Christine Timko

Behavioral and psychological implications of body dissatisfaction: Do men and women differ?

The relationships of body satisfaction, self-esteem, dieting, and exercise were studied in 92 men and women. Men and women did not differ in degree of body dissatisfaction as assessed by three different measures. However, on the direction of body dissatisfaction, men were as likely to want to be heavier as thinner, whereas virtually no women wished to be heavier. Although overall body esteem was correlated with self-esteem for both men and women, measures of weight dissatisfaction were not associated with self-esteem for women. The normative nature of weight dissatisfaction for women today may serve to buffer its effects on self-esteem. Women reported exercising for weight control more than men, and exercising for weight control was associated with disregulated eating.

Are Iraq and Afghanistan veterans using mental health services? New data from a national random-sample survey

OBJECTIVE This study analyzed data from a national survey of Iraq and Afghanistan veterans to improve understanding of mental health services use and perceived barriers. METHODS The National Post-Deployment Adjustment Survey randomly sampled post-9/11 veterans separated from active duty or in the Reserves or National Guard. The corrected response rate was 56% (N=1,388). RESULTS Forty-three percent screened positive for posttraumatic stress disorder (PTSD), major depression, or alcohol misuse. Past-year psychiatric treatment was reported by 69% of the PTSD group, 67% of the depression group, and 45% of those with alcohol misuse. Most received care at Veterans Affairs (VA) facilities, although women were more likely than men to seek non-VA services. Veterans with more severe symptoms reported greater treatment utilization. Eighteen percent saw a pastoral counselor (chaplain) in the past year. Veterans with mental health needs who did not access treatment were more likely to believe that they had to solve problems themselves and that medications would not help. Those who had accessed treatment were more likely to express concern about being seen as weak by others. CONCLUSIONS Veterans in greatest need were more likely to access services. More than two-thirds with probable PTSD obtained past-year treatment, mostly at VA facilities. Treatment for veterans may be improved by increasing awareness of gender differences, integrating mental health and pastoral services, and recognizing that alcohol misuse may reduce utilization. Veterans who had and had not used services endorsed different perceptions about treatment, indicating that barriers to accessing care may be distinct from barriers to engaging in care.

The 8-year course of alcohol abuse: gender differences in social context and coping.

BACKGROUND The aim of this study was to compare women (n=230) and men (n=236) who had alcohol use disorders in terms of social context and coping methods and in terms of changes in these indices associated with participation in professional treatment and Alcoholics Anonymous (AA). METHODS Initially untreated problem drinkers were followed up for 8 years. RESULTS Women and men did not differ in regard to the type of help received, but women had longer professional treatment. At baseline, women had more stressors and fewer resources from family and relied more on avoidance coping and drinking to cope. During the next 8 years, women, more so than men, increased on approach coping and reduced their use of avoidance coping and drinking to cope. When baseline status was controlled, women had better social resource, coping, and drinking outcomes than men did at 1 year and 8 years. A longer duration of professional treatment during year 1 was associated with improved approach coping among men but not women. A longer duration of AA attendance during year 1 and the full 8 years was associated with more resources from friends, more use of approach coping, and less drinking to cope. In turn, more friends resources and approach coping and less drinking to cope were associated with better drinking outcomes. Decreases in avoidance coping and drinking to cope were more strongly associated with better drinking outcomes among men than among women. CONCLUSIONS It may be important to target men for formal services or self-help to increase their use of approach coping in efforts to maintain abstinence. Womens strategies for improving their social context need further explication to be adapted for transfer to male problem drinkers.

Cognitive biases in blaming the victim

Abstract Past research on cognitive biases has demonstrated the existence of a hindsight effect, whereby the receipt of outcome knowledge increases the perceived likelihood of the reported event. Three experiments were conducted that tested and supported the hindsight effect as a cause of victim blaming. Subjects read detailed accounts that were identical except for the concluding sentence, which provided outcome information. Half the subjects in each experiment were informed that the woman narrating the account was raped; the other half read a neutral outcome. Experiment 1 demonstrated that subjects were unable to ignore the influence of outcome knowledge, leading to an exaggerated perception of how likely the outcome appeared. In Experiment 2, the woman was blamed more by subjects who read the rape outcome than by those who read the neutral outcome, despite the presentation of identical behaviors and personality traits prior to outcome information. The increased blame attributed by rape outcome subjects was behavioral, and not characterological, in nature. Experiment 3 found a direct association between the hindsight effect and victim blaming and also demonstrated that an attempt to reduce the negative impact of the hindsight effect on victim blaming was ineffective due to the salience of the rape outcome. Explaining how a neutral outcome was possible given the same account did not reduce victim blaming by subjects who received a rape outcome. Rather, those who received a neutral outcome increased their victim blaming when asked to explain a rape outcome. The implications for victims are discussed.

Feminity/masculinity and disordered eating in women: How are they related?

Issues around femininity and masculinity have been implicated as etiological variables in the development of eating disorders among women. However, previous research on this subject has produced inconsistent results. This study examined the hypothesis that this inconsistency is due partially to incomplete conceptualizations of sex role orientation. Three aspects of the current female sex role stereotype were considered to be related to symptoms of eating disorders: importance of physical appearance, importance of masculine and feminine traits, and the number of roles a woman considers central to her identity. A non-clinical sample of 45 female undergraduates completed a battery of questionnaires. Results showed no relationship between a standard measure of femininity (the PAQ) and disordered eating. However, importance of appearance was related to both femininity and disordered eating. Furthermore, placing greater importance on possessing socially desirable masculine traits was a significant predictor of disordered eating. Finally, subjects who felt that many roles rather than few roles were central to their sense of self obtained high scores on a measure of disordered eating. These findings are discussed in light of the “superwoman” image and disordered eating, and arguments are made for the development of more complete conceptualizations of masculinity and femininity.

The process of treatment selection among previously untreated help-seeking problem drinkers

A sample of 515 untreated problem drinkers was followed up for 1 year after contacting alcohol information and referral or detoxification services. At the 1-year follow-up, participants were placed into one of four treatment status groups: no treatment (24%), Alcoholics Anonymous only (18%), outpatient (25%), and inpatient or residential (32%). Participants with fewer financial resources, more serious drinking problems, and poorer functioning at baseline were more likely to enter inpatient or residential programs than outpatient treatment. Persons who selected AA only for treatment were of lower socioeconomic status than outpatients, and were functioning better than those who opted for treatment in inpatient or residential settings. In general, individuals who entered treatment received a considerable amount of treatment. Poorer baseline functioning was related to attending more AA meetings or outpatient sessions, and to staying longer in inpatient or residential treatment. The results are discussed in the context of a conceptual model of selection into alcoholism treatment.

Outcome of treatment for alcohol abuse and involvement in Alcoholics Anonymous among previously untreated problem drinkers.

A sample of 515 initially untreated problem drinkers was followed for one year after contacting alcohol information and referral or detoxification services. At a one-year follow-up, participants had self-selected into one of four groups: no treatment (24%), Alcoholics Anonymous (AA) only (18%), outpatient treatment (25%), and residential or inpatient treatment (32%); some outpatients also attended AA, and some inpatients also attended AA and/or outpatient programs. These four groups were compared on changes in drinking-related variables, other aspects of functioning, and stressors and resources over the follow-up year. Also examined were associations between amount of treatment and outcomes at one year. All four groups improved on drinking and functioning outcomes but changed less on stressors and resources. Although individuals who received no help improved, persons in the two treatment and the AA-only groups improved more, particularly on drinking-related outcomes. Inpatients were more likely than outpatients or AA-only participants to be abstinent; otherwise, type of intervention had few differential effects. More AA attendance was associated with abstinence among AA-only, outpatient, and inpatient group members. Among outpatients and inpatients, more formal treatment was associated with abstinence and improvement on other drinking-related outcomes.

Coping with traumatic life events: The role of denial in light of people's assumptive worlds.

Through our work with a number of populations that have experienced traumatic negative events (e.g., rape victims, cancer patients, paralyzed accident victims) we have come to recognize the extent to which we ordinarily take for granted our very basic assumptions about ourselves and our world. These assumptions play a significant role in the emotional trauma and the coping process following severe negative events. In what follows we will consider the process of denial in light of the existence of people’s assumptive worlds, in hopes of providing a richer framework for considering the role of denial. We will argue that the often-maligned process of denial is natural and often necessary, and that it generally facilitates the process of adaptation to traumatic experiences. Unfortunately, denial has generally been evaluated solely with respect to some external reality and too infrequently in view of the victim’s internal reality. First, then, let us consider the nature of this internal world.

Women's childhood and adult adverse experiences, mental health, and binge drinking: The California Women's Health Survey

BackgroundThis study examined sociodemographic, physical and mental health, and adult and childhood adverse experiences associated with binge drinking in a representative sample of women in the State of California.Materials and methodsData were from the 2003 to 2004 (response rates of 72% and 74%, respectively) California Womens Health Survey (CWHS), a population-based, random-digit-dial annual probability survey sponsored by the California Department of Health Services. The sample was 6,942 women aged 18 years or older.ResultsThe prevalence of binge drinking was 9.3%. Poor physical health, and poorer mental health (i.e., symptoms of PTSD, anxiety, and depression, feeling overwhelmed by stress), were associated with binge drinking when demographics were controlled, as were adverse experiences in adulthood (intimate partner violence, having been physically or sexually assaulted, or having experienced the death of someone close) and in childhood (living with someone abusing substances or mentally ill, or with a mother vicimized by violence, or having been physically or sexually assaulted). When adult mental health and adverse experiences were also controlled, having lived as a child with someone who abused substances or was mentally ill was associated with binge drinking. Associations between childhood adverse experiences and binge drinking could not be explained by womens poorer mental health status in adulthood.ConclusionIdentifying characteristics of women who engage in binge drinking is a key step in prevention and intervention efforts. Binge drinking programs should consider comprehensive approaches that address womens mental health symptoms as well as circumstances in the childhood home.

Prevalence and Correlates of Intimate Partner Violence Victimization Among Men and Women Entering Substance Use Disorder Treatment

Intimate partner violence victimization was examined in men (N = 4,459) and women (N = 1,774) entering substance use disorder treatment. Nearly 1 in 2 women and 1 in 10 men reported lifetime victimization by an intimate partner. Entering treatment for alcohol, as compared to drug abuse and history of childhood abuse, were each associated with intimate partner violence victimization. Victimization by an intimate partner was also associated with mental health problems, including depression, anxiety, and attempted suicide. Although victimization was linked to physical health problems, the nature of these problems varied by gender. Women and men with a history of intimate partner victimization present to substance use disorder treatment with a complex array of mental and physical health problems.