Domestic Violence Research: Methodological Issues Related to a Community‐Based Intervention With a Vulnerable Population1

Presently, in our society, thousands of children, adolescents, and adults are physically, mentally, and emotionally traumatized from exposure to domestic violence (DV). Exposure to DV, defined here as male violence against their female partners, occurs among all ethnic, cultural, socioeconomic, geographical, and racial groups. DV can lead to depression, negative self‐esteem, and general psychological distress in women. Children exposed to DV have an increased risk of behavioral, emotional, and social problems. DV shelters often provide group counseling and support services for battered women, children, and adolescents residing there, but the programs do not reach the majority of women living in the broader community. Furthermore, few studies have examined the effectiveness and efficacy of support group treatment intervention programs for battered women and children. This is due, in part, to the methodological difficulties inherent in this design. As a way to meet the needs of families that have experienced DV, academic researchers from a Midwestern university and a director of counseling services from a local domestic violence agency have partnered to offer a psycho‐educational intervention designed to     

Stability and change in mothers' internal representations of their infants over time

This study examined predictors of stability and change in women's maternal representations of their children. Participants were 180 women, recruited from the community, half of whom had experienced domestic violence during pregnancy. Maternal representations of were assessed with the Working Model of the Child Interview (WMCI; Zeanah, Benoit, Hirshberg, Barton, & Regan, 1994) during the last trimester of pregnancy and again at the child's first birthday. Results indicated that when collapsed into balanced and non-balanced categories, 71% of the sample was stable over time, and women who had balanced representations had significantly more stable representations than women who had non-balanced representations (p < .001). Income, single parenthood, abuse status, and depressive symptomatology predicted change. In addition, women who became non-balanced postnatally benefited from having balanced representations while pregnant to buffer the quality of their interactions with their children.     

Griffithsin and Carrageenan Combination To Target Herpes Simplex Virus 2 and Human Papillomavirus

Extensive preclinical evaluation of griffithsin (GRFT) has identified this lectin to be a promising broad-spectrum microbicide. We set out to explore the antiviral properties of a GRFT and carrageenan (CG) combination product against herpes simplex virus 2 (HSV-2) and human papillomavirus (HPV) as well as determine the mechanism of action (MOA) of GRFT against both viruses. We performed the experiments in different cell lines, using time-of-addition and temperature dependence experiments to differentiate inhibition of viral attachment from entry and viral receptor internalization. Surface plasmon resonance (SPR) was used to assess GRFT binding to viral glycoproteins, and immunoprecipitation and immunohistochemistry were used to identify the specific glycoprotein involved. We determined the antiviral activity of GRFT against HSV-2 to be a 50% effective concentration (EC₅₀) of 230 nM and provide the first evidence that GRFT has moderate anti-HPV activity (EC₅₀ = 0.429 to 1.39 μM). GRFT blocks the entry of HSV-2 and HPV into target cells but not the adsorption of HSV-2 and HPV onto target cells. The results of the SPR, immunoprecipitation, and immunohistochemistry analyses of HSV-2 combined suggest that GRFT may block viral entry by binding to HSV-2 glycoprotein D. Cell-based assays suggest anti-HPV activity through α₆ integrin internalization. The GRFT-CG combination product but not GRFT or CG alone reduced HSV-2 vaginal infection in mice when given an hour before challenge (P = 0.0352). While GRFT significantly protected mice against vaginal HPV infection when dosed during and after HPV16 pseudovirus challenge (P < 0.026), greater CG-mediated protection was afforded by the GRFT-CG combination for up to 8 h (P < 0.0022). These findings support the development of the GRFT-CG combination as a broad-spectrum microbicide.     

Alternative Models of DSM‐5 Posttraumatic Stress Disorder in Portuguese Adolescents Exposed to Trauma and Childhood Adversity

The factor structure of DSM‐5 posttraumatic stress disorder (PTSD) has been extensively debated, with evidence supporting the recently proposed seven‐factor hybrid model. However, few studies examining PTSD symptom structure have assessed the implications of these proposed models on diagnostic criteria and PTSD prevalence. In the present study, we examined seven alternative DSM‐5 PTSD models within a confirmatory factor analysis (CFA), using the Child PTSD Symptom Scale–Self‐Report for DSM‐5 (CPSS‐5). Additionally, we generated prevalence rates for each of the seven models by using a symptom‐based diagnostic algorithm and assessed whether substance abuse, depression, anxiety symptoms, and daily functioning were differentially associated with PTSD depending on the model used to derive the diagnosis. Participants were 317 adolescents aged 13–17 years (M = 15.93, SD = 1.23) who had experienced a DSM‐5 Criterion A trauma and/or childhood adversity. The CFA results showed good fit indices for all models, with the seven‐factor hybrid model presenting the best fit. The rates of PTSD diagnosis varied according to each model. The four‐factor DSM‐5 model presented the highest rate (30.6%), and the seven‐factor hybrid model presented the lowest rate (17.4%). Similar to the CFA analysis, the inclusion criteria for the diagnosis based on the hybrid model also presented the strongest associations with daily functional impairment, odds ratio (OR) = 1.48, 95% CI [1.25, 1.75]; and adverse childhood experiences, OR = 1.46, 95% CI [1.16, 1.82]. Research and clinical implications of these results are discussed, and suggestions for future investigation are presented.     

Geotemporal analysis of perinatal care changes and maternal mental health: an example from the COVID-19 pandemic

Archives of Women's Mental Health - Our primary objective was to document COVID-19 induced changes to perinatal care across the USA and examine the implication of these changes for maternal...     

Development of a Vaginal Fast-Dissolving Insert Combining Griffithsin and Carrageenan for Potential Use Against Sexually Transmitted Infections

Precoital, on-demand topical microbicides to reduce a woman's risk of sexually transmitted infections have been in development for nearly 3 decades, but no product has been approved due to acceptability issues and poor adherence in clinical trials. We set out to develop a self-administered vaginal fast-dissolving insert (FDI) produced by freeze-drying that would deliver safe and effective amounts of the antiviral agents griffithsin (GRFT) and carrageenan (CG) and would have properties women and their partners find acceptable. We evaluated FDI physical criteria, attributes of the gel produced upon dissolving, and GRFT stability. The lead formulation, FDI-024, was selected from 13 candidates and contains 4 mg of GRFT, 15 mg of CG, and excipients (the cryoprotectant sucrose and bulking agents dextran 40 and mannitol). The FDI exhibits good friability and hardness and is stable for at least 6 months at up to 40°C/75% relative humidity. It disintegrates in less than 60 s in a physiologically relevant volume (～1 mL) of simulated vaginal fluid, forming a viscous semi-solid gel with favorable mucoadhesive and spreading properties. The formulation retains the antiviral activity of GRFT and CG against HIV type 1 and human papillomavirus, respectively, in cell-based assays.     

Phase-shifting effects of bright morning light as treatment for delayed sleep phase syndrome

Bright light has recently been shown to have phase-shifting effects on human circadian rhythms. In this study we applied this effect to 20 patients with delayed sleep phase syndrome (DSPS) who were unable to fall asleep at conventional clock times and had a problem staying alert in the morning. In a controlled treatment study, we found that 2 h of bright light exposure in the morning together with light restriction in the evening successfully phase advanced circadian rhythms of core body temperature and multiple sleep latencies in these patients. This finding corroborates the importance of light for entraining human circadian rhythms.     

Core body temperature in patients with seasonal affective disorder and normal controls in summer and winter

The rationale for phototherapy in seasonal affective disorder (SAD) was originally based on the notion that SAD patients were light deprived during the wintertime and needed more light. We previously found normal temperature profiles of untreated SAD patients during the winter, and that phototherapy significantly enhanced the amplitude of the circadian temperature profile in SAD patients during the winter (Rosenthal et al 1990). We hypothesized that summer would act similarly on the temperature rhythm of these patients. In this study we examined the temperature data from SAD patients and normal controls during the summer and compared it to the results of our previous study. We found identical profiles for SAD patients and normal controls during the summer and that summer significantly lowered the overall temperature profiles of both groups and did not alter the amplitudes. These results raise questions about the validity of the current theories of the mechanism of light therapy.     

Women survivors of intimate partner violence and post-traumatic stress disorder: prediction and prevention

A considerable body of research has demonstrated that women who are abused by their male romantic partners are at substantially elevated risk for the development of post-traumatic stress disorder (PTSD). This article reviews recent literature regarding intimate partner violence (IPV) and resultant PTSD symptoms. The article is intended to be an introduction to the topic rather than an exhaustive review of the extensive literature in this area. Factors that enhance and reduce the risk for PTSD, including social support, coping styles, and types of abusive behavior experienced, are described. In addition, the unique risks associated with IPV for women who have children are discussed. Prevention efforts and treatment are briefly reviewed.     

Introduction to the Special Section on Complex Posttraumatic Stress Disorder (CPTSD): The Evolution of a Disorder

The inclusion of complex posttraumatic stress disorder (CPTSD) in the 11th revision of the International Classification of Diseases is an important development in the field of psychotraumatology. Complex PTSD was developed as a response to a clinical need to describe difficulties commonly associated with exposure to traumatic stressors that are predominantly of an interpersonal nature. With this special section, we bring attention to this common condition following exposure to traumatic stressors that only recently has been designated an official diagnosis. In this introduction, we review the history of CPTSD as a new condition and we briefly introduce the papers for the special section in the present issue of the Journal of Traumatic Stress. It is our hope that the work presented in the special section will add to an ever‐expanding evidence base. We also hope that this work inspires further research on the cultural validity of CPTSD, its assessment, and treatment.