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2023, Number 3

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Salud Mental 2023; 46 (3)

Comparison of two psychotherapies in cortisol response and their efficacy in reducing symptoms of anxiety and depression in women victims of intimate partner violence

Cerda-De la O B, Cerda-Molina AL, Biagini-Alarcón M, Mayagoitia-Novales L, De La Cruz-López M, Whaley-Sánchez JA

Language: English
References: 56
Page: 137-146
PDF size: 280.23 Kb.


ABSTRACT

Introduction. There is a growing need to implement evidence-based psychological treatments for women victims of intimate partner violence (IPV) who commonly experience stress-related disorders such as anxiety, depression, or suicide risk, as well as altered cortisol reactivity. Objective. 1. To compare the changes in depressive and anxious symptomatology, quality of life, and cortisol reactivity after two different interventions, Acceptance and Commitment Therapy (ACT, based on psychological flexibility) or Interpersonal Therapy (IPT, based on empowerment) in women exposed to IPV. 2. To compare the changes in relation to the presence of suicide thoughts. Method. A clinical sample of 50 women (ages 21-74) randomly assigned to attend ACT or IPT, completed pre- and post-intervention questionnaires about intimate partner violence, quality of life, depression, anxiety, and measurements of salivary cortisol reactivity (basal, 15, 30, and 45 minutes after a cognitive challenge). We used Generalized Estimating Equation Models for data analysis. Results. There was a significant improvement post-intervention in all variables, regardless of the type of psychotherapy or the presence of suicide thoughts. Before interventions, women that reported suicide thoughts had severe symptoms of depression, anxiety, worse quality of life, and a cortisol hyper-response profile, in contrast to women without suicide thoughts who had moderate symptoms and no cortisol response. Cortisol response to the cognitive test decreased in all women after both therapies. Discussion and conclusion. Although different psychological approach, ACT, and IPT effectively improved mental health, quality of life, and changed cortisol reactivity of women exposed to IPV, including women at suicide risk.


REFERENCES

  1. Achchappa, B., Bhandary, M., Unnikrishnan, B., Ramapuram, J. T., Kulkarni, V.,Rao, S., ... Priyadarshni, S. (2017). Intimate Partner Violence, Depression,and Quality of Life among Women Living with HIV/AIDS in a Coastal Cityof South India. Journal of the International Association of Providers of AIDSCare, 16(5), 455-459. doi: 10.1177/2325957417691137

  2. Ahmadabadi, Z., Najman, J. M., Williams, G. M., Clavarino, A. M., d’Abbs, P.,& Tran, N. (2020). Intimate partner violence and subsequent depression andanxiety disorders. Social Psychiatry and Psychiatric Epidemiology, 55(5), 611-620. doi: 10.1007/s00127-019-01828-1

  3. Alsaker, K., Moen, B. E., Morken, T., & Baste, V. (2018). Intimate partner violenceassociated with low quality of life-a cross-sectional study. BMC Women’sHealth, 18(1), 1-7. doi: 10.1186/s12905-018-0638-5

  4. American Psychiatric Association. (2013). Diagnostic and statistical manual ofmental disorders: DSM-5™ (5th ed). American Psychiatric Publishing, Inc. doi:10.1176/appi.books.9780890425596

  5. Asplund, M., Rück, C., Lenhard, F., Gunnarsson, T., Bellander, M., Delby, H., &Ivanov, V. Z. (2021). ACT-enhanced group behavior therapy for trichotillomaniaand skin-picking disorder: A feasibility study. Journal of Clinical Psychology,77(7), 1537-1555. doi: 10.1002/jclp.23147

  6. Basu, A., Levendosky, A. A., & Lonstein, J. S. (2013). Trauma sequelae andcortisol levels in women exposed to intimate partner violence. PsychodynamicPsychiatry, 41(2), 247-275. doi: 10.1521/pdps.2013.41.2.247

  7. Biagini-Alarcón, M. (2016). Modelo de intervención terapéutica grupal para mujeresreceptoras de violencia. In: Primero-Rivas, L, & Biagini-Alarcón, M. (Eds).The New Epistemology and Mental Health in Mexico, (pp. 95-108). Mexico:Educational Horizons, National Pedagogical University (UPN).

  8. Biagini-Alarcón, M., Cerda-de la O. B., & Cerda-Molina, A. L. (2020). Violencia depareja, modelos explicativos e intervenciones psicoterapéuticas en víctimas. In:Martínez López, J. N. I. (Ed). Salud Mental Forense, (pp. 497-518). México:Tirant Lo Blanch, INPRFM.

  9. Burlingame, G., Fuhriman, A., & Johnson, J. (2001). Cohesion in grouppsychotherapy. Psychotherapy: Theory, Research, Practice, Training, 38(4),373-379. doi.10.1037/0033-3204.38.4.373

  10. Cerda-Molina, A. L., Borráz-León, J. I., Mayagoitia-Novales, L., & Gaspar del Río,A. T. (2018). Reactividad del cortisol y salud mental en adultos expuestos aviolencia temprana: revisión sistemática. Revista Panamericana de SaludPública, 41, e171. doi: 10.26633/RPSP.2017.171

  11. Chandan, J. S., Thomas, T., Bradbury-Jones, C., Russell, R., Bandyopadhyay, S.,Nirantharakumar, K., & Taylor, J. (2020). Female survivors of intimate partnerviolence and risk of depression, anxiety and serious mental illness. The BritishJournal of Psychiatry, 217(4), 562-567. doi: 10.1192/bjp.2019.124

  12. Devries, K. M., Mak, J. Y., Bacchus, L. J., Child, J. C., Falder, G., Petzold, M., &Watts, C. H. (2013). Intimate partner violence and incident depressivesymptoms and suicide Attempts: A Systematic Review of Longitudinal Studies. PLoSMedicine, 10(5), e1001439. doi: 10.1371/journal.pmed.1001439

  13. Dwivedi, Y. (Ed.). (2012). The Neurobiological Basis of Suicide. Boca Raton, FL:CRC Press/Taylor & Francis Group.

  14. Elzinga, B. M., Roelofs, K., Tollenaar, M. S., Bakvis, P., van Pelt, J., & Spinhoven,P. (2008). Diminished cortisol responses to psychosocial stress associatedwith lifetime adverse events: a study among healthy young subjects.Psychoneuroendocrinology, 33(2), 227-237. doi: 10.1016/j.psyneuen.2007.11.004

  15. Fischer, S., Strawbridge, R., Vives, A. H., & Cleare, A. J. (2017). Cortisol as apredictor of psychological therapy response in depressive disorders: Systematicreview and meta-analysis. The British Journal of Psychiatry, 210(2), 105-109.doi: 10.1192/bjp.bp.115.180653

  16. Giletta, M., Calhoun, C. D., Hastings, P. D., Rudolph, K. D., Nock, M. K., &Prinstein, M. J. (2015). Multi-level risk factors for suicidal ideation amongat-risk adolescent females: the role of hypothalamic-pituitary-adrenal axisresponses to stress. Journal of Abnormal Child Psychology, 43(5), 807-820.doi: 10.1007/s10802-014-9897-2

  17. Gordon, J. L., Eisenlohr-Moul, T. A., Rubinow, D. R., Schrubbe, L., & Girdler,S. S. (2016). Naturally occurring changes in estradiol concentrations inthe menopause transition predict morning cortisol and negative mood inperimenopausal depression. Clinical Psychological Science, 4(5), 919-935. doi:10.1177/2167702616647924

  18. Hameed, M., O’Doherty, L., Gilchrist, G., Tirado-Muñoz, J., Taft, A., Chondros, P.,… Hegarty, K. (2020). Psychological therapies for women experience intimatepartner violence. The Cochrane Database of Systematic Reviews, 7(7). doi:10.1002/14651858.CD013017.pub2

  19. Hansen, N. B., Eriksen, S. B., & Elklit, A. (2014). Effects of an intervention programfor female victims of intimate partner violence on psychological symptoms andperceived social support. European Journal of Psychotraumatology, 5(1). doi:10.3402/ejpt.v5.24797

  20. Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptanceand commitment therapy: model, processes and outcomes. Behavior Researchand Therapy, 44(1), 1-25. doi: 10.1016/j.brat.2005.06.006

  21. Hayes, S. C, Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitmenttherapy: The process and practice of mindful change. New York, NY: TheGuilford Press. ISBN 9781462528943

  22. Hegarty, K., O’Doherty, L., Taft, A., Chondros, P., Brown, S., Valpied, J., …Gunn, J. (2013). Screening and counseling in the primary care setting forwomen who have experienced intimate partner violence (WEAVE): a clusterrandomised controlled trial. Lancet, 382(9888), 249-258. doi: 10.1016/S0140-6736(13)60052-5

  23. Heim, C., Newport, D. J., Heit, S., Graham, Y. P., Wilcox, M., Bonsall, R., …Nemeroff, C. B. (2000). Pituitary-adrenal and autonomic responses to stress inwomen after sexual and physical abuse in childhood. Jama, 284(5), 592-597.doi: 10.1001/jama.284.5.592

  24. Jurado, S., Villegas, M. E., Mendez, L., Rodriguez, F., Loperena, V., & Varela,R. (1998). Standardization of the Beck depression inventory for residents ofMexico City. Salud Mental, 21(3), 26-31.

  25. Keynejad, R. C., Hanlon, C., & Howard, L. M. (2020). Psychological interventionsfor common mental disorders in women experiencing intimate partnerviolence in low-income and middle-income countries: a systematic reviewand meta-analysis. The Lancet Psychiatry, 7(2), 173-190. doi: 10.1016/S2215-0366(19)30510-3

  26. Li, S. H., & Graham, B. M. (2017). Why are women so vulnerable to anxiety, traumarelatedand stress-related disorders? The potential role of sex hormones. TheLancet Psychiatry, 4(1), 73-82. doi: 10.1016/S2215-0366(16)30358-3

  27. Mielock, A. S., Morris, M. C., & Rao, U. (2017). Patterns of cortisol and alphaamylasereactivity to psychosocial stress in maltreated women. Journal ofAffective Disorders, 209, 46-52. doi: 10.1016/j.jad.2016.11.009

  28. Morfín López, T., & Sánchez-Loyo, L. M. (2015). Violencia doméstica y conductasuicida: relatos de mujeres sobre la violencia y sus efectos. Acta Universitaria,25(2), 57-61. doi: 10.15174/au.2015.886

  29. Morris, M., Okoth, V., Prigmore, H. L., Ressler, D. J., Mbeya, J., Rogers, A., …Audet, C. M. (2020). The prevalence of interpersonal violence (IPV) againstwomen and its associated variables: an exploratory study in the Rongo Sub-County of Migori County, Kenya. Journal of Interpersonal Violence, 37(5-6),2083-2101. doi: 10.1177/0886260520935484

  30. O’Connor, D. B., Ferguson, E., Green, J. A., O’Carroll, R. E., & O’Connor,R. C. (2016). Cortisol levels and suicidal behavior: A meta-analysis.Psychoneuroendocrinology, 63, 370-379. doi: 10.1016/j.psyneuen.2015.10.011

  31. O’Connor, D. B., Gartland, N., & O’Connor, R. C. (2020). Stress, cortisol and suiciderisk. International Review of Neurobiology, 152, 101-130. Academic Press. doi:10.1016/bs.irn.2019.11.006

  32. Páez Blarrina, M., & Gutiérrez Martínez, O. (2012). Multiple applications ofAcceptance and Commitment Therapy (ACT). Madrid: Ediciones Pirámide.ISBN-13:9788436826487

  33. Pan American Health Organization [PAHO]. (2016). Health care for women who haveexperienced intimate partner violence or sexual violence. Clinical Handbook.Retrieved from: https://iris.paho.org/bitstream/handle/10665.2/31381/OPSFGL16016-spa.pdf

  34. Pekár, S., & Brabec, M. (2018). Generalized estimating equations: A pragmaticand flexible approach to the marginal GLM modeling of correlated data in thebehavioral sciences. Ethology, 124(2), 86-93. doi: 10.1111/eth.12713

  35. Pinna, K. L., Johnson, D. M., & Delahanty, D. L. (2014). PTSD, comorbiddepression, and the cortisol waking response in victims of intimate partnerviolence: preliminary evidence. Anxiety, Stress &Coping, 27(3), 253-269. doi:10.1080/10615806.2013.852185

  36. Reyes-Ortega, M., & Vargas-Salinas, A. (2016). Intervention Manual in Acceptanceand Commitment Therapy for victim care. Single module. Mexico. Institute ofBehavioral and Contextual Therapies.

  37. Reynolds, T. A., Makhanova, A., Marcinkowska, U. M., Jasienska, G., McNulty, J.K., Eckel, L. A., ... Maner, J. K. (2018). Progesterone and women’s anxietyacross the menstrual cycle. Hormones and Behavior, 102, 34-40. doi: 10.1016/j.yhbeh.2018.04.008

  38. Robles, R., Varela, R., Jurado, S., & Páez, F. (2001). Versión mexicana del inventario deansiedad de Beck: propiedades psicométricas. Revista Mexicana de Psicología,18(2), 211-218. Retrieved from: https://scinapse.io/papers/1597953883

  39. Ruiz, F. J., Flórez, C. L., García-Martín, M. B., Monroy-Cifuentes, A., Barreto-Montero, K., García-Beltrán, D. M., … Gil-Luciano, B. (2018). A multiplebaselineevaluation of a brief acceptance and commitment therapy protocolfocused on repetitive negative thinking for moderate emotional disorders.Journal of Contextual Behavioral Science, 9, 1-14. doi: 10.1016/j.jcbs.2018.04.004

  40. Sabri, B., & Granger, D. A. (2018). Gender-based violence and trauma inmarginalized populations of women: Role of biological embedding andtoxic stress. Health Care for Women International, 39(9), 1038-1055. doi:10.1080/07399332.2018.1491046

  41. Sarasua, B., Zubizarreta, I., Echeburúa, E., & del Corral, P. (2007) Perfilpsicopatológico diferencial de las víctimas de violencia de pareja en función dela edad. Psicotema, 19(3), 459-66.

  42. Schultheiss, O. C., Dargel, A., & Rohde, W., (2003). Implicit motives and gonadalsteroid hormones: effects of menstrual cycle phase, oral contraceptive use, andrelationship status. Hormones and Behavior, 43(2), 293-301. doi: 10.1016/S0018-506X(03)00003-5

  43. Secretaría de Salud. (2012). Norma Oficial Mexicana NOM-012-SSA3-2012, queestablece los criterios para la ejecución de proyectos de investigación para lasalud en seres humanos. México: Diario Oficial de la Federación. Retrieved from:http://www.dof.gob.mx/nota_detalle.php?codigo=5284148&fecha=04/01/2013

  44. Seedat, S., Stein, M. B., Kennedy, C. M., & Hauger, R. L. (2003). Plasmacortisol and neuropeptide Y in female victims of intimate partner violence.Psychoneuroendocrinology, 28(6), 796-808. doi: 10.1016/s0306-

  45. 4530(02)00086-045. Skevington, S. M., Lotfy, M., & O’Connell, K. A. (2004). The World HealthOrganization’s WHOQOL-BREF quality of life assessment: psychometricproperties and results of the international field trial. A report fromthe WHOQOL group. Quality of Life Research, 13(2), 299-310. doi:1023/B:QURE.0000018486.91360.00

  46. Terlizzi, E. P., & Villarroel, M. A. (2020). Symptoms of generalized anxiety disorderamong adults: United States, 2019. US Department of Health and HumanServices, Centers for Disease Control and Prevention, National Center forHealth Statistics. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db378.htm

  47. Tirado-Muñoz, J., Gilchrist, G., Lligoña, E., Gilbert, L., & Torrens, M. (2015). Agroup intervention to reduce intimate partner violence among female drug users.Results from a randomized controlled pilot trial in a community substanceabusecenter. Adicciones, 27(3), 168-178.

  48. Valdéz-Santiago, R., Híjar-Medina, M. C., Salgado de Snyder, V. N., Rivera-Rivera, L., Avila-Burgos, L., & Rojas, R. (2006). Violence scale and severityindex: a methodological proposal for measuring violence by the partner inMexican women. Salud Pública de México, 48(Supp. 2), 221-231. Retrievedfrom: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0036-36342006000800002&lng=es&tlng=es

  49. Vargas-Salinas, A., & Reyes-Ortega, M. (2016). Acceptance and CommitmentTherapy (ACT) intervention manual for victim care. Módulo Grupal. México.Instituto de Terapias Conductuales y Contextuales.

  50. Whoqol Group. (1998). Development of the World Health Organization WHOQOLBREFquality of life assessment. Psychological Medicine, 28(3), 551-558. doi:10.1017/S0033291798006667

  51. World Health Organization [WHO]. (2013). Responding to intimate partner violenceand sexual violence against women. World Health Organization. ISBN 978 924 154859 5

  52. World Health Organization [WHO]. (2005). WHO multi-country study on women’shealth and domestic violence against women: initial results on prevalence,health events and women’s responses to domestic violence against women. tosuch violence. Summary Report. Geneva: World Health Organization. ISBN92 4 159358 X

  53. Wynne, B., McHugh, L., Gao, W., Keegan, D., Byrne, K., Rowan, C., … Mulcahy, H.E. (2019). Acceptance and commitment therapy reduces psychological stress inpatients with inflammatory bowel diseases. Gastroenterology, 156(4), 935-945.doi: 10.1053/j.gastro.2018.11.030

  54. Wüst, S., Federenko, I. S., van Rossum, E. F., Koper, J. W., & Hellhammer, D. H.(2005). Habituation of cortisol responses to repeated psychosocial stress—furthercharacterization and impact of genetic factors. Psychoneuroendocrinology,30(2), 199-211. doi: 10.1016/j.psyneuen.2004.07.002

  55. Yalom, I. (1986). Theory and practice of group psychotherapy. México: Fondo deCultura Económica. ISBN 9681621662 9789681621667

  56. Zhang, C. Q., Leeming, E., Smith, P., Chung, P. K., Hagger, M. S., & Hayes, S.C. (2018). Acceptance and commitment therapy for health behavior change:acontext-driven approach. Frontiers in Psychology, 8, 2350. doi: 10.3389/fpsyg.2017.02350




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