evaluate a multifaceted, community-based depression care program (the Interconnections Project) for African American women with a history of IPV., Methods: We used a community-based participatory research (CBPR) approach to develop, implement, and evaluate the intervention. Participants were African American women who had current depressive symptoms and a lifetime history of IPV. They participated in a 6-month intervention where a peer advocate provided education, skills training, and case management services, and used Motivational Interviewing to support self-management behaviors. We conducted pre-intervention and post-intervention assessments using quantitative and qualitative data., Results: Fifty-nine women participated, with 92 % attending any sessions and 51 % attending at least 6 h of intervention activities. Intervention changes made to better accommodate participants' unpredictable schedules improved participation rates. Participants noted high levels of satisfaction with the program. There were significant improvements in depression severity (PHQ-9 13.9 to 7.9, p < 0.001), self-efficacy, self-management behaviors, and self-esteem (all p < 0.001), but no increase in use of antidepressants. Common themes related to why the program was helpful included that the program was by and for African American women, that it fostered trust, and that it taught self-management strategies with practical, lasting value., Conclusion: Culturally specific, community-based interventions led by peer advocates may be a promising way to help African American IPV survivors effectively address depression.

Background: Latinos are less likely than non-Hispanic whites to be adequately treated for depression. Intimate partner violence (IPV) is strongly associated with depression. Less is known about how Latina IPV survivors understand depression., Objective: To understand Latina women's beliefs, attitudes, and recommendations regarding depression and depression care, with a special focus on the impact of gender, ethnicity, violence, and social stressors., Design: Focus group study., Participants: Spanish-speaking Latina women with a lifetime history of IPV and moderate to severe depressive symptoms., Approach: We used a community-based participatory research (CBPR) approach to conduct a thematic analysis using an inductive approach., Results: Thirty-one women participated in five focus groups. Women felt depression is caused by "keeping things inside". They also felt that keeping things inside could lead to physical illness or an inability to function. Their inability to talk was fueled by issues such as stigma, fear, isolation, cultural norms, or simply "not having the words". They felt that the key to treating depression was finding a way to talk about the things that they had kept inside. They greatly valued information about depression and appreciated learning from providers that their physical symptoms were caused by depression. They wanted confidential depression care programs that not only helped them deal with their depression, but also addressed the violence in their lives, gave them practical skills, and attended to practical issues such as childcare. They had negative attitudes toward antidepressants, primarily due to experiences with side effects. Negative experiences with the health care system were primarily attributed to lack of good healthcare insurance., Conclusions: The concept of "keeping things inside" was key to participants' understanding of the cause of depression and other health problems. Clinicians and depression care programs can potentially use such information to provide culturally-appropriate depression care to Latina women.

Objectives: We sought to understand how African American women's beliefs regarding depression and depression care are influenced by racism, violence, and social context., Methods: We conducted a focus group study using a community-based participatory research approach. Participants were low-income African American women with major depressive disorder and histories of violence victimization., Results: Thirty women participated in 4 focus groups. Although women described a vicious cycle of violence, depression, and substance abuse that affected their health, discussions about health care revolved around their perception of racism, with a deep mistrust of the health care system as a "White" system. The image of the "strong Black woman" was seen as a barrier to both recognizing depression and seeking care. Women wanted a community-based depression program staffed by African Americans that addressed violence and drug use., Conclusions: Although violence and drug use were central to our participants' understanding of depression, racism was the predominant issue influencing their views on depression care. Providers should develop a greater appreciation of the effects of racism on depression care. Depression care programs should address issues of violence, substance use, and racism.

Objective: Little is known regarding how providers should use information about intimate partner violence (IPV) to care for depressed patients. Our objective was to explore what depressed IPV survivors believe about the relationship between abuse, mental health, and physical symptoms and to elicit their recommendations for addressing depression., Design: Focus group study., Patients/participants: Adult, English-speaking, female, Internal Medicine clinic patients with depressive symptoms and a history of IPV., Interventions: Thematic analysis using an inductive approach (consistent with grounded theory), at a semantic level, with an essentialist paradigm., Measurements and Main Results: Twenty three women participated in 5 focus groups. Although selected because of their depression, participants often felt their greatest concerns were physical. They acknowledged that their abuse history, depression, and physical complaints compound each other. They appreciated the need for health care workers to know about their depression and IPV history to get a "full picture" of their health, but they were often hesitant to discuss such issues with providers because of their fear that such information would make providers think their symptoms were "all in their head" or would encourage providers to discount their pain. Participants discussed difficulties related to trust and control in relationships with providers and gave recommendations as to how providers can earn their trust., Conclusions: Understanding a patient's IPV history may allow providers to develop a better therapeutic relationship. To treat depression adequately, it is important for providers to reassure patients that they believe their physical symptoms; to communicate respect for patients' intelligence, experience, and complexity; and to share control.

Cognitive-behavioral therapy (CBT) can improve anxiety and depression in autistic adults, but few autistic adults receive this treatment. We examined factors that may influence clinicians' use of CBT with autistic adults. One hundred clinicians completed an online survey. Clinicians reported stronger intentions (p = .001), more favorable attitudes (p

This article focuses on design, training, and delivery of a culturally tailored, multi-faceted intervention that used motivational interviewing (MI) and case management to reduce depression severity among African American survivors of intimate partner violence (IPV). We present the details of the intervention and discuss its implementation as a means of creating and providing culturally appropriate depression and violence services to African American women. We used a community-based participatory research approach to develop and evaluate the multi-faceted intervention. As part of the evaluation, we collected process measures about the use of MI, assessed MI fidelity, and interviewed participants about their experiences with the program. [ABSTRACT FROM AUTHOR]

BACKGROUND: Multi-faceted depression care programs based within the healthcare system have been found to be effective, but may not fully address the needs of African American Intimate Partner Violence (IPV) survivors, many of whom are not seeking depression care in healthcare settings. OBJECTIVES: To develop and evaluate a multifaceted, community-based depression care program (the Interconnections Project) for African American women with a history of IPV. METHODS: We used a community-based participatory research (CBPR) approach to develop, implement, and evaluate the intervention. Participants were African American women who had current depressive symptoms and a lifetime history of IPV. They participated in a 6-month intervention where a peer advocate provided education, skills training, and case management services, and used Motivational Interviewing to support self-management behaviors. We conducted pre-intervention and post-intervention assessments using quantitative and qualitative data. RESULTS: Fifty-nine women participated, with 92 % attending any sessions and 51 % attending at least 6 h of intervention activities. Intervention changes made to better accommodate participants' unpredictable schedules improved participation rates. Participants noted high levels of satisfaction with the program. There were significant improvements in depression severity (PHQ-9 13.9 to 7.9, p < 0.001), self-efficacy, self-management behaviors, and self-esteem (all p < 0.001), but no increase in use of antidepressants. Common themes related to why the program was helpful included that the program was by and for African American women, that it fostered trust, and that it taught self-management strategies with practical, lasting value. CONCLUSION: Culturally specific, community-based interventions led by peer advocates may be a promising way to help African American IPV survivors effectively address depression. [ABSTRACT FROM AUTHOR]

Background: Latinos are less likely than non-Hispanic whites to be adequately treated for depression. Intimate partner violence (IPV) is strongly associated with depression. Less is known about how Latina IPV survivors understand depression.Objective: To understand Latina women's beliefs, attitudes, and recommendations regarding depression and depression care, with a special focus on the impact of gender, ethnicity, violence, and social stressors.Design: Focus group study.Participants: Spanish-speaking Latina women with a lifetime history of IPV and moderate to severe depressive symptoms.Approach: We used a community-based participatory research (CBPR) approach to conduct a thematic analysis using an inductive approach.Results: Thirty-one women participated in five focus groups. Women felt depression is caused by "keeping things inside". They also felt that keeping things inside could lead to physical illness or an inability to function. Their inability to talk was fueled by issues such as stigma, fear, isolation, cultural norms, or simply "not having the words". They felt that the key to treating depression was finding a way to talk about the things that they had kept inside. They greatly valued information about depression and appreciated learning from providers that their physical symptoms were caused by depression. They wanted confidential depression care programs that not only helped them deal with their depression, but also addressed the violence in their lives, gave them practical skills, and attended to practical issues such as childcare. They had negative attitudes toward antidepressants, primarily due to experiences with side effects. Negative experiences with the health care system were primarily attributed to lack of good healthcare insurance.Conclusions: The concept of "keeping things inside" was key to participants' understanding of the cause of depression and other health problems. Clinicians and depression care programs can potentially use such information to provide culturally-appropriate depression care to Latina women. [ABSTRACT FROM AUTHOR]

Objective: Little is known regarding how providers should use information about intimate partner violence (IPV) to care for depressed patients. Our objective was to explore what depressed IPV survivors believe about the relationship between abuse, mental health, and physical symptoms and to elicit their recommendations for addressing depression.Design: Focus group study.Patients/participants: Adult, English-speaking, female, Internal Medicine clinic patients with depressive symptoms and a history of IPV.Interventions: Thematic analysis using an inductive approach (consistent with grounded theory), at a semantic level, with an essentialist paradigm.Measurements and Main Results: Twenty three women participated in 5 focus groups. Although selected because of their depression, participants often felt their greatest concerns were physical. They acknowledged that their abuse history, depression, and physical complaints compound each other. They appreciated the need for health care workers to know about their depression and IPV history to get a "full picture" of their health, but they were often hesitant to discuss such issues with providers because of their fear that such information would make providers think their symptoms were "all in their head" or would encourage providers to discount their pain. Participants discussed difficulties related to trust and control in relationships with providers and gave recommendations as to how providers can earn their trust.Conclusions: Understanding a patient's IPV history may allow providers to develop a better therapeutic relationship. To treat depression adequately, it is important for providers to reassure patients that they believe their physical symptoms; to communicate respect for patients' intelligence, experience, and complexity; and to share control. [ABSTRACT FROM AUTHOR]