Trump World: What Do Women Want?

Abstract

Feminism and the role and rights of women became a central theme of the 2016 presidential election. Trump, since taking office, has acted in ways that directly and adversely affect women. One issue that unites both the women who voted for and those who voted against Trump is the conviction that the world has become a threatening, dangerous, and treacherous place. What is, or could be, the unique contribution of psychoanalysis to this dangerous political climate? What we do have to offer is our expertise as listeners, our ability to hold opposing and even contradictory views in mind simultaneously and our ability to maintain an attitude of neutrality. As such, we are in a position to facilitate dialogue between groups and individuals who have become polarized. Without dialogue, splits become even more extreme and those on the “other side” are increasingly vilified, their views exaggerated.     

Working conditions of male and female psychiatrists

The percentage of females among Danish medical graduates has increased from 1% in 1900-10 to 33% in 1980-84. In 1980 women doctors comprised 21% of all Danish medical doctors; the percentage among psychiatrists was 29. The purpose of the study has been to analyse the job-profiles of male and female psychiatrists, and their activities in research, teaching, committees, etc. The job-profiles of males and females differ, females more likely being in less influential positions. Based on an investigation among members of the Danish Psychiatric Association, the working conditions and professional activity of 307 male and female psychiatrists were analysed. Male psychiatrists were found to complete their training at a younger age than females. Among those aged 25-44, 29% of males and 6% of females had reached a position as chief consultant. Males report greater activity in all areas of research, and 35% of females and 17% of males do not research at all. In all age groups and all fields investigated more males take part in organisational activities, while 48% of females and 25% of males report no such activity. No difference was found regarding teaching experience, but men were relatively more often involved in teaching professional groups and women, nursing staff. A significant preponderance of males had their main interest in biological psychiatry, females in psychotherapy.     

Catamenial epilepsy occurrence and patterns in a mixed population of women with epilepsy

We evaluated the occurrence and distribution of patterns of catamenial epilepsy in a heterogenous cohort of women with epilepsy on no hormonal therapies, enrolled in a prospective, observational study. The primary aim of the study was pregnancy rate in women with epilepsy with no prior reproductive problems. In this analysis, we included women who recorded one or more menstrual cycles with one or more seizures. We measured progesterone concentrations for one to three cycles. We defined catamenial patterns as twofold or greater average daily seizure frequency around menstruation (C1), ovulation (C2), and for anovulatory cycles, from midcycle through menstruation (C3). Twenty-three of the 89 enrolled women with epilepsy were eligible for this analysis; 12 of 23 met criteria for catamenial epilepsy; five of 23 demonstrated only a C1 pattern, two of 23 only a C2 pattern, five of 23 a combined C1/C2 pattern, and the one woman with anovulatory cycles did not demonstrate a C3 pattern. There were no differences in likelihood of demonstrating a catamenial pattern between those who reported a prior catamenial pattern and those who did not (p = .855). This analysis demonstrates the utility of app-based tracking to determine a catamenial pattern. Larger prospective studies could confirm these findings and inform potential therapeutic trial designs for catamenial epilepsy.     

Characteristics of women seeking treatment for premenstrual syndrome in Taiwan

OBJECTIVE: To analyze the characteristics of 150 women who visited a premenstrual syndrome (PMS) clinic in a Taiwanese medical center staffed by both psychiatrists and gynecologists. METHOD: All subjects were interviewed and assessed for premenstrual dysphoric disorder (PMDD) using DSM-IV criteria, a PMS questionnaire, and the structured Mini-International Neuropsychiatric Interview (MINI). Where PMDD was suspected, subjects were followed using a daily symptom record. RESULTS: A total of 110 subjects (73%) met the ICD-10 criteria for PMS. The most common PMS symptoms were minor psychological discomfort, muscular tension, and aches or pains. For 129 subjects (86%), other concurrent psychiatric disorders were diagnosed using the MINI. Of these, 48 (37%) reported premenstrual exacerbation (PME) of a previously diagnosed psychiatric condition. CONCLUSION: The results of this study indicate that women who complain of PMS may be at a high risk of other psychiatric dysfunction, especially mood disorder. Further, the high proportion of PME cases determined in this study suggests that further investigation is required.     

Screening of antenatal depression in Pakistan: risk factors and effects on obstetric and neonatal outcomes

Introduction: To determine the frequency of probable antenatal depression (AD) in pregnant women in third trimester, assess the risk factors and its impact on obstetric and neonatal outcomes in a developing country. Methods: A prospective study conducted in a tertiary care hospital in Lahore from March 2007 to July 2007. Two hundred and thirteen pregnant women in the third trimester, attending the Gynecology Outpatient Clinic were recruited. They were assessed by a semistructured questionnaire to gather demographic details and various risk factors for AD. AD was assessed by Edinburgh Postnatal Depression Scale. All women were followed until delivery to determine their obstetric and neonatal outcomes. Results: Out of 213 women, 91 (42.7%) scored above the cut‐off for AD. More women with depression reported problems in their marriage, problems with parents/in laws, history of domestic violence, past history of psychiatric problems and history of postnatal depression. In the obstetric risk factors history of previous miscarriages, stillbirths, and complications in previous pregnancy reached statistical significance. Thirty‐seven (17.3%) women were lost to follow up. Women with AD had more obstetric complications during delivery. Babies of mothers with AD had significantly low birth weight, as well as low mean APGAR scores at 1 and 5 minutes following birth. Discussion: AD is a common problem in Pakistani Society. In view of the risk factors and adverse outcomes associated with depression during pregnancy, there is need for close liaison between Gynaecologists and Psychiatrists in managing these patients.     

Life events,number of social relationships,and twelve-month naturalistic course of major depression in a community sample of women

Research suggests that negative life events and social support are associated with the course of major depressive episodes. However, the manner in which these variables may be specifically interrelated remains unclear. The present study compared two models of the relation among life events, number of social relationships, and the naturalistic course of major depression in a community sample of women. The life event profiles of 32 women were assessed during their index episode of major depression (T1) and again 1 year later (T2). Measures included the Hamilton Depression Rating Scale, the Beck Depression Inventory, and the Life Events and Difficulties Schedule. Data analysis focused on whether life events and social relationships were independent predictors of depressive symptomatology (i.e., "main effects" model) or whether social relationships moderated the influence of life events on the naturalistic course of participants' major depressive episodes (i.e., "stress buffering" model). The results only partially supported the main effects model and failed to support the buffering model of the relation among life events, social relationships, and naturalistic depression course. In particular, the present findings indicated that number of social relationships was a significantly stronger predictor of naturalistic depression course than were life events. These findings suggest that insufficient social support is a particularly strong prospective predictor of elevated depressive symptomatology. Determining the quality of patients' social support networks should be a regular part of clinical assessment, and efforts should be made to help depressed patients establish supportive relationships both in the therapeutic environment and in their personal lives.     

Recruitment and consent of women with intellectual disabilities in a randomised control trial of a health promotion intervention

Background The need for evidence‐based health promotion interventions for women with intellectual and developmental disabilities is critical. However, significant barriers impede them from participating in research, including those related to recruitment and obtaining informed consent. Methods This study describes a procedure for the recruitment and consent of women with intellectual disabilities into a community‐based, multi‐site randomised controlled trial. Results Of 269 women who participated in information sessions, 203 (75%) enrolled in the study. While women with and without legal guardians consented at the same approximate rates (83% and 85%, respectively), those with legal guardians enrolled at significantly lower rates (61%) because of lower rates (74%) of guardian consent. Conclusions It is possible to recruit community‐dwelling women with intellectual disabilities into randomised controlled trials at relatively high participation rates. Recruiting women who have guardians poses additional challenges for researchers.     

The Impact of Sex-Specific Survival on the Incidence of Dementia in Parkinson's Disease

Objective

The aim of our study is to analyze sex-specific patterns of Parkinson's disease dementia (PDD) incidence. We are investigating the extent to which sex differences in survival after initial Parkinson's disease (PD) diagnosis influence differences in PDD risk among PD patients.

Methods

We used a random sample of German longitudinal health claims data of persons ages 50+ (2004–2019; n = 250,000) and identified new PD cases ages 65+ who were followed-up for a PDD diagnosis or death between 2006 and 2017. We performed Cox and competing-risk regression models, with death as competing event, to calculate PDD hazard ratios (HR) adjusted for age at PD onset, PD severity as measured by the modified Hoehn and Yahr (HY) scale, comorbidities, and medications.

Results

Of 2195 new PD cases, 602 people died before PDD and 750 people developed PDD by the end of 2017. The adjusted risk of PDD differs by sex, with men having a higher PDD risk than women. When accounting for death, men and women do not differ in their PDD risk (HR = 1.02, P = 0.770). Sex-specific analyses showed significant age and severity effects in women (age: HR = 1.05, P < 0.001; HY 3–5 vs. 0–2.5: HR = 1.46, P = 0.011), but not in men.

Conclusion

Older age at first PD diagnosis and higher disease severity increase PDD risk, but this association is attenuated for PD men when controlling for death. This implies that the most frail PD men die rapidly before receiving a dementia diagnosis, whereas women with PD survive at higher rates, regardless of their age at onset and disease severity. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.     

Changes,changes? Women's experience of sexuality in later life

ABSTRACT

Research employing representative samples has provided data about the sexual expression of older adults in the past decade. The results indicate that sexual activity declines with age. Most of the data are quantitative. The purpose of this research was to study the lived experience of women aged 55–80. We ask: how does women's sexuality change in later life, and how do women experience these changes? We conducted face-to-face interviews with 24 women aged 55–80; all self-identified as heterosexual. Most of the women recounted declining sexual desire in the recent past; some attributed it to feeling less attractive or “frumpy”, others to physical changes that made sexual activity uncomfortable, and others to partners’ health problems. Paradoxically, only a minority reported declining frequency of sexual activity, while others reported stable frequencies, citing the importance of sex to the relationship. A minority described increased frequency, in some cases associated with entering a new relationship. Most women reported reacting to the changes by exercising agency; they described a diverse set of behavioral changes designed to maintain or enhance sexual expression. Our results provide insights into older women's experiences of change in sexuality, and their use of agency to cope with these changes.     

Unmet Needs of Women Living with Parkinson's Disease: Gaps and Controversies

Personalized medicine considering sex, gender, and cultural context has become the vanguard of delivery of care. However, women's issues in Parkinson disease (PD), especially from a psychosocial standpoint, have been an overlooked field. The key research areas include women-inclusive drug and device studies and genetic and hormonal considerations. Moreover, women with PD need to be educated and empowered on how to communicate their symptoms and needs, get engaged in research, get organized as a community, and support one another. Women with PD need tools to help track and convey their unique motor and nonmotor symptoms and psychological and social support needs. The management of PD needs to be customized to include the unique stages of women's lives, including menstrual cycles, pregnancy, perimenopause, menopause, and postmenopause. Specific guidelines for the use of hormonal treatments and customized dopamine replacement dosing need to be developed. Women need guidance on culturally sensitive wellness and self-care strategies that are customized for them. Basic core competencies in knowledge for all clinicians treating women with PD need to be established, including how to accurately diagnose, proactively identify, and treat the symptoms of PD in women and to ensure timely referral for specialty care, advanced therapies, and research studies. Caregivers and families need guidance on holistically supporting women with PD. The voices of women living with PD must be amplified to catalyze real change in this neglected field. This paper provides an overview of the current knowledge, gaps, and possible strategies to deal with the unmet needs of women living with PD with a focus on the clinical and psychosocial aspects. © 2022 International Parkinson and Movement Disorder Society     

Men and women differ in the neural basis of handwriting

There is an ongoing debate about whether, and to what extent, males differ from females in their language skills. In the case of handwriting, a composite language skill involving language and motor processes, behavioral observations consistently show robust sex differences but the mechanisms underlying the effect are unclear. Using functional magnetic resonance imaging (fMRI) in a copying task, the present study examined the neural basis of sex differences in handwriting in 53 healthy adults (ages 19–28, 27 males). Compared to females, males showed increased activation in the left posterior middle frontal gyrus (Exner's area), a region thought to support the conversion between orthographic and graphomotor codes. Functional connectivity between Exner's area and the right cerebellum was greater in males than in females. Furthermore, sex differences in brain activity related to handwriting were independent of language material. This study identifies a novel neural signature of sex differences in a hallmark of human behavior, and highlights the importance of considering sex as a factor in scientific research and clinical applications involving handwriting.     

Sexual adjustment of women after gynaecological and breast cancer

Following treatment for gynaecological or breast cancer, most women eventually successfully re-establish some sexual activity. Motivation to resume sexual contact after treatment for cancer appears to be more important than the type of physical handicap caused by the treatment. It is extremely important to provide adequate information and counselling for the patient and her partner during the process of adjustment. In practice, it appears that this is often neglected. A stepwise model of patient information and support is presented which aims to offer a solution.     

Calming the tempest,bridging the gorge: healing in couples ruptured by “sex addiction”

Frequently couples seek marital therapy for the painful impact of one partner's “sex addiction.” Disagreement abounds in both the clinical world and the larger society, about what the designation “sex addiction” actually means. A variety of diagnostic categories are subsumed under it, creating confusion about both its causes and effective treatments. The current paper proposes precise definition and diagnostic language regarding a range of compulsive sexual behaviors. It maps a model for understanding and treating compulsive sexual activity in marital therapy in a stepwise sequence, beginning with careful history taking and diagnostics of both partners, identification of the mutually reinforcing relationship dynamics keeping destructive behaviors in play, processing of underlying psychological and developmental roots of such behaviors, cultivation of empathy and trust, and revitalizing of the couple's sexual relationship. The method is illustrated with a case history.