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Barut A, Mohamud SA. The psychosexual and psychosocial impacts of polygamous marriages: a cross-sectional study among Somali women. BMC Womens Health 2023; 23:669. [PMID: 38093249 PMCID: PMC10720057 DOI: 10.1186/s12905-023-02830-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Polygamous marriages are common in many Africa countries. This study aimed to document psychosexual and psychosocial problems of Somali women engaged in monogamous or polygamous marriages. METHODS This cross-sectional study included 607 consecutive women who had presented between June 7 and October 1, 2022, to the Department of Gynaecology of Mogadishu Somali Turkey Training and Research Hospital in Mogadishu, the capital city of Somalia. Data included maternal age, type of marriage (polygamy, monogamy, and arranged marriage), wives' education, husbands' education, husband income, residence area (rural or urban), number of marriages, living in houses (same or different), number of co-wives, and age of marriage. The participants were asked to complete three questionnaires: The Female Sexual Function Index (FSFI), the Rosenberg Self-Esteem Scale (RSE), and the Brief Symptom Inventory-18 (BSI-18). RESULTS Of 607 women, 435 (71.7%) had monogamous marriages and 172 (28.3%) had polygamous marriages. The mean age was 29.0 ± 7.2 years (range 16-46). In polygamous marriages, the mean number of wives a husband had was 2.4 ± 0.7 women (range 2- 4). The overall incidences of sexual dysfunction, low self-esteem and arranged marriage were 59.8%, 79.4% and 64.4%, respectively. Wives in polygamous marriages differed from those in monogamous marriages with significantly higher rate of illiterateness (41.9% vs. 27.4%, p = 0.004). Increases in husband income corresponded to higher rates of polygamous marriage. Women in polygamous marriages had significantly lower scores in the desire, arousal, orgasm, and satisfaction sub-domains. Sexual dysfunction, with a significantly increased rate among women in polygamous marriages. Polygamous marriages were associated with significantly higher levels of anxiety, and depression, and a significantly higher total BSI score (p = 0.010, p = 0.004, and p = 0.020, respectively). Women in both groups had similar levels of low self-esteem (p > 0.05). In univariate analysis, polygamous marriage was in significant inverse associations with the total FSFI score and subdomain scores of desire, arousal, orgasm, satisfaction, and sexual dysfunction and in significant associations with the BSI total score and subdomain scores of anxiety and depression (p < 0.05). CONCLUSION Our findings suggest that women in polygamous marriages experience considerably higher psychosexual and psychosocial adverse effects as compared with their monogamous counterparts.
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Affiliation(s)
- Adil Barut
- Obstetrics and Gynaecology Department, Somali-Mogadishu Recep Tayyip Erdoğan Research and Training Hospital, Mogadishu, Somalia.
| | - Samira Ahmed Mohamud
- Obstetrics and Gynaecology Department, Somali-Mogadishu Recep Tayyip Erdoğan Research and Training Hospital, Mogadishu, Somalia
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YILMAZ E. Psychological symptoms and sexual satisfaction in polygamic and monogamic wives. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1029011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Shaiful Bahari I, Norhayati MN, Nik Hazlina NH, Mohamad Shahirul Aiman CAA, Nik Muhammad Arif NA. Psychological impact of polygamous marriage on women and children: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2021; 21:823. [PMID: 34903212 PMCID: PMC8667458 DOI: 10.1186/s12884-021-04301-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/23/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Over the last two decades, there has been significant growth in public, political, and academic awareness of polygamy. Polygamous families have distinct household problems, usually stemming from jealousy between co-wives over the husband's affections and resources. This study aimed to ascertain the psychological impact of polygamous marriage on women and children worldwide. METHODS A systematic search was performed in MEDLINE (PubMed), Scopus, CINAHL (EBSCOhost), Google Scholar, and ProQuest using search terms such as "marriage" and "polygamy." Studies published from the inception of the respective databases until April 2021 were retrieved to assess their eligibility for inclusion in this study. The Joanna Briggs Institute Critical Appraisal Checklist was used for data extraction and the quality assessment of the included studies. The generic inverse variance and odds ratios with 95% confidence intervals (CI) were calculated using RevMan software. RESULTS There were 24 studies fulfilling the eligibility criteria, and 23 studies had a low risk of bias. The pooled meta-analysis showed women in polygamous marriages had a 2.25 (95% CI: 1.20, 4.20) higher chance of experiencing depression than in monogamous marriages. Children with polygamous parents had a significantly higher Global Severity Index with a mean difference of 0.21 (95% CI: 0.10, 0.33) than those with monogamous parents. CONCLUSIONS The psychological impact of polygamous marriage on women and children was found to be relatively higher than monogamous marriage. Awareness of the proper practices for polygamy should be strengthened so that its adverse effects can be minimized. The agencies involved in polygamous practices should broaden and enhance their understanding of the correct practice of polygamy.
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Affiliation(s)
- Ismail Shaiful Bahari
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Noor Norhayati
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - Nik Hussain Nik Hazlina
- Women's Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | | | - Nik Ahmad Nik Muhammad Arif
- Women's Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
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Kassaw C, Shumye S. The prevalence of suicidal behavior and its associated factors among wives with polygamy marriage living in Gedeo zone, southern Ethiopia, 2020. PLoS One 2021; 16:e0259029. [PMID: 34695161 PMCID: PMC8544854 DOI: 10.1371/journal.pone.0259029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Polygamy is a trend of marriage characterized by having two and more wives or husbands at the same time. In low and middle-income countries including Ethiopia, polygamy has a significant negative effect on the social, economic, physical, and mental well-being of women. Therefore, this study aimed to assess the prevalence and associated factors of suicidal behavior among wives with polygamy marriage living in the Gedeo zone, Southern Ethiopia, 2020. METHODS A community-based study employing cross-sectional design and systematic sampling technique was used to select wives with polygamy marriage who are residents of Gedeo Zone from November to December 2020. The World Health Organization Suicidal Behavior Questions (SBQ-5) was adapted to explore the outcome variable. The Logistic regression at 95% CI, p<0.05 was used to identify factors associated with suicidal behavior. RESULTS This study enrolled 423 respondents. The study revealed that, the overall prevalence of suicidal behavior was 157(37%). Illiteracy, being a wife of a husband with three and more other wives, current history of depression, intimate partner violence, and poor social support were significantly associated with suicidal behavior at 95% confidence interval, p < 0.05. CONCLUSION This study found that one-third of the respondents had suicidal behavior. Different significant socio-demographic and psychosocial variables were identified. Thus, due attention should be given to minimize the practice and its effect on the mental wellbeing of a mother and their children.
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Affiliation(s)
- Chalachew Kassaw
- Department of Psychiatry, College of Health Science, Dilla University, Dilla, Ethiopia
| | - Seid Shumye
- Department of Psychiatry, College of Health Science, Dilla University, Dilla, Ethiopia
- * E-mail:
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Damtie Y, Kefale B, Yalew M, Arefaynie M, Adane B. Multilevel analysis of determinants of polygyny among married men in Ethiopia. BMC Public Health 2021; 21:1677. [PMID: 34525988 PMCID: PMC8442388 DOI: 10.1186/s12889-021-11701-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 08/31/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Polygyny occurs when a man has more than one wife at the same time. It often contributes to poor health among family members, particularly young children. It encourages the spread of sexually transmitted infections (STIs) including HIV/AIDS. The determinants of polygyny have not yet been adequately explored in Ethiopia. This study adds to the body of knowledge concerning the prevalence and distribution of polygyny in the country. METHODS This study is a secondary analysis of the 2016 Ethiopian Demographic and Health Survey (EDHS) data. Using a two-stage stratified cluster sampling, 7470 married men were selected. After verifying the assumptions of multilevel logistic regression analysis, Stata version 14.0 was used to analyse the data. A multilevel mixed-effects logistic regression model was used to identify predictors of polygyny. An adjusted odds ratio with a 95% confidence interval was used to measure the association. A p-value of < 0.05 was considered to indicate statistical significance. RESULTS Age from 30 to 44 years [AOR = 5.78, 95% CI = (3.13, 10.7)], age from 45 to 59 years [AOR = 16.5, 95% CI = (8.59, 31.8)], men with primary education or no formal education [AOR = 3.40, 95% CI = (1.50, 7.69)], being Muslim [AOR = 2.47, 95% CI = (1.28, 4.77)], sexual initiation at or above the age of 18 years [AOR = 0.46, 95% CI = (0.30, 0.68)] and being from a less developed region of Ethiopia [AOR = 3.67, 95% CI = (2.30, 5.83)] were factors associated with polygyny. CONCLUSION Both individual and community level factors were identified as predictors of polygyny. Improving educational attainment and delaying men's sexual debut could encourage the reduction of polygyny in Ethiopia.
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Affiliation(s)
- Yitayish Damtie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, PO Box: 1145, Dessie, Ethiopia.
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, PO Box: 1145, Dessie, Ethiopia
| | - Melaku Yalew
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, PO Box: 1145, Dessie, Ethiopia
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, PO Box: 1145, Dessie, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Rahmanian P, Munawar K, Mukhtar F, Choudhry FR. Prevalence of mental health problems in women in polygamous versus monogamous marriages: a systematic review and meta-analysis. Arch Womens Ment Health 2021; 24:339-351. [PMID: 33000343 DOI: 10.1007/s00737-020-01070-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023]
Abstract
While some studies suggest different mental health outcomes among women in polygamous versus monogamous marriages, no published systematic review or meta-analysis has analyzed the relevant research literature. This article aims to review the evidence of marriage types (i.e., polygamous and monogamous marriages) and differences in the prevalence of mental health issues. Eleven electronic databases, along with further identified references lists, were searched. Thirteen studies met the inclusion criteria. They included 3166 participants, and 986 women were in a polygamous marriage. All studies were rated for quality and were tested for publication bias. Meta-analyses were conducted on the five symptoms to assess for the effect of marriage type. The studies indicate a significant association of marriage type with psychological symptoms. The meta-analysis indicates that women in polygamous marriage had worsened mental health as compared with women in monogamous marriages. The weighted mean differences with 95% confidence intervals were somatization 0.53, 0.44-0.63; obsession-compulsion 0.35, 0.14-0.56; interpersonal sensitivity 0.42, 0.12-0.73; depression 0.41, 0.15-0.67; anxiety 0.41, 0.15-0.68; hostility = 0.47, 0.28-0.66; phobic anxiety 0.39, 0.17-0.61; paranoid ideation 0.35, 0.24-0.47; psychoticism 0.41, 0.23, 0.59; and Global Severity Index (GSI) 0.43, 0.25-0.60. A higher self-esteem and life satisfaction among women in polygamous marriages and statistically superior family functioning among women in monogamous marriages were also found. However, there was no statistically significant difference between the marital satisfaction of women in polygamous versus monogamous marriages. Results are consistent with the existing research on the prevalence of mental health issues among women in polygamous marriages. Nonetheless, these women were found to have elevated self-esteem and life satisfaction than women in monogamous marriages. Directions for future research are indicated.
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Affiliation(s)
- Parisa Rahmanian
- Zahedan Medical School, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Khadeeja Munawar
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
| | - Firdaus Mukhtar
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
| | - Fahad Riaz Choudhry
- Department of Psychology, Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia, 53100, Kuala Lumpur, Malaysia
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Daoud N, Berger-Polsky A, Abu-Kaf S, Sagy S. Sense of coherence among Bedouin women in polygamous marriages compared to women in monogamous marriages. Women Health 2020; 60:43-59. [PMID: 31068120 DOI: 10.1080/03630242.2019.1610826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 03/28/2019] [Accepted: 04/02/2019] [Indexed: 10/26/2022]
Abstract
We compared sense of coherence (SOC) among Bedouin women in polygamous with those in monogamous marriages. SOC is a global orientation toward life as comprehensible, manageable, and meaningful, and is derived from generalized resistance resources that promote effective coping in stressful life situations. Strong SOC may be a resource for strengthening resilience and promoting health. We administered questionnaires to 464 Indigenous Arab Bedouin women (ages 18-49 years) in 2008-2009 using the 13-item SOC questionnaire. Contrary to our hypothesis, SOC was higher among women in polygamous compared to monogamous marriages. Husband's education, husband's abandonment of the household, living in unrecognized villages, and low mastery (perception of one's ability to control life situations) were associated with higher SOC. These results might suggest that polygamy may provoke new coping mechanisms among women as they reappraise life amidst low mastery, accept cultural norms, and marshal new resources, thereby increasing key elements of SOC, including comprehensibility, manageability, and meaningfulness. Interventions and services seeking to empower women in polygamous marriages should build on their resilience.
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Affiliation(s)
- Nihaya Daoud
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Alexandra Berger-Polsky
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Sarah Abu-Kaf
- Conflict Management & Resolution Program, Department of Interdisciplinary Studies, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Shifra Sagy
- Department of Education, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Berger-Polsky A, Daoud N, Sergienko R, Sheiner E, Shoham-Vardi I, Bilenko N. Polygamy and birth outcomes among Bedouin women of the Negev: The contribution of social determinants and pregnancy complications. Health Care Women Int 2019; 41:54-74. [PMID: 31339470 DOI: 10.1080/07399332.2019.1639708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Polygamy has been associated with adverse health outcomes. We examined the association between polygamy and adverse birth outcomes (composite score of preterm birth, low birth weight, small for gestational age, Apgar score < 7) using survey data linked to retrospective medical data of 9,872 cohort Bedouin women who bore live singletons in a large medical center in Southern Israel between 2008 and 2014. Women in polygamous marriages (18%) were more likely to have adverse birth outcomes after considering different factors (AOR = 1.28, 95% CI = 1.09-1.51), indicating that polygamy is an independent risk factor for birth outcomes that should be considered in research and clinical practice.
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Affiliation(s)
- Alexandra Berger-Polsky
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Nihaya Daoud
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Ruslan Sergienko
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Ilana Shoham-Vardi
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Natalya Bilenko
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel
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Ekerbiçer HÇ, Resim S, Efe E, Bahar MR, Altunören Ö, Küçükdurmaz F, Benlioğlu C. A Comparison of Sexual Function, Psychological Status, and Sociodemographic Characteristics of Turkish Men within Polygamous and Monogamous Marriages. Balkan Med J 2016; 33:383-389. [PMID: 27606132 PMCID: PMC5001814 DOI: 10.5152/balkanmedj.2016.16459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 10/20/2015] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND A limited number of studies within the literature have entailed objective evaluations of psychological, sexual, and emotional features of women within polygamous marriages. However, there is a lack of studies reporting these features among polygamous and monogamous men. AIMS The aim of this study was to investigate sociodemographic characteristics, sexual function, and psychological status of polygamously and monogamously married men. STUDY DESIGN Cross-sectional study. METHODS The study sample comprised two groups: 35 polygamous and 45 monogamous men in Kahramanmaraş Province, Turkey. Door-to-door surveys covered sociodemographic factors and adopted Beck Depression Inventory (BDI), and International Index of Erectile Function - Erectile Function Domain (IIEF-EFD) scales. RESULTS Polygamous men showed considerably higher IIEF-EFD scores (p<0.05). While the median score of IIEF-EFD was 25.0 for polygamous men, it was 22.0 for monogamous men. A comparison of the two groups revealed that polygamous men had lower BDI scores. However, the difference between the groups was statistically non-significant (p>0.05). Odds ratios and 95% confidence intervals of monogamous men for erectile dysfunction and depression were 14.4 (95% CI: 3.1-67.5) and 7.4 (95% CI: 0.9-61.9), respectively. The main reasons for multiple marriages reported by polygamous men, in descending order, were: 1) decreased satisfaction of sexual desires by a wife (37.1%); 2) falling in love with the second wife (22.8%); and 3) incompatibility with the first wife (17.1%). However, 62.9% of them responded negatively to the question: "Would you recommend polygamous marriage to other men?" CONCLUSION Our results showed that polygamous men had higher erectile function and lower depression scores than monogamous men. Further studies investigating the effects of polygamy on men's psychosexual function are warranted. Additionally, studies that address the perspectives of offspring and women's expectations within polygamous marriages should be conducted.
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Affiliation(s)
| | - Sefa Resim
- Department of Urology, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Erkan Efe
- Department of Urology, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Mustafa Remzi Bahar
- Department of Urology, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Özlem Altunören
- Department of Psychiatry, Kahramanmaraş State Hospital, Kahramanmaraş, Turkey
| | | | - Can Benlioğlu
- Department of Urology, Adıyaman University School of Medicine, Adıyaman, Turkey
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Obimakinde AM, Ladipo MM, Irabor AE. Familial and socio-economic correlates of somatisation disorder. Afr J Prim Health Care Fam Med 2015; 7:746. [PMID: 26245602 PMCID: PMC4564913 DOI: 10.4102/phcfm.v7i1.746] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 01/28/2015] [Accepted: 11/28/2014] [Indexed: 11/24/2022] Open
Abstract
Background Somatisation disorder can result from an interplay between suboptimal family environment and socio-economic deprivation, which enhances the underlying cognitive tendency for this disorder. There are pertinent familial and socio-economic factors associated with this disorder, but research addressing this is sparse. Aim and setting The study aims to evaluate family and socio-economic factors that are associated with somatisation disorder amongst patients presenting to the Family Medicine clinic, University College Hospital, Ibadan, Nigeria. Methods This is an observational case-control study of 120 participants who presented to the clinic between May and August 2009. Data collection was by interviewer-administered structured questionnaire using the World Health Organization Screener for Somatoform Disorder and Somatoform Disorder Schedule to ascertain somatisation in 60 patients who were then matched with 60 controls. The respondents’ demographic and family data were also collected and their interpersonal relationships were assessed with the Family Relationship Index. Results The somatising patients were mostly females (70%), with a female to male ratio of 2.3:1 and mean age of 43.65 ± 13.04years.Living in a polygamous family (as any member of the family) was significantly related to somatisation (p = 0.04). Somatisation was also more common in people who were separated, divorced or widowed (p = 0.039). Somatisers from a lower social class or those earning below a dollar a day experienced poorer cohesion (p = 0.042) and more conflicts (p = 0.019) in their interpersonal relationship. Conclusion This study was able to demonstrate that a polygamous family setting, disrupted marriage, low social status and financial constraints are correlates of somatisation. It is of essence to identify these factors in holistic management of somatising patients.
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Daoud N, Shoham-Vardi I, Urquia ML, O'Campo P. Polygamy and poor mental health among Arab Bedouin women: do socioeconomic position and social support matter? ETHNICITY & HEALTH 2014; 19:385-405. [PMID: 23721210 DOI: 10.1080/13557858.2013.801403] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Polygamy is a complex phenomenon and a product of power relations, with deep cultural, social, economic, and political roots. Despite being banned in many countries, the practice persists and has been associated with women's marginalization and mental health sequelae. In this study, we sought to improve understanding of this ongoing, complex phenomenon by examining the contribution of socioeconomic position (SEP) and social support to the excess of depressive symptoms (DS) and poor self-rated health (SRH) among women in polygamous marriages compared to women in monogamous marriages. Measuring the contribution of these factors could facilitate policies and interventions aimed at protecting women's mental health. DESIGN The study was conducted among a sample of Arab Bedouin women living in a marginalized community in southern Israel (N=464, age 18-50). The women were personally interviewed in 2008-2009. We then used logistic regression models to calculate the contribution of SEP (as defined by the women's education, family SEP, and household characteristics) and social support to excess of depressive symptoms and poor SRH among participants in polygamous versus monogamous marriages. RESULTS About 23% of the participants were in polygamous marriages. These women reported almost twice the odds of depressive symptoms (OR=1.91, 95%CI=1.22, 2.99) and poorer SRH (OR=1.73, 95%CI=1.10, 2.72) than those in monogamous marriages. Women's education changed these associations slightly, but family SEP and household characteristics resulted in virtually no further change. Social support reduced the odds for poor SRH and DS by about 23% and 28%, respectively. CONCLUSION Polygamy is associated with higher risk for poor mental health of women regardless of their SEP and education. Social support seems to have some protective effect.
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Affiliation(s)
- Nihaya Daoud
- a Department of Epidemiology and Health Systems Evaluation, Faculty of Health Sciences , Ben-Gurion University of the Negev , Beer- Sheva , Israel
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Özer A, Orhan FÖ, Ekerbiçer HÇ. Sociodemographic Variables and Depression in Turkish Women From Polygamous Versus Monogamous Families. Health Care Women Int 2013; 34:1024-34. [DOI: 10.1080/07399332.2012.692414] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Miller AC, Karkazis K. Health beliefs and practices in an isolated polygamist community of southern Utah. JOURNAL OF RELIGION AND HEALTH 2013; 52:597-609. [PMID: 22438183 DOI: 10.1007/s10943-012-9593-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Short Creek is a largely closed and isolated community on the border between Utah and Arizona, made up of the sister towns of Hildale, Utah, and Colorado City, Arizona. Beginning from childhood, the 6,000 or so members of the Fundamentalist Church of Jesus Christ of Latter-Day Saints (FLDS) are brought up in a lifestyle of plural marriage, meaning a marriage among one man and more than one woman, and are surrounded by their peers in "the covenant." A lifestyle of plural marriage is likely to affect the health of community members, but its effects have not been studied because of the community's isolation and distrust of outsiders. This paper addresses several questions that arise in contemplating the health of the Short Creek community: What are the health beliefs in this community, and what are their historical bases? Where do families seek medical care, and for what or at what threshold of illness or injury? What is the attitude of care providers serving this community, and how are the providers viewed by the community? More broadly, this paper examines the ways in which polygamy configures health. In order to meet this objective, this paper aims first to provide a brief account of this community's history and demographic profile, followed by a discussion of health care in this community and how it is affected by the practice of plural marriage, with the data comprised of qualitative interviews with health care providers to the community. The goals of this project are to gain a rich, historically nuanced understanding of the health of community members, and to identify directions for further academic and policy research. Our findings indicate that health in this community is shaped by limited resources, an attitude of health fatalism, and a profound insularity and corresponding isolation from the outside world.
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Affiliation(s)
- Anne Catherine Miller
- Stanford University School of Medicine, 670 Sharon Park Drive #31, Menlo Park, CA 94025, USA.
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Al-Krenawi A. Mental health and polygamy: The Syrian case. World J Psychiatry 2013; 3:1-7. [PMID: 24175180 PMCID: PMC3782180 DOI: 10.5498/wjp.v3.i1.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 11/29/2012] [Accepted: 02/07/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To examine the psychological, self-esteem (SE), family function, marital satisfaction, life satisfaction and degree of agreement with the practice of polygamy among polygamous women with a control group from monogamous women in Syria.
METHODS: Convenience sample of 136 women, 64 of whom were wives in polygamous marriages and 72 were wives in monogamous marriages participated in this study. A snowball method of sampling was used, conducted by undergraduate local female students trained to collect data according to culturally competent methods. The following research instruments were deployed: the symptoms checklist-90, the Rosenberg SE, the Life Satisfaction, family function and marital satisfaction.
RESULTS: Findings revealed that women in polygamous marriages experienced lower SE, less life satisfaction, less marital satisfaction and more mental health symptomatology than women in monogamous marriages. Many of the mental health symptoms were different; noteworthy were elevated somatization, depression, hostility and psychoticism and their general severity index was higher. Furthermore, “first wife syndrome” was examined in polygamous families, comparing first with second and third wives in polygamous marriages. Findings indicated that first wives reported on more family problems, less SE, more anxiety, more paranoid ideation, and more psychoticism than second and third wives.
CONCLUSION: These results are best understood through consideration of the socio-cultural and economic realities facing these women. Implications for mental health practice, policy and further research are discussed.
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Affiliation(s)
- Alean Al-Krenawi
- Alean Al-Krenawi, Department of Social Work, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel
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Shepard LD. The impact of polygamy on women's mental health: a systematic review. Epidemiol Psychiatr Sci 2013; 22:47-62. [PMID: 22794315 PMCID: PMC6998378 DOI: 10.1017/s2045796012000121] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 02/08/2012] [Accepted: 02/14/2012] [Indexed: 01/31/2023] Open
Abstract
Aims. The purpose of this systematic review is to identify and appraise the present state of prevalence research on the mental health of polygynous women, or plural wives, and to summarize its implications for future research and social work practice. Methods. PsycInfo (1967 to November 2011) and Medline (1985 to November 2011) databases, systematic bibliography hand-searches, personal communication with a leading expert, and gray literature searching were applied in a systematic literature search of the prevalence of mental-health issues in polygynous women compared to monogamous women. Twenty-two studies meeting eligibility criteria were identified. Study characteristics, methods and findings were systematically extracted and appraised for quality. Results. The identified studies are of mixed methodological quality, but generally suggest a more significant prevalence of mental-health issues in polygynous women compared to monogamous women. Individual studies report a higher prevalence of somatization, depression, anxiety, hostility, psychoticism and psychiatric disorder in polygynous wives as well as reduced life and marital satisfaction, problematic family functioning and low self-esteem. Conclusions. The current state of the research reveals with moderate confidence, a more significant prevalence of mental-health issues in polygynous women as compared to monogamous women. Implications for practice and research are indicated.
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Affiliation(s)
- L. D. Shepard
- Department of Social Policy and Social Work, University of Oxford, Oxford, OX1 2ER, UK
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Al-Krenawi A. A study of psychological symptoms, family function, marital and life satisfactions of polygamous and monogamous women: the Palestinian case. Int J Soc Psychiatry 2012; 58:79-86. [PMID: 21088033 DOI: 10.1177/0020764010387063] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Polygamy is defined as a marriage in which a spouse of either gender has more than one mate at the same time. Polygamy is considered a valid form of marriage in many countries and communities around the globe. AIM The purpose of this study is to examine the psychological symptoms, family function, marital satisfaction, life satisfaction and the degree of agreement with the practice of polygamy among 'senior wives' - the first wife in the polygamous marriage - and women in monogamous marriages in the West Bank, Palestine. METHOD A convenience sample of 309 women, 187 from polygamous and 122 from monogamous families, participated in this study. All women from polygamous families were senior wives. The following instruments were deployed: the McMaster Family Assessment Device (FAD), the ENRICH marital satisfaction questionnaire, the SCL-90 mental health symptoms checklist, the Rosenberg self-esteem (SE) scale, the Diener et al. (1985), a life satisfaction scale, and a basic socio-demographic scale, including the degree of agreement of the practice of polygamy. RESULTS The findings revealed significant differences between senior wives in polygamous marriages and wives in monogamous marriages with regard to family functioning, marital satisfaction, self-esteem and life satisfaction. Likewise, many of the mental health symptoms were different. Particularly noteworthy were somatization, depression, hostility psychotism and the General Severity Index (a global index of distress). More women in polygamous marriages agreed with the practice of polygamy than their monogamous counterparts. CONCLUSION Practitioners and policy makers need to be aware of the consequences of polygamy on first wives and on society as whole.
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Affiliation(s)
- Alean Al-Krenawi
- School of Social Work, Memorial University of Newfoundland, St John's NL, Canada, A1C 5S1.
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Abstract
OBJECTIVES Vaginismus is a sexual dysfunction involving various branches of medicine, including psychiatry and gynaecology. Psychiatric help is sought in only a small proportion of cases, although it is probable that the psychopathological aetiology is more frequent than generally recognized. This article deals with the causes and psychological circumstances in four Turkish couples who presented with unconsummated marriage for 3 to 7 years. Vaginismus F52.5 to the ICD-10 is a sexual dysfunction characterised as: deep anxiety about coitus leading to extreme spasm of musculature making coitus impossible or extremely unpleasant and painful. PATIENTS AND METHODS Four Turkish couples with unconsummated marriage due to the female partners' penetration phobia were included to this study. A patient-oriented multidimensional individual treatment (combination therapy) is a cost effective, short-term (typically 10- to 12-week) treatment model for both partners. It includes some elements of cognitive behavioural therapy and systemic partner therapy which were considered not radically different from previous therapeutic strategies. RESULTS Results were successful in all cases; the couples were extremely satisfied with having a normal sex life for the first time. This led to desired pregnancies and avoiding of possible breakdown of their families. DISCUSSION The couples did well with combination behavioural therapy. This methodology is discussed in its various aspects and with a cultural background. We also emphasise the need for physicians to be mindful of cases of vaginismus requiring psychiatric intervention rather than gynaecological treatment.
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Affiliation(s)
- V Gül
- Praxis für Psychiatrie, Königsberger Strasse 3, 75417, Mühlacker, Deutschland.
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Abbo C, Ekblad S, Waako P, Okello E, Muhwezi W, Musisi S. Psychological distress and associated factors among the attendees of traditional healing practices in Jinja and Iganga districts, Eastern Uganda: a cross-sectional study. Int J Ment Health Syst 2008; 2:16. [PMID: 19105804 PMCID: PMC2621117 DOI: 10.1186/1752-4458-2-16] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2008] [Accepted: 12/23/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health problems are a major public health concern worldwide. Evidence shows that African communities, including Uganda, use both modern and traditional healing systems. There is limited literature about the magnitude of psychological distress and associated factors among attendees of traditional healing practices. This study aimed to determine the prevalence and associated factors of psychological distress among attendees of traditional healing practices in two districts in Uganda. METHODS Face-to-face interviews with the Lusoga version of the Self Reporting Questionnaire (SRQ-20) were carried out with 400 patients over the age of 18 years attending traditional healing in Iganga and Jinja districts in Eastern Uganda. Patients were recruited consecutively in all the traditional healers' shrines that could be visited in the area. Persons with 6 or more positive responses to the SRQ were identified as having psychological distress. Prevalence was estimated and odds ratios of having psychological distress were obtained with multiple logistic regression analysis. RESULTS 387 questionnaire responses were analyzed. The prevalence of psychological distress in connection with attendance at the traditional healers' shrines was 65.1%. Having a co-wife and having more than four children were significantly associated with psyclogical distress. Among the socioeconomic indicators, lack of food and having debts were significantly associated with psychological distress. The distressed group was more likely to need explanations for ill health. Those who visited both the healer and a health unit were less likely to be distressed. CONCLUSION This study provides evidence that a substantial proportion of attendees of traditional healing practices suffer from psychological distress. Associated factors include poverty, number of children, polygamy, reason for visiting the healer and use of both traditional healing and biomedical health units. These findings may be useful for policy makers and biomedical health workers for the engagement with traditional healers.
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Affiliation(s)
- Catherine Abbo
- Karolinska Institutet, Department of Clinical Neuroscience, Section of Psychiatry, Stockholm, Sweden
- Department of Psychiatry, College of Health Sciences, Makerere University, P.O box 7072, Kampala, Uganda
| | - Solvig Ekblad
- Karolinska Institutet, Department of Clinical Neuroscience, Section of Psychiatry, Stockholm, Sweden
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Paul Waako
- Department of Pharmacology and Therapeutics, College of Health Sciences, Makerere University, BOX 7072, Kampala, Uganda
| | - Elialilia Okello
- Department of Psychiatry, College of Health Sciences, Makerere University, P.O box 7072, Kampala, Uganda
| | - Wilson Muhwezi
- Department of Psychiatry, College of Health Sciences, Makerere University, P.O box 7072, Kampala, Uganda
| | - Seggane Musisi
- Department of Psychiatry, College of Health Sciences, Makerere University, P.O box 7072, Kampala, Uganda
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Patil C, Hadley C. Symptoms of anxiety and depression and mother's marital status: an exploratory analysis of polygyny and psychosocial stress. Am J Hum Biol 2008; 20:475-7. [PMID: 18257059 DOI: 10.1002/ajhb.20736] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Many biocultural studies have examined the fitness consequences of polygynous marriage for women in Africa. Few studies have examined the mental health correlates of polygynous marriage despite the emerging interest by human biologists in mental health outcomes. In this study, we tested for an association between measures of psychosocial stress and marital status in a representative sample of 408 mothers in two Tanzania communities. Results showed no association between measures of psychological distress and marital status. Our results suggest that despite the widely cited reproductive costs to polygynously married women, there do not appear to be accompanying costs to mental health.
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Affiliation(s)
- Crystal Patil
- Department of Anthropology, University of Illinois at Chicago, Chicago, Illinois 60607-7139, USA.
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