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Brody R, Emrich M, Williams C, Haug NA. The Role of Shame in the Relationship between Alcohol Use Severity and Relational Intimacy among Sexual Minority Women. Subst Use Misuse 2023; 59:177-183. [PMID: 37942565 DOI: 10.1080/10826084.2023.2267108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Background: Sexual Minority Women (SMW) are disproportionately likely to struggle with substance use and shame, two factors that are associated with poorer relationship quality and decreased relational intimacy (Doyle & Molix, 2015). However, there is a dearth of research examining shame and substance use concurrently among SMW. Objectives: The current study elucidated the role of shame-based cognitions (SBCs) and shame-based behaviors (SBBs) in explaining the relationship between alcohol use severity and relational intimacy. We recruited adult cisgender women (N = 105) in a romantic relationship who self-identified as a sexual minority and reported alcohol use during the past three months through Amazon Mechanical Turk. Participants completed an online survey assessing alcohol use, SBCs, SBBs, and relational intimacy. Results: There was a significant positive relationship between alcohol use severity with SBCs (r = .29, p = .003) and with SBBs (r = .62, p <.001). SBBs were shown to be negatively correlated with relational intimacy (r = -.48, p < .001). Parallel mediation analysis demonstrated that SBCs and SBBs accounted for approximately 34.4% of the variance in intimacy. The indirect effects of SBCs were significant (β = .10, 95% CI [.02, .18] while SBBs (β = -.14, 95% CI [-.29, .01]) did not show effects. Discussions: Given the disproportionate rates of alcohol use among SMW, this study offers a nuanced picture of the relationships between constructs known to impact alcohol use. The findings underscore the importance of SBCs and point to a potential treatment target among SMW presenting with alcohol use and diminished relational intimacy.
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Affiliation(s)
- Robin Brody
- PGSP-Stanford Psy.D. Consortium, Palo Alto University, Palo Alto, California, USA
| | - Mariel Emrich
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Christian Williams
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Nancy A Haug
- PGSP-Stanford Psy.D. Consortium, Palo Alto University, Palo Alto, California, USA
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Dewan MF, Gorman JR, Hayes-Lattin B, Lyons KS. Open Communication and Physical Intimacy in Young and Midlife Couples Surviving Cancer Beyond the First Year of Diagnosis. Oncol Nurs Forum 2021; 48:669-679. [PMID: 34673757 DOI: 10.1188/21.onf.669-679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To assess the association between levels of dyadic coping (e.g., collaboration, communication) and sexual satisfaction in young and midlife couples surviving cancer beyond the first year of diagnosis. SAMPLE & SETTING This cross-sectional study included 49 young and midlife couples (aged 21-57 years) beyond the first year of diagnosis. Couples were from rural and urban areas. METHODS & VARIABLES A mailed survey was used to gather data from cancer survivors and their partners. RESULTS Controlling for cancer survivor sex and age, open communication was significantly associated with greater involvement in affectionate and sexual behaviors of the couple. Protective buffering behaviors (i.e., concealing worries and avoiding communication) were not significantly associated with engagement in physical intimacy. Perception of how much a partner openly communicates was more salient for engaging in physical intimacy than one's own open communication. IMPLICATIONS FOR NURSING Nurses should include partners in planned care, assess the concerns of the partner, and treat the couple as the unit of care.
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Gerritsen S, Widdershoven GAM, Bossenbroek BJ, Voskes Y. Moral Dilemmas in Contact-Based Care: The Relevance of Moral Case Deliberation for Forensic Psychiatry. Front Psychiatry 2020; 11:574336. [PMID: 33192704 PMCID: PMC7655130 DOI: 10.3389/fpsyt.2020.574336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/24/2020] [Indexed: 11/13/2022] Open
Abstract
Currently, forensic psychiatry shows a shift from a control-based to a contact-based approach. Working from contact may, however, entail new moral questions and dilemmas. How to secure safety when focusing on contact? Does contact imply being physically close to the patient, or should one refrain from intimate relations? In order to help care professionals to deal with these moral issues, clinical ethics support can be useful. A specific approach in clinical ethics support is moral case deliberation (MCD). An MCD is a structured dialogue between professionals on a moral issue they experience in practice, structured by a conversation method and guided by a facilitator. In this article, we describe the background and procedures of MCD. Furthermore, we present a case example in which care professionals reflect on the moral question of whether provision of care in forensic psychiatry may entail physical closeness. The MCD shows that an open conversation results in a better understanding of different perspectives and creates the basis for finding a joint way to proceed in the case. We conclude that MCD can enable professionals to reflect on moral issues and develop shared values in forensic psychiatry.
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Affiliation(s)
- Sylvia Gerritsen
- Department of Ethics, Law, and Humanities, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Guy A M Widdershoven
- Department of Ethics, Law, and Humanities, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Bernard J Bossenbroek
- Fivoor, Forensische Psychiatrische Afdeling/Forensische Psychiatrische Kliniek, Rotterdam, Netherlands
| | - Yolande Voskes
- Department of Ethics, Law, and Humanities, Amsterdam University Medical Center, Amsterdam, Netherlands.,GGz Breburg, Tilburg, Netherlands.,Tranzo, Tilburg University, Tilburg, Netherlands
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Nahata L, Morgan TL, Lipak KG, Olshefski RS, Gerhardt CA, Lehmann V. Romantic Relationships and Physical Intimacy Among Survivors of Childhood Cancer. J Adolesc Young Adult Oncol 2019; 9:359-366. [PMID: 32091940 DOI: 10.1089/jayao.2019.0114] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Childhood cancer survivors are at risk for impaired psychosocial functioning, but limited research has focused on psychosexual outcomes in young adulthood. This qualitative study examined the perceived impact of childhood cancer on adult survivors' romantic relationships and sexual/physical intimacy. Methods: Phone interviews were completed with adult survivors of childhood cancer, exploring the impact of cancer on (1) romantic relationships and (2) sexual/physical intimacy. Verbatim transcripts were coded using thematic content analysis until saturation was confirmed (n = 40). Results: Survivors in this study (n = 40) were 23-42 years old (M = 29.8; 63% female) and 10-37 years postdiagnosis (M = 18.4). Regarding romantic relationships, 60% of participants reported a negative impact, while 55% of participants reported positive effects; ∼25% of participants reported no impact of childhood cancer on adult romantic relationships. Negative themes included fertility-related concerns, physical effects (e.g., self-consciousness), feeling emotionally guarded, and delayed dating. Positive themes were creating new perspectives, increased maturity, and stronger bonds with partners. Forty percent of survivors in this study perceived having fewer partners than peers. Regarding sexual/physical intimacy, 68% of participants reported a negative impact (themes: body image, fertility-related concerns, sexual/physical dysfunction), while 33% of participants reported no effects. Conclusions: This study demonstrates both positive and negative effects of childhood cancer on adult survivors' romantic relationships, whereas effects on physical intimacy were predominantly negative. Further research is needed to inform effective psychosexual interventions, and health care providers should routinely address these topics in survivorship care.
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Affiliation(s)
- Leena Nahata
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA.,Nationwide Children's Hospital, Columbus, Ohio, USA.,The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Taylor L Morgan
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Keagan G Lipak
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Randal S Olshefski
- Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Cynthia A Gerhardt
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA.,Nationwide Children's Hospital, Columbus, Ohio, USA.,The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Vicky Lehmann
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Medical Psychology, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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