Vanessa Tirone

Going Along With It: Sexually Coercive Partner Behavior Predicts Dating Women’s Compliance With Unwanted Sex

Sexual compliance involves willing consent to unwanted sex despite a lack of sexual desire.The authors hypothesized that compliance would be significantly more common among women with sexually coercive partners because compliance allows women to bypass possible coercion. Undergraduate women in heterosexual relationships ( N = 76) responded to self-report measures of partner sexually coercive behavior at baseline and sexual compliance 6 weeks later. As expected, reports of partner coercive behavior at Time 1 predicted women’s willing consent to unwanted sex at Time 2. Most compliant women consented to unwanted sex after learning their partners may coerce them if they refuse.

Breaking up is hard to do: psychological entrapment and women's commitment to violent dating relationships.

Psychological entrapment occurs when people continue investing in unfavorable situations after already devoting too much to lose. We predicted that women who already invested more time and resources into their relationships would exert effort to improve their relationships following partner violence. In turn, these efforts were expected to increase women’s subjective investment in, and thus, commitment to violent relationships. Undergraduate women (N = 98) in heterosexual relationships reported on partner violence and relationship duration at Time 1 and relationship sacrifices, subjective investment, and commitment at Times 1 and 2. As expected, women with violent partners who were in longer term relationships sacrificed more 6 weeks later. Unexpectedly, in multivariate analyses, Time 2 sacrifices were not significantly associated with Time 2 subjective investment, although subjective investment was positively associated with concurrent commitment. These results provide preliminary evidence for women’s entrapment in violent relationships.

A Pilot Study of Tailored Cognitive–Behavioral Resilience Training for Trauma Survivors With Subthreshold Distress

This pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of tailored cognitive-behavioral resilience training (TCBRT) for trauma-exposed individuals with a variety of subsyndromal psychological symptoms. TCBRT is a brief, flexible intervention that allows individuals to select the areas they wish to target using common cognitive-behavioral change principles. There were 14 individuals (78.6% female) who were recruited from a major medical center and enrolled in the 5-session intervention. There were 12 (85.7%) who completed all TCBRT sessions, and 2 (14.3%) who dropped out after 3 sessions. All participants reported that they received benefit from, were engaged in, and were satisfied with the intervention. Of the 12 with postintervention data, 5 of the participants demonstrated reliable increases in resilience and 6 demonstrated reliable decreases in anxiety. These improvements appeared to be maintained at 2-month follow-up; of the 11 participants with follow-up data, 5 demonstrated reliable increases in resilience and 6 demonstrated reliable decreases in anxiety. Our findings suggested that TCRBT was acceptable to trauma-exposed individuals with varying types of subthreshold distress.

Examining the effectiveness of a coordinated perinatal mental health care model using an intersectional-feminist perspective

Untreated perinatal depression and anxiety are significant public health problems that disproportionately affect ethno-racial minorities. The purpose of this study was to examine the effectiveness of a coordinated perinatal mental health care model, focusing on socially-disadvantaged, ethno-racial minority women, with an intersectional-feminist perspective. The treatment model was grounded in intersectionality theory with the aim of addressing complex social vulnerability factors in the context of perinatal mental health treatment. Participants were 67 perinatal women (64% African American or Hispanic/Latina) referred by medical providers at an urban teaching hospital. Results demonstrated high treatment engagement and effectiveness, with 65.9% of participants demonstrating reliable improvement in symptoms. Moreover, African American and Hispanic/Latina patients had similar treatment outcomes compared to White patients, despite facing greater socio-economic disadvantages. Findings indicate that the treatment model may be a promising approach to reducing perinatal mental health disparities. Strengths and limitations of the study are discussed within the intersectionality framework.

A feasibility study of trauma-sensitive obstetric care for low-income, ethno-racial minority pregnant abuse survivors

Abstract Purpose: This study evaluated the feasibility and acceptability of an integrated (psychological and obstetric) intervention for pregnant abuse survivors with posttraumatic stress symptoms (PTS) from low-income, ethno-racial minority backgrounds. Methods: Trauma-sensitive obstetrics to promote control, anxiety-reduction and empowerment (TO-CARE) offers cognitive-behavioral therapy (CBT) coping skills delivered over six sessions by therapists, coupled with trauma-sensitive obstetric care from specially-trained obstetric physicians. Results: Participants were 21 women who completed at least three sessions of CBT, totaling 51.2% of eligible participants. Participants received approximately one-third (M = 2.29; SD = 2.15) of their prenatal visits with obstetric residents trained in trauma-sensitive care. Nearly all participants (95%) reported that they benefited from the intervention. Although most participants demonstrated improvement in PTS, only four demonstrated reliable improvement, and two demonstrated reliable improvement in depression symptoms. These improvements appeared to be maintained at postpartum follow-up for two of the participants. Conclusions: Our findings suggest that TO-CARE was acceptable to pregnant abuse survivors and may be a promising intervention to reduce symptoms of distress. Implications of the low retention rate for the CBT (51.2%) are discussed in the context of interventions for low-income minority pregnant women. Limitations regarding feasibility of the integrated intervention are discussed.

Posttraumatic stress and depression may undermine abuse survivors’ self-efficacy in the obstetric care setting

Abstract Introduction: Posttraumatic stress symptoms (PTS) are associated with increased risk of obstetric complications among pregnant survivors of trauma, abuse and interpersonal violence, but little is known about how PTS affects women’s actual experiences of obstetric care. This study investigated the rate at which abuse history was detected by obstetricians, whether abuse survivors experienced more invasive exams than is typically indicated for routine obstetric care, and whether psychological distress was associated with abuse survivors’ sense of self-efficacy when communicating their obstetric care needs. Methods: Forty-one pregnant abuse survivors completed questionnaires about abuse history, current psychological distress and self-efficacy for communicating obstetric care needs and preferences. Electronic medical records (EMRs) were reviewed to examine frequency of invasive prenatal obstetric procedures (e.g. removal of clothing for external genital examination, pelvic exams and procedures) and to examine the detection rate of abuse histories during the initial obstetric visit. Results: The majority of participants (83%) reported at least one past incident of violent physical or sexual assault. Obstetricians detected abuse histories in less than one quarter of cases. Nearly half of participants (46%) received invasive exams for non-routine reasons. PTS and depression symptoms were associated with lower self-efficacy in communicating obstetric care preferences. Discussion: Women most at risk for experiencing distress during their obstetric visits and/or undergoing potentially distressing procedures may also be the least likely to communicate their distress to obstetricians. Results are discussed with implications for improving screening for abuse screening and distress symptoms as well as need for trauma-sensitive obstetric practices.

Conservation of Resources Theory Applied to Major Stress

Abstract Conservation of resources (COR) theory informs our understanding of how individuals cope with major stress and trauma. COR theory asserts that traumatic stress occurs when events threaten and erode the basic resources human beings need for survival or self-integrity. This process occurs within an ecological framework, meaning that patterns of risk and resilience in the face of resource loss are intimately tied to an individuals family, community, and culture. The basic principles and corollaries of COR theory are reviewed to illustrate patterns of post-trauma adjustment over time. Finally, the use of COR theory in guiding individual and collective post-trauma interventions is explored.

Sleep Disturbance and Depression Symptoms Mediate the Relationship between Pain and Cognitive Dysfunction in Lupus Patients

To determine whether sleep disturbance and symptoms of depression mediate the relationship between pain and cognitive dysfunction (CD) in a sample of 115 patients with systemic lupus erythematosus (SLE).