The purpose of this study was to examine the relationship between interpersonal violence and background traumas and symptom distress in a community sample of Colombian women (N = 217). The Life Stressor Checklist-Revised was used to measure lifetime interpersonal violence and background trauma exposure. The Brief Symptom Inventory was used to measure current symptom distress. Although both exposures were common in this sample, interpersonal violence was strongly correlated with current symptom distress; background traumas made no unique contribution to the variance in current symptom distress. The findings suggest that interpersonal events may be particularly distressing.

Abstract

Coming Through it Together:

Narratives on the Relational Aspects of Maternal Postpartum Depression and Parenting Practices

Alyssa J. Abraham O’Brien

Depression that occurs in new mothers during the postpartum period is the most common complication of childbirth with an etiology and course similar to depression that occurs in women during other life events. However, postpartum depression (PPD) deserves dedicated research and clinical focus because of the critical role this period plays in the development of a family. The partner relationship is a well-known support for women during this time, yet little is understood about the associations between PPD and this relationship. The aim of this interpretive phenomenological study, conducted using the narrative and thematic interviewing style and analysis methods of Benner (1994), was to examine the experiences of couples as they made the transition to parenthood within the context of a maternal PPD diagnosis. Ten couples were interviewed within three years of the mother’s PPD diagnosis. Findings indicate that couples experienced a range of responses to maternal PPD, including the processes of dismissal, acknowledgment and accommodation. These processes influenced their experience of their transition to parenthood, and their interpersonal relationship, and the functioning of their household. Multiple patterns of interaction and coping that varied by relationship style, were also identified and impacted daily habits and practices in the home. Three relationship styles were identified: 1) an equally supportive relationship style; 2) a relationship style that consisted of differing perspectives, but was still supportive; and 3) a discordant relationship style that created significant dysfunction in all aspects of the relationship. Relationship and parenting experiences were impacted differently depending on the couple’s style of interaction and the quality of the support they reported. Finally, results highlighted ways that parenting practices were influenced by a mother’s PPD and how couples worked together, even through disagreements in the attempt to shelter their children from a mother’s depression and their relationship conflicts. These findings suggest a need for perinatal nurses and health professionals to develop family centered postpartum assessments and interventions when the mother is diagnosed with PPD.

The purpose of this Grounded Theory study was to explore the reasons for the seemingly underuse of emergency contraceptive pills (ECP) in older adolescent and young adults. Knowledge, attitudes, experiences, partner influence, and couple dynamics as they relate to decision making about ECP use were explored. Observations and interviews were conducted with 22 sexually involved, heterosexual couples with members ranging from 18 to 25 years of age. Basic knowledge of ECP was a requirement but prior use was not. Both individual and couple interviews were conducted with each dyad.

Participants revealed several meanings that ECP use held for them based on moral principles, personal responsibility, and the safety and efficacy of ECP. Each of these categories represented a continuum of value judgments. Despite the relatively high educational level of the participants, these ascribed meanings were often based on incomplete or erroneous information. The majority of couples favored ECP use though often in limited circumstances only; within couple concordance on this issue was high. Couple dynamics and decision making about ECP use revealed issues of trust and power, with female participants expressing feelings of control and their partners expressing vulnerability. Theses emotions stemmed from the reality that females could make the final decision about ECP use. Perceived and actual contraceptive responsibility sometimes varied both with individuals and within couples.

Implications for practice include more comprehensive health education regarding contraception in general, including ECP, with a concerted effort to including young men in the process. Clinicians need to be aware of popular misconceptions about ECP so that they might provide accurate information. Those practicing with young adult populations also need to be aware that contraceptive decision making does not occur in isolation, but rather often includes a young woman's partner, and therefore, realize the salience of couple dynamics in their approach. Additionally, the results of this study may provide a basis for future theory development regarding ECP decision making in young adult couples.

Workplace violence accounted for 18% of all violent crimes in the United States with a Federal source reporting 17% of workplace homicides against women were attributable to intimate partner violence (IPV). The purpose of this study was to provide insight into how the workplace either facilitates or hampers women in dealing with IPV. An ethnographic approach was used to uncover the stories of women who worked while experiencing IPV. A theoretical model was developed to facilitate understanding of the precarious balance between home and work environments that was necessarily maintained by women experiencing IPV. Formerly abused women (N=11) were recruited through advertisements and were asked questions regarding the severity of abuse, their personal challenges with sustaining employment while involved in IPV, and how the workplace impacted their ability to sustain employment. This study was a departure from previous studies in that women were specifically asked about their work experiences while in an abusive relationship. Three major themes were identified from the data: (1) the Value of Work, had two subcategories: financial stability and breathing room; (2) the Struggle of Abuse, had three subcategories: shame, difficulty concentrating, and lies, and (3) the Environment of Work, had five subcategories: fear of intrusion, hiding and covering up the truth, job loss, and availability of resources. The results were revealing about the extensiveness of the abuse, the value women attributed to being employed, and in most cases, the lack of resources and the non-supportive atmosphere of the workplace. The results from this study also reveal the pressing need to support and protect victims of IPV. The occupational health nurse is perfectly positioned for the employer, the employee, professional colleagues and the nursing profession as an advocate for written policies, and increasing awareness and gain competencies in identifying the signs of IPV.

A significant percentage of adolescents involved in dating relationships experience dating abuse. Adolescent dating abuse has been linked to diverse health-related outcomes including depression, risky behavior, and suicidal ideation. Little literature has yet examined the effects of adolescent dating abuse on young women's health in adulthood. The purpose of this study was to develop better understanding of the experiences and health consequences of abusive dating relationships among young women. Specific aims were to discover how young women define and describe abuse in adolescent dating relationships, explore the occurrence of depression and suicidal ideation as outcomes among young women who experienced such abuse, and explore engagement in risky behaviors concurrent with and as outcomes among young women who experienced adolescent dating abuse. Data were collected via questionnaires and semi-structured interviews. Questionnaires were completed by 100 community-based women, ages 19 to 35, who self-reported an experience of adolescent dating abuse. Ten of these women also completed interviews with the primary investigator.

Participants reported a variety of abusive behaviors in their adolescent dating relationships. The average length of the abusive relationship was 36 months, and participants were between the ages of 11 and 20 at the time of the relationship. Threatening and emotionally or verbally abusive behavior by the partner were most often reported. All participants reported fear of their partner at some time during the relationship.

As adults, participants rated their health an average of 8.15 out of 10. Depression was common however, with 41% reporting moderate to severe depressive symptoms. Participants also described a variety of ways they felt the experience of adolescent dating abuse had affected them, including influencing self-image or self-concept, instilling fear that something could happen to them or their children, and causing them to question relationships with others.

The results of this study demonstrate the complex nature of adolescent dating abuse and its potential to affect adult health and wellbeing. This study also demonstrates the fullness of lifetime risks that may be associated with adolescent dating abuse. Seeking ways to alleviate this risk is an important task for those practicing with adolescent and young adult populations.

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