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Williams CC, Gibson MF, Mooney E, Forbes JR, Curling D, green DC, Ross LE. A Structural Analysis of Gender-Based Violence and Depression in the Lives of Sexual Minority Women and Trans People. AFFILIA 2023; 38:350-366. [PMID: 37538836 PMCID: PMC10394395 DOI: 10.1177/08861099231155887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
This article explores structural mechanisms that are the context for violence and depression in the lives of sexual minority women and trans people in Ontario, Canada. The article draws on interviews with 14 people who reported experiences of depression in the previous year, foregrounding three representative narratives. Narrative and case study analysis reveal that violence is a repeated and cumulative experience over lifetimes, occurring across different interpersonal contexts and institutional encounters. A common theme across the narratives is that experiences of violence are connected to a broader context in which structural arrangements, cultural norms, and institutional processes create conditions where marginalized people are put in harm's way, perpetrators are empowered, and justice and access to help are elusive. As the violence experienced by these sexual minority women and trans people is rooted in structural and cultural oppression represented in poverty, racism, misogyny, homophobia, and transphobia, the prevention of violence and its consequences for these and other marginalized populations requires systemic transformation of the structures and systems that currently allow and perpetuate harm.
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Affiliation(s)
- Charmaine C. Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Margaret F. Gibson
- School of Social Work, Renison University College, University of Waterloo, Waterloo, Ontario, Canada
| | - Emily Mooney
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Joellean R. Forbes
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Lori E. Ross
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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2
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Kokorikou DS, Sarigiannidis I, Fiore VG, Parkin B, Hopkins A, El-Deredy W, Dilley L, Moutoussis M. Testing hypotheses about the harm that capitalism causes to the mind and brain: a theoretical framework for neuroscience research. FRONTIERS IN SOCIOLOGY 2023; 8:1030115. [PMID: 37404338 PMCID: PMC10315660 DOI: 10.3389/fsoc.2023.1030115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023]
Abstract
In this paper, we will attempt to outline the key ideas of a theoretical framework for neuroscience research that reflects critically on the neoliberal capitalist context. We argue that neuroscience can and should illuminate the effects of neoliberal capitalism on the brains and minds of the population living under such socioeconomic systems. Firstly, we review the available empirical research indicating that the socio-economic environment is harmful to minds and brains. We, then, describe the effects of the capitalist context on neuroscience itself by presenting how it has been influenced historically. In order to set out a theoretical framework that can generate neuroscientific hypotheses with regards to the effects of the capitalist context on brains and minds, we suggest a categorization of the effects, namely deprivation, isolation and intersectional effects. We also argue in favor of a neurodiversity perspective [as opposed to the dominant model of conceptualizing neural (mal-)functioning] and for a perspective that takes into account brain plasticity and potential for change and adaptation. Lastly, we discuss the specific needs for future research as well as a frame for post-capitalist research.
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Affiliation(s)
- Danae S. Kokorikou
- Psychoanalysis Unit, Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Ioannis Sarigiannidis
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Vincenzo G. Fiore
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Beth Parkin
- Department of Psychology, School of Social Sciences, University of Westminster, London, United Kingdom
| | - Alexandra Hopkins
- Department of Psychology, Royal Holloway, University of London, London, United Kingdom
| | - Wael El-Deredy
- Centro de Investigación y Desarrollo en Ingeniería en Salud, Universidad de Valparaíso, Valparaíso, Chile
| | - Laura Dilley
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, United States
| | - Michael Moutoussis
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, United Kingdom
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Kovacevic M, Patel AR, Newman E. Mixed-Method Investigations Uncovering Tension, PTSD Symptoms, and Trauma-Related Difficulties Among Indian Women from Slums Reporting Gender-Based Violence. Cult Med Psychiatry 2023; 47:195-216. [PMID: 35099672 PMCID: PMC9339029 DOI: 10.1007/s11013-021-09759-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 10/19/2022]
Abstract
Indian women exposed to gender-based violence (GBV) report experiencing cultural concepts of distress, such as tension, and trauma-related difficulties. However, tension and trauma-related sequalae have not been explicitly explored. The present study examined the symptoms, causes, and coping strategies associated with tension among slum-residing Indian women reporting GBV (N = 100). This study also explored linkages between tension and posttraumatic stress disorder (PTSD) symptom severity. Qualitative results among a subsample of women (n = 38) indicated tension was commonly reported. Tension was characterized by varied affective, behavioral, cognitive, and somatic components and was most commonly caused by interpersonal stressors. Participants described various coping strategies to manage tension, including avoiding, cognitively reframing, considering consequences, distracting themselves, seeking medical, religious and/or spiritual assistance, finding social support, and tolerating tension. Barriers to coping were stigma, hopelessness about present circumstances, and negative reactions from others. One-way analysis of covariance with Bonferroni-adjusted post hoc results (N = 100) indicated that participants with higher tension exhibited significantly higher PTSD symptom severity as compared to participants reporting no tension. Altogether, the polyvalence of tension suggested that it requires idiographic assessment. Tension appears responsive to skills consistent with evidence-based psychological treatments for Indian women from slums reporting GBV.
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Affiliation(s)
| | - Anushka R Patel
- Trauma Recovery Center, University of California, San Francisco, San Francisco, CA, USA.
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Concepcion T, Velloza J, Kemp CG, Bhat A, Bennett IM, Rao D, Polyak CS, Ake JA, Esber A, Dear N, Maswai J, Owuoth J, Sing'oei V, Bahemana E, Iroezindu M, Kibuuka H, Collins PY. Perinatal Depressive Symptoms and Viral Non-suppression Among a Prospective Cohort of Pregnant Women Living with HIV in Nigeria, Kenya, Uganda, and Tanzania. AIDS Behav 2023; 27:783-795. [PMID: 36210392 PMCID: PMC9944362 DOI: 10.1007/s10461-022-03810-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 12/14/2022]
Abstract
Depression is common during pregnancy and is associated with reduced adherence to HIV-related care, though little is known about perinatal trajectories of depression and viral suppression among women living with HIV (WLHV) in sub-Saharan Africa. We sought to assess any association between perinatal depressive symptoms and viral non-suppression among WLWH. Depressive symptomatology and viral load data were collected every 6 months from WLWH enrolled in the African Cohort Study (AFRICOS; January 2013-February 2020). Generalized estimating equations modeled associations between depressive symptoms [Center for Epidemiological Studies Depression (CES-D) ≥ 16] and viral non-suppression. Of 1722 WLWH, 248 (14.4%) had at least one pregnancy (291 total) and for 61 pregnancies (21.0%), women reported depressive symptoms (13.4% pre-conception, 7.6% pregnancy, 5.5% one-year postpartum). Depressive symptomatology was associated with increased odds of viral non-suppression (aOR 2.2; 95% CI 1.2-4.0, p = 0.011). Identification and treatment of depression among women with HIV may improve HIV outcomes for mothers.
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Affiliation(s)
- Tessa Concepcion
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Jennifer Velloza
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Christopher G Kemp
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA
| | - Amritha Bhat
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Ian M Bennett
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Department of Family Medicine, University of Washington, Seattle, WA, USA
| | - Deepa Rao
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Christina S Polyak
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Julie A Ake
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Allahna Esber
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Nicole Dear
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Jonah Maswai
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- US Army Medical Research Directorate-Africa, Kericho, Kenya
| | - John Owuoth
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
- HJF Medical Research International, Kisumu, Kenya
| | - Valentine Sing'oei
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
- HJF Medical Research International, Kisumu, Kenya
| | - Emmanuel Bahemana
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- HJF Medical Research International, Mbeya, Tanzania
| | - Michael Iroezindu
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- HJF Medical Research International, Abuja, Nigeria
| | - Hannah Kibuuka
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Pamela Y Collins
- Department of Global Health, University of Washington, Seattle, WA, USA.
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
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Patel AR, Kovacevic M, Hinton D, Newman E. "I put a stone on my heart and kept going": An explanatory model of how distress is generated and regulated among Indian women from slums reporting gender-based violence. Transcult Psychiatry 2022; 59:522-538. [PMID: 34860626 DOI: 10.1177/13634615211055003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clinical variation in the expression of panic disorder, depression and anxiety, and posttraumatic stress disorder (PTSD) has have been documented across cultures. However, local (emic) cultural models that explain how people make sense of their illness experiences remain relatively understudied in India among trauma-exposed populations. Further, the integration of emic findings into clinical care is limited, underscoring the need for emic perspectives following trauma to improve the development or adaptation of trauma-focused treatments in India. This study describes an emic explanatory model of distress, which includes idioms of distress, perceived causes of distress, and coping/help-seeking behaviors among Indian women from slums reporting gender-based violence. This explanatory model can be used as a culturally grounded way to develop clinical case conceptualizations to adapt and deliver psychological treatments for this under-served population.
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Affiliation(s)
| | | | - Devon Hinton
- Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Jungari S. Violent Motherhood: Prevalence and Factors Affecting Violence Against Pregnant Women in India. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP6323-NP6342. [PMID: 30484355 DOI: 10.1177/0886260518815134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Violence against women is widely recognized as a serious public health problem in the world. Especially violence against pregnant women has more severe health consequences for both women and child. The objective of this study is to examine the prevalence and factors affecting violence during pregnancy in India. Data from the National Family Health Survey (NFHS)-4 are used to analyze this study. NFHS is a series of demographic health surveys conducted in India. Information on violence against pregnant women was collected for the first time in NFHS-4. Univariate and multivariate analyses are used to show the factors affecting violence during pregnancy. Study results reveal that the prevalence of violence varied among states from 0.5% to 9%, and women in South India were at a greater risk of abuse during pregnancy than that of women in other parts of India. Women with no education, women in poor household, women having three and more children, and women from rural area are at greater risk of being victims of violence during motherhood. Effective strategies such as responsive health care system, effective implementation of legal measures, and educating and engaging men in preventing violence are urgently needed.
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Patel AR, Weobong B, Patel VH, Singla DR. Psychological treatments for depression among women experiencing intimate partner violence: findings from a randomized controlled trial for behavioral activation in Goa, India. Arch Womens Ment Health 2019; 22:779-789. [PMID: 31363925 PMCID: PMC6841649 DOI: 10.1007/s00737-019-00992-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/11/2019] [Indexed: 12/03/2022]
Abstract
Intimate partner violence (IPV) strongly predicts depression, but it is unknown if women experiencing IPV can benefit from depression treatments in contexts where depression and IPV are prevalent. This study explored whether women experiencing IPV in Goa, India, can benefit from the Healthy Activity Program (HAP), a culturally adapted behavioral activation treatment, compared with enhanced usual care (EUC). Cross-sectional and longitudinal analyses were performed on data from a clinical trial. Measures assessed at baseline and 3 and 12 months included depressive symptoms. Measures assessed at 3 and 12 months included activation and IPV. Independent t tests were conducted to assess if participants experiencing IPV had higher depressive symptoms and lower activation at 3 and 12 months; hierarchical linear regression was conducted to determine if 3-month IPV predicted 12-month depressive symptoms across trial arms (Hypothesis 1). Hierarchical linear regression was then conducted to examine if the relationship between 3-month activation and 12-month depressive symptoms was moderated by 3-month IPV within each trial arm (Hypothesis 2). As expected, participants experiencing IPV had significantly lower activation levels and higher depressive symptoms compared with participants who did not experience IPV at 3 and 12 months in cross-sectional analyses. Similarly, IPV endorsed at 3 months significantly predicted depressive symptoms at 12 months. However, activation was significantly associated with less severe depressive symptoms at 12 months, irrespective of IPV endorsement among HAP participants. For EUC participants, IPV remained the only significant predictor of depressive symptoms at 12 months. Results suggest that women experiencing IPV can still benefit from behavioral activation.
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Affiliation(s)
- Anushka Rajesh Patel
- Department of Psychology, The University of Tulsa, 800 S. Tucker Drive, Tulsa, OK, 74104, USA
| | - Benedict Weobong
- School of Public Health, Department of Social and Behavioural Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Vikram Harshad Patel
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
- Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Bardez, Porvorim, Goa, 403501, India
| | - Daisy Radha Singla
- Department of Psychiatry, University of Toronto and Sinai Health System, 600 University Ave, Rm914A, Toronto, Ontario, M5T 1R8, Canada.
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Bhattacharya A, Camacho D, Kimberly LL, Lukens EP. Women's Experiences and Perceptions of Depression in India: A Metaethnography. QUALITATIVE HEALTH RESEARCH 2019; 29:80-95. [PMID: 30799765 DOI: 10.1177/1049732318811702] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In India, social determinants of health, including poverty, domestic violence, and inadequate social support disproportionately affect women, leaving them more vulnerable to depression than men. We conducted a metaethnography to synthesize qualitative data from 13 studies (1987-2017) that explored women's experiences and perceptions of depression in India. We used a feminist standpoint to critically examine how gender shapes these experiences and perceptions. Indian women's experiences of depression were embedded in their social worlds. Women perceived interpersonal conflict, caregiving burden, domestic violence, financial insecurity, adverse reproductive events and widowhood as causes of depression. Women used cultural expressions to describe physical, emotional, and cognitive distress. The detrimental impact of discriminatory social conditions, gender inequalities, and traditional gender roles on Indian women's mental health highlights the need for gender-sensitive mental health research and practice that can attend to women's sociocultural context and promote values of gender equality and social justice.
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Tomori C, Srikrishnan AK, Mehta SH, Nimmagadda N, Anand S, Vasudevan CK, Celentano DD, Solomon SS. HIV risks among women who are married to men who have sex with men in India: a qualitative investigation. CULTURE, HEALTH & SEXUALITY 2018; 20:873-887. [PMID: 29125041 PMCID: PMC5945330 DOI: 10.1080/13691058.2017.1390161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In countries such as India, men who have same-sex partnerships may marry women due to cultural pressures regardless of their sexual desires and preferences. The wives of such men may be at risk for HIV but limited existing research addresses this issue. This qualitative study used in-depth interviews to investigate HIV-related risk among married men who have sex with men (n = 34) and women who were aware of their husband's same-sex behaviour (n = 13) from six research sites in five states and a Union Territory in India: Delhi (Delhi), Visakhapatnam (Andhra Pradesh), Hyderabad (Telangana), Bengaluru (Karnataka), Chennai and Madurai (Tamil Nadu). Thematic analysis revealed that wives of men who have sex with men were at risk for HIV from their husbands' sexual practices, which are often hidden to avoid the potential consequences of stigmatisation, as well as from gender-based inequities that make husbands the primary decision-makers about sex and condom use, even when wives are aware of their husband's same-sex behaviour. Innovative interventions are needed to address HIV-related risk in couples where wives remain unaware of their husband's same-sex behaviour, and for wives who are aware but remain within these marriages.
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Affiliation(s)
- Cecilia Tomori
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Shruti H. Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Santhanam Anand
- YR Gaitonde Centre for AIDS Research and Education, Chennai, India
| | | | - David D. Celentano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Sunil S. Solomon
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- YR Gaitonde Centre for AIDS Research and Education, Chennai, India
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Heylen E, Shamban E, Steward WT, Krishnan G, Solomon R, Srikrishnan AK, Ekstrand ML. Alcohol Use and Experiences of Partner Violence Among Female Sex Workers in Coastal Andhra Pradesh, India. Violence Against Women 2018; 25:251-273. [PMID: 29953335 DOI: 10.1177/1077801218778384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This cross-sectional study describes the prevalence and context of violence by sexual partners against female sex workers (FSWs, N = 589) in Andhra Pradesh and its association with alcohol use by FSWs and abusive partners. In all, 84% of FSWs reported alcohol use; 65% reported lifetime physical abuse by a sexual partner. Most abused women suffered abuse from multiple partners, often triggered by inebriation or FSW's defiance. In multivariate logistic regressions, frequency of FSW's alcohol use was associated with abuse by clients and primary partner, whereas partner's alcohol use was only significant for abuse by primary partner, not clients.
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Affiliation(s)
- Elsa Heylen
- 1 University of California, San Francisco, USA
| | | | | | | | | | - A K Srikrishnan
- 4 Y.R. Gaitonde Centre for AIDS Research and Education, Chennai, India
| | - Maria L Ekstrand
- 1 University of California, San Francisco, USA.,5 St. John's Research Institute, Bangalore, India
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Malan M, Spedding M, Sorsdahl K. The prevalence and predictors of intimate partner violence among pregnant women attending a midwife and obstetrics unit in the Western Cape. Glob Ment Health (Camb) 2018; 5:e18. [PMID: 29868238 PMCID: PMC5981656 DOI: 10.1017/gmh.2018.9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 02/01/2018] [Accepted: 02/06/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) during pregnancy is prevalent across the world, but more so in low- and middle-income countries. It is associated with various adverse outcomes for mothers and infants. This study sought to determine the prevalence and predictors of IPV among pregnant women attending one midwife and obstetrics unit (MOU) in the Western Cape, South Africa. METHODS A convenience sample of 150 pregnant women was recruited to participate in the study. Data were collected using several self-report measures concerning the history of childhood trauma, exposure to community violence, depression and alcohol use. Multivariable logistic models were developed, the first model was based on whether any IPV occurred, the remaining models investigated for physical-, sexual- and emotional abuse. RESULTS Lifetime and 12-month prevalence rates for any IPV were 44%. The 12-month IPV rates were 32% for emotional and controlling behaviours, 29% physical and 20% sexual abuse. The adjusted model predicting physical IPV found women who were at risk for depression were more likely to experience physical IPV [odds ratios (ORs) 4.42, 95% confidence intervals (CIs) 1.88-10.41], and the model predicting sexual IPV found that women who reported experiencing community violence were more likely to report 12-month sexual IPV (OR 3.85, CI 1.14-13.08). CONCLUSION This is the first study, which illustrates high prevalence rates of IPV among pregnant woman at Mitchells Plain MOU. A significant association was found between 12-month IPV and unintended pregnancy. Further prospective studies in different centres are needed to address generalisability and the effect of IPV on maternal and child outcomes.
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Affiliation(s)
- M. Malan
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Western Cape, South Africa
| | - M.F. Spedding
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Western Cape, South Africa
| | - K. Sorsdahl
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Western Cape, South Africa
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Bowling J, Dodge B, Banik S, Bartelt E, Mengle S, Guerra-Reyes L, Hensel D, Herbenick D, Anand V. Social support relationships for sexual minority women in Mumbai, India: a photo elicitation interview study. CULTURE, HEALTH & SEXUALITY 2018; 20:183-200. [PMID: 28664771 DOI: 10.1080/13691058.2017.1337928] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Little research exists on women who do not identify as heterosexual in India. Social support for sexual minority women may protect against the effects of discrimination. An examination of significant social relationships may point to both strengths and weaknesses in this support. We aimed to understand relationship prioritisation and communication patterns associated with the social support of sexual minority women in Mumbai. In partnership with the Humsafar Trust, India's oldest and largest sexual and gender minority-advocacy organisation, we conducted photo-elicitation interviews with 18 sexual minority women, using participants' photographs to prompt dialogue about their social support. Intimate partners were a source of dependable support and many of those without relationships were seeking them. Participants' extended networks included friends and family as well as less formal relationships of social support. Participants mediated their communication with particular social network members, which involved filtering information sexual identity, romantic interests, and personal aspirations, among others. The diverse relationships that sexual minority women have in their social support networks may be used to guide programmes to improve health outcomes.
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Affiliation(s)
- Jessamyn Bowling
- a Department of Applied Health Science, Center for Sexual Health Promotion , Indiana University , Bloomington , IN , USA
| | - Brian Dodge
- a Department of Applied Health Science, Center for Sexual Health Promotion , Indiana University , Bloomington , IN , USA
| | - Swagata Banik
- b Public Health Program , Baldwin Wallace University , Berea , OH , USA
| | - Elizabeth Bartelt
- a Department of Applied Health Science, Center for Sexual Health Promotion , Indiana University , Bloomington , IN , USA
| | | | - Lucia Guerra-Reyes
- a Department of Applied Health Science, Center for Sexual Health Promotion , Indiana University , Bloomington , IN , USA
| | - Devon Hensel
- d Department of Pediatrics , Indiana University , Indianapolis , IN , USA
- e Department of Sociology , Indiana University-Purdue University , Indianapolis , IN , USA
| | - Debby Herbenick
- a Department of Applied Health Science, Center for Sexual Health Promotion , Indiana University , Bloomington , IN , USA
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13
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Bowling J, Dodge B, Banik S, Rodriguez I, Mengele SR, Herbenick D, Guerra-Reyes L, Sanders S, Dange A, Anand V. Perceived health concerns among sexual minority women in Mumbai, India: an exploratory qualitative study. CULTURE, HEALTH & SEXUALITY 2016; 18:826-840. [PMID: 26873141 DOI: 10.1080/13691058.2015.1134812] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The experiences of sexual minority women (i.e., women who do not identify as 'heterosexual') in India have largely been absent in scientific literature. In partnership with India's oldest and largest sexual and gender minority-advocacy organisation, the Humsafar Trust, our study used community-based participatory research principles to explore the lived experiences and health concerns of sexual minority women in Mumbai. Study methodologies included interviews with key informants, a focus group comprised of six women, and an additional 12 in-person interviews with sexual minority women to identify important physical, mental, social and other health priorities from these women's perspectives. Thematic data are organised within the framework offered by the social ecological model, including individual, interpersonal, micro and macro levels. Findings from this study are important in providing the groundwork for future research and intervention involving sexual minority women in India, a dramatically underserved population.
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Affiliation(s)
- Jessamyn Bowling
- a Center for Sexual Health Promotion , Indiana University , Bloomington, USA
| | - Brian Dodge
- a Center for Sexual Health Promotion , Indiana University , Bloomington, USA
| | - Swagata Banik
- b Public Health Program , Baldwin Wallace University , Berea, USA
| | - Israel Rodriguez
- a Center for Sexual Health Promotion , Indiana University , Bloomington, USA
| | | | - Debby Herbenick
- a Center for Sexual Health Promotion , Indiana University , Bloomington, USA
| | - Lucia Guerra-Reyes
- a Center for Sexual Health Promotion , Indiana University , Bloomington, USA
| | - Stephanie Sanders
- d The Kinsey Institute for Research in Sex, Gender and Reproduction , Indiana University , Indiana , USA
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O'Connor M, Colucci E. Exploring domestic violence and social distress in Australian-Indian migrants through community theater. Transcult Psychiatry 2016; 53:24-44. [PMID: 26341404 DOI: 10.1177/1363461515599327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In many parts of the world, young adult women have higher levels of common mental disorders than men. The exacerbation of domestic violence (DV) by migration is a salient social determinant of poor mental health. Ecological models describe factors contributing to DV as operating at individual, family, cultural, and societal levels. We explored the interplay among these factors in an Indian community living in Melbourne, Australia, in a qualitative participatory action research study using a modified Forum Theater approach. We here present findings on connections between migration, societal factors, and social/family/cultural factors in DV. The study captured the voices of women living in the community as they describe how DV contributes to their emotional difficulties. Improved understanding of the sociocultural dynamics of DV and the associated social distress in this migrant Indian community can be used to guide the development of culturally sensitive prevention and response programs to assist migrant women from the Indian subcontinent who present with psychopathology and suicidal behaviors associated with DV.
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15
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Raguram R. The Ache of Exile. PSYCHOLOGY AND DEVELOPING SOCIETIES 2015. [DOI: 10.1177/0971333615593003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Stigma associated with mental illness is one of the major impediments in evolving effective treatment interventions to address the burden associated with these disorders. Research enquiries in the Indian context have explored various facets of the phenomenon. While providing an overview of these studies, the present paper draws attention to the fact that stigma of mental illness is not solely a reflection of the social determinants of the problem. It is equally indicative of structural inequalities of power which result in rejection, marginalisation and social exclusion of the individuals afflicted with mental illness.
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Affiliation(s)
- R. Raguram
- Professor and Head, Department of Psychiatry, Kempegowda Institute of Medical Sciences & Research, Bangalore, India
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16
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Stigma and mental illness. Asian J Psychiatr 2014; 9:1-2. [PMID: 24813027 DOI: 10.1016/j.ajp.2014.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Kulesza M, Raguram R, Rao D. Perceived mental health related stigma, gender, and depressive symptom severity in a psychiatric facility in South India. Asian J Psychiatr 2014; 9:73-7. [PMID: 24813041 DOI: 10.1016/j.ajp.2014.03.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 03/04/2014] [Accepted: 03/08/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Few studies exist on the topic of gender associated with depression and mental health-related stigma coming out of non-Western countries such as India. We aimed to add to the literature by assessing these relationships among adults seeking psychiatric services in India. METHODS Participants were 60 individuals seeking care at a psychiatric clinic in Bangalore, India. The majority of participants were female with a mean age of 36 years (SD=9.75). RESULTS Contrary to our prediction, there were no significant differences between men (M=28.96; SD=9.85) and women (M=33.03; SD=12.08) on depression severity, t(58)=1.42, p=.16. Yet, women (M=10.09, SD=8.23) reported significantly more perceived stigma than men (M=5.79, SD=5.86), t(58)=2.30, p=.02. CONCLUSION While men and women seeking psychiatric services at the psychiatric clinic in India report similar levels of depression severity, women reported more perceived mental illness stigma. Having experienced regular forms of discrimination associated with female status in India, it may be the case that women are more attuned to other forms of stigma, such as mental health stigma investigated in the present study. Given the detrimental impact of stigma on treatment adherence and engagement in care, additional research is needed support this work, including research on interventions to reduce stigma and improve engagement in care.
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Affiliation(s)
- Magdalena Kulesza
- Department of Psychiatry and Behavioral Sciences, Center for Study of Health and Risk Behaviors, University of Washington, 1100 NE 45th Street, Suite 300, Seattle, WA 98105, United States.
| | - R Raguram
- Department of Psychiatry, Kempegowda Institute of Medical Sciences, Bangalore, India
| | - Deepa Rao
- Department of Global Health, University of Washington, 325 9th Avenue, Seattle, WA 98104, United States
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