Pandemic's mental health impact harder on older women with trauma history

Older women with a history of childhood abuse or intimate partner violence (IPV) experienced significantly greater depression, anxiety, and sleep disorders during the COVID-19 pandemic, according to a study presented at the annual meeting of the North American Menopause Society (NAMS), being held Sept. 22-25 in Washington, D.C.

“Although there is a growing number of studies looking at mental health during the pandemic, few studies have data on participants before the pandemic or have explored the role of trauma history on women’s experiences during the pandemic,” said principal investigator Karen Jakubowski, PhD, an assistant professor of psychiatry at the University of Pittsburgh in Pennsylvania.

The investigators assessed the Study of Women’s Health Across the Nation (SWAN), a long-standing cohort of women who reported on trauma, mental health symptoms, and sleep roughly 4 to 12 years prior to the pandemic and who also took part in an ancillary study of the impact of the pandemic on their lives.

“We were able to leverage SWAN to obtain a more comprehensive picture of how pre-pandemic trauma and mental health symptoms related to health during the pandemic among aging women,” Jakubowski told Contemporary OB/GYN®.

Women from 3 SWAN sites (Pittsburgh; Boston; and Newark, New Jersey) received a survey between June 2020 and March 2021 on the impact of the pandemic on their lives. In total, 72% (n = 644) returned the survey, with 582 women comprising the final analytic sample.

The mean age of the sample was 70 years old, with 63% of the sample White, 25% Black, and 12% Hispanic.

Overall, 48% of women reported childhood trauma and 35% reported pre-pandemic IPV, largely emotional IPV.

However, elevated pandemic depressive, anxiety, and sleep symptoms were reported by 27%, 32% and 46% of women, respectively.

In addition, 29% and 17% of women reported elevated conflict with household members and non-household family, respectively, during the pandemic.

Childhood trauma and IPV were linked to elevated pandemic depressive symptoms, sleep problems and household conflict, whereas childhood trauma alone was connected to elevated pandemic anxiety symptoms and conflict with non-household family.

“It is striking that women who experienced violence or abuse years before the pandemic, and decades earlier in the case of childhood abuse, reported worse mental health and sleep during the pandemic,” Jakubowski said. “These results highlight the potent impact that trauma can have on health over the life course.”

Health care providers should consider women’s trauma histories to better understand who is at greatest risk for mental health and sleep problems during the pandemic, according to Jakubowski.

“Women should also discuss any concerns about mental health, sleep or relationships with their health care providers, who can then connect them to support and services in their communities,” she said. “Finding opportunities for social connection, including virtual options, is critical during this time of physical distancing.”

A wind down period before bed, such as engaging in an activity that women find calming or restful, without using phones/screens if possible, “can help promote relaxation and sleep,” Jakubowski said.

Jakubowski noted that the pandemic is not going away any time soon, and that the impact on mental health will likely persist for years to come. “It is therefore critical that we continue to study the experiences of vulnerable groups during the pandemic, particularly aging women with trauma histories, and develop interventions to enhance their health and well-being,” she said.

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Disclosure

Jakubowski reports no relevant financial disclosures.

Reference

Jakubowski K, Koffer R, Matthews K, et al. Psychosocial Impacts of the COVID-19 Pandemic on Women with Trauma Histories: Study of Women’s Health Across the Nation (SWAN). Poster session. The North American Menopause Society Annual Meeting. September 24, 2021.