Mastectomy, Body De-Construction and Impact on Identity: A qualitative study

Objectives: This qualitative study aims at understanding the consequences of body deconstruction through mastectomy on corporality and identity in women with breast cancer. Design: Nineteen women were contacted through the hospital. All had to undergo mastectomy. Some were offered immediate breast reconstruction, others, because of cancer treatments, had no planned reconstruction. A qualitative reflexive methodological background was chosen. Method: Women were invited to participate in three semi-structured interviews, one shortly before or after mastectomy, and the other interviews later in their illness courses, after surgery. All interviews were transcribed verbatim. Thematic analysis was performed. The analysis of the first interview of each woman is presented in this article. Results: Mastectomy provokes a painful experience of body deconstruction. Even when immediate reconstruction is proposed, contrasted feelings and dissonance are expressed when comparing the former healthy body to the present challenged body entity. Body transformations are accompanied with experiences of mutilation, strangeness, and modify the physical, emotional social, symbolic and relational dimensions of the woman's gendered identity. Although the opportunity of breast reconstruction is seen as a possible recovery of a lost physical symmetry and body integrity, grieving the past body and integrating a new corporality leads to a painful identity crisis. Conclusion: With mastectomy, the roots of the woman's identity are challenged, leading to a re-evaluation of her existential values. The consequences of mastectomy transform the woman's corporality and embodiment, and question her identity. Psychological support is discussed in the perspective of our results.

Patson Approach versus the Standard Approach for increasing breast reconstruction rates in women undergoing mastectomy. A randomized, controlled, open-label clinical trial

Breast cancer is the most prevalent neoplasm among women in the majority of countries worldwide. Breast cancer treatment include mastectomy which is associated to strong impact in women. Breast reconstruction is an option for many women to re-establish their body image and also to decrease psychological impact. However, breast reconstruction rates are low and many factors are involved in not undergoing breast reconstruction. Patient involvement in the decision-making process increases breast reconstruction rates and is associated to higher satisfaction and less anxiety and depression symptoms. More physician-patient relation and more education in terms of breast reconstruction are needed to achieve our objective. A new approach of medical care, called Patson Approach, is created in order to meet our goal with more patient involvement, as well as, physician and psychological counsellingObjective: to increase breast reconstruction rates in women who are candidates for breast reconstruction after mastectomy and are included in the Patson Approach compared to women included in the Standard ApproachMethods: the study design will be a randomized, controlled, open-label clinical trial. 62 patients will be recruited during two years and randomly divided in two groups, 31 will be included in the Standard Approach and 31 will be included in the Patson Approach. Preoperative and postoperative appointments are established in order to do a follow-up of the patients and collect all the data

Sexual dysfunction in obese women is more affected by psychological domains than that of non-obese

Abstract PURPOSE: To compare differences in the occurrence and changed domains of sexual dysfunction in obese and non-obese Brazilian women. METHODS: Female Sexual Function Index, based on six domains, to investigate 31 sexual dysfunction incidence for obese compared to 32 non-obese women, was used. Statistical analysis using ANOVA and MANOVA were performed to compare total scores of Female Sexual Function Index among groups and to identify the differences among domains, Student t -test was used. Statistical significant level was established for all tests for p<0.05. RESULTS: No difference in female sexual dysfunction frequency between obese (25.8%) and non-obese women (22.5%) was found. However, an important distinction in which aspects of sexual life were affected was found. While the obese group was impaired in three domains of sexual life (desire, orgasm, and arousal), in the control group five aspects were dysfunctional (desire, orgasm, arousal, pain and lubrication). Future research exploring psychological outcomes in obese females, such as body image and measures of positive and negative effect, might better characterize the female sexual dysfunction in this group. CONCLUSIONS: Obesity does not appear to be an independent factor for allow quality of female sexual life. However, disturbance associated to obesity indicates a low frequency of disorder in physical domains, suggesting that psychological factors seem to be mainly involved in the sexual dysfunction in obese women.

Utilizing a Phenomenological Approach to Examine the Experience of Sexuality for Women Concerned about Urinary Incontinence following Spinal Cord Injury

Sexuality after spinal cord injury (SCI) is a complex issue that is influenced by a number of social, psychological and physiological factors, one of which is urinary incontinence (UI). Using a phenomenological approach, seven mixed methods interviews combining both the interview guide and standardized open-ended approaches were conducted to examine the experience of sexuality for women who are concerned about UI following SCI. Sexual function was one of the top priorities for the women after SCI, and UI was one of the main concerns the women had regarding sexuality. The findings of this study demonstrate that various dimensions of intimacy and the sexual experience as a whole were affected by UI, and the women discussed both physical and psychological concerns. The main issues regarding sexuality included concerns related to relationships, frustrations with limited sexual activities and the difficulty of being sexually satisfied, the number of unanswered questions and concerns, and a fear of being hurt or injured while participating in sexual activities. The main concerns regarding UI were embarrassment, the work and inconvenience involved with the clean-up of UI, bladder infections, the lack of accessible washrooms, and the negative effects of UI medications. When examining sexuality and UI together, the major issues were the constant comparison to the way things were before SCI, as well as the new concerns that the women did not have to worry about previously, worrying about how their partner would react if UI were to occur during sexual activity, and the impact of their own feelings toward UI on sexuality, a connection between pleasurable sexual sensations and UI as well as difficulty differentiating between the sensation of UI with the sensation of UI, dealing with infected urine during sexual activity, having to discuss UI with a new potential sexual partner, and a fear of rejection. Other identified issues included those related to body image, a lack of resources, Doctors who were inadequately educated regarding SCI, and issues related to both having and raising children. There is a significant shortage of information available for women with SCI to use as a resource regarding sexual function in general, and sexual function as it relates to UI. It is necessary that future work focus on creating resources to assist in this area, and that the dissemination of those resources becomes both appropriate and effective. Addressing sexual function and UI which are among the top concerns for this population has the opportunity to greatly improve quality of life (QOL) for these individuals.

Weighing the Details: Gender Dualisms in Lightweight Women's Rowing

The purpose of this research project was to explore how women lightweight rowers in Ontario negotiate their gender and body identity. Through a feminist post-structural lens I investigated both ‘acceptable’ and contradictory gender and sport performances that exist in the culture of rowing in order to understand how identity is constructed at the intersection of these discourses. My goal was to learn how human experiences are shaped by discourses of power, and resulting constructions of acceptable gender attributes. Seven university-aged lightweight women’s rowers were interviewed, and the following themes were uncovered: the women are constantly engaging in acts of bodily control; often body image is affected by participation in the sport; there are instances of femininity that exist within the culture of lightweight rowing; inequalities are present within the culture, as are excuse making practices; and the potential for resistance is extremely complicated.

Exploring Body-Related Experiences among Individuals with Spinal Cord Injury

Using modified constructivist grounded theory, the purpose of the present study was to explore body-related experiences, specifically body image, in people with spinal cord injury. A total of nine participants (five women, four men) who had a broad range of body image experiences (from very negative to very positive) were interviewed. Most participants explained experiencing a fluctuating body image that varied from day-to-day. Negative body image experiences were represented by appearance, weight concerns, and function with all body image experiences encompassed by self-presentational concerns and tactics (an unanticipated finding). Positive body image was represented by acceptance, appreciation and gratitude of the body. Interestingly, negative body image experiences were not found to be represented by the opposite of positive body image experiences as they were each distinct. These findings have direct implications for medical professionals in hospital and rehabilitation settings to understand the importance of body image after spinal cord injury.

Sexual abuse in childhood and postoperative depression in women with breast cancer who opt for immediate reconstruction after mastectomy

INTRODUCTION Breast reconstruction is routinely offered to women who undergo mastectomy for breast cancer. However, patient-reported outcomes are mixed. Child abuse has enduring effects on adults’ well-being and body image. As part of a study into damaging effects of abuse on adjustment to breast cancer, we examined: (i) whether women with history of abuse would be more likely than other women to opt for reconstruction; and (ii) whether mood problems in women opting for reconstruction can be explained by greater prevalence of abuse. PATIENTS AND METHODS We recruited 355 women within 2-4 days after surgery for primary breast cancer; 104 had mastectomy alone and 29 opted for reconstruction. Using standardised questionnaires, women self-reported emotional distress and recollections of childhood sexual abuse. Self-report of distress was repeated 12 months later. RESULTS Women who had reconstruction were younger than those who did not. Controlling for this, they reported greater prevalence of abuse and more distress than those having mastectomy alone. They were also more depressed postoperatively, and this effect remained significant after controlling for abuse. CONCLUSIONS One interpretation of these findings is that history of abuse influences women's decisions about responding to the threat of mastectomy, but it is premature to draw inferences for practice until the findings are replicated. If they are replicated, it will be important to recognise increased vulnerability of some patients who choose reconstruction. Studying the characteristics and needs of women who opt for immediate reconstruction and examining the implications for women's adjustment should be a priority for research.

Estudo sobre a construção da imagem de corpo feminino na revista Women's Health

The human being and consequently the human body is a subject that opens a range of possibilities for research in Physical Education study it never hurts and issues facing health helps us understand the paths chosen by the company. Women are targeted exposure and cult of the body and it is not uncommon to search for tips on how to have the silhouette of dreams through magazines that provide recommendations for achieving this purpose. The objective of this study aims to examine some concepts of body image, body and health, targeting study two books originated from the women's magazine Women's Health . Evaluate strengths and possible dangerous points of information. Through these studies we noted the importance of understanding the role of body image in the design to be healthy and yes we found studies that are presented in the magazine, good contribution, but there is also information that must be analyzed carefully, as not to prejudice the reader . We suggest further studies in this area to a greater understanding of topics covered in this work

Do the physical discomforts from breast cancer treatments affect the sexuality of women who underwent mastectomy?

The objective of this integrative review is to analyze the scientific production addressing the sexuality of women with breast cancer following mastectomy, focused on the effects that the physical discomfort due to cancer treatments have on their sex life. The search included articles published in the period between 2000 and 2009 on the MEDLINE, LILACS and PsycINFO databases, using the following descriptors: mastectomy, breast neoplasms, sexuality, sexual behavior, amputation, psychosexual development, and marital relations. Nine articles were selected, which addressed the effects of the physical discomfort from cancer treatments on the patients' sexuality. The findings revealed that, even when the patient's sex life is intense and fulfilling before the disease, factors such as stress, pain, fatigue, insult to body image, and low self-esteem due to the treatments may alter the sexual functioning of the affected woman. Healthcare professionals must be sensitized in order to welcome and include the topic in policies as well as in preventive, diagnostic, and therapeutic strategies.

THE RELATIONSHIP BETWEEN OBESITY AND PSYCHOLOGICAL GENERAL WELL-BEING IN UNITED STATES WOMEN

While clinical studies have shown a negative relationship between obesity and mental health in women, population studies have not shown a consistent association. However, many of these studies can be criticized regarding fatness level criteria, lack of control variables, and validity of the psychological variables.^ The purpose of this research was to elucidate the relationship between fatness level and mental health in United States women using data from the First National Health and Nutrition Examination Survey (NHANES I), which was conducted on a national probability sample from 1971 to 1974. Mental health was measured by the General Well-Being Schedule (GWB), and fatness level was determined by the sum of the triceps and subscapular skinfolds. Women were categorized as lean (15th percentile or less), normal (16th to 84th percentiles), or obese (85th percentile or greater).^ A conceptual framework was developed which identified the variables of age, race, marital status, socioeconomic status (education), employment status, number of births, physical health, weight history, and perception of body image as important to the fatness level-GWB relationship. Multiple regression analyses were performed separately for whites and blacks with GWB as the response variable, and fatness level, age, education, employment status, number of births, marital status, and health perception as predictor variables. In addition, 2- and 3-way interaction terms for leanness, obesity and age were included as predictor variables. Variables related to weight history and perception of body image were not collected in NHANES I, and thus were not included in this study.^ The results indicated that obesity was a statistically significant predictor of lower GWB in white women even when the other predictor variables were controlled. The full regression model identified the young, more educated, obese female as a subgroup with lower GWB, especially in blacks. These findings were not consistent with the previous non-clinical studies which found that obesity was associated with better mental health. The social stigma of being obese and the preoccupation of women with being lean may have contributed to the lower GWB in these women. ^

Between anxiety and hope: the experiences of women with vulval intraepithelial neoplasia during their illness trajectory - a qualitative approach

The vulvar intraepithelial neoplasia (VIN) is a rare chronic skin condition that may progress to an invasive carcinoma of the vulva. Major issues affecting women's health were occurring symptoms, negative influences on sexuality, uncertainty concerning the illness progression and changes in the body image. Despite this, there is little known about the lived experiences of the illness trajectory. Therefore, the aim of this study was to describe the experiences of women with VIN during the illness trajectory. In a secondary data analysis of the foregoing qualitative study we analysed eight narrative interviews with women with VIN by using thematic analysis in combination with critical hermeneutics. Central for these women during their course of illness was a sense of "Hope and Fear". This constitutive pattern reflects the fear of recurrence but also the trust in healing. The eight narratives showed women's experiences during their course of illness occurred in five phases: "there is something unknown"; "one knows, what IT is"; "IT is treated and should heal"; "IT has effects on daily life"; "meanwhile it works". Women's experiences were particularly influenced by the feeling of "embarrassment" and by "dealing with professionals". Current care seems to lack adequate support for women with VIN to manage these phases. We suggest, based on our study and the international literature, that new models of counselling and providing information need to be developed and evaluated.

Investigation on Heart Rate Variability (HRV) and psycho-social-affective adjustment in Italian women with ovarian cancer

INTRODUZIONE: L’integrazione mente-corpo applicata ad un ambito patologico predominante in questi tempi, come il cancro, è il nucleo di questa tesi. Il background teorico entro cui è inserita, è quello della Psiconeuroendocrinoimmunologia (Bottaccioli, 1995) e Psico-Oncologia. Sono state identificate, nella letteratura scientifica, le connessioni tra stati psicologici (mente) e condizioni fisiologiche (corpo). Le variabili emerse come potenzialmente protettive in pazienti che si trovano ad affrontare il cancro sono: il supporto sociale, l’immagine corporea, il coping e la Qualità della Vita, insieme all’indice fisiologico Heart Rate Variability (HRV; Shaffer & Venner, 2013). Il potenziale meccanismo della connessione tra queste variabili potrebbe essere spiegato dall’azione del Nervo Vago, come esposto nella Teoria Polivagale di Stephen Porges (2007; 2009). OBIETTIVI: Gli obiettivi principali di questo studio sono: 1. Valutare l’adattamento psicologico alla patologia in termini di supporto sociale percepito, immagine corporea, coping prevalente e qualità della vita in donne con cancro ovarico; 2. Valutare i valori di base HRV in queste donne; 3. Osservare se livelli più elevati di HRV sono associati ad un migliore adattamento psicologico alla patologia; 4. Osservare se una peggiore percezione dell’immagine corporea e l’utilizzo di strategie di coping disadattive sono associate ad una Qualità della Vita più scarsa. METODO: 38 donne affette da cancro ovarico, al momento della valutazione libere da patologia, sono state reclutate presso la clinica oncologica del reparto di Ginecologia dell’Azienda Ospedaliero-Universitaria di Parma, Italia. Ad ogni partecipante è stato chiesto di compilare una batteria di test composta da: MSPSS, per la valutazione del supporto sociale percepito; DAS-59, per la valutazione dell’immagine corporea; MAC, per la valutazione delle strategie di coping prevalenti utilizzate verso il cancro; EORTC-QLQ30, per la valutazione della Qualità della Vita. Per ogni partecipante è stato registrato HRV di base utilizzando lo strumento emWave (HeartMath). RISULTATI PRINCIPALI: Rispondendo agli obiettivi 1 e 2, in queste donne si è rilevato una alto tasso di supporto sociale percepito, in particolare ricevuto dalla persona di riferimento. L’area rivelatasi più critica nel supporto sociale è quella degli amici. Per quanto riguarda l’immagine corporea, la porzione di campione dai 30 ai 61 anni, ha delle preoccupazioni globali legate all’immagine corporea paragonabili ai dati provenienti dalla popolazione generale con preoccupazioni riguardo l’aspetto corporeo. Invece, nella porzione di campione dai 61 anni in su, il pattern di disagio verso l’aspetto fisico sembra decisamente peggiorare. Inoltre, in questo campione, si è rilevato un disagio globale verso l’immagine corporea significativamente più alto rispetto ai valori normativi presenti in letteratura riferiti a donne con cancro al seno con o senza mastectomia (rispettivamente t(94)= -4.78; p<0.000001; t(110)= -6.81;p<0.000001). La strategia di coping più utilizzata da queste donne è lo spirito combattivo, seguito dal fatalismo. Questo campione riporta, inoltre, una Qualità della Vita complessivamente soddisfacente, con un buon livello di funzionamento sociale. L’area di funzionalità più critica risulta essere il funzionamento emotivo. Considerando i sintomi prevalenti, i più riferiti sono affaticamento, disturbi del sonno e dolore. Per definire, invece, il pattern HRV, sono stati confrontati i dati del campione con quelli presenti in letteratura, riguardanti donne con cancro ovarico. Il campione valutato in questo studio, ha un HRV SDNN (Me=28.2ms) significativamente più alto dell’altro gruppo. Tuttavia, confrontando il valore medio di questo campione con i dati normativi sulla popolazione sana (Me=50ms), i nostri valori risultano drasticamente più bassi. In ultimo, donne che hanno ricevuto diagnosi di cancro ovarico in età fertile, sembrano avere maggiore HRV, migliore funzionamento emotivo e minore sintomatologia rispetto alle donne che hanno ricevuto diagnosi non in età fertile. Focalizzando l’attenzione sulla ricerca di relazioni significative tra le variabili in esame (obiettivo 3 e 4) sono state trovate numerose correlazioni significative tra: l’età e HRV, supporto percepito , Qualità della Vita; Qualità della Vita e immagine corporea, supporto sociale, strategie di coping; strategie di coping e immagine corporea, supporto sociale; immagine corporea e supporto sociale; HRV e supporto sociale, Qualità della Vita. Per verificare la possibile connessione causale tra le variabili considerate, sono state applicate regressioni lineari semplici e multiple per verificare la bontà del modello teorico. Si è rilevato che HRV è significativamente positivamente influenzata dal supporto percepito dalla figura di riferimento, dal funzionamento di ruolo, dall’immagine corporea totale. Invece risulta negativamente influenzata dal supporto percepito dagli amici e dall’uso di strategie di coping evitanti . La qualità della vita è positivamente influenzata da: l’immagine corporea globale e l’utilizzo del fatalismo come strategia di coping prevalente. Il funzionamento emotivo è influenzato dal supporto percepito dalla figura di riferimento e dal fatalismo. DISCUSSIONI E CONCLUSIONI: Il campione Italiano valutato, sembra essere a metà strada nell’adattamento dello stato psicologico e dell’equilibrio neurovegetativo al cancro. Sicuramente queste donne vivono una vita accettabile, in quanto sopravvissute al cancro, ma sembra anche che portino con sé preoccupazioni e difficoltà, in particolare legate all’accettazione della loro condizione di sopravvissute. Infatti, il migliore adattamento si riscontra nelle donne che hanno avuto peggiori condizioni in partenza: stadio del cancro avanzato, più giovani, con diagnosi ricevuta in età fertile. Pertanto, è possibile suggerire che queste condizioni critiche forzino queste donne ad affrontare apertamente il cancro e la loro situazione di sopravvissute al cancro, portandole ad “andare avanti” piuttosto che “tornare indietro”. Facendo riferimento alle connessioni tra variabili psicologiche e fisiologiche in queste donne, si è evidenziato che HRV è influenzata dalla presenza di figure significative ma, in particolare, è presumibile che sia influenzata da un’appropriata condivisione emotiva con queste figure. Si è anche evidenziato che poter continuare ad essere efficaci nel proprio contesto personale si riflette in un maggiore HRV, probabilmente in quanto permette di preservare il senso di sé, riducendo in questo modo lo stress derivante dall’esperienza cancro. Pertanto, HRV in queste donne risulta associato con un migliore adattamento psicologico. Inoltre, si è evidenziato che in queste donne la Qualità della Vita è profondamente influenzata dalla percezione dell’immagine corporea. Si tratta di un aspetto innovativo che è stato rilevato in questo campione e che, invece, nei precedenti studi non è stato indagato. In ultimo, la strategia di coping fatalismo sembra essere protettiva e sembra facilitare il processo di accettazione del cancro. Si spera sinceramente che le ricerche future possano superare i limiti del presente studio, come la scarsa numerosità e l’uso di strumenti di valutazione che, per alcuni aspetti come la scala Evitamento nel MAC, non centrano totalmente il target di indagine. Le traiettorie future di questo studio sono: aumentare il numero di osservazioni, reclutando donne in diversi centri specialistici in diverse zone d’Italia; utilizzare strumenti più specifici per valutare i costrutti in esame; valutare se un intervento di supporto centrato sul miglioramento di HRV (come HRV Biofeedback) può avere una ricaduta positiva sull’adattamento emotivo e la Qualità della Vita.

Renegotiating sexual intimacy in the context of altered embodiment:the experiences of women with breast cancer and their male partners following mastectomy and reconstruction

OBJECTIVE: Breast cancer diagnosis and treatments can have a profound impact upon women's well-being, body image, and sexual functioning, but less is known about the relational context of their coping and the impact upon their intimate partners. Our study focuses upon couples' experiences of breast cancer surgery, and its impact on body image and sexual intimacy. METHOD: Utilizing a dyadic design, we conducted 8 semistructured individual interviews, with 4 long-term heterosexual couples, after the women had undergone mastectomy with reconstruction. Interviews explored both partners' experiences of diagnosis, decision-making, and experiences of body image and sexual intimacy. Interpretative phenomenological analysis (IPA) was adopted; this is a qualitative research approach characterized by in-depth analysis of the personal meaning of experiences. RESULTS: Findings illustrate the positive acceptance that partners may express toward their wives' postsurgical bodies. They illuminate ways in which gendered coping styles and normative sexual scripts may shape couples' negotiations of intimacy around "altered embodiment." Reciprocal communication styles were important for couples' coping. The management of expectations regarding breast reconstruction may also be helpful. CONCLUSIONS: The insights from the dyadic, multiple perspective design suggest that psychologists must situate the meaning of supportive relationships and other protective factors in the context of complex life events and histories, in order to understand and support people's developing responses to distress. (PsycINFO Database Record

Menopause, rurlity, and obesity in rural African American women

In the US, one in every eight deaths is due to an obesity-related chronic health condition (ORCHC). More than half of African American women (AAW) 20 years old or older are obese or morbidly obese, as are 63% of menopausal AAW. Many have ORCHC that increase their morbidity and mortality and increase health care costs. In 2013, 42.6 percent of AAs living in South Carolina (SC) were obese. The purpose of this cross-sectional study was to identify the cognitive, behavioral, biological, and demographic factors that influence health outcomes (BMI, and ORCHC) of AAW living in rural SC. A sample of 200 AAW (50 in each of the 4 groups of rurality by menopausal status), 18-64 years, completed the: Menopausal Rating Scale (symptoms); Body Image Assessment for Obesity (self-perception of body); Mental Health Inventory; Block Food Frequency Questionnaire; Eating Behaviors and Chronic Conditions, Traditional Food Habits, and Food Preparation Technique questionnaires — and measures for Body Mass Index. Most rural, and premenopausal AAW were single and not living with a partner. Premenopausal women had significantly higher educational levels. Sixty percent of AAW had between 1 and 5 ORCHC. Most AAW used salt based seasonings, ate deep fried foods 1 to 3 times a week, and ate outside the home 1 to 3 times a month. Few AAW knew the correct daily serving for grains and dairy, and most consumed less than the recommended daily serving of fruits, vegetables and dairy. Morbidly obese AAW used more traditional food preparation techniques than obese and normal-weight AAW. Rural, and menopausal AAW had significantly higher morbid obesity levels, consumed larger portions of meats and vegetables, and reported more body image dissatisfaction than very rural AAW, and premenopausal AAW, respectively. Controlling for socioeconomic factors the relationships between perceptions of body images, psychological distress, and psychological wellbeing remained significant for numbers of ORCHC^

Menopause, Rurality, And Obesity in Rural African American Women

In the US, one in every eight deaths is due to an obesity-related chronic health condition (ORCHC). More than half of African American women (AAW) 20 years old or older are obese or morbidly obese, as are 63% of menopausal AAW. Many have ORCHC that increase their morbidity and mortality and increase health care costs. In 2013, 42.6 percent of AAs living in South Carolina (SC) were obese. The purpose of this cross-sectional study was to identify the cognitive, behavioral, biological, and demographic factors that influence health outcomes (BMI, and ORCHC) of AAW living in rural SC. A sample of 200 AAW (50 in each of the 4 groups of rurality by menopausal status), 18-64 years, completed the: Menopausal Rating Scale (symptoms); Body Image Assessment for Obesity (self-perception of body); Mental Health Inventory; Block Food Frequency Questionnaire; Eating Behaviors and Chronic Conditions, Traditional Food Habits, and Food Preparation Technique questionnaires – and measures for Body Mass Index. Most rural, and premenopausal AAW were single and not living with a partner. Premenopausal women had significantly higher educational levels. Sixty percent of AAW had between 1 and 5 ORCHC. Most AAW used salt based seasonings, ate deep fried foods 1 to 3 times a week, and ate outside the home 1 to 3 times a month. Few AAW knew the correct daily serving for grains and dairy, and most consumed less than the recommended daily serving of fruits, vegetables and dairy. Morbidly obese AAW used more traditional food preparation techniques than obese and normal-weight AAW. Rural, and menopausal AAW had significantly higher morbid obesity levels, consumed larger portions of meats and vegetables, and reported more body image dissatisfaction than very rural AAW, and premenopausal AAW, respectively. Controlling for socioeconomic factors the relationships between perceptions of body images, psychological distress, and psychological wellbeing remained significant for numbers of ORCHC