Women's Mental Health and Addiction: Research Annual Report 2003

Section Head: Dr. Brenda Toner

The Women's Mental Health and Addiction Research Section continues to focus on multidisciplinary research collaboration at international and local levels. This year, we have strengthened our section by recruiting two outstanding research scientists, Drs. Lori Ross and Nili Benazon. The following represent selected highlights of our new and ongoing research programs.

Mental Health Issues in Marginalized Populations of Women

In a new program, Dr. Ross has fostered collaborations with researchers and clinicians across disciplines and fields of study, including community partners, to study mental health issues in marginalized populations of women.

Examples of pilot projects in this program include studies on the role of culture in postpartum mood problems and mental health in lesbian biological mothers and co-parents.

This research seeks to examine potential relationships between experiences of discrimination (including racism and homophobia) and mental health. We also aim to determine whether existing mental services for new mothers meet the unique needs of women who are immigrants and/or identify as lesbian.

Psychosocial Issues in Medical Disorders

Dr. Benazon's area of expertise is the role of affective and anxiety disorders, as well as the family environment, on recovery from physical health conditions. A CIHR investigator, Dr. Benazon is principal investigator on a new study evaluating the quality of care for depression among cardiac patients.

Functional Gastrointestinal Disorders in Women

We completed a study, funded by the U.S. National Institute of Heath, of a multicentre trial of functional bowel disorders. We are pleased to say that that the first paper to come out of this work, "Cognitive-behavioral therapy versus education and desipramine versus placebo for moderate to severe functional bowel disorders," has recently been published in Gastroenterology, a high-impact journal in the field.

This study, a collaboration between mental health professionals and gastroenterologists from the University of Toronto (Drs. Toner and Nick Diamant) and the University of North Carolina (Drs. Bill Whitehead and Doug Drossman), aimed to improve understanding and treatment of these chronic and debilitating illnesses, which are diagnosed mainly in women.

This study is the first to take a holistic view of these disorders, assessing both the biological and psychosocial impact of cognitive behaviour therapy (CBT) versus antidepressant medication. We have continued, and expect to continue, to produce papers, abstracts and presentations from this rich database over the past five years.

We are pleased to report that we have had a large grant approved from CIHR (funds released contingent on NIH funding for U.S. collaborators) to continue this very productive program of research. Our new grant will focus on comparing the effect of combination treatment (CBT and antidepressants) versus monotreatment (CBT or antidepressants) for women with functional gastrointestinal disorders.

Development of a Gender Role Scale for Women

Theorists suggest that many mental health problems experienced by women are influenced by socialization into the female gender role. We are one year into a three-year study, funded by the Social Sciences and Humanities Research Council of Canada, to develop and validate a scale to measure gender role socialization in women.

This year, we recruited over 800 research participants from local universities, the community, and health and mental health clinics to complete the candidate items for our scale together with other questionnaires that will help us validate the scale.

Gender Role Messages for Women: An Intervention

Feminist researchers and clinicians have agreed on the need to develop interventions that expose and challenge gender role messages for women. During this year, we have further developed and refined a manual for such an intervention.

We continue to look for a publisher for our prospectus for this work, Exposing and Challenging Gender Role Messages for Women: Theoretical, Empirical and Clinical Perspectives.

Complex Post-traumatic Stress Disorder

Dr. Linda McLean's study (co-supervised by Drs. Brenda Toner and Noreen Stuckless), "The development of a complex posttraumatic stress disorder, dissociation, somatization, childhood trauma, and alexithymia in an outpatient sample of women," funded by an Eli Lilly Canada Fellowship in Women's Mental Health Research, is proceeding as planned. Participant recruitment is almost complete.

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

Ms Taryn Tang leads this longitudinal program of research that examines the transitional life event of immigration and the changes in Chinese women's roles.

This year, she has recruited 50 Chinese women using a semi-structured interview protocol. This study incorporates quantitative and qualitative research methods and analyses to examine sources of coping and support that are associated with mental health and well-being.

Trichotillomania

Ms Josee Casati is developing a research proposal to further identify themes involving women's experiences with trichotillomania, or compulsive hair pulling.

Ms Casati's previous work in this area was a qualitative study that investigated psychosocial concerns for women with trichotillomania. Critical to this was the need to understand how women with trichotillomania conceptualized their condition and what feelings and concerns were associated with their hair-pulling.

The study identified several concerns, including negative affects, control and triggers. This timely study addressed the importance of identifying and integrating psychosocial concerns into current treatment protocols.

Her current research project will examine factors that may contribute to the development of trichotillomania and affect the quality of life for women with this condition. While providing a foundation for future research, findings from this study will help to define the relationship between early life events and trichotillomania.

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