Rape Aggression Defense Course: Physical, Psychological, and Interpersonal Benefits Among Women With and Without Interpersonal Victimization Histories

Women's self-defense training increases self-efficacy and reduces subsequent assaults, but self-defense training's effects on women's psychological and interpersonal functioning are understudied, particularly for women with histories of interpersonal victimization. This study examined the effects of a self-defense course on somatic symptoms, post-traumatic stress symptoms, depression, anxiety, interpersonal problems, and locus of control among women with and without interpersonal victimization histories and explored how women's disinhibition of their aggression during simulated attacks predicts changes in their symptoms and functioning. In all, 82 women reported their symptoms and functioning before participation and 6 weeks after participation in a university-based Rape Aggression Defense course. Among the whole sample, participation in the course led to significantly decreased posttraumatic stress, somatic, and hostility symptoms and problems with being too nonassertive, overly accommodating, and self-sacrificing. Women who reported interpersonal victimization histories (n = 49) did not differ in the degree of improvements when compared with women without interpersonal victimization histories (n = 33). Greater disinhibition during the simulation predicted less improvement in some symptoms; moderation analyses showed that this association occurred only among those women with high baseline anxiety or hostility. These findings highlight the value of self-defense training in improving the health of women, including posttraumatic stress symptoms and interpersonal functioning, regardless of women's history of interpersonal victimization. Results also suggest the importance of considering women's baseline symptoms in modulating the degree of aggression that is optimally expressed during training.

Effects of a Sexual Health Interview among Arab American Women: An Experimental Disclosure Study

Although sexuality is an important aspect of peoples' health and well-being, many people-professionals and patients alike-find sexuality uncomfortable to discuss. In Arab culture, certain sexual thoughts and behaviors are taboo, particularly for women, and it is not known whether an interview in which Arab American women disclose their sexuality to a health professional would be well-received and beneficial or upsetting and harmful. This experimental study tested whether engaging in a disclosure-oriented sexual health interview affects Arab American women's sexual and psychological health. A sample of 134 Arab American women, ages 18-35 years (M = 20.6), completed self-report measures of sexual health and attitudes and psychological symptoms, and then were randomized to an interview or control (waitlist) condition. The 60-min disclosure interview inquired about sexual attitudes, experiences, and conflicts. Five weeks later, all participants completed follow-up measures. Post-interview reports suggest that participants responded favorably to the interview and generally benefited from participation. Analyses of covariance (controlling for baseline levels of the outcome measure) indicated that the interview led to significantly greater sexual satisfaction and less discomfort with sexual self-disclosure at 5-week follow-up, compared to controls; the two conditions did not differ on follow-up sexual self-schema, sexual self-esteem, or psychological symptoms. Moderation analyses revealed that participation in the interview differentially improved the sexual self-schema of women with no past sexual experience, compared to women with sexual experience. These experimental findings suggest the value, rather than the risk, of clinicians encouraging Arab American women to openly disclose and discuss their sexual experiences and attitudes in a confidential, empathic setting.

The Effects of a Life Stress Emotional Awareness and Expression Interview for Women with Chronic Urogenital Pain: A Randomized Controlled Trial

OBJECTIVE

Women with chronic urogenital pain (CUP) conditions have elevated rates of lifetime trauma, relational stress, and emotional conflicts, but directly assessing and treating psychological stress is rarely done in women's health care settings. We developed and tested the effects on patients' somatic and psychological symptoms of a life stress interview that encourages disclosure about stressors and uses experiential techniques to increase awareness of links between stress, emotions, and symptoms.

METHODS

In this randomized trial, women with CUP recruited at a multidisciplinary women's urology center received either a single 90-minute life stress interview (N = 37) or no interview (treatment-as-usual control; N = 25). Self-report measures of pain severity (primary outcome), pain interference, pelvic floor symptoms, and psychological symptoms (anxiety and depression) were completed at baseline and six-week follow-up.

RESULTS

Differences between the life stress interview and control conditions at follow-up were tested with analyses of covariance, controlling for baseline level of the outcome and baseline depression. Compared with the control condition, the interview resulted in significantly lower pain severity and pelvic floor symptoms, but the interview had no effect on pain interference or psychological symptoms.

CONCLUSIONS

An intensive life stress emotional awareness expression interview improved physical but not psychological symptoms among women with CUP seen in a tertiary care clinic. This study suggests that targeting stress and avoided emotions and linking them to symptoms may be beneficial for this complex group of patients.

Ambivalence over emotional expression and perceived social constraints as moderators of relaxation training and emotional awareness and expression training for irritable bowel syndrome

OBJECTIVE

Psychological treatments are generally beneficial for patients with irritable bowel syndrome (IBS), but patients' responses vary. A prior randomized controlled trial found that both relaxation training (RT) and emotional awareness and expression training (EAET) were superior to a waitlist control condition for IBS symptoms, quality of life, depression, and anxiety among IBS patients (Thakur et al., 2017).

METHOD

We conducted secondary analyses on these data to examine potential moderators of treatment outcomes. Baseline measures of patients' ambivalence over emotional expression and perceived social constraints, which have been hypothesized to influence some treatments, were tested as possible moderators of the effects of RT and EAET, compared to the control condition.

RESULTS

Results indicated that these variables moderated the effects of RT but not EAET. The benefits of RT occurred for patients who reported higher ambivalence over emotional expression or perceived social constraints, whereas the benefits of EAET were not influenced by these factors.

CONCLUSION

These findings suggest that RT might be particularly helpful for people who tend to avoid emotional disclosure and expression, supporting the possible benefit of targeting treatments to patient characteristics and preferences, whereas EAET might be helpful for a broader range of patients with IBS.

Emotional awareness and expression training improves irritable bowel syndrome: A randomized controlled trial

BACKGROUND

Current clinical guidelines identify several psychological treatments for irritable bowel syndrome (IBS). IBS patients, however, have elevated trauma, life stress, relationship conflicts, and emotional avoidance, which few therapies directly target. We tested the effects of emotional awareness and expression training (EAET) compared to an evidence-based comparison condition-relaxation training-and a waitlist control condition.

METHODS

Adults with IBS (N=106; 80% female, Mean age=36 years) were randomized to EAET, relaxation training, or waitlist control. Both EAET and relaxation training were administered in three, weekly, 50-minute, individual sessions. All patients completed the IBS Symptom Severity Scale (primary outcome), IBS Quality of Life, and Brief Symptom Inventory (anxiety, depressive, and hostility symptoms) at pretreatment and at 2 weeks posttreatment and 10 weeks follow-up (primary endpoint).

KEY RESULTS

Compared to waitlist controls, EAET, but not relaxation training, significantly reduced IBS symptom severity at 10-week follow-up. Both EAET and relaxation training improved quality of life at follow-up. Finally, EAET did not reduce psychological symptoms, whereas relaxation training reduced depressive symptoms at follow-up (and anxiety symptoms at posttreatment).

CONCLUSIONS & INFERENCES

Brief emotional awareness and expression training that targeted trauma and emotional conflicts reduced somatic symptoms and improved quality of life in patients with IBS. This emotion-focused approach may be considered an additional treatment option for IBS, although research should compare EAET to a full cognitive-behavioral protocol and determine which patients are best suited for each approach. Registered at clinicaltrials.gov (NCT01886027).

Qualitative perspectives toward prostitution's perceived lifestyle addictiveness

BACKGROUND AND AIMS

The aim of the present study was to provide a phenomenological perspective of individuals who actively engage in street-level prostitution and identified a lifestyle addiction associated with their activities.

METHODS

We interviewed 25 women who were incarcerated in American county jails (at the time of interviews) for prostitution crimes. The transcripts were analyzed for themes that represented the shared consensus of the research participants.

RESULTS

Four negative psychological dynamics related to prostitution. First, participants described accounts of physical and emotional violence which they experienced at the hand of clients and others involved in the lifestyle. Second, interviewees explained an extreme dislike for their actions relating to and involving prostitution. These individuals did not describe themselves as being sexually addicted; sex was means to a desired end. Third, participants described how prostitution's lifestyle had evolved into something which they conceptualized as an addiction. As such, they did not describe themselves as feeling addicted to sex acts - but to lifestyle elements that accompanied prostitution behaviors. Finally, participants believed that freedom from prostitution's lifestyle would require social service assistance in order to overcome their lifestyle addiction.

CONCLUSIONS

The results show that, although the prostitutes repeatedly and consistently used the term "addiction" when describing their lifestyles, they did not meet the DSM-IV-TR criteria for addiction. Rather, they shared many of the same psychological constructs as do addicts (e.g., feeling trapped, desiring escape, needing help to change), but they did not meet medical criteria for addictive dependence (e.g., tolerance or withdrawal).

Undergraduate college students' perceptions of psychiatric nurses

We surveyed undergraduate students' perceptions of psychiatric nurses' effectiveness and analyzed other sources of data. Students reported that psychiatric nurses' strengths include helping in situations that involve psychiatric symptoms, mental health evaluation, and drug abuse. Psychiatric nurses also were said to be effective when helping an individual with psychiatric symptoms, such as delusions and hallucinations. Friends or associates, common knowledge, school and education, and movies are some sources by which students learn about psychiatric nurses. Sources that provided less influential information include insurance carriers, newspapers, and personal experience.