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Iraola E, Menard JP, Buresi I, Chariot P. Gynecological health and uptake of gynecological care after domestic or sexual violence: a qualitative study in an emergency shelter. BMC Womens Health 2024; 24:264. [PMID: 38678204 PMCID: PMC11055245 DOI: 10.1186/s12905-024-03112-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 04/23/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Domestic and sexual violence have been linked to adverse gynecological and obstetric outcomes. Survivors often find it difficult to verbalize such violence due to feelings of shame and guilt. Vulnerable or socially excluded women are frequently excluded from research, particularly qualitative studies on violence. This study aimed to characterize the perceived impact of domestic or sexual violence on the gynecological health and follow-up among women with complex social situations. METHODS We analyzed the data following inductive thematic analysis methods. RESULTS Between April 2022 and January 2023, we conducted 25 semi-structured interviews, lasting on average 90 min (range: 45-180), with women aged between 19 and 52, recruited in an emergency shelter in the Paris area. The women described physical and psychological violence mainly in the domestic sphere, their altered gynecological and mental health and their perception of gynecological care. The levels of uptake of gynecological care were related to the characteristics of the violence and their consequences. The description of gynecological examination was close to the description of coerced marital sexuality which was not considered to be sexual violence. Gynecological examination, likely to trigger embarrassment and discomfort, was always perceived to be necessary and justified, and consent was implied. CONCLUSION This study can help question the appropriateness of professional practices related to the prevention of violence against women and gynecological examination practices. Any gynecological examination should be carried out within the framework of an equal relationship between caregiver and patient, for the general population and for women with a history of violence. It participates in preventing violence in the context of care, and more widely, in preventing violence against women.
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Affiliation(s)
- Elisabeth Iraola
- Institut de Recherche interdisciplinaire sur les Enjeux Sociaux (IRIS), UMR, CNRS U997 Inserm EHESS UFR SMBH, Université Sorbonne Paris Nord, 8156-997, 93300, Aubervilliers, France.
- Direction de la protection maternelle et infantile et promotion de la santé, Conseil départemental du Val-de-Marne, 94000, Créteil, France.
| | - Jean-Pierre Menard
- Direction de la protection maternelle et infantile et promotion de la santé, Conseil départemental du Val-de-Marne, 94000, Créteil, France
| | - Isabelle Buresi
- Direction de la protection maternelle et infantile et promotion de la santé, Conseil départemental du Val-de-Marne, 94000, Créteil, France
| | - Patrick Chariot
- Institut de Recherche interdisciplinaire sur les Enjeux Sociaux (IRIS), UMR, CNRS U997 Inserm EHESS UFR SMBH, Université Sorbonne Paris Nord, 8156-997, 93300, Aubervilliers, France
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Malecki JS, Rhodes P, Ussher J, Boydell K. The embodiment of childhood abuse and anorexia nervosa: A body mapping study. Health Care Women Int 2023; 44:1192-1217. [PMID: 35727112 DOI: 10.1080/07399332.2022.2087074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 04/25/2022] [Accepted: 06/04/2022] [Indexed: 10/18/2022]
Abstract
Childhood trauma has long been implicated in the development of anorexia nervosa and is known to impact more women than men. Still, less is known about the meaning women attribute to food and bodily practices and how they contribute to feminine subjectivity. In this article, we examine the subjective experiences of women with histories of childhood abuse and anorexia and women who did not develop an eating disorder. Through a visual narrative analysis of eight body maps and narratives, we identified five themes: "time and the body have a way of showing what matters," "femininity and family," "sexual subjectivities and food meanings," "voices, dissociation, and sexual subjectivities," and "religion and healthism." In women with anorexia, specific eating and bodily practices reconstructed the traumatic events to align with the available cultural discourses related to health, religion, and family and had implications for their feminine and sexual subjectivities and self-worth. This research showcased how arts-based methodologies add value and advance knowledge about the role of culturally available representations in the development of anorexia and has implications for therapy and prevention of anorexia.
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Affiliation(s)
| | - Paul Rhodes
- University of Sydney, Camperdown, New South Wales, Australia
| | - Jane Ussher
- Women's Health Psychology, Translational Research Institute School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Katherine Boydell
- Hospital Road Randwick, Black Dog Institute, Randwick, New South Wales, Australia
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3
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O'Loghlen E, Galligan R, Grant S. The functions of binge eating scale (FBES): Development and preliminary psychometric validation. Appetite 2023; 183:106479. [PMID: 36736905 DOI: 10.1016/j.appet.2023.106479] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 01/19/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Binge eating within binge-eating disorder (BED) is a behaviour widely understood as a response to dietary restraint and emotion dysregulation. However, qualitative literature suggests that a wider range of functions of binge eating exist, with associations between functions of binge eating and adverse childhood experiences highlighted across this research. The present study sought to develop a scale to measure a wide range of functions of binge eating within BED. A secondary aim was to examine the relationship between these functions and adverse childhood experiences (ACEs). METHOD The researchers developed an initial item pool for the Functions of Binge Eating Scale (FBES) and invited experts within the eating disorder (ED) field (n = 22) to review the items. The refined item pool was administered online to adults with self-reported binge eating symptoms (N = 882), along with related measures to establish scale validity. RESULTS Exploratory and confirmatory factor analyses produced an eight-factor structure (emotion regulation, hedonic hunger, compensatory eating, numbness/dissociation, emotion expression, self-punishment, control, self-protection). The scale demonstrated good internal reliability and adequate construct and predictive validity. Results also showed that functions theoretically related to childhood maltreatment were predicted by ACEs. DISCUSSION Findings extend our understanding of the range of functions of binge eating experienced in BED. Additionally, findings indicate that type of adverse childhood experience predicts functions of binge eating. Initial validation of the FBES suggests that functions of binge eating are wider than previously understood. Accordingly, clinicians are encouraged to explore and target more complex processes which might perpetuate binge-eating behaviour.
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Affiliation(s)
- Elyse O'Loghlen
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
| | - Roslyn Galligan
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
| | - Sharon Grant
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
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Olofsson ME, Vrabel KR, Hoffart A, Oddli HW. Covert therapeutic micro-processes in non-recovered eating disorders with childhood trauma: an interpersonal process recall study. J Eat Disord 2022; 10:42. [PMID: 35314004 PMCID: PMC8935733 DOI: 10.1186/s40337-022-00566-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/07/2022] [Indexed: 12/01/2022] Open
Abstract
METHOD To uncover therapeutic micro-processes from the perspectives of eating disorder (ED) treatment non-responders with childhood trauma (CT) late effects, we explored in-session experiences of poor long-term outcome patients. Female inpatients aged 28-59 (M = 40.2, SD = 5.0) from a randomised trial comparing Compassion Focused Therapy for EDs (n = 3) with Cognitive Behavioural Therapy for EDs (n = 3) were interviewed with video-assisted recall about a self-selected session. Data were analysed through Interpretative Phenomenological Analysis (IPA) with Grounded Theory (GT) elements. RESULTS Covert patient strategies included self-effacement, regulating therapeutic distance to open up, and engaging with reflective rather than experiential interventions. First, self-effacement included submissive, passive or pretend responses to perceived criticising or violating therapist behaviours as well as other orientation and submission for approval. Second, some preferred a close patient-therapist alliance with therapist self-disclosure and reciprocity was a requirement for opening up; others required distance. Third, informants detached from experiential trauma work while engaging in joint reflection on post-trauma responses. CONCLUSION Informants were preoccupied with calibrating the emotional-relational landscape in session; we hypothesized that psychological insecurity and affective intolerance from CT limit their freedom to explore own in-session experiences.
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Affiliation(s)
- Malin E Olofsson
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway.
| | - KariAnne R Vrabel
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway.,Research Institute, Modum Bad, Vikersund, Norway
| | - Asle Hoffart
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway.,Research Institute, Modum Bad, Vikersund, Norway
| | - Hanne W Oddli
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway
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Olofsson ME, Oddli HW, Vrabel KAR, Hoffart A. «In solitude is safeness»: a patient perspective on eating disorders in the context of multiple childhood trauma. NORDIC PSYCHOLOGY 2020. [DOI: 10.1080/19012276.2020.1762714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | | | - Asle Hoffart
- Department of Psychology, Oslo University, Oslo, Norway
- Modum Bad Research Institute, Vikersund, Norway
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Huston JC, Grillo AR, Iverson KM, Mitchell KS. Associations between disordered eating and intimate partner violence mediated by depression and posttraumatic stress disorder symptoms in a female veteran sample. Gen Hosp Psychiatry 2019; 58:77-82. [PMID: 30965163 DOI: 10.1016/j.genhosppsych.2019.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/05/2019] [Accepted: 03/27/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study established a link between intimate partner violence (IPV) and eating disorders (EDs) via mediators of depression and posttraumatic stress disorder (PTSD) symptoms in female veterans. METHOD A nationally representative sample of female veterans (N = 190, Mean age = 48.41 years) completed online surveys assessing IPV and symptoms of depression, PTSD, and EDs, at three time points from 2014 to 2017. RESULTS Approximately 14.11% of participants met criteria for any ED (7.83% Bulimia Nervosa; 6.28% Binge Eating Disorder), and 49.42% reported lifetime histories of IPV. Eating disorder symptoms were significantly associated with lifetime IPV, PTSD and depression symptoms at the bivariate level. Mediation model results revealed that lifetime IPV was indirectly associated with EDDS scores, via PTSD symptoms and depression symptoms. CONCLUSION Findings confirmed elevated rates of probable EDs and lifetime IPV among female veterans; significant associations between EDs, lifetime IPV, depression, and PTSD; and mediation of the association between IPV and EDs by PTSD and depression symptoms. Implications for screening, treatment and research are discussed.
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Affiliation(s)
- J C Huston
- National Center for PTSD, VA Boston Healthcare System, 150 S. Huntington Ave., Boston, MA 02130, USA; Department of Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA 02118, USA; Department of Psychiatry, Harvard University Medical School, 25 Shattuck St., Boston, MA 02115, USA.
| | - A R Grillo
- National Center for PTSD, VA Boston Healthcare System, 150 S. Huntington Ave., Boston, MA 02130, USA.
| | - K M Iverson
- National Center for PTSD, VA Boston Healthcare System, 150 S. Huntington Ave., Boston, MA 02130, USA; Department of Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA 02118, USA.
| | - K S Mitchell
- National Center for PTSD, VA Boston Healthcare System, 150 S. Huntington Ave., Boston, MA 02130, USA; Department of Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA 02118, USA.
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Statement of removal. Health Care Women Int 2018; 39:1316. [DOI: 10.1080/07399332.2018.1443108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Women’s Constructions of Childhood Trauma and Anorexia Nervosa: a Qualitative Meta-Synthesis. HUMAN ARENAS 2018. [DOI: 10.1007/s42087-018-0029-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Malecki J, Rhodes P, Ussher J. Childhood trauma and anorexia nervosa: from body image to embodiment. Health Care Women Int 2018; 39:936-951. [PMID: 30152723 DOI: 10.1080/07399332.2018.1492268] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Contemporary understandings of anorexia nervosa are framed by the body-image paradigm. The body-image framework considers that women's bodily experiences are reflected through distorted mental images of their bodies or disordered thinking and behavior around food and eating. Body image has come to symbolize all that can go wrong with women's relationships with their bodies, food, and eating. The problem with this approach is its failure to consider the experience of women who have survived childhood abuse. Women's bodily disturbances are not easily discernible through objective measures because they lie within the inner subjective realm of the embodied 'self' and embodied emotional experience. Consideration of the different ways that women inhabit their bodies informs this paper's examination of the conceptual framework of embodiment as an alternative to the body-image paradigm.
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Affiliation(s)
- Jennifer Malecki
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Paul Rhodes
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Jane Ussher
- School of Psychology, The University of Sydney, Sydney, NSW, Australia.,Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia
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Abstract
In this article, I argue that eating disorders constitute a form of social suffering, in which sufferers embody liminality as a response to, and a reflection of, oppressive sociality, structural violence, and institutional constraints. Based on the illness narratives of people with anorexia nervosa, bulimia nervosa, and their subclinical variants in Israel, the analysis draws the experiential, the social, and the structural into critical focus. These narratives, which delineate lived experiences of self-starving, bingeing, and purging, and the attendant viscerality of hunger, fullness, and emptiness, reveal how participants developed an embodied drawing inward and away, being at once within and without society for extended periods of time, through eating disordered practices. This liminal positioning, I argue, was a mode through which participants cultivated alternative (if temporary) personal spaces, negotiated identities, and anesthetized pain: processes many deemed essential to survival. Embedding the participants' narratives of eating disordered experiences within familial, societal, and political-economic forces that shaped their individual lives, I examine the participants' striving for liminality as at once intimately embodied and structurally mapped. The analysis suggests that policy initiatives for eating disorder prevention must address the social suffering that eating disorders manifest: suffering caused by structures and institutions that reinforce social inequality, violence, and injustice.
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Caudillo Ortega L, Valdez Montero C, Flores Arias ML, Ahumada Cortez JG, Gámez Medina ME, Ramos Frausto VM. Relación entre la violencia contra la mujer y el índice de masa corporal: revisión integradora. AVANCES EN ENFERMERÍA 2018. [DOI: 10.15446/av.enferm.v36n2.66009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: el propósito de esta revisión es conocer la evidencia científica existente de la relación entre la violencia contra la mujer (VCM) y su índice de masa corporal (IMC) (alto y bajo).Síntesis del contenido: se realizó una revisión integradora de las publicaciones científicas que abordaran y relacionaran la VCM y el IMC en diferentes bases de datos. Se consideraron los siete pasos de Cooper. Se analizaron por título, año de publicación, autores y fuente; finalmente, se estudiaron los aspectos metodológicos. Se identificaron 85 artículos y se excluyeron 67 por no cumplir con los criterios de inclusión. De los artículos incluidos en la revisión, 5 reportaron correlación positiva y significativa entre la VCM con el índice de masa corporal alto (sobrepeso/obesidad). Asimismo, 6 de los artículos refieren una relación positiva entre la VCM y el IMC bajo; es decir, a mayor violencia, se reporta un IMC alto. Pero, también, 1 reporta una relación negativa y significativa; es decir, a menor violencia, menor el IMC de las mujeres.Conclusión: los resultados encontrados muestran la existencia escasa literatura científica que aborde la temática de la VCM y el IMC. Algunos estudios muestran la relación entre la VCM y el IMC alto y bajo. Los resultados no son concluyentes, por lo que se requiere generar líneas de acción y atención a las mujeres receptoras de los diferentes tipos de violencia.
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