ABSTRACT
Low-income and African American patients in women's health clinics are at risk for depression and under-treatment of their depression. This study aimed to understand women's health patients' experiences of depressive symptoms and perspectives on the low uptake of psychotherapy. Twenty-three women with depressive symptoms from a women's health clinic completed individual qualitative interviews. Women reported risk of harm in the therapeutic relationship as the primary barrier; physical and mental health symptoms and doubt that psychotherapy will help were also described. Women also reported psychotherapy can be helpful by allowing women to express their feelings, gain insight, and make life changes.
Subject(s)
Black or African American/psychology , Depression/ethnology , Depression/therapy , Patient Acceptance of Health Care/ethnology , Psychotherapy/statistics & numerical data , Women/psychology , Adolescent , Adult , Depression/psychology , Female , Health Services Accessibility , Healthcare Disparities , Humans , Interviews as Topic , Middle Aged , Patient Acceptance of Health Care/psychology , Physician-Patient Relations , Poverty , Qualitative Research , Socioeconomic Factors , Surveys and Questionnaires , Vulnerable Populations/ethnology , Vulnerable Populations/psychology , Women's Health Services/organization & administration , Young AdultABSTRACT
Up to 37% of individuals experience chronic pain during their lifetimes. Approximately one-fourth of primary care patients with chronic pain also meet criteria for major depression. Many of these individuals fail to receive psychotherapy or other treatment for their depression; moreover when they do, physical pain is often not addressed directly. Women, socioeconomically disadvantaged individuals, African Americans and Latinos all report higher rates of pain and depression compared to other groups. This article describes a version of Interpersonal Psychotherapy tailored for patients with comorbid depression and chronic pain, Interpersonal Psychotherapy for Depression and Pain (IPT-P). While IPT-P potentially could be delivered to many different patient populations in a range of clinical settings, this article focuses on its delivery within primary care settings for socioeconomically disadvantaged women. Adaptations include a brief 8-session protocol that incorporates strategies for anticipating barriers to psychotherapy, accepting patients' conceptualization of their difficulties, encouraging patients to consider the impact of their pain on their roles and relationships, emphasizing self-care, incorporating pain management techniques, and flexible scheduling. In addition, IPT-P is designed as an adjunct to usual medical pain treatment, and seeks to engage non-treatment seeking patients in psychotherapy by focusing on accessibility and relevance of the intervention to concerns common among patients with pain. Identifying patients with comorbid depression and chronic pain and offering IPT-P as a treatment option has the potential to improve clinical outcomes for individuals with depression and chronic pain.
ABSTRACT
Differences in basic memory processes between maltreated and nonmaltreated children were examined in an experiment in which middle-socioeconomic-status (SES; N = 60), low-SES maltreated (N = 48), and low-SES nonmaltreated (N = 51) children (ages 5-7, 8-9, and 10-12 years) studied 12 Deese-Roediger-McDermott lists. Using recall and recognition measures, the results showed that both true and false memories increased with age and, contrary to some speculation, these trends did not differ as a function of maltreatment status. However, there were differences in overall memory performance as a function of SES. These results are discussed in the broader framework of children's memory development and the effects of the chronic stress associated with child maltreatment on basic memory processes.
