The Role of Social Support on Depression Among Vulnerable Caregivers Reporting Bidirectional Physical Violence

Intimate partner violence (IPV) is a public health concern found across genders, socioeconomic strata, cultures, and ethnicities. While IPV is traditionally examined from either the victim or initiator role, it is also important to consider relationships in which both partners experience and demonstrate violence. The current study examined the relation between IPV chronicity and depression among 403 female caregivers with young children. Specifically, the current study examined the association between bidirectional IPV and depression. Furthermore, the impact of social support on depression levels among those caregivers was assessed. Results suggest that of those couples who experienced violence, bidirectional IPV was reported significantly more frequently than unidirectional IPV only. No significant differences in depression were found between those reporting bidirectional versus unidirectional IPV. Among those involved in bidirectional IPV, having greater social support was associated with significantly lower depression levels. Findings suggest that both initiation and experiences of IPV should be assessed among caregivers of vulnerable children. The potential impact of social support was also identified in this study. Clinicians may consider assessing family violence broadly, including bidirectional IPV, particularly among parents of young children with other adverse life conditions. Development and sustainment of healthy relationships through social support may facilitate adjustment for the caregivers.

Depression in Latina mothers: Examining the roles of acculturation, enculturation, social support, and family resources

OBJECTIVES

Previous findings on the relationship between acculturation and depression have been mixed, such that acculturation has been demonstrated as a protective factor, risk factor, and neutral factor for depressive symptomology. The current study sought to clarify this association by examining the roles of acculturation and enculturation (retention of traditional values and practices) on depression while incorporating contextual variables such as social support and resource adequacy.

METHOD

This study utilized archived data from 308 Latina mothers who participated in a randomized clinical trial evaluating the effectiveness of a home-based child maltreatment prevention model that was culturally adapted for a midwestern Latino/a community.

RESULTS

Findings from this study suggest that although enculturation was negatively associated with depression, this impact was no longer significant when multiple factors were examined. Rather, increased family resources and social support were related to fewer depressive symptoms. Furthermore, social support and family resources both demonstrated mediating roles between the relation of acculturation and depression. Family resources also mediated the relation between enculturation and depression.

CONCLUSIONS

Findings highlight the importance of assessing access to resources and interpersonal connections when working with Latina mothers experiencing depression. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The effect of low alcohol consumption during pregnancy on the lipid peroxidation-antioxidant defense system of women, their alcohol-exposed infants, and growth, health, and developmental outcomes

BACKGROUND

Few studies have examined the effects of low-dose alcohol consumption on the "lipid peroxidation-antioxidant defense" (LPO-AOD) system of mothers and infants, and on infant growth and development. This study examined effects of alcohol consumption on the LPO-AOD system of pregnant women and newborns and infant development.

METHODS

A total of 209 pregnant women were recruited for this prospective study at the first prenatal visit and followed until delivery: 112 consumed alcohol and 97 reported no alcohol use during pregnancy. Infants were evaluated at birth, and at 6 and 12 months of age. The study controlled for the confounding effect of maternal smoking.

RESULTS

Biomarkers of lipid peroxidation, for example, thiobarbituric acid reactants, were higher and the activity of the antioxidant defense system was lower in drinkers and their infants. Higher rates of pathological conditions and slower postnatal growth were observed among infants who were prenatally exposed to alcohol. Low-dose alcohol use and tobacco smoking were associated with lower postnatal infant growth trajectories, resulting in restricted growth at 6 and 12 months among infants born to mothers who drank or smoked during pregnancy. Alcohol had a broad effect on the infant and maternal LPO-AOD system, while the effect of smoking was limited in this study to maternal glutathione peroxidase.

CONCLUSIONS

Small amounts of alcohol consumed during pregnancy are associated with dysfunction of the LPO-AOD system and development of oxidative stress in women and their children. Identification and preventive interventions are needed for pregnant women who use alcohol in any amount.

Predictors of Intrusive Sexual Behaviors in Preschool-Aged Children

Intrusive sexual behaviors (ISBs) are a specific type of problematic sexual behavior characterized by the invasive nature of the acts (e.g., touching others' private parts, attempting intercourse; Friedrich, 1997). The limited amount of research on ISBs has focused on sexual abuse history as the primary predictor. However, Friedrich, Davies, Feher, and Wright (2003) found that ISBs in children up to age 12 were related to four broad conceptual factors: (a) exposure to sexual content, (b) exposure to violent behavior, (c) family adversity, and (d) child vulnerabilities. The current study sought to replicate Friedrich's study using a clinical sample of 217 preschool-aged children (ages two to six). Results supported variables from within the child vulnerabilities construct (externalizing behaviors, β_EXT = 0.032, p = 0.001), post-traumatic stress disorder (PTSD) criteria met (β_PTSD = 0.177, p = 0.02), and an inverse relationship with age (β_AGE = -0.206, p = 0.024). These results highlight the importance of considering childhood behavioral patterns and reactivity to traumatic events as correlates of ISBs in young children.

Latent Class Analysis of HIV Risk Behaviors Among Russian Women at Risk for Alcohol-Exposed Pregnancies

The number of HIV cases attributed to heterosexual contact and the proportion of women among HIV positive individuals has increased worldwide. Russia is a country with the highest rates of newly diagnosed HIV infections in the region, and the infection spreads beyond traditional risk groups. While young women are affected disproportionately, knowledge of HIV risk behaviors in women in the general population remains limited. The objectives of this study were to identify patterns of behaviors that place women of childbearing age at high risk for HIV transmission and determine whether socio-demographic characteristics and alcohol use are predictive of the risk pattern. A total of 708 non-pregnant women, aged between 18 and 44 years, who were at risk for an alcohol-exposed pregnancy were enrolled in two regions in Russia. Participants completed a structured interview focused on HIV risk behaviors, including risky sexual behavior and alcohol and drug use. Latent class analysis was utilized to examine associations between HIV risk and other demographic and alcohol use characteristics and to identify patterns of risk among women. Three classes were identified. 34.93% of participants were at high risk, combining their risk behaviors, e.g., having multiple sexual partners, with high partner's risk associated with partner's drug use (class I). Despite reporting self-perceived risk for HIV/STI, this class of participants was unlikely to utilize adequate protection (i.e., condom use). The second high risk class included 13.19% of participants who combined their risky sexual behaviors, i.e., multiple sexual partners and having STDs, with partner's risk that included partner's imprisonment and partner's sex with other women (class II). Participants in this class were likely to utilize protection/condoms. Finally, 51.88% of participants were at lower risk, which was associated primarily with their partners' risk, and these participants utilized protection (class III). The odds of being in class I compared with class III were 3.3 (95% CI [1.06, 10.38]) times higher for those women who had Alcohol Use Disorders Identification Test scores ≥ 8 than those who had lower scores, and were 3.9 (95% CI [1.69, 8.97]) times higher for those who used alcohol before sex than those who did not. In addition, women who drank more days per week were 1.36 times more likely to be in class II than in class III. The study informs prevention by identifying specific population groups and targets for interventions. Alcohol use is a significant predictor and an overarching factor of HIV risk in women. Since at-risk drinking is common among young Russian women, alcohol risk reduction should be an essential component of HIV prevention efforts.

Alcohol and HIV Risk Among Russian Women of Childbearing Age

Russia has one of the fastest rising rates of HIV among women in the world. This study sought to identify key factors in HIV transmission among women in Russia. Data were collected as part of a larger clinical trial to prevent alcohol-exposed pregnancies (AEP). Women at risk for an AEP were recruited at women's clinics; 708 women, aged 18-44 (M = 29.04 years), completed HIV risk surveys. Structural Equation Modeling was used to test the relationships between alcohol use and sex behavior constructs with HIV/STI risk. While the model indicated that multiple factors are involved in women's HIV/STI risk, the independent alcohol use variable explains 20 % of the variance in women's HIV/STI risk. The findings suggest that alcohol use directly and indirectly predicts HIV/STI risk among women, and its effect is mediated by alcohol use before sex.

Evaluating alcohol use among Russian women at risk for an alcohol-exposed pregnancy: A comparison of three measures of alcohol use

The Quick Drinking Screen (QDS) and Timeline Followback (TLFB), measures of alcohol use, have yielded similar reports of drinking with English speakers. The present study, a secondary data analysis, compared three measures of alcohol use (i.e., QDS, TLFB, and AUDIT) among Russian-speaking women. This is the first study to compare all three measures. This study replicated the findings of studies with English speakers and demonstrated that brief screening measures (QDS, AUDIT) provide reliable summary measures of alcohol use when compared to a detailed drinking measure (TLFB). The use of brief screening measures is recommended for use with Russian women.

Using a single binge drinking question to identify Russian women at risk for an alcohol-exposed pregnancy

INTRODUCTION

Low rates of contraception and at-risk drinking place many Russian women at risk of an alcohol-exposed pregnancy (AEP). The only realistic way to determine when women are at risk of AEP is by self-reports. A U.S. study found that a single binge-drinking question (SBD) effectively identified nearly all women whose drinking placed them at risk of AEP.

METHODS

The present study replicated the U.S.

STUDY

Participants were 689 non-pregnant Russian women of childbearing age who were at AEP risk. Their answers to SBD, "During the previous three months, how often did you have four or more drinks on one occasion", were compared with their reports of binge drinking on a 90-day Timeline Followback (TLFB) calendar.

RESULTS

The SBD identified 99% of at-risk Russian women as binge drinkers, replicating U.S.

FINDINGS

Only 8% of the women were identified at-risk using a second AEP criterion of ≥8 drinks on average per week. Although Russian women did not report heavy weekly drinking and two-thirds did not meet AUDIT criteria for problem drinking, when they did drink, 40% of the time it was binge drinking.

CONCLUSIONS

Almost all Russian women who were at risk of an AEP were identified by a single binge-drinking question. Results from this study suggest that Russian health care practitioners can use SBD to successfully screen women for AEP risk. SBD identified 99% of Russian women who were at AEP risk. Consequently, it is recommended that SBD be incorporated into routine health care screenings at OB/GYN clinic visits.

Electrocardiographical case. J wave and presyncope in a middle-aged woman

A 46-year-old woman presented with three episodes of presyncope in the previous two days. Electrocardiogram (ECG) showed sinus rhythm, relatively short QT interval (QTc of 340 msec) and prominent J-waves in the inferior leads. Biochemical evaluation revealed serum calcium of 17.4 mg/dL, phosphorus of 2.3 mg/dL and alkaline phosphatase of 533 IU/ml. She was managed with saline diuresis followed by elective parathyroidectomy. ECG became normal with the disappearance of J-waves after correction of hypercalcaemia. She was asymptomatic at six months of follow-up. The presence of J-waves (Osborne waves) in hypercalcaemia has rarely been reported.