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Library of Congress Cataloging-in-Publication Data:

Women's health psychology / edited by Mary V. Spiers, Pamela A. Geller, and Jacqueline D. Kloss.

pages ; cm

Includes bibliographical references and index.

ISBN 978-0-470-89066-0 (paper); ISBN 978-1-118-41819-2 (ebk); ISBN 978-1-118-41551-1 (ebk); ISBN 978-1-118-43351-5 (ebk)

1. Women–Health and hygiene–Psychological aspects. I. Spiers, Mary, editor of compilation. II. Geller, Pamela A., editor of compilation. III. Kloss, Jacqueline D., 1970- editor of compilation.

RA564.85.W6833 2013

613′.04244—dc23

2012032035

Foreword

Nancy E. Adler, PhD

Women's Health Psychology provides an important overview and analysis of key issues affecting women's health and well-being. In 2010 I had the privilege of chairing an Institute of Medicine (IOM) committee charged with evaluating progress in women's health research. The committee was composed of eminent researchers and clinicians representing a wide range of aspects of women's health. The committee considered whether the right questions had been asked about women's health, whether the right methods had been used to answer those questions, and whether the findings had been communicated effectively and had resulted in better health outcomes for women. In reading the contributions to Women's Health Psychology, I was struck by the resonance between the lessons the committee learned from our review and this volume.

The first thing that struck me was the broad perspective that the editors of this volume took in defining women's health. Women's health has sometimes been defined narrowly, referring only to health associated with women's reproductive organs and hormones, but this view has evolved. Just as the IOM committee embraced a wider definition that included diseases that are more prevalent among women than among men, present differently (e.g., differences in age of onset or in typical presenting symptoms), respond differently to treatment, or represent a major burden of illness for women, this book covers an impressive array of health issues that affect women and/or differ in their impact for women than for men. Although one section of the book deals specifically with reproductive health, spanning menstruation and sexual health, infertility and pregnancy, breastfeeding, and menopause, the remaining sections cover a wide swath of health problems. The authors of the various chapters highlight both commonalities and differences in the etiology and treatment of these conditions.

In addition to considering a wide range of health conditions, the editors have also included chapters that deal both with sex differences (those caused by biological differences between the sexes) and gender differences (those caused by socially determined factors to which men and women are differentially exposed). The IOM committee observed that the social determinants of women's health had received relatively less attention than the biological underpinnings. Social determinants are important in understanding how gender effects impact on health, as well as in understanding, within groups of women, why there are marked disparities in health status between those who are socially disadvantaged versus those who live in more favorable social conditions. Women's Health Psychology highlights the critical role of these factors in the initial section that discusses the intersectionality among different bases of social disadvantage. The stage is set by considering the historical context and then discusses two domains in which women encounter social threats to their health: employment and intimate partner violence.

Finally, almost every chapter in this volume touches on the importance of quality of life, not just longevity. Women live longer lives than do men, but they suffer more years of disability. The burden of diseases such as Alzheimer's, which occur primarily late in life, fall disproportionately upon women. Even earlier in life, women are more prone to diseases that are not fatal but that interfere with well-being and full functioning. These include autoimmune diseases, depression and other mood disorders, and unintended pregnancy. The IOM committee observed that relatively less attention had been paid to nonfatal diseases and that less progress had occurred for many of these disorders. This volume underlines the importance of well-being and the burden to women of health challenges such as irritable bowel syndrome, rheumatic disease, multiple sclerosis, and Alzheimer's. Importantly, it also includes chapters that analyze the role of risk factors such as alcohol and tobacco use, weight and eating disorders, sleep and sedentary behaviors that may contribute to a range of diseases and that may impair quality of life.

In sum, this volume covers a wide array of conditions, causes, and approaches to understanding and improving health among women. It will serve as a valuable reference for health and mental health providers, researchers, and those in training for professional or research careers.

Preface

In the 1990s, when specific courses and texts in women's health psychology emerged, Annette Stanton and Sheryle Gallant (Stanton & Gallant, 1995) commented on questions they faced relating to the advisability of presenting such specialized content. Both the empirical foundations and the reasons for separating women's health psychology from “general” health psychology were questioned. At that time, the study of women's health psychology was just beginning to blossom. For the first time, the United States was seeing the development of organizations such as the Office of Research on Women's Health in 1990, national initiatives to include women in clinical health trials (the Women's Health Equity Act, 1990), federal research requirements to include women and individuals from diverse ethnic-racial groups (the NIH Revitalization Act of 1993), physician (the Council on Graduate Medical Education, 1995) and clinical psychology (the American Psychological Association) training in women's health. In the years following, several U.S.-based programs and organizations became cornerstones in the field of women's health, including the American Medical Women's Association, Division 35 of the American Psychological Association (i.e., Society for the Psychology of Women), the Office of Research on Women's Health, the Society for Women's Health Research, and the Women's Health Initiative (WHI).

From that foundation, the interest and impact of women's health and women's health psychology continues to be evidenced by the increase in women's health programs instituted by hospitals and universities and the number of professional organizations that have identified women's health as a focus area. General booksellers now have entire sections devoted to narratives and educational information on women's health for consumers. One of the questions facing us at the inception of this book was whether the research work in women's health psychology has kept pace with the interest it has garnered.

In this second decade of the 21st century, the empirical foundation of women's health psychology has become both broader and deeper. It has grown into a specialty area that in some instances converges with research and theories of general health psychology in common with men while in other instances reflects unique or different needs of women. Perhaps one of the major advancements is that today, more than ever, the field of women's health psychology recognizes that women are a diverse group. There is also more attention to the idea that women's health can be impacted by a variety of factors related to economic and social backgrounds and practices, as well as cultural, political, and relational contexts, and that women will face a variety of issues during different life stages related to reproduction, family, and work.

With these issues in mind, Women's Health Psychology was designed to focus on important health psychology issues of women spanning from young adulthood to post-menopause. It is intended to describe how behaviors, attitudes, and lifestyle choices influence women's health, to examine interactions between psychological and physical health, and to present these findings within a developmental and diverse sociocultural context.

Our goal is to present current research in women's health psychology that incorporates the broad and diverse context of women's lives. The book is divided into four sections. The first section of the book considers several important general issues of historical and current context for women's health that help to expand thinking related to intersections of women's health with wider social issues, employment, and relationships. The section “Well-Being and Health Challenges” includes chapters related to a number of behaviors and conditions known to enhance and/or compromise healthy lifestyles among women. The manifestation of addictive behaviors (namely smoking and alcohol use) among women and strategies tailored to women and for women are presented. The importance of physical activity and sleep throughout women's lives, coupled with the impairments related to sleep disturbance and sedentary lifestyle, are highlighted. The growing epidemic of obesity, along with eating disorders and body image, are addressed within a sociocultural context. Likewise, the increasing popularity of cosmetic treatments and their hypothesized underlying motives are discussed. The next section presents a range of reproductive health topics that women encounter during their lifespan including sexual health issues, decision-making surrounding childbearing, breastfeeding, and menopause, as well as topics that may be experienced by a subset of women, including premenstrual dysphoric disorder, infertility, and psychiatric symptoms during the perinatal period. The final section, “Disability and Chronic Conditions,” opens with a chapter on women's responses to disability followed by chapters dealing with some of the more important health threats and chronic conditions experienced by women. These include the experience of cancer in women, the psychology of irritable bowel syndrome, neurological disorders in women, and converging issues in heart disease, stroke, and Alzheimer's disease in women.

Authors were invited to provide a critical review of an area, focusing on one to two key issues and to address, where possible, how the health behavior, reproductive issue, or disorder might interact with developmental milestones or cultural, socioeconomic, or social identity (e.g., gender orientation or disability). We anticipate that this book will be useful to a broad range of practitioners, including psychologists, mental health counselors, physicians, nurses, allied health professionals, and medical social workers as well as students, educators, and researchers in the medical and social sciences who are interested in the evidence-based foundation for offering effective services to women.

Reference

Stanton, A. L., & Gallant, S. J. (Eds). (1995). The psychology of women's health: Progress and challenges in research and application. Washington, DC: American Psychological Association.

Acknowledgments

We are grateful to the many people who gave of their time and expertise in support of this book's completion. First, the development of this book would not have been possible without the efforts of our contributing authors. Our selection of authors was designed to reflect the current state of the field of women's health psychology. Authors represent both well established and “up and coming” researchers and clinicians. We wish to thank our graduate students Alexa Bonacquisti, Casey Burkard, Efrat Eichenbaum, Meredith Gillis, Sara Levine Kornfield, Mitra Khaksari, Alexandra R. Nelson, Emily Reid O'Connor, and Victoria Wright for their assistance in proposal and chapter development research and initial conceptualization of the book sections. We thank them, as well as Katherine Alvarez, Jessica Bartholow, Lindey Bartolucci, Elizabeth Culnan, Kara Douglas, Aimee Hildenbrand, Sarah Horsey, Christina Nash, Colleen Walsh, and Maisa Ziadni, for their assistance with editing, referencing, and many administrative tasks.

To our wonderful editorial assistants, Alexa Bonacquisti and Emily Reid O'Connor (1981–2011), we want to express our heartfelt gratitude. Emily's dedication and passion for women's health psychology was infectious. Although her passing left us with deep sadness, she also engendered in us a resolve to live life fully and always ask the important questions, as she did. Alexa's amazing organizational abilities, initiative, and positive attitude contributed immensely to the management of this project. Alexa was truly “the hub” and often anticipated our needs before we could voice them. We are grateful that our editorial assistants were willing to abide by our editors' edict to “nourish our spirits by holding all meetings away from our offices” and repeatedly accompanied us to coffee shops and restaurants as we hashed out the details of the book. Also, to our editor, Patricia Rossi, and the staff at John Wiley & Sons, our many thanks for your advice and input in guiding the development and publication of the manuscript.

We are grateful to our families and friends who have provided unwavering support and enthusiasm throughout this process, particularly our spouses (Sean Duffy, Steve Nocella, and Brian Kloss) who have supported us, not only with this professional endeavor, but who also, on a daily basis, enable us to achieve a healthy work-life balance. And to the Kloss girls—the assistants, Ella and Abby—and the Geller Nocella boys—Ean and Maxwell—for their smiles, giggles, boundless energy, and curiosity that give inspiration every day. It is our children who remind us to plant seeds to grow future generations of health and happiness.

Finally, with this book, we pay homage to the generations of women who came before us and those who will come after, united in our engagement in multiple roles that influence women's physical, psychological, and spiritual health and well-being (including roles as mothers, sisters, daughters, wives and partners, primary caretakers, workers, and friends).

List of Contributors

Sarah K. Ballou, BA

Northwestern University, Feinberg School of Medicine, Chicago, IL

Lisa Bowleg, PhD

Drexel University, School of Public Health, Philadelphia, PA

Meghan L. Butryn, PhD

Drexel University, Philadelphia, PA

Canice E. Crerand, PhD

University of Pennsylvania, School of Medicine, Philadelphia

Bradley N. Collins, PhD

Temple University, Philadelphia, PA

Sharon Danoff-Burg, PhD

San Diego State University & UCSD Moores Cancer Center, CA

Paula S. Derry, PhD

Paula Derry Enterprises in Health Psychology, Baltimore, MD

Heather E. Dillaway, PhD

Wayne State University, Detroit, MI

Alice D. Domar, PhD

Domar Center for Mind/Body Health, Waltham, MA

Kara R. Douglas-Newman, MS

Drexel University, Philadelphia, PA

Alice V. Ely, MS

Drexel University, Philadelphia, PA

Efrat Eichenbaum, MS

Drexel University, Philadelphia, PA

Heather A. Flynn, PhD

Florida State University, Tallahassee

Matthew Fuller-Tyszkiewicz, PhD

Deakin University, Victoria, Australia

Pamela A. Geller, PhD

Drexel University, Philadelphia, PA

M. Meredith Gillis, PhD

Emory University, Atlanta, GA

Maggie L. Gorraiz, MA

University of Rhode Island, Kingston

Jennifer Hahn-Holbrook, PhD

University of California, Los Angeles

Sheri Hartman, PhD

UCSD Moores Cancer Center, San Diego, CA

Martie Haselton, PhD

University of California, Los Angeles

Deidre Hussey

University of Hartford, CT

Laurie Keefer, PhD

Northwestern University, Feinberg School of Medicine, Chicago, IL

Wendy Kline, PhD

University of Cincinnati, OH

Jacqueline D. Kloss, PhD

Drexel University, Philadelphia, PA

Ross Krawczyk, MA

University of South Florida, Tampa

Allison Kulig, MA

University of North Dakota, Grand Forks

Kaitlin Raines Lilienthal, MS

University of North Dakota, Grand Forks

Sarah Linke, PhD, MPH

University of California, San Diego

Michael R. Lowe, PhD

Drexel University, Philadelphia, PA

Leanne Magee, PhD

University of Pennsylvania School of Medicine, Philadelphia

Bess H. Marcus, PhD

University of California, San Diego

Nancy L. Marshall, EdD

Wellesley College, Wellesley, MA

Kathy McCloskey, PhD, PsyD, ABPP

University of Hartford, CT

Patricia J. Morokoff, PhD

University of Rhode Island, Kingston

Dori Pekmezi, PhD

University of Alabama at Birmingham

Heather Munro Prescott, PhD

Central Connecticut State University, New Britain

Uma S. Nair, PhD

Temple University, Philadelphia, PA

Christina O. Nash, M.S.

Drexel University, Philadelphia, PA

Alexandra R. Nelson, PhD

Drexel University, Philadelphia, PA

Danielle L. Novick, PhD

University of Michigan Medical School, Ann Arbor

Rhoda Olkin, PhD

California School of Professional Psychology, Los Angeles

Lauren B. Prince, BA

Wake Forest University, Winston-Salem, NC

Lina Ricciardelli, PhD

Deakin University, Victoria, Australia

David B. Sarwer, PhD

University of Pennsylvania School of Medicine, Philadelphia

Chris Dunkel Schetter, PhD

University of California, Los Angeles

Mary V. Spiers, PhD

Drexel University, Philadelphia, PA

Jacqueline Spitzer, MSEd

University of Pennsylvania School of Medicine, Philadelphia

Annette L. Stanton, PhD

University of California, Los Angeles

Meir Steiner, MD, PhD, FRCPC

McMaster University and St. Joseph's Healthcare, Ontario, Canada

J. Kevin Thompson, PhD

University of South Florida, Tampa

Simone N. Vigod, MD, MSc, FRCPC

Women's College Hospital, University of Toronto, Canada

Nancy Vogeltanz-Holm, PhD

University of North Dakota School of Medicine and Health Sciences, Grand Forks

Sharon C. Wilsnack, PhD

University of North Dakota School of Medicine and Health Sciences, Grand Forks

Betina Yanez, PhD

Northwestern University Feinberg School of Medicine, Chicago, IL

Section I

Women's Health in Context