Library Watch - On Women

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...on Women

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Summer 2010

Pilot study of inducing smoking cessation attempts by activating a sense of looming vulnerability.

McDonald D; O'Brien J; Farr E; Haaga DAF. Addictive Behaviors 35(6): 599-606, 2010. (39 refs.)
Despite widespread knowledge of the negative health consequences of cigarette smoking, in 2007 a majority (60%) of daily smokers in the USA did not make a quit attempt lasting at least 24 h. Drawing on Riskind's looming cognitive vulnerability model of anxiety, we developed a guided imagery induction intended to increase smokers' perceived susceptibility to the consequences of continued smoking and thereby to increase quit attempts. In a pilot study of this induction, 72 adult daily smokers were randomly assigned to the looming imagery condition or to a control condition exposed to guided imagery that did not concern smoking or its dangers. Those in the looming condition reported significantly higher state anxiety and highly accessible negative outcome expectancies for smoking immediately after the induction, and a significantly lower smoking rate in the month after the experiment. Nonsignificant trends favored the looming condition also for increasing contemplation of quitting, self-efficacy for abstaining from cigarettes, intrinsic motivation to quit as a function of health concerns, and most importantly the likelihood of making a quit attempt in the month following the experiment. Further development and testing of the looming induction as a way to motivate quit attempts is warranted.

Factors related to loss of child custody in HIV plus women in drug abuse recovery.

Mitrani VB; Weiss-Laxer NS; Feaster DJ. American Journal of Drug and Alcohol Abuse 35(5): 320-324, 2009. (25 refs.)
Background: Mothers who are dually-diagnosed with HIV/AIDS and drug abuse are particularly burdened and vulnerable to loss of child custody. Objectives: This study explores factors associated with child custody loss among HIV+ women in drug abuse recovery, and compares mothers who have custody of their children to mothers who do not have custody of all of their children. Methods: Descriptive analyses were conducted on 68 HIV+ mothers in drug recovery, 46% who had custody of all of their children, and 54% who did not. Results: The lost-custody group was less likely to be employed and had more history of violent impulses and arrest, particularly on drug charges. The groups reported similar recent and lifetime drug use patterns, but the custody group had received more drug treatment. Post-hoc analyses found the lost-custody group had lower rates of participation in the interventions offered in the parent clinical trial and higher avoidant coping. Conclusions: The sample in the current study supports that HIV+ women in drug recovery are at high risk of loss of child custody. Non-adherence to available treatment seems to be associated with loss of child custody. Scientific significance: Results suggest the need for further research and active treatment outreach for this population.

Maternal alcohol consumption during pregnancy and infant social, mental, and motor development.

Brown CW; Olson HC; Croninger RG. Journal of Early Intervention 32(2): 110-126, 2010. (55 refs.)
Maternal alcohol consumption during pregnancy is a significant social problem associated with developmental difficulties in young children. Child developmental and behavioral characteristics were examined from the 9-month data point of the Early Childhood Longitudinal Studies-Birth Cohort, a prospective nationally representative study. Several findings indicate linear patterns between the amount of prenatal alcohol dosage and sensory regulation, mental, and motor development outcomes. Undesirable social engagement and child interaction were found to be statistically significant at the prenatal alcohol level of one to three drinks per week. Children exposed to four or more drinks per week showed statistically significant and clinically passive behavior on three sensory regulation variables.

The comorbidity of substance use disorders and eating disorders in women: Prevalence, etiology, and treatment. (review).

Harrop EN; Marlatt GA. Addictive Behaviors 35(5): 392-398, 2010. (30 refs.)
Substance use disorders often co-occur with eating disorders in female populations. This review addresses the prevalence and etiology of this comorbidity in women. Thirteen peer reviewed journal articles are reviewed. Conclusions are drawn concerning prevalence rates, theory, and implications for treatment. Current research supports distinct etiologies and growth trajectories for both disorders. Thus, comorbidity presents with unique challenges, and often, worse outcomes. Though comorbidity rates are high, little research has been done concerning treatment. Given the high prevalence rates of these comorbid disorders, a specific treatment needs to be developed that targets both disorders simultaneously.

Brief screening questionnaires to identify problem drinking during pregnancy: A systematic review. (review).

Burns E; Gray R; Smith LA. Addiction 105(4): 601-614, 2010. (80 refs.)
Aims: Although prenatal screening for problem drinking during pregnancy has been recommended, guidance on screening instruments is lacking. We investigated the sensitivity, specificity and predictive value of brief alcohol screening questionnaires to identify problem drinking in pregnant women. Methods: Electronic databases from their inception to June 2008 were searched, as well as reference lists of eligible papers and related review papers. We sought cohort or cross-sectional studies that compared one or more brief alcohol screening questionnaire(s) with reference criteria obtained using structured interviews to detect 'at-risk' drinking, alcohol abuse or dependency in pregnant women receiving prenatal care. Results: Five studies (6724 participants) were included. In total, seven instruments were evaluated: TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), T-ACE [Take (number of drinks), Annoyed, Cut down, Eye-opener], CAGE (Cut down, Annoyed, Guilt, Eye-opener], NET (Normal drinker, Eye-opener, Tolerance), AUDIT (Alcohol Use Disorder Identification Test), AUDIT-C (AUDIT-consumption) and SMAST (Short Michigan Alcohol Screening Test). Study quality was generally good, but lack of blinding was a common weakness. For risk drinking sensitivity was highest for T-ACE (69-88%), TWEAK (71-91%) and AUDIT-C (95%), with high specificity (71-89%, 73-83% and 85%, respectively). CAGE and SMAST performed poorly. Sensitivity of AUDIT-C at score >= 3 was high for past year alcohol dependence (100%) or alcohol use disorder (96%) with moderate specificity (71% each). For life-time alcohol dependency the AUDIT at score >= 8 performed poorly. Conclusion: T-ACE, TWEAK and AUDIT-C show promise for screening for risk drinking, and AUDIT-C may also be useful for identifying alcohol dependency or abuse. However, their performance as stand-alone tools is uncertain, and further evaluation of questionnaires for prenatal alcohol use is warranted.

Alcoholic liver injury: Influence of gender and hormones.

Eagon PK. World Journal of Gastroenterology 16(11): 1377-1384, 2010. (84 refs.)
This article discusses several subjects pertinent to a consideration of the role of gender and hormones in alcoholic liver injury (ALI). Beginning with an overview of factors involved in the pathogenesis of ALI, we review changes in sex hormone metabolism resulting from alcohol ingestion, summarize research that points to estrogen as a cofactor in ALI, consider evidence that gut injury is linked to liver injury in the setting of alcohol, and briefly review the limited evidence regarding sex hormones and gut barrier function. In both women and female animals, most studies reveal a propensity toward greater alcohol-induced liver injury due to female gender, although exact hormonal influences are not yet understood. Thus, women and their physicians should be alert to the dangers of excess alcohol consumption and the increased potential for liver injury in females.

Severity of withdrawal symptomatology in follicular versus luteal quitters: The combined effects of menstrual phase and withdrawal on smoking cessation outcome.

Allen AM; Allen SS; Lunos S; Pomerleau CS. Addictive Behaviors 35(6): 549-552, 2010. (23 refs.)
Women are at an increased risk of relapse after a smoking cessation attempt. While the reasons for this phenomenon are not fully understood, recent research indicates that both the menstrual cycle and negative symptomatology may play a role. The goal of this study was to describe the association between withdrawal symptoms during attempted smoking cessation, and to investigate the impact of these symptoms on smoking cessation outcomes as defined by 7-day point prevalence at 14 and 30 days. Negative symptoms associated with the premenstrual period were also assessed. Participants (n = 202) were 29.8 (SD +/- 6.6) years old and smoked 16.6 (SD +/- 5.6) cigarettes per day. They were randomly assigned to quit smoking in the follicular (n = 106) or luteal (n = 96) menstrual phase. We observed several significantly more severe premenstrual and withdrawal symptoms in the luteal phase. Regardless of quit phase, most withdrawal symptoms were associated with an increased risk of relapse at 14 and 30 days post quit date. Participants: attempting to quit smoking in the follicular phase who had higher levels of Anger and Craving were more likely to relapse to smoking at 14-days (OR = 2.00, p-value = 0.026; OR = 2.63, p-value = 0.006; respectively). These data suggest that the menstrual cycle may play a role in smoking cessation outcome, as well as in the symptomatology experienced during a cessation attempt.

Struggling to survive: Sexual assault, poverty, and mental health outcomes of African American women.

Bryant-Davis T; Ullman SE; Tsong Y; Tillman S; Smith K. American Journal of Orthopsychiatry 80(1): 61-70, 2010. (90 refs.)
A substantial body of research documents the mental health consequences of sexual assault including, but not limited to, depression, posttraumatic stress disorder, substance use, and suicidality. Far less attention has been given to the mental health effects of sexual assault for ethnic minority women or women living in poverty. Given African American women's increased risk for sexual assault and increased risk for persistent poverty, the current study explores the relationship between income and mental health effects within a sample of 413 African American sexual assault survivors. Hierarchical regression analyses revealed that after controlling for childhood sexual abuse there were positive relationships between poverty and mental health outcomes of depression, posttraumatic stress disorder, and illicit drug use. There was no significant relationship between poverty and suicidal ideation. Counseling and research implications are discussed.

Alcohol consumption, weight gain, and risk of becoming overweight in middle-aged and older women. (editorial).

Wang L; Lee IM; Manson JE; Buring JE; Sesso HD. Archives of Internal Medicine 170(5): 453-461, 2010. (42 refs.)
Background: The obesity epidemic is a major health problem in the United States. Alcohol consumption is a source of energy intake that may contribute to body weight gain and development of obesity. However, previous studies of this relationship have been limited, with inconsistent results. Methods: We conducted a prospective cohort study among 19,220 US women aged 38.9 years or older who were free of cardiovascular disease, cancer, and diabetes mellitus and had a baseline body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) within the normal range of 18.5 to less than 25. Alcoholic beverage consumption was reported on a baseline questionnaire. Body weight was self-reported on baseline and 8 annual follow-up questionnaires. Results: There was an inverse association between amount of alcohol consumed at baseline and weight gained during 12.9 years of follow-up. A total of 7942 (41.3%) initially normal-weight women became over-weight or obese (BMI >= 25) and 732 (3.8%) became obese (BMI >= 30). After adjusting for age, baseline BMI, smoking status, nonalcohol energy intake, physical activity level, and other lifestyle and dietary factors, the relative risks of becoming overweight or obese across total alcohol intake of 0, more than 0 to less than 5, 5 to less than 15, 15 to less than 30, and 30 g/d or more were 1.00, 0.96, 0.86, 0.70, and 0.73, respectively (P for trend <.001). The corresponding relative risks of becoming obese were 1.00, 0.75, 0.43, 0.39, and 0.29 (P for trend <.001). The associations were similar by subgroups of age, smoking status, physical activity level, and baseline BMI. Conclusion: Compared with nondrinkers, initially normal-weight women who consumed a light to moderate amount of alcohol gained less weight and had a lower risk of becoming overweight and/or obese during 12.9 years of follow-up.

Is smoking in pregnancy an independent predictor of academic difficulties at 14 years of age? A birth cohort study.

O'Callaghan FV; Al Mamun A; O'Callaghan M; Alati R; Williams GM; Najman JM. Early Human Development 86(2): 71-76, 2010. (35 refs.)
Background. Studies of the effects of maternal smoking during pregnancy have reported inconsistent findings in relation to measures of offspring cognitive functioning Few studies, however, have examined learning outcomes in adolescents, as opposed to IQ Aim To examine the association between maternal smoking during pregnancy and academic performance among adolescent offspring Study design: Population-based birth cohort study. Subjects: 7223 mothers and children were enrolled in the Mater-University of Queensland Study of Pregnancy in Brisbane (Australia) from 1981 to 1984. Analyses were restricted to the 4294 mothers and children for whom all information was reported at 14-year follow-up Outcome measures Reports of academic performance of 14-year-old offspring in English. Science and Mathematics with different patterns of maternal smoking (never smoked, smoked before and/or after pregnancy but not during pregnancy, or smoked during pregnancy) Results. Low academic achievement was more common only in those whose mothers had smoked during pregnancy. Effect sizes were, however, small. The adjusted mean difference in total learning score for smoking before and/or after pregnancy but not during pregnancy, and for smoking during pregnancy were -0.18 (-0 58, 0 22) and -0 40 (-0 69, -0 12). Similarly, the adjusted odds ratios were 0.9 (0.65, 1.24) and 1.35(1 07, 1 70) Conclusion: Maternal smoking during pregnancy is a preventable prenatal risk factor associated with small decrements in offspring academic performance that continue into adolescence.

Gender, sexuality, power and drug acquisition strategies among adolescent girls who use meth.

Lopez V; Jurik N; Gilliard-Matthews S. Feminist Criminology 4(3): 226-251, 2009. (48 refs.)
This study drew on social construction of gender and reflexive methodological approaches to examine how adolescent girls procured meth within the context of relationships with boys and men. A total of 18 incarcerated adolescent girls, aged 14 to 17 years, were interviewed about their meth-using experiences. The findings indicate that girls used five relationship strategies and one nonrelationship strategy to procure meth on the streets. Close examination revealed that girls' meth procurement strategies, with few exceptions, occurred in ways resonant with culturally dominant views of femininity (referred to hereafter as emphasized femininities). However, most girls presented themselves in interviews as breaking out of culturally prescribed constraints and crafting their own version of femininity. However, their agency was contextualized or limited by the social power relations that surrounded them.

Gender differences in the choreography of alcohol-related violence: An observational study of aggression within licensed premises.

Forsyth AJM; Lennox JC. Journal of Substance Use 15(2): 75-88, 2010. (54 refs.)
Aims: To examine patterns of gender involvement in violent incidents observed within licensed premises. Methods: Field observations were conducted in a sample of eight city centre nightclubs allowing alcohol-related aggressive incidents to be witnessed in their naturalistic setting. Results: Although most of those involved in aggressive incidents were males (108/171), many of the conflicts witnessed involved female combatants (36.8%). Additionally, female-to-female incidents were found to be as potentially injurious as those between males. Nevertheless, female-to-female and male-to-male conflicts did differ, in terms of the nature of the violence observed with, for example, female conflicts being less likely to involve an easily recognizable set pre-fight choreography. Conclusions: This research the challenges belief that female conflicts within licensed premises are less problematic than those involving males. These findings are discussed in terms of alcohol, masculinity, and harm reduction.

Women and tobacco dependence.

Reichert VC; Seltzer V; Efferen LS; Kohn N. Obstetrics and Gynecology Clinics of North America 36(4): 877-+, 2009. (70 refs.)
Millions of American girls and women have been drawn to smoking by an industry that has been clearly and systematically targeting women of all ages and life circumstances. Tobacco marketing strategies skillfully link cigarette use to typical female values. Biologically speaking, women are especially vulnerable to the legion of health problems of tobacco use. Smoking is a critical hazard for women in their reproductive years, particularly when they are pregnant.

Factors related to injection drug use among female prisoners.

Jackson DO; Cropsey KL; Weaver MF; Villalobos GC; Eldridge G; Stitzer ML. Substance Use & Misuse 45(3): 368-383, 2010. (45 refs.)
Female inmates (N = 655) of a large prison facility in the southeastern United States were surveyed about their substance use, social histories, and demographics. Multinomial logistic regression was used to identify predictors of injection drug use. The sample was primarily young (M = 34 +/- 9 years), and evenly split on race (45.3% White and 44.6% Black). Four predictors were identified as significant risk factors for injection drug use: being White, having a prior history of substance user treatment, having a prior drug-related charge, and being a problem drinker. Implications, limitations, and future directions are discussed.