Investigating the under-recognition of childbirth-related post-traumatic stress disorder among the public and mental health professionals.

BACKGROUND: Childbirth posttraumatic stress disorder (PTSD) poses significant challenges, impacting both mothers and infants. This work investigates whether childbirth PTSD is less recognized than PTSD caused by other index events. METHODS: In two preregistered experimens we investigated the public and professional perception of PTSD resulting from childbirth compared to other traumatic events (i.e., sexual assault, car accident, terror attack, and an earthquake). FINDINGS: Study 1, conducted among the general population in the U.S. revealed that a woman depicted as experiencing PTSD symptoms due to childbirth, was less likely to be recognized as suffering from PTSD than a woman with the same symptoms resulting from other traumatic events. Study 2 demonstrated that mental health professionals worldwide are also less inclined to diagnose PTSD when childbirth is the index event in comparison to other index events. DISCUSSION: Due to the importance of social recognition in the treatment of PTSD, the findings underscore the urgent need for heightened awareness and education regarding childbirth PTSD to bridge the recognition gap among the general population and mental health professionals.

Exploring women's strong preference for women surgeons in breast healthcare.

BACKGROUND: This study challenges the prevalent belief that surgical roles demand masculine traits, potentially limiting women's suitability for such positions. Contrary to this stereotype, we explored the hypothesis that in sensitive surgical procedures, where communal traits are valued, women patients might favor women surgeons. Two experimental studies investigated women's preferences for a man versus a woman surgeon in a breast exam and breast surgery. METHODS: In two studies we experimentally tested women's preferences for a man versus a woman surgeon for a breast exam (a noninvasive and non-complicated procedure), and breast surgery (an invasive and more complicated procedure). Study 2 delved into factors influencing these preferences, including patients' age, stereotypical perceptions of women surgeons as communal/warm, past negative experiences with men and women doctors, and previous body-related trauma. RESULTS: Women consistently preferred a woman surgeon for both procedures and expressed increased willingness to wait for an appointment with a woman surgeon. However, this preference was less pronounced for surgery than for an exam. Study 2 identified the stereotypical perception of women surgeons as communal/warm as the strongest predictor for this preference, along with previous negative experiences with men doctors and age. CONCLUSIONS: While some gender bias persists, this study underscores a notable preference for women surgeons in intimate medical services like breast exams or surgery. This preference holds practical implications for healthcare providers encouraging women's preventive checkups and offers insights for women medical students making residency choices.

Is Oxytocin Administration During Childbirth Associated With Increased Risk for Postpartum Posttraumatic Stress Symptoms?: A Preliminary Investigation.

INTRODUCTION: Synthetic oxytocin is one of the most regularly administered medications to facilitate labor induction and augmentation. The present study examined the associations between oxytocin administration during childbirth and postpartum posttraumatic stress symptoms (PTSS). MATERIALS AND METHODS: In a multicenter longitudinal study, women completed questionnaires during pregnancy and at 2 months postpartum (N = 386). PTSS were assessed with the Impact of Event Scale. Logistic regression was used to examine the difference in PTSS at Time 2 between women who received oxytocin and women who did not. RESULTS: In comparison with women who did not receive oxytocin, women who received oxytocin induction were 3.20 times as likely to report substantial PTSS (P = .036, 95% confidence interval: 1.08-9.52), and women who received oxytocin augmentation were 3.29 times as likely to report substantial PTSS (P = .036, 95% confidence interval: 1.08-10.03), after controlling for being primiparous, preeclampsia, prior mental health diagnosis, mode of birth, postpartum hemorrhage, and satisfaction with staff. DISCUSSION: Oxytocin administration was associated with a 3-fold increased risk of PTSS. The findings may reflect biological and psychological mechanisms related to postpartum mental health and call for future research to establish the causation of this relationship.

Effects of attachment security priming on women's math performance.

Introduction: Activating people's sense of attachment security can buffer against psychological threats. Here we tested whether security priming can also buffer the adverse effects of stereotype threat among women. Method: Three studies (a pilot study (N = 79 women, 72 men), a laboratory study; N = 474 women, and an online study; N = 827 women) compared security priming to neutral and positive affect priming. Results: The pilot study revealed that women exposed to attachment security primes (e.g., the word "love") had better math performance than women exposed to neutral primes (e.g., "boat"). Men's math performance did not differ across priming conditions. Study 1 revealed that women showed better math performance in the attachment security priming condition than in the neutral or positive (e.g., "luck") priming conditions. The effect was observed among women high on math identification. In Study 2, despite an effect of security priming on the manipulation check [higher State Adult Attachment Measure (SAAM) security score], security did not buffer stereotype threat effects. Discussion: Our findings provide partial support to the idea that security priming (an interpersonal process) can buffer stereotype threat (an intergroup process). Theoretical and practical implications related to attachment security priming and stereotype threat are discussed.

High-Quality Contact With Fellow Majority Group Students Is Associated With Better Academic Performance of Minority Group Students.

We examined the association between intergroup contact and academic performance at university among minority students in a context with a segregated pre-university school system. Study 1 tested whether participation in a group dynamics course, which involves intimate interpersonal contact between Israeli Arab (n = 125) and Jewish students, was associated with better grade point average (GPA). As expected, Arab students who participated in the course had a higher GPA than those who did not, even when controlling for pre-university achievements. The corresponding difference among Jews was substantially smaller. Study 2 (N = 90), a longitudinal study, revealed that the quality of contact with Jewish students at university was associated with Arab students' subsequent higher GPA, even when controlling for pre-university contact, proxies of academic achievements, and perceptions of intergroup relations. The quality of contact with Jewish students was also associated with Arab students' sense of academic belonging. Theoretical and practical implications are discussed.

Gender bias in the evaluation of interns in different medical specialties: An archival study.

INTRODUCTION: The field of medicine is characterized by within-field gender segregation: Gender ratios vary systematically by subdisciplines. This segregation might be, in part, due to gender bias in the assessment of women and men medical doctors. METHODS: We examined whether the assessments, i.e. overall score, department scores and skills scores, interns receive by their superiors during their internship year, vary as a function of their gender and the representation of women in the field. We analyzed an archival data set from a large hospital in Israel which included 3326 assessments that were given to all interns who completed their internship year between 2015 and 2019. RESULTS: Women received lower department scores and skills scores in fields with a low (versus high) representation of women. Men received higher scores in fields with a high (versus low) representation of men, yet there was no difference in their skills scores. CONCLUSIONS: Women are evaluated more negatively in fields with a low representation of women doctors. Similarly, men are evaluated more negatively in fields with a low representation of men, yet this cannot be explained by their skills. This pattern of results might point to a gender bias in assessments. A better understanding of these differences is important as assessments affect interns' career choices and options.

Mother-infant contact after birth can reduce postpartum post-traumatic stress symptoms through a reduction in birth-related fear and guilt.

OBJECTIVES: Despite the well-documented negative effects of posttraumatic stress symptoms following childbirth (PTSS-FC), research on protective factors for PTSS-FC is still missing. Aiming to fill this gap, we proposed and examined a process model through which maternal-infant skin-to-skin contact after birth reduces PTSS-FC by decreasing negative emotions, especially for women who had operative births. METHOD: In this longitudinal study, pregnant women (N = 1833) were recruited at community and hospital medical centres in the center of Israel and through internet forums. At Time 1, during pregnancy, they rated their prenatal depressive symptoms which served as an indicator for prenatal vulnerabilities. At Time 2, two-months postpartum (N = 1371, 75% of the sample), they reported their mode of birth, whether they had skin-to-skin contact with their newborn after birth, their emotions during birth, and rated their current PTSS-FC. A moderated mediation analysis was used to examine the proposed model. RESULTS: Guilt and fear during birth mediated the association between mode of birth (instrumental or cesarean versus vaginal) and PTSS-FC. Skin-to-skin contact was related to reduced feelings of guilt and fear during birth, especially for women who had a cesarean section. CONCLUSIONS: Our results recognize the specific emotions that contribute to the development of PTSS-FC following operative births and show how skin-to-skin contact can possibly reduce them. As such they emphasize the importance of the implementation of skin-to-skin contact following childbirth, and especially following a cesarean section as recommended by the Baby Friendly Health Initiative (World Health Organization & UNICEF, 2009).

The complex effects of maternal expectations on postpartum depressive symptoms: when does a protective factor become a risk factor?

PURPOSE: The present study assessed the effects of several prenatal maternal expectations on postpartum depression (PPD), while considering two relevant factors - incongruence between planned and actual birth and the rigidity of the birth plan - that can affect whether maternal expectations act as protective factors or risk factors for PPD. METHODS: Primiparous women (N = 527) were recruited to a longitudinal study about women's birth choices and experiences. At time 1, during pregnancy, women completed a questionnaire assessing prenatal depression, preferred birth plan, birth plan flexibility-rigidity and maternal expectations (i.e. Natural-Fulfillment, Infant-Reflects-Mothering, Sacrifice). At time 2, two-months post-partum, they reported their actual birth mode and answered a questionnaire assessing their PPD symptoms. RESULTS: Natural-fulfillment maternal expectations were negatively related to PPD symptoms. Yet, the interaction of high natural-fulfillment expectations with an unfulfilled birth plan and the rigidity of the birth plan, served as a risk factor for PPD symptomatology. CONCLUSIONS: Understanding the conditions under which specific prenatal maternal expectations serve as a risk factor for PPD, can help healthcare providers identify women who are at high risk for developing PPD symptoms and plan preemptive interventions.

Who benefits most from skin-to-skin mother-infant contact after birth? Survey findings on skin-to-skin and birth satisfaction by mode of birth.

OBJECTIVE: Previous research has shown that skin-to-skin contact in the delivery room is associated with an increase satisfaction with childbirth. The purpose of the present study was to examine whether this association differs as a function of mode of birth, such that the positive effect of skin-to-skin contact would be especially pronounced for women who had operative births. DESIGN: Survey design using self-administered questionnaires during pregnancy (Time 1) and at two months postpartum (Time 2). SETTING: At Time 1, women were recruited at community and hospital medical centres in two large metropolitan areas in the centre of Israel and through home midwives and internet forums. At Time 2, women completed a second questionnaire in which they reported whether they had skin-to-skin contact with their infant immediately after birth and their birth satisfaction. PARTICIPANTS: Pregnant women, gestation week ≥24, with singleton pregnancy, who took part in both T1 and T2 (N = 1371, 75% of the 1833 women recruited at T1). MEASUREMENTS: Analysis of covariance (ANCOVA) was used to examine whether the association between skin-to-skin contact after birth and birth satisfaction two months post-partum, differs as a function of mode of birth. Maternal or infant complications during birth, parity, and whether the pregnancy was planned, served as covariates. Birth satisfaction was measured using the Childbirth Satisfaction Scale. All measures were self-reported. FINDINGS: The frequency of skin-to-skin was high (83%) for women who had vaginal birth, but lower for women who had an instrumental birth (66%) or a caesarean section (31%). At two months postpartum, women who had operative births reported less satisfaction with their birth than women who gave birth via vaginal birth. A significant interaction between skin-to-skin and mode of birth showed that although skin-to-skin was associated with higher birth satisfaction among women across all three modes of birth, i.e., vaginal (Cohen's d = .41), instrumental (Cohen's d = .64) and caesarean (Cohen's d = .87), the effect for the difference in birth satisfaction between women with and without skin-to-skin was especially large for operative births, particularly for caesarean sections. KEY CONCLUSIONS: Operative birth is related to lower satisfaction with childbirth and lower rates of skin-to-skin contact immediately after birth. Yet, the association between skin-to-skin and birth satisfaction is especially strong for women who had operative births and specifically a caesarean section, suggesting that the possible contribution of skin-to-skin to birth satisfaction should be emphasised particularly after operative births. IMPLICATIONS FOR PRACTICE: It is recommended that maternity care providers, managers, policy makers and medical teams facilitate skin-to-skin contact between the woman and her infant immediately, or as soon as possible, after childbirth, in both operative and non-operative births.

Power matters: The role of power and morality needs in competitive victimhood among advantaged and disadvantaged groups.

Competitive victimhood denotes group members' efforts to establish that their ingroup has suffered greater injustice than an adversarial outgroup. Previous research in contexts of structural inequality has stressed the role of the need to defend the ingroup's moral identity, rather than the need for power, in leading advantaged and disadvantaged group members to engage in competitive victimhood. Focusing on the structural inequality between Jewish and Arab citizens of Israel (Study 1) and Israeli women and men (Study 2), we found that across all groups and contexts, power needs predicted competitive victimhood. Also, the need to protect the ingroup's moral reputation (i.e., defensive moral needs) positively predicted competitive victimhood, whereas among advantaged group members, the need to protect the ingroup's moral essence negatively predicted competitive victimhood. Finally, exploratory analyses revealed that competitive victimhood correlated, positively for advantaged and negatively for disadvantaged group members, with support for policies securing realistic and symbolic resources for the disadvantaged group. Theoretical and practical implications of these results, which are consistent with the logic of the needs-based model of reconciliation, are discussed.

Experimental Studies on State Self-Objectification: A Review and an Integrative Process Model.

This paper provides an organizing framework for the experimental research on the effects of state self-objectification on women. We explain why this body of work, which had grown rapidly in the last 20 years, departs from the original formulation of objectification theory (Fredrickson and Roberts, 1997). We compare the different operationalizations of state self-objectification and examine how they map onto its theoretical definition, concluding that the operationalizations have focused mostly on one component of this construct (concerns about one's physical appearance) while neglecting others (adopting a third-person perspective and treating oneself as a dehumanized object). We review the main findings of studies that experimentally induced state self-objectification and examined its affective, motivational, behavioral, cognitive, and physiological outcomes. We note that three core outcomes of this state as specified by objectification theory (safety anxiety, reduced flow experiences, and awareness of internal body states) have hardly been examined so far. Most importantly, we introduce an integrative process model, suggesting that the reported effects are triggered by four different mechanisms: appearance monitoring, experience of discrepancy from appearance standards, stereotype threat, and activation of the "sex object" schema. We propose strategies for distinguishing between these mechanisms and explain the theoretical and practical importance of doing so.

Positive stereotypes, negative outcomes: Reminders of the positive components of complementary gender stereotypes impair performance in counter-stereotypical tasks.

Gender stereotypes are complementary: Women are perceived to be communal but not agentic, whereas men are perceived to be agentic but not communal. The present research tested whether exposure to reminders of the positive components of these gender stereotypes can lead to stereotype threat and subsequent performance deficits on the complementary dimension. Study 1 (N = 116 female participants) revealed that compared to a control/no-stereotype condition, exposure to reminders of the stereotype about women's communality (but not to reminders of the stereotype about women's beauty) impaired women's math performance. In Study 2 (N = 86 male participants), reminders of the stereotype about men's agency (vs. a control/no-stereotype condition) impaired men's performance in a test of socio-emotional abilities. Consistent with previous research on stereotype threat, in both studies the effect was evident among participants with high domain identification. These findings extend our understanding of the potentially adverse implications of seemingly positive gender stereotypes.