Traumatic life events and womens health - Department of Clinical and Molecular Medicine
Traumatic Life Events and Women’s Health
Traumatic Life Events and Women’s Health
Research projects for traumatic life events and womens health
Rape and sexual assault is one of the traumatic life events associated with the highest risks for developing chronic posttraumatic stress disorder (PTSD) and other mental health and psychosomatic problems. PTSD is a mental disorder characterized by involuntary, intrusive posttraumatic memories of the event, avoidance of things that reminds the victim of the rape, negative changes in emotions and beliefs about the self and the world, and hyperarousal. For most people PTSD is associated with significant functional impairment.
Presently, we have adequate research-based knowledge that trauma-focused cognitive-behavioral treatments have reasonable effects in the treatment of chronic PTSD. However, we have limited evidence about effective interventions to prevent the development of chronic PTSD after traumatic life events. Given the fact that rape is an especially potent risk factor for the development of chronic PTSD it is important to investigate how we might prevent the onset of this debilitating disorder.
Thus, in the present project we will conduct a multicenter randomized controlled trial to examine if a brief psychological intervention in the immediate period after rape might prevent the development of PTSD and other mental health and psychosomatic disorders.
Patients who seek health care at Sexual Assault Centers immediately after rape will be eligible to participate in the trial given that they consent to participate. Patients will be randomized to either up to five sessions of prolonged exposure (PE) therapy or psychosocial follow-up services as usual.
The severity of posttraumatic symptoms and other mental health and psychosomatic symptoms will be measured before and after the intervention in order to examine whether a brief specialized intervention is more effective than treatment as usual. In addition, we will strive to identify factors that might explain why some patients respond well to treatment whereas other patients do not (i.e. so-called moderators).
Chronic pelvic pain (CPP) in women is an often-overlooked condition, women may be reluctant to disclose the problem, the doctor may not ask, and the causes are not well understood. It has a potentially large impact on health care utilization, sexual health, quality of life, and work ability. Sometimes, the pain is found to have a distinct somatic causation as in endometriosis. More often the objective signs cannot explain the reported complaints, and the woman is at risk of unnecessary intervention with potentially harmful impact on her reproductive health. Hence, there is an urgent need to broaden the causal model and assess contributing factors such as adverse childhood experiences and psychological distress. These factors have been shown to contribute to triggering and maintaining other pain conditions, like chronic widespread pain (CWP) but less is known of their role in CPP.
The purpose of the study is to utilize the data from the HUNT Study to prospectively study if experience of interpersonal violence in adolescence is associated with risk of CPP in adulthood, and if mental distress in young adult females give increased risk of reporting CPP 10 years later. We want to obtain updated estimates for the prevalence of CPP in the general population, and the possible dependency between CPP and CWP.
Findings from the proposed study have the potential to increase identification of CPP patients, guide diagnostic process and develop optimal prevention and treatment strategies.
The Study is funded by The Liaison Committee for education, research and innovation in Central Norway.
A research group from the Netherlands led by Ellen T.M. Laan and H.W. van Lunsen has developed a questionnaire in which patients themselves report occurrence and degree of symptoms of pelvic floor hyperactivity.
This questionnaire is called the “Amsterdam hyperactive Pelvic Floor Scale” (AHPFS) for women and includes 30 questions. Each question deals with one symptom and has a 5-point Likert scale varying from never (score 1) to very often (score 5). The score of the different symptoms give an indication of general tense in the woman´s body (such as muscular pain and stiffness in shoulders and neck) and additionally symptoms often associated with “overactivity” in the pelvic floor muscles.
The AHPFS has been translated into English. To our knowledge, the questionnaire has never been translated into Norwegian or tested in a Norwegian setting.
The overall aim of this study is to understand the variety of symptoms and the importance of mapping out the right clinical diagnosis among women with pelvic floor disorders. These are important aspects for understanding women’s health.
The purpose 1) to translate this questionnaire “Amsterdam hyperactive Pelvic Floor Scale for women” into Norwegian, 2) pretesting of equivalence by performing cognitive interview, 3) testing for reliability and validation of the Norwegian version of the questionnaire among different female participants to approach pelvic floor dysfunction in women, and 4) use the collected data to describe a Norwegian female population.
Sexual assault can affect various aspects of a person's life and may have long-lasting negative mental and physical health consequences. Annually, around 2000 patients subjected to a recent sexual assault visit the 24/7 sexual assault centers(SAC) in Norway. Patients contacting SACs need acute medical care to ensure short and long-term health consequences are reduced to a minimum. The patient is examined and cared for by trained interdisciplinary health personnel providing both emergency medical treatment and psychosocial support and care.
This project will explore patients’ experiences from encountering a SAC and how health personnel experience assisting patients throughout the examination and follow-up course in the acute phase(until 1mth after sexual assault).
The study is funded by the Norwegian University of Science and Technology.