Women's Mental Health and Addictions Research: Research Annual Report 2002

The Women's Mental Health and Addiction Research Section is dedicated to developing health care that is more responsive to the needs of women. We focus on social, psychological and biological factors to further our understanding of the origin, expression, prevention and treatment of mental health problems and addictions in women. We seek partnerships with a diversity of women to conduct research that will be helpful to all women with mental health and addiction issues.

The section continues to focus on multidisciplinary research collaboration at international and local levels. This year, we strengthened our links to the Clinical Division at CAMH by formally integrating into our section Drs. Nili Benazon and Noreen Stuckless, who are research scientists in the Society, Women and Health Program. The following highlights represent selections of our ongoing and new initiatives.

Functional Gastrointestinal Disorders in Women : Multicentre Trial of Functional Bowel Disorders

The Women's Mental Health and Addiction Research Section has completed recruitment for a study by the United States National Institute of Heath for a multicentre trial of functional bowel disorders. We are now in the data analysis phase of the study.

This ongoing study is a unique collaboration between mental health professionals and gastroenterologists from the University of Toronto and the University of North Carolina. We hope to improve understanding and treatment of these chronic and debilitating illnesses that are mainly diagnosed in women.

This study is the first to take a holistic view of these disorders, assessing both the biological and psychosocial impact of cognitive-behavioural therapy versus antidepressant medication. Several papers, abstracts and presentations have been produced from this rich database over the past four years. We anticipate several more papers to be submitted for publication over the next several months.

Gender Role Socialization : Development of Gender Role Scale for Women

Gender role socialization refers to the internalization of prescribed gender role messages for women as depicted by multiple sources in society. Theoretical literature suggests that many mental health problems experienced by women are influenced by socialization into the female gender role. We do not yet have a validated tool that measures gender role socialization.

Our group continues working to develop such a tool -- a scale to reflect the diversity of women's experience in this area. This scale will serve as a predictive and outcome measure in feminist-informed treatment interventions for women.

We have recently received funding from the Social Sciences and Humanities Research Council of Canada to support this ongoing work for the next three years.

Gender Role Messages for Women: An Intervention

Feminist researchers and clinicians agree on the need to develop interventions that expose and challenge gender role messages for women. However, no existing interventions provide a systematic and detailed account of possible themes and sessions for group or individual therapy with women. As well, very little work has been devoted to empirically testing the efficacy of feminist-informed therapies.

Our group developed an intervention that brings women together across diagnostic categories and encourages women, in a supportive and normalizing shared environment, to openly explore how gender role messages may have affected their sense of well-being. Our group continues to test the efficacy of this approach against more traditional forms of therapy. This project is a collaboration between feminist therapists and researchers in the Society, Women and Health Program and our section.

We have recently written a prospectus for this work, called Exposing and Challenging Gender Role Messages for Women: Theoretical, Empirical and Clinical Perspectives. We are currently looking for a publisher for this work.

Complex Post-traumatic Stress Disorder

Dr. Linda McLean received an Eli Lilly Canada Fellowship in Women's Mental Health Research. This fellowship will help facilitate a program of research called "The development of a complex post-traumatic stress disorder, dissociation, somatization, childhood trauma, and alexithymia in an outpatient sample of women."

The objective of this research will be to examine the strength of the relationship between the diagnosis of complex post-traumatic stress disorder, "early" (i.e., 12 years of age or less) childhood trauma variables, dissociation, somatization and alexithymia. We hope the findings will advance the understanding of the course, expression, prevention and clinical implications of such childhood experience(s), and inform treatment.

Trichotillomania

Using qualitative methodologies, Josee Casati has played a leadership role in identifying themes involving women's experiences with trichotillomania or compulsive hair pulling. Specifically, the purpose of this study was to better understand how women with trichotillomania conceptualized their condition, what their worries and concerns were and what feelings were associated with their hair pulling.

The study identified ten major themes prominent for women with trichotillomania, including embarrassment/shame, isolation, fear/guilt, anger/frustration, humiliation/pain, body image, lack of control, self-disclosure, lack of information from the medical community and precipitating triggers.

Findings from this study point to the importance of acknowledging and addressing psychosocial concerns for women with trichotillomania. Increasing our understanding of psychosocial issues underlying compulsive hair-pulling will contribute to improved treatment strategies for women.

Immigrant Women and Women of Colour

Dr. Alisha Ali, who has worked at CAMH as a research scientist, has accepted a position as Assistant Professor in the Department of Applied Psychology at New York University. We are also pleased to state that Alisha will continue to collaborate with our important work focusing on immigrant women and women of colour and with our ongoing research on gender role socialization.

Life Role Changes that Contribute to Well-Being among Immigrant Chinese Women

Taryn Tang leads this program of research, now in its second year, that examines Chinese immigrant women's negotiation of change in their lives and the types of mechanisms and processes that contribute to adjustment in Canada.

Anticipating and meeting the needs of a healthy population in a given society is a preventative measure that is a more cost-effective long-term solution than retrospectively maintaining
the health demands of an ill population. This research can inform the investment practice of governments: we will compare different models of coping and support to develop an understanding of factors that guard against mental illness and promote mental health.

Training and Education

The Women's Mental Health and Addiction Research Section is also active in professional training, media presentations and public forums with a view of influencing the provision of care to women locally and internationally. In particular, we have been active in teaching undergraduate, graduate and post-graduate levels in psychiatry and psychology. We encourage electives, fellowships and post-doctoral positions in Women's Mental Health and Addiction, and are particularly interested in helping to develop academic careers in women's health. To increase communication among all staff and students interested in women's health issues, we developed and maintain the city-wide Women's Mental Health Interest Group in Toronto, a group that arranges monthly presentations on issues across the spectrum of women's health.