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Women's Mental Health: A Framework for Its Assessment, Prevention, and Promotion in Health Care Settings

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (10 October 2021) | Viewed by 51291

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Prof. Dr. Carmela Mento

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Leading Guest Editor

Biomorf Department, University of Messina, Psychiatric Unit Policlinico Hospital, via Consolare Valeria 1, 98122 Messina, Italy
Interests: clinical psychology; psychological assessment in medical setting; psychological assessment in eating disorders and bariatric surgery; mental pain and suicide risk; adolescent mental health; women's mental health; autistim spectrum disorder in adults; psychoanalysis and health care
Special Issues, Collections and Topics in MDPI journals

Dr. Maria Catena Silvestri

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Guest Editor

Psychiatric Unit Policlinico Hospital Messina, University of Messina, 1-98122 Messina, Italy
Interests: clinical psychology in medical setting; personality assessment; workplace violence on health professions

Special Issue Information

Dear Colleagues,

In the last decade, the general consideration of women’s mental disorders has been limited to some attempts aimed at promoting mental health. However, it is important to consider subjective well-being factors connected with cultural, environmental and personality aspects.

According to the World Health Organization, psychological health is the capability of an individual to interact with others in ways that promote subjective well-being. Many factors, such as the roles assigned to women now, social and work context, and personality traits, can act as predisposing conditions in the etiology of psychopathological frame in particular affective disorders.

Furthermore, in the developmental life of a woman, important risk factors can be highlighted such as the postpartum period and pregnancy, where the vulnerability to psychological distress increases in women and couples. Another important risk factor for women is the experience of menopause; in fact, this condition is very complex, and psychological support is necessary for the management of this experience.

In other developmental conditions, such as adolescence, women are exposed to negative emotions, mental pain, or loneliness, and are at major risk of suicide behavior, altered eating habits, and the onset of eating and nutrition disorders.

The psychological assessment and prevention of women’s mental health brings attention to the female condition, which is currently affected by a greater attention to the quality of couple's life as well as important social educational aspects in the prevention and recognition of psychological and physical violence.

Wellbeing promotion in healthcare settings is needed to increase knowledge and promote positive attitudes towards women’s mental health, also in relation to the promotion of training and assistance courses based on gender medicine.

Women’s support frameworks can have an important role in the prevention of mental diseases, especially in relation to sub-threshold conditions that do not reach clinical observations. In addition, treatments need to be sensitive to and reflect gender differences.

Prof. Dr. Carmela Mento
Dr. Maria Catena Silvestri
Guest Editors

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Keywords

women’s mental health
affective disorders
eating disorders
intimate violence
empower and personality
gender medicine

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Published Papers (10 papers)

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Research

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11 pages, 471 KiB

Open AccessArticle

Sexual Desire and Body Image. Gender Differences and Correlations before and during COVID-19 Lockdown

by Clemente Cedro, Carmela Mento, Maria Cristina Piccolo, Fiammetta Iannuzzo, Amelia Rizzo, Maria Rosaria Anna Muscatello and Gianluca Pandolfo

Int. J. Environ. Res. Public Health 2022, 19(7), 4351; https://doi.org/10.3390/ijerph19074351 - 5 Apr 2022

Cited by 5 | Viewed by 4384

Abstract

Recent literature has extensively examined sexual behavior during lockdown due to COVID-19. However, there are no recent studies that have considered the relationship between body image quality, sexual arousability, and sexual anxiety. The present study has two main objectives: (1) to examine gender differences in bodily and sexual experience; and (2) the comparison of bodily and sexual experience, before and during the COVID-19 lockdown. A total of 301 adult subjects (161 women and 140 men) aged between 16 and 73 years (Mean = 37.4; S.D. = 10.3) participated in the study. Data on biographical information were collected via an online panel. The Body Uneasiness Test (BUT) and the Sexual Arousability Inventory (SAI) were used for the assessment. Univariate ANOVA showed worse scores for women, compared with men, in terms of body image avoidance, depersonalization, overall severity of body image quality, sexual arousability, and sexual anxiety dimensions. When compared against time, only women showed significant correlations between the function of sexual arousal and all parameters concerning body image alteration. Interestingly, these correlations were weak and sporadic before lockdown, but strong and numerous during lockdown. This finding suggests that the impact of COVID-19 restrictions affected the female population more, with a profound repercussion on self-image and sexual and mental well-being. Full article

(This article belongs to the Special Issue Women's Mental Health: A Framework for Its Assessment, Prevention, and Promotion in Health Care Settings)

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15 pages, 579 KiB

Open AccessArticle

HAPPY MAMA Project (Part 2)—Maternal Distress and Self-Efficacy: A Pilot Randomized Controlled Field Trial

by Alice Mannocci, Sara Ciavardini, Federica Mattioli, Azzurra Massimi, Valeria D’Egidio, Lorenza Lia, Franca Scaglietta, Andrea Giannini, Roberta Antico, Barbara Dorelli, Alessandro Svelato, Luigi Orfeo, Pierluigi Benedetti Panici, Antonio Ragusa, Giuseppe La Torre and HAPPY MAMA Group

Int. J. Environ. Res. Public Health 2022, 19(3), 1461; https://doi.org/10.3390/ijerph19031461 - 27 Jan 2022

Cited by 1 | Viewed by 3390

Abstract

Introduction: The aim of the pilot randomized controlled field trial is to assess if a midwifery intervention is able to increase the maternal self-efficacy and reduce the stress level during the first six months after birth. Methods: The study was conducted in two different hospitals in Rome, Italy, involving women delivering at or beyond term, aged >18 years old and with normal APGAR scores of the infant. The participants were randomly divided into two groups: “Individual Intervention Group” (they received home midwifery assistance for one month after birth, I) and the “Control Group” (C). A self-administered questionnaire was administered four times: at the baseline about one week after the hospital delivery (T0), after the intervention about one month after the delivery (T1), and at three months (T2) and at six months after birth (T3). The questionnaire included different validated scales needed to assess maternal perceived self-efficacy (KPCS), parental stress scale stress (PSS) and maternal depressive risk symptoms (EPDS). Results: The study population counted 51 mothers: 28 women in the “C” group and 23 women in the “I” group. The PSS score was statistically higher in the “C” than “I” group at T1 (p = 0.024); whereas the KPCS score was statistically higher in the “I” (p = 0.039) group; EPDS score did not show significant difference between the two groups in the follow-up period. An inverse significant correlation between KPCS and PSS was found during the study window time (p < 0.0001). Conclusions: These results potentially give the opportunity to explore this area of focus further, in order to better address maternal individual needs for the successful transition to motherhood. More research in this area is required. Full article

(This article belongs to the Special Issue Women's Mental Health: A Framework for Its Assessment, Prevention, and Promotion in Health Care Settings)

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14 pages, 391 KiB

Open AccessArticle

Italian Validation of the Scale of Psychological Abuse in Intimate Partner Violence (EAPA-P)

by Giulia Lausi, Benedetta Barchielli, Jessica Burrai, Anna Maria Giannini and Clarissa Cricenti

Int. J. Environ. Res. Public Health 2021, 18(23), 12717; https://doi.org/10.3390/ijerph182312717 - 2 Dec 2021

Cited by 1 | Viewed by 2868

Abstract

Psychological and emotional forms of violence often represent a danger alarm and an important risk factor for other forms of intimate partner violence (IPV). Measuring psychological violence raises several issues of conceptualization and definition, which lead to the development of several assessment instruments; among them, the Scale of Psychological Abuse in Intimate Partner Violence (EAPA-P) showed good psychometric proprieties in a Spanish population and is used to identify which strategies are acted out to engage in psychological violence. The aim of the present study was to investigate the psychometric properties of the Italian version of EAPA-P among a group of Italian-speaking women (N = 343), thus evaluating its psychometric characteristics. Based on the English translation of the original Spanish version, an 11-item form of the EAPA-P was obtained, validity has been assessed through measures of emotion dysregulation, interpersonal guilt, conflict among partners and depression, anxiety, and stress symptomatology. Moreover, differences among groups were conducted to identify the capacity of the Italian version of EAPA-P to discriminate among women reporting experiencing psychological violence (N = 179), and who don’t (N = 150). Results showed an excellent internal validity, good correlations, and a good discriminatory ability of the scale. Strengths, limitations, and practical implications of the study have been discussed according to recent literature. Full article

(This article belongs to the Special Issue Women's Mental Health: A Framework for Its Assessment, Prevention, and Promotion in Health Care Settings)

12 pages, 356 KiB

Open AccessArticle

by Maria Di Blasi, Gaia Albano, Giulia Bassi, Elisa Mancinelli, Cecilia Giordano, Claudia Mazzeschi, Chiara Pazzagli, Silvia Salcuni, Gianluca Lo Coco, Omar Carlo Gioacchino Gelo, Gloria Lagetto, Maria Francesca Freda, Giovanna Esposito, Barbara Caci, Aluette Merenda and Laura Salerno

Int. J. Environ. Res. Public Health 2021, 18(21), 11656; https://doi.org/10.3390/ijerph182111656 - 6 Nov 2021

Cited by 12 | Viewed by 3258

Abstract

Background. A growing body of research has highlighted the negative effects of the COVID-19 pandemic on women’s mental health. Previous studies showed that women have higher levels of depression, anxiety and PTSD, and worse psychological adjustment than men, which also persisted after the earlier phase of the pandemic. This study aimed to evaluate changes in women’s psychological distress during the pandemic and to evaluate the factors that have a more significant impact in predicting women’s psychological distress. Methods. This two-wave longitudinal study (T1 = Italian first lockdown, and T2 = second phase, when the restrictive measures were eased) involved 893 women (M_age = 36.45, SD = 14.48). Participants provided demographic and health data as well as measures of psychological distress, emotion regulation processes, and ability to tolerate uncertainty. Results. No significant changes were found in women’s psychological distress between T1 and T2, i.e., during and after the first lockdown. Lower social stability status and higher maladaptive emotional coping predicted high psychological distress. Conclusions. Results showed that modifiable psychological variables play a central role in predicting distress and indicated that emotion regulation interventions might be helpful in increasing psychological resilience and mitigating the adverse impacts of the COVID-19 pandemic within the female population. Full article

(This article belongs to the Special Issue Women's Mental Health: A Framework for Its Assessment, Prevention, and Promotion in Health Care Settings)

10 pages, 543 KiB

Open AccessArticle

Health-Related Quality of Life of Elderly Women with Fall Experiences

by Jiyoung Song and Eunwon Lee

Int. J. Environ. Res. Public Health 2021, 18(15), 7804; https://doi.org/10.3390/ijerph18157804 - 23 Jul 2021

Cited by 7 | Viewed by 2729

Abstract

This study aimed to describe the health-related quality of life of elderly women with experience in fall treatment as well as to prepare basic data for the development of interventions to improve the quality of life for this group. The study was based on raw data from the 2019 Korea Community Health Survey. Using the SPSS program, the characteristics of the subjects were tested by frequency, percentage, and chi-square test. To establish the impact of fall experience on the health-related quality of life of elderly women, the OR and 95% CI were calculated using multiple logistic regression analysis. Of the 4260 people surveyed, 44.7% of the elderly women said they had a high quality of life, whereas 55.3% of the elderly women said they had a low quality of life. A younger age was associated with a better-rated health-related quality of life. Those who lived in a city and had a high level of education tended to describe a high quality of life. The quality of life was considered high by those who exercised, but low by those who were obese or diabetic. The results of this study can lead to a better understanding of the experiences of elderly women who have experienced falls, and they can be used as basic data for the development of related health programs. Full article

(This article belongs to the Special Issue Women's Mental Health: A Framework for Its Assessment, Prevention, and Promotion in Health Care Settings)

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12 pages, 1135 KiB

Open AccessArticle

HAPPY MAMA Project (PART 1). Assessing the Reliability of the Italian Karitane Parenting Confidence Scale (KPCS-IT) and Parental Stress Scale (PSS-IT): A Cross-Sectional Study among Mothers Who Gave Birth in the Last 12 Months

by Alice Mannocci, Azzurra Massimi, Franca Scaglietta, Sara Ciavardini, Michela Scollo, Claudia Scaglione and Giuseppe La Torre

Int. J. Environ. Res. Public Health 2021, 18(8), 4066; https://doi.org/10.3390/ijerph18084066 - 12 Apr 2021

Cited by 5 | Viewed by 2852

Abstract

The purposes of this study were: (1) to adapt two validated questionnaires used to evaluate maternal confidence (KPCS-IT) and maternal stress (PSS-IT) to the Italian context, in order to (2) measure the stress level and the self-efficacy in an Italian sample of mothers. The validation process has provided the construction of an online questionnaire. It was administered on a convenience mothers sample with at least a child aged 0–12 months, twice (T0 and T1) with a two day interval. Assessment of instrument stability over time was estimated by applying test–retest reliability between T0 and T1, and the Cronbach’s alpha coefficient. A cross-sectional study was carried out to assess the second aim. Italian mothers with at least one child living at home aged between 0–12 months were recruited. Statistical reliability methods were applied to assess the internal validity of the two questionnaires. PSS-IT was analyzed using univariate and multivariate statistical analyses in order to study the association between KPCS-IT, demographic and maternal characteristics. Statistical significance was established as p < 0.05. The Cronbach’s alpha reported a good level of internal consistency of the questionnaires: PSS-IT alpha = 0.862; KPCS-IT alpha = 0.801. 32% of the mothers declared low maternal confidence and the mean value of PSS-IT was 35.4 (SD = 8). The significant inverse correlation was found between the PSS-IT and the KPCS-IT (coeff = −0.353; p < 0.001): this means that a high level of perceived self-efficacy reduces the maternal stress level. The study identifies that interventions on maternal confidence can be useful to support mothers in the first months after delivery in order to prevent stress risk: the perceived self-efficacy is as a modifiable factor and the results of the study indicate that it significantly reduces the PSS-IT and EPDS scores. In future, more field trials are necessary in order to assess the realistic and feasible interventions on maternal confidence and competence to prevent maternal distress. Full article

(This article belongs to the Special Issue Women's Mental Health: A Framework for Its Assessment, Prevention, and Promotion in Health Care Settings)

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18 pages, 1591 KiB

Open AccessArticle

Analysis of Effectiveness of Individual and Group Trauma-Focused Interventions for Female Victims of Intimate Partner Violence

by María Crespo, María Arinero and Carmen Soberón

Int. J. Environ. Res. Public Health 2021, 18(4), 1952; https://doi.org/10.3390/ijerph18041952 - 17 Feb 2021

Cited by 17 | Viewed by 6317

Abstract

Group psychological programs for intimate partner violence (IPV) survivors would seem particularly useful since they contribute to interrupting women’s isolation and have cost-effectiveness advantage. This study aims to analyze whether the effectiveness of group interventions for female survivors of IPV is equivalent to that of the individual format. A cognitive-behavioral trauma-focused intervention program was applied in eight weekly sessions in Madrid (Spain) to IPV female survivors with significant posttraumatic symptoms that were randomly assigned to the individual (n = 25) or group (n = 28) intervention format. Measures of posttraumatic stress (Severity of Posttraumatic Stress Disorder Symptoms Scale), depression (Beck Depression Inventory), anxiety (Beck Anxiety Inventory), self-esteem (Rosenberg’s Scale) and social support were analyzed at pre-treatment, post-treatment, and 1-, 3-, 6- and 12-months follow-ups. A total of 28.3% of women dropped out, without significant format differences. Intervention (both formats) had significant improvements with large effect sizes in posttraumatic stress (η²_p = 0.56), depression (η²_p = 0.45), anxiety (η²_p = 0.41) and self-esteem (η²_p = 0.26) that maintained in follow-ups (p < 0.001), without significant differences between formats. Both intervention formats had different evolutions for depression and anxiety (p < 0.05), with better effects in the individual format at the first post-test measurements, but the differences tended to disappear over time. Intervention was effective in improving social support, with no significant differences between formats. All in all, both formats showed similar effectiveness. The group format could be an alternative when applying psychological interventions for female IPV survivors, since it would maintain good cost-effectiveness balance, mainly in the long-term. Full article

(This article belongs to the Special Issue Women's Mental Health: A Framework for Its Assessment, Prevention, and Promotion in Health Care Settings)

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13 pages, 4782 KiB

Open AccessArticle

Responses to Stress: Investigating the Role of Gender, Social Relationships, and Touch Avoidance in Italy

by Marcello Passarelli, Laura Casetta, Luca Rizzi and Raffaella Perrella

Int. J. Environ. Res. Public Health 2021, 18(2), 600; https://doi.org/10.3390/ijerph18020600 - 12 Jan 2021

Cited by 8 | Viewed by 3494

Abstract

Stress is a physiological response to internal and external events we call “stressors”. Response to the same daily stressors varies across individuals and seems to be higher for women. A possible explanation for this phenomenon is that women perceive sociality, relationships, and intimacy—important sources of both stress and wellbeing—differently from how men experience them. In this study, we investigate how gender, attachment, and touch avoidance predict stress responses on a sample of 335 Italians (216 females; age = 35.82 ± 14.32). Moreover, we analyze the network of relationships between these variables through multiple linear regression and exploratory network analysis techniques. The results recontextualize the role of gender in determining stress responses in terms of (lack of) confidence and touch avoidance toward family members; attitudes toward relationships seem to be the main determinants of stress responses. These results have implications for reducing stress in both clinical settings and at a social level. Full article

(This article belongs to the Special Issue Women's Mental Health: A Framework for Its Assessment, Prevention, and Promotion in Health Care Settings)

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8 pages, 327 KiB

Open AccessArticle

Exploring the Gender Difference and Predictors of Perceived Stress among Students Enrolled in Different Medical Programs: A Cross-Sectional Study

by Carmenrita Infortuna, Francesco Gratteri, Andrew Benotakeia, Sapan Patel, Alex Fleischman, Maria Rosaria Anna Muscatello, Antonio Bruno, Rocco Antonio Zoccali, Eileen Chusid, Zhiyong Han and Fortunato Battaglia

Int. J. Environ. Res. Public Health 2020, 17(18), 6647; https://doi.org/10.3390/ijerph17186647 - 11 Sep 2020

Cited by 18 | Viewed by 3720

Abstract

Female medical students seem to experience higher level of perceived stress. Moreover, there is a lack of research examining perceived stress in students enrolled in different medical programs. We analyzed the association between temperament traits, optimism, self-esteem, and perceived stress of students pursuing a Doctor of Medicine (MD) degree and students pursuing a Doctor of Podiatric Medicine (DPM) degree. A cross-sectional study was conducted of two cohorts: allopathic medical students (N = 154) and the podiatric medical students (N = 150). Students anonymously completed the Perceived Stress Scale (PSS-10), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto Questionnaire (TEMPS-A), Rosenberg Self-Esteem Scale, and Life Orientation Test—Revised (LOT-R). We analyzed differences in the two cohort of students and predictors of perceived stress. There were no differences in the overall perception of stress between both cohorts (allopathic medical students: 18.83 ± 0.56; podiatric medical students: 19.3 ± 0.72; p = 0.4419). Women reported higher perceived stress in both programs (allopathic medical students: p = 0.0.038; podiatric medical students: p = 0.0.038). In both allopathic and podiatric medical students, the cyclothymic temperaments and anxious traits were positive predictors while hyperthymic temperaments and optimism traits were negative predictors of perceived stress. The level of perceived stress experienced by students pursuing different doctoral degrees in healthcare is similar. Regardless of the curriculum differences, female students experience higher perceived stress and there is evidence for similarities in predictors amongst allopathic and podiatric medical students. Full article

(This article belongs to the Special Issue Women's Mental Health: A Framework for Its Assessment, Prevention, and Promotion in Health Care Settings)

Review

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14 pages, 1050 KiB

Open AccessReview

Psychological Impact of Pro-Anorexia and Pro-Eating Disorder Websites on Adolescent Females: A Systematic Review

by Carmela Mento, Maria Catena Silvestri, Maria Rosaria Anna Muscatello, Amelia Rizzo, Laura Celebre, Martina Praticò, Rocco Antonio Zoccali and Antonio Bruno

Int. J. Environ. Res. Public Health 2021, 18(4), 2186; https://doi.org/10.3390/ijerph18042186 - 23 Feb 2021

Cited by 28 | Viewed by 15851

Abstract

(1) Background: Teenagers (in particular, females) suffering from eating disorders report being not satisfied with their physical aspect and they often perceive their body image in a wrong way; they report an excessive use of websites, defined as PRO-ANA and PRO-MIA, that promote an ideal of thinness, providing advice and suggestions about how to obtain super slim bodies. (2) Aim: The aim of this review is to explore the psychological impact of pro-ana and pro-mia websites on female teenagers. (3) Methods: We have carried out a systematic review of the literature on PubMed. The search terms that have been used are: “Pro” AND “Ana” OR “Blogging” AND “Mia”. Initially, 161 publications were identified, but in total, in compliance with inclusion and exclusion criteria, 12 studies have been analyzed. (4) Results: The recent scientific literature has identified a growing number of Pro Ana and Pro Mia blogs which play an important role in the etiology of anorexia and bulimia, above all in female teenagers. The feelings of discomfort and dissatisfaction with their physical aspect, therefore, reduce their self-esteem. (5) Conclusion: These websites encourage anorexic and bulimic behaviors, in particular in female teenagers. Attention to healthy eating guidelines and policies during adolescence, focused on correcting eating behavioral aspects, is very important to prevent severe forms of psychopathology with more vulnerability in the perception of body image, social desirability, and negative emotional feedback. Full article

(This article belongs to the Special Issue Women's Mental Health: A Framework for Its Assessment, Prevention, and Promotion in Health Care Settings)

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