Determinants of depressive symptoms in Jordanian working women

The Risk of Severe Fibromyalgia, Depression, Anxiety, and Insomnia Symptoms in Arab Women: An Implication of Self-Medication with Analgesics? A Cross-Sectional Study

Background and Objectives: The investigation of the psychosomatic symptoms in women residing in developing countries is still emerging. To be precise, the prevalence and correlates of severe fibromyalgia, depression, anxiety, and insomnia are understudied in Arab women, as these symptoms could relate to improper self-medication. This study mainly investigated the association between self-medication with analgesics and fibromyalgia, depression, anxiety, and insomnia symptoms among a community-based cohort of females in Jordan. Materials and Methods: We used a web-based cross-sectional study design. Fibromyalgia, depression, anxiety, and insomnia were assessed using validated scales. The used over-the-counter (OTC) painkillers were recorded. Results: Data were analyzed from 741 women, and fibromyalgia was screened in 16.4%, depression in 37.4%, anxiety in 27.8%, and insomnia in 38.3%. Fibromyalgia was associated with "married" (OR = 1.5, 95% CI = 1.017-2.305), "using OTC acetaminophen" (OR = 1.75, 95% CI = 1.15-2.69), "using herbal remedies" (OR = 2.02, 95% CI = 1.33-3.07), and "using antiseizure medications" (OR = 2.43, 95% CI = 1.38-4.28). Severe depression was significantly associated with "age" (OR = 0.97, 95% CI = 0.96-0.99), "high school education" (OR = 1.90, 95% CI = 1.21-2.98), "smoking" (OR = 1.72, 95% CI = 1.15-2.56), "OTC acetaminophen" (OR = 1.40, 95% CI = 1.02-1.92), "OTC non-steroidal anti-inflammatory drugs" (OR = 1.75, 95% CI = 1.15-2.65), and "antiseizures" (OR = 2.19, 95% CI = 1.30-3.70). Severe anxiety was significantly associated with "smoking" (OR = 2.08, 95% CI = 1.40-3.12), "OTC acetaminophen" (OR = 1.48, 95% CI = 1.06-2.06), and "antiseizure medications" (OR = 2.04, 95% CI = 1.22-3.41). Severe insomnia was significantly associated with "age" (OR = 0.98, 95% CI = 0.96-0.99), "high school education" (OR = 1.58, 95% CI = 1.01-2.47), "smoking" (OR = 1.51, 95% CI = 1.01-2.25), "OTC non-steroidal anti-inflammatory drugs" (OR = 1.74, 95% CI = 1.13-2.64), "antiseizure medications" (OR = 1.84, 95% CI = 1.09-3.11), and "No analgesics" (OR = 0.48, 95% CI = 0.32-0.71). Conclusions: Self-medication with analgesics is associated with a high burden of psychosomatic symptoms in Arab women, and awareness campaigns are required to guide self-medication behavior.

Smart phone addiction and its mental health risks among university students in Jordan: a cross-sectional study

BACKGROUND

Addiction to smart phones is classified clinically as behavioral addiction resulted from an excessive problematic usage of smart phones that effect the daily life of the users. Therefore, this study aims to explore the prevalence of smart phone addiction, its associated psychological distress risk, and its associated predictors among university students in Jordan.

METHODS

Between November 2022 and January 2023, a cross-sectional online survey study was conducted in Jordan. In this study, we used previously developed questionnaire instruments, the psychological Distress scale of Kessler and the Smartphone Addiction Scale. A score of 30 was used to identify the dummy variable in the binary logistic regression analysis to identify predictors of severe psychological distress, and smartphone addiction score of 38.7 was used to to identify predictors of smartphone addiction.

RESULTS

A total of 2337 university students participated in this study. The mean psychological distress score for the study participants was 30.0 (SD: 8.9). More than half of the study participants (59.1%) had a psychological distress score of 30 and above, which indicates a severe mental disorder state. More than half of the study participants (56.7%) had a smartphone addiction score of 30 and above, which reflects a smartphone addiction state. Females, divorced, those who feel that their mental abilities have been negatively affected by the use of smart phones, those who feel that using smartphones has affected their sleep and made it harder to fall asleep, and those feel that everything requires effort and fatigue, and they do not want to do any activity that requires effort were more likely to have severe psychological distress compared to others (p < 0.05). Females, those who feel that using smartphones has affected their sleep and made it harder to fall asleep, and those feel that everything requires effort and fatigue, and they do not want to do any activity that requires effort were more likely to be smartphone addicted compared to others (p < 0.05).

CONCLUSION

Mental diseases are a major public health concern in Jordan, especially among university students. Females, those who thought smartphone usage hurt their mental capacities, and those who had trouble sleeping and fatigue were more likely to develop serious psychological discomfort and smartphone addiction. Smartphones are indispensable, but excessive use can lead to addiction and harm university students' mental health.

Physical violence in college women: Psychometric evaluation of the safe dates-physical violence victimization scale

Researchers examined psychometric characteristics of the Safe Dates-Physical Violence Victimization scale in 97 Jordanian college women. Reliability coefficient and Principal Components Analysis were used. Construct validity was examined using independent samples t-test. Cronbach's alpha of 0.80 was yielded. Two dimensions (injury-causing tactics and threatening tactics) were identified. Using construct validity analysis, researchers indicated significant differences in the mean depression, anxiety, stress, and childhood victimization scores among women reporting physical violence, compared to their counterparts. College women possess psychological stressors due to academic and social responsibilities. Such stressors influence their decision to leave the partner which adversely impacts their psychological health.

Digital or Digitally Delivered Responses to Domestic and Intimate Partner Violence During COVID-19

Before the coronavirus disease (COVID-19), 1 in 3 women and girls, globally, were victimized by an abusive partner in intimate relationships. However, the current pandemic has amplified cases of domestic violence (DV) against women and girls, with up to thrice the prevalence in DV cases compared to the same time last year. Evidence of the adverse effects of the pandemic on DV is still emerging, even as violence prevention strategies are iteratively being refined by service providers, advocacy agencies, and survivors to meet stay-at-home mandates. Emotional and material support for survivors is a critical resource increasingly delivered using digital and technology-based modalities, which offer several advantages and challenges. This paper rapidly describes current DV mitigation approaches using digital solutions, signaling emerging best practices to support survivors, their children, and abusers during stay-at-home advisories. Some examples of technology-based strategies and solutions are presented. An immediate priority is mapping out current digital solutions in response to COVID-19-related DV and outlining issues with uptake, coverage, and meaningful use of digital solutions.

Prevalence of intimate partner violence against women in the Arab world: a systematic review

Background

Violence against women has particular importance for women’s health and wellbeing in the Arab world, where women face persistent barriers to social, political and economic equality. This review aims to summarize what is known about the prevalence of physical, sexual and emotional/psychological intimate partner violence (IPV) against women in the 22 countries of the Arab League, including geographic coverage, quality and comparability of the evidence.

Methods

A systematic review of IPV prevalence in Arab countries was carried out among peer-reviewed journal articles and national, population-based survey reports published by international research programmes and/or governments. Following PRISMA guidelines, Medline and the Social Sciences Citation Index were searched with Medical Subject Headings terms and key words related to IPV and the names of Arab countries. Eligible sources were published between January 2000 and January 2016, in any language. United Nations databases and similar sources were searched for national surveys. Study characteristics, operational definitions and prevalence data were extracted into a database using Open Data Kit Software. Risk of bias was assessed with a structured checklist.

Results

The search identified 74 records with population or facility-based IPV prevalence data from eleven Arab countries, based on 56 individual datasets. These included 46 separate survey datasets from peer-reviewed journals and 11 national surveys published by international research programmes and/or governments. Seven countries had national, population-based IPV estimates. Reported IPV prevalence (ever) ranged from 6% to more than half (59%) (physical); from 3 to 40% (sexual); and from 5 to 91% (emotional/ psychological). Methods and operational definitions of violence varied widely, especially for emotional/psychological IPV, limiting comparability.

Conclusions

IPV against women in Arab countries represents a public health and human rights problem, with substantial levels of physical, sexual and emotional/psychological IPV documented in many settings. The evidence base is fragmented, however, suggesting a need for more comparable, high quality research on IPV in the region and greater adherence to international scientific and ethical guidelines. There is a particular need for national, population-based data to inform prevention and responses to violence against women, and to help Arab countries monitor progress towards the Sustainable Development Goals.

Disclosure of Spousal Violence: Viewpoints From the Jordanian Society

The objectives of this study were to identify reasons behind not disclosing spousal violence and examine relationships between these reasons and women's demographic profile including the experience of spousal violence. Jordanian women ( N = 709) aged 16 to 66 years ( M = 32.6, SD = 8.7) attending health care centers were recruited. Results indicated that women's intentions to maintain the family unit and use of patience with abuser represented the top two reasons for not disclosing violence. Non-significant relationships were, generally, identified between not disclosing spousal violence and women's demographic profile. Women's justification of spousal violence and witnessing parental violence were the proposed reasons for women's lack of disclosure of violence. Implications for this study include health professionals' use of evidence-based knowledge and skills to deal with victims of violence. Researchers' roles include creating physical and emotional environment that urges disclosure of violence. Furthermore, they can contribute with health professionals in the implementation of health education programs directing victims and perpetrators in the places where they can be located. Proper collaboration between health professionals, researchers, and policy makers may significantly limit suffering of victims of violence.

Depressive Symptoms in College Women: Examining the Cumulative Effect of Childhood and Adulthood Domestic Violence

The purpose of this study was to examine the cumulative effect of childhood and adulthood violence on depressive symptoms in a sample of Jordanian college women. Snowball sampling technique was used to recruit the participants. The participants were heterosexual college-aged women between the ages of 18 and 25. The participants were asked about their experiences of childhood violence (including physical violence, sexual violence, psychological violence, and witnessing parental violence), partner violence (including physical partner violence and sexual partner violence), experiences of depressive symptoms, and about other demographic and familial factors as possible predictors for their complaints of depressive symptoms. Multiple linear regression analysis was implemented to identify demographic- and violence-related predictors of their complainants of depressive symptoms. Logistic regression analysis was further performed to identify possible type(s) of violence associated with the increased risk of depressive symptoms. The prevalence of depressive symptoms in this sample was 47.4%. For the violence experience, witnessing parental violence was the most common during childhood, experienced by 40 (41.2%) women, and physical partner violence was the most common in adulthood, experienced by 35 (36.1%) women. Results of logistic regression analysis indicated that experiencing two types of violence (regardless of the time of occurrence) was significant in predicting depressive symptoms (odds ratio [OR] = 3.45, p < .05). Among college women's demographic characteristics, marital status (single vs. engaged), mothers' level of education, income, and smoking were significant in predicting depressive symptoms. Assessment of physical violence and depressive symptoms including the cumulative impact of longer periods of violence on depressive symptoms is recommended to be explored in future studies.

Disclosure of intimate partner violence in current marital/partner relationships among female university students and among women at an emergency department

Detecting intimate partner violence (IPV) might empower women to start working on the impact that the abuse experience has had on their lives. Little, however, is known about disclosure of abuse in community and in clinical settings. The purpose of this study was to explore whether there was a difference in the disclosure of abuse experience among women who were attending the emergency department (ED) at Landspitali University Hospital or were located at a university site, that is, at the University Square at the University of Iceland. A cross-sectional research design was used. Data were collected at the same time in 2009 over a period of 9 months from N = 306 women ranging in age from 18 to 67 years (n = 166 at the University Square and n = 140 at the ED). A significantly higher proportion of the women at the ED reported that they were victims of IPV in their current marital/partner relationship and scored higher on the Women Abuse Screening Tool total scale than the women at the university site. This gave a clear indication that the women at the ED experienced significantly more frequent and more severe IPV in their current marital/partner relationship compared with the women at the university site. Identifying IPV in primary and clinical settings might, therefore, function as a protective factor if these women are offered appropriate first response and interventions.

Jordanian Nurses’ Barriers to Screening for Intimate Partner Violence

Screening rates for intimate partner violence (IPV) among nurses are still very low. The study purpose is to evaluate IPV screening and barriers by Jordanian nurses. A cross-sectional design was used with a stratified random sample ( N = 125) of Jordanian nurses. Findings included a significantly lower IPV screening rate among Jordanian nurses compared with those in the United States, no difference in screening between IPV victims compared with non-victimized nurses, and that the IPV screening barriers related to a lack of system support were the most clinically important barriers. Nurses can work in partnership with health care providers and managers to increase screening and overcome barriers.

Prevalence of intimate partner violence among women visiting health care centers in Palestine refugee camps in Jordan

This study was conducted to investigate the prevalence of intimate partner violence (IPV) among a sample of women visiting health care centers in Palestine refugee camps in Jordan. We found that different types of IPV, including physical, emotional, sexual, economic, and control behaviors by the partners were experienced by the participants. This study was among a number of studies that investigated this phenomenon in residents of Palestinian camps. It adds to existing studies in this field, however, as it focuses on the prevalence of the top five types of IPV in these women. Co-occurrence of IPV, that is, experiencing two or more types of partner violence at the same time, was noticed in these women. Experiencing control by one's partner and the presence of different attitudes between men and women toward the use of violence were factors contributing to the occurrence of this phenomenon in these women. National efforts aiming at breaking the cycle of violence should be fostered through media and public awareness campaigns. Changing people's attitudes concerning men's use and women's acceptance of violence should be the aim of these efforts.

Mental health status of women in Jordan: a comparative study between attendees of governmental and UN relief and works agency's health care centers

This study aimed at investigating differences in mental health problems between attendees of governmental and United Nations Relief and Works Agency for Palestine Refugees health care centers in Jordan. Further, predictors of mental health problems based on women's demographic profile were investigated. A convenience sample of 620 women attending governmental and United Nations Relief and Works Agency for Palestine Refugees health care centers in Jordan was recruited for this purpose. Independent samples t-tests were used to identify differences in mental health, and multiple linear regression was implemented to identify significant predictors of women's mental health problems. Results indicated an absence of significant differences in mental health problems between attendees of the two types of health care centers. Further, among the demographic indicators that were tested, income, spousal violence, and general health were the predictors of at least three different mental health problems in women. This study highlights opportunities for health professionals to decrease women's propensity for mental health problems by addressing these factors when treating women attending primary care centers in different Jordanian towns, villages, and refugee camps.

Mental health status among married working women residing in Bhubaneswar city, India: a psychosocial survey

Mental health is a major public health concern worldwide. This study aimed to assess the mental health status and its correlates among married working women residing in Bhubaneswar city of Odisha, India. A cross-sectional study was undertaken in 240 households involving 240 married working women following a multistage cluster random sampling design. Using the predesigned, pretested interview schedule and self-reporting questionnaire, all relevant information was collected. Our study revealed that 32.9% of study respondents had poor mental health and only about 10% of these women had sought any kind of mental health services. Logistic regression analysis showed that 3 predictors such as favourable attitude of colleagues, sharing their own problems with husband, and spending time for yoga/meditation/exercise had significant positive impact on the mental health status of married working women. A preventive program regarding various aspects of mental health for married working women at workplace as well as community level could be a useful strategy in reducing this public health problem.

Predictors of antenatal depression among Jordanian pregnant women in their third trimester

Antenatal depression has not been well studied worldwide. The objective of this study was to identify the prevalence and predictors of antenatal depression among Jordanian pregnant women in their third trimester. A correlational design was used with a convenience sample of 218 Jordanian pregnant women. Data were collected using valid and reliable measures and were analyzed with regression. Fifty-seven percent of the women displayed symptoms of depression. Thirty-seven percent (34% adjusted) of the variability in depression levels was predicted by knowing scores on life satisfaction, perceived stress, family and nonfamily stressful relationships, education, and parity. For that, antenatal depression needs early detection and treatment.

Prevalence and predictors of postpartum depression among Arabic Muslim Jordanian women serving in the military

The purpose of this cross-sectional correlational study was to investigate the prevalence of symptoms and psychosocial predictors of postpartum depression (PPD) among Arabic Muslim Jordanian women serving in the military. Jordanian active-duty military women who had given birth within the last year (n = 300) and were working in 4 military hospitals participated in the study. Tools used included the Edinburgh Postnatal Depression Scale, the Impact of Event Scale-Revised, and the Multidimensional Perception of Social Support. Sixty-seven percent of study participants had mild to moderate symptoms of PPD, and 16% had high levels of symptoms of PPD. Seventy-five percent reported having adequate social support, and 75% reported perceived stress above the cutoff score. There was a strong positive significant relationship between symptoms of PPD and perceptions of stress. There was a significant moderate negative relationship between symptoms of PPD and perception of social support. Income, intendedness of pregnancy, mode of birth, family social support, and perception of stress were the strongest predictors of PPD. There was a reciprocal relationship between PPD and psychosocial variables, with women having low levels of perceived stress and satisfaction with social support having fewer symptoms of postpartum. These findings demonstrate the need to address the psychosocial needs of Arabic Muslim Jordanian childbearing women serving in the military through comprehensive interventions. Findings highlight the importance of social support in decreasing perceived stress and symptoms of PPD in these women.

Psychological partner violence and women's vulnerability to depression, stress, and anxiety

Psychological partner violence is a considerable problem, despite its invisible outcomes on victims' physical health. Focusing on mental health, the present study looked at differences in mental illness, such as depression, stress, and anxiety, among victims and non-victims of psychological violence. A convenience sample of women (n = 267) visiting health-care centres in refugee camps in Jordan provided data about their experiences of psychological violence and their mental health status. The results indicated that, compared to their non-victimized counterparts, women reporting psychological violence had significantly higher mean scores of depression (t = -4.92), stress (t = -3.73), and anxiety (t = -4.22), with P < 0.0001 for all results. It was suggested that factors that have significant roles in determining poor mental health status included victims' low self-esteem; poor socioeconomic profile, in terms of education level and income; and responsibilities associated with child and family requirements. The impacts of these factors on victims' mental health status are discussed.

Intimate partner violence against adult women and its association with major depressive disorder, depressive symptoms and postpartum depression: a systematic review and meta-analysis

To date, few systematic reviews of observational studies have been conducted to comprehensively evaluate the co-morbidity of intimate partner violence (IPV) and specific depression outcomes in women. In this systematic review and meta-analysis, we summarize the extant literature and estimate the magnitude of the association between IPV and key depressive outcomes (elevated depressive symptoms, diagnosed major depressive disorder and postpartum depression). PubMed (January 1, 1980-December 31, 2010) searches of English-language observational studies were conducted. Most of the selected 37 studies had cross-sectional population-based designs, focused on elevated depressive symptoms and were conducted in the United States. Most studies suggested moderate or strong positive associations between IPV and depression. Our meta-analysis suggested two to three-fold increased risk of major depressive disorder and 1.5-2-fold increased risk of elevated depressive symptoms and postpartum depression among women exposed to intimate partner violence relative to non-exposed women. A sizable proportion (9%-28%) of major depressive disorder, elevated depressive symptoms, and postpartum depression can be attributed to lifetime exposure to IPV. In an effort to reduce the burden of depression, continued research is recommended for evaluating IPV preventive strategies.

A mixed methods study of participant reaction to domestic violence research in Jordan

Research on domestic violence against women has increased considerably over the past few decades. Most participants in such studies find the exercise worthwhile and of greater benefit than emotional cost; however, systematic examination of participant reaction to research on violence is considerably lacking, especially in the Middle East region. This study begins to fill this gap by examining women's reactions to domestic violence research in Jordan and whether a personal history of violence is associated with unfavorable experiences. This sequential exploratory mixed methods study included 17 focus group discussions (FGD) with women in Amman followed by a survey conducted in reproductive health clinics throughout the country (pilot n = 30; survey n = 517). Open coding was used to identify the theme related to participant reaction in the FGD data. This construct was further examined by the subsequent survey that included dichotomous questions inquiring whether the respondent thought the study questions were important and whether they were angry or felt resentment as a result of the survey. One open-ended question on the survey provided additional qualitative data on the theme that was combined with the FGD data. Themes identified in the qualitative data pertained to expressions of gratitude and comments on the survey's value. Findings of this study indicate that Jordanian women's responses to the research process are similar to women currently represented by the extant literature in that a vast majority of its participants felt that the study was important (95%) and it did not evoke anger or resentment (96%). Many even found the study to be useful to them personally or to society. Among those who had a negative emotional reaction, most still found the research to be important. This study's findings highlight the safety and potential benefits of ethically conducted violence research.