Co-OccurringRiskFactors for Mental Health Abortion Report

Reportofthe

APATaskForceon

MentalHealthandAbortion

APATaskForceonMentalHealthandAbortion

Brenda Major, PhD, ChairMark Appelbaum, PhDLinda Beckman, PhDMary Ann Dutton, PhDNancy Felipe Russo, PhDCarolyn West, PhD

A copy of the report is available online at

http://www.apa.org/pi/wpo/mental-health-abortion-report.pdf

Suggested bibliographic reference: American Psychological Association, Task Force on Mental Health and Abortion. (2008). Report of the Task Force onMental Health and Abortion. Washington, DC: Author. Retrieved from

http://www.apa.org/pi/wpo/mental-health-abortion-report.pdf

Also APA reports synthesize current psychological knowledge in a given area and may offer recommendations for future action. They do not constituteAPA policy nor commit APA to the activities described therein.

Copyright © 2008 by the American Psychological Association. This material may be reproduced in whole or in part without fees or per-mission provided that acknowledgment is given to the American Psychological Association. This material may not be reprinted, translated,or distributed electronically without prior permission in writing from the publisher. For permission, contact APA, Rights and Permissions,750 First Street, NE, Washington, DC 20002–4242.Printed in the USA.

REPORTOFTHEAPATASKFORCEONMENTALHEALTHANDABORTION

TableofContents

ExecutiveSummary

.................................................................................................3

Introduction

.........................................................................................................5Overview........................................................................................................6DefinitionsandScopeofReport .................................................................................6QuestionsAddressed ............................................................................................7ImportanceofRecognizingVariabilityintheAbortionExperience ................................................9

ConceptualFrameworks...................................................................................

10AbortionWithinaStress-and-CopingPerspective ...............................................................10AbortionasaTraumaticExperience.............................................................................11AbortionWithinaSocioculturalContext ........................................................................11AbortionandCo-OccurringRiskFactors.........................................................................12Systemicriskfactors.......................................................................................13Personalriskfactors .......................................................................................13SummaryofConceptualFrameworks...........................................................................14

MethodologicalIssuesinAbortionResearch

......................................................................15Comparison/ContrastGroups...................................................................................15Co-OccurringRiskFactors ......................................................................................16Sampling.......................................................................................................16MeasurementofReproductiveHistoryandProblemsofUnderreporting.........................................17Attrition........................................................................................................18OutcomeMeasures:Timing,Source,andClinicalSignificance ....................................................18OtherStatisticalIssues..........................................................................................19InterpretationalProblemsandLogicalFallacies..................................................................19SummaryofMethodologicalIssues.............................................................................20

ReviewofScientificLiterature

.....................................................................................21SearchStrategyandCriteriaforInclusion .......................................................................21DescriptiveOverviewofLiteratureIdentifiedforThisReview ....................................................21

ReviewofComparisonGroupStudies

.............................................................................22Record-BasedStudiesandSecondaryAnalysesWithComparisonGroups........................................22Medicalrecords ...........................................................................................22Secondaryanalysesofsurveydata.........................................................................31Evaluationofrecord-basedandsecondaryanalysesstudies ................................................55Summaryofmedical-recordandsecondaryanalysesstudies ...............................................56

Report of the APATask Force on

MentalHealthandAbortion

1

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