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Stress, psychological distress, psychosocial factors, menopause symptoms and physical health in women
Abstract
Relatively few studies have evaluated relationships between stress, psychological distress, psychosocial factors and menopause symptoms, and none have evaluated emotional intelligence (EI) in relation to menopause. In this study, direct and indirect relationships were evaluated between stress, psychological distress, psychosocial factors (e.g. social support, coping, EI), menopause symptom severity and physical health in middle-aged women.
One hundred and sixteen women aged 45-55 years were recruited through women's health centres and community organizations. They completed a short questionnaire asking about stress, psychological distress (i.e. anxiety, depression), EI, attitude to menopause, menopause symptoms and physical health.
Low emotional intelligence was found to be related to worse menopause symptoms and physical health, and these associations were partly mediated by high stress, anxiety and depression, a negative attitude to menopause and low proactive coping.
Women with high EI appear to hold more positive attitudes to menopause and experience less severe stress, psychological distress and menopause symptoms and better physical health. These results suggest that women who expect menopause to be a negative experience or are highly stressed or distressed may be more likely to experience a more negative menopause.
... Optimism seems to have a positive effect on the adaptation to menopausal symptoms (Caltabiano and Holzheimer 1999;Elavsky and McAuley 2009) and is associated with fewer depressive symptoms (Bromberger et al. 2015). Women with high emotional intelligence seem to experience less severe menopausal symptoms (Bauld and Brown 2009) and describe a higher health-related quality of life compared with women with lower emotional intelligence (Extremera and Fernández-Berrocal 2002;Bauld and Brown 2009). Emotional stability appears to explain a notable amount of variance in the adaptation to menopausal symptoms (Caltabiano and Holzheimer 1999) and is associated with less menopausal stress and fewer depressive symptoms (Bosworth et al. 2003;Mauas et al. 2014). ...
... Optimism seems to have a positive effect on the adaptation to menopausal symptoms (Caltabiano and Holzheimer 1999;Elavsky and McAuley 2009) and is associated with fewer depressive symptoms (Bromberger et al. 2015). Women with high emotional intelligence seem to experience less severe menopausal symptoms (Bauld and Brown 2009) and describe a higher health-related quality of life compared with women with lower emotional intelligence (Extremera and Fernández-Berrocal 2002;Bauld and Brown 2009). Emotional stability appears to explain a notable amount of variance in the adaptation to menopausal symptoms (Caltabiano and Holzheimer 1999) and is associated with less menopausal stress and fewer depressive symptoms (Bosworth et al. 2003;Mauas et al. 2014). ...
... **p < 0.01, ***p < 0.001 Data are presented as mean (M) ± standard deviation (SD); minimum (MIN), maximum (MAX) scores; and range. Except for emotional stability (BFI-K-N) and general psychological health (GHQ-10), higher scores indicate higher levels of the respective domains Psychosocial factors promoting resilience during the menopausal transition regard to their contribution to resilience during the menopausal transition (Caltabiano and Holzheimer 1999;Extremera and Fernández-Berrocal 2002;Bosworth et al. 2003;Bauld and Brown 2009;Elavsky and McAuley 2009;Brown et al. 2014). Since the resilience-associated variables investigated across previous studies are very heterogeneous , the present study considered a broad range of resilience-associated variables within the same sample of perimenopausal women. ...
Despite significant biological, psychological, and social challenges in the perimenopause, most women report an overall positive well-being and appear to be resilient to potentially negative effects of this life phase. The objective of this study was to detect psychosocial variables which contribute to resilience in a sample of perimenopausal women. A total of 135 healthy perimenopausal women aged 40–56 years completed a battery of validated psychosocial questionnaires including variables related to resilience, well-being, and mental health. First, using exploratory factor analysis, we examined which of the assessed variables related to resilience can be assigned to a common factor. Second, linear regression analyses were performed to investigate whether a common resilience factor predicts well-being and mental health in the examined sample of women. Optimism (LOT-R-O), emotional stability (BFI-K-N), emotion regulation (ERQ), self-compassion (SCS-D), and self-esteem (RSES) in perimenopausal women can be allocated to a single resilience-associated factor. Regression analyses revealed that this factor is related to higher life satisfaction (SWLS; β = .39, p < .001, adj. R2 = .20), lower perceived stress (PSS-10; β = − .55, p < .001, adj. R2 = .30), lower psychological distress (BSI-18; β = − .49, p < .001, adj. R2 = .22), better general psychological health (GHQ-12; β = − .49, p < .001, adj. R2 = .22), milder menopausal complaints (MRS II; β = − .41, p < .001, adj. R2 = .18), and lower depressive symptoms (ADS-L; β = − .32, p < .001, adj. R2 = .26). The α levels were adjusted for multiple testing. Our findings confirm that several psychosocial variables (optimism, emotional stability, emotion regulation, self-compassion, and self-esteem) can be allocated to one common resilience-associated factor. This resilience factor is strongly related to women’s well-being as well as mental health in perimenopause.
... Estrogen is involved in memory function, while in menopause, the hormone estrogen is decreased, so women who consume protein will help in boosting the release of neurotransmitters that serve to convey the information in the brain and other body parts (Mulyani, 2013). Consuming fruits and vegetables is good for maintaining a healthy body because they contain vitamins, minerals, beta-carotene, and antioxidants that are important for the body (Bauld & Brown, 2009;Gayatri, 2011). Foods containing vitamin E may help reduce the complaints of hot flushes and vaginal dryness problems (Muharam, 2007;Mulyani, 2013). ...
... Stress is not only about dysfunction or abnormalities of organs, but it also has a psychological impact, for example anxiety and/or depression (Yusuf, Armini, & Hardiyan, 2008). Severe levels of stress can affect the cardiovascular system, causing symptoms such as heart palpitations, and blood vessel dilation or constriction; other than that the body feels hot flushes that aggravate the symptoms of hot flushes (Bauld & Brown, 2009). Somatic symptoms are often seen as a symptom of follow up or a result of stress, anxiety, and depression is prolonged. ...
... Almost all respondents are housewives, where the frequency of socializing with neighbors and family is more flexible to follow the teaching activities and exercises organized by the posyandu. Bauld & Brown (2009) and Moon et al. (2017) reported that negative events or emotions can worsen the symptoms of menopause, which demonstrates the importance of the effect of psychosocial factors on menopausal symptoms. ...
Introduction: Every woman will have menopausal experiences at the end of a biological process called menstrual cycles. Several complaints can be aggravated by lifestyle and stress. This study was to analyze the relation of lifestyle and stress levels with a menopausal complaint in women.
Methods: This study was correlational with a cross-sectional approach. The study involved 101 menopausal women lived in a community selected by proportional random sampling. The independent variables were lifestyle and stress levels in menopausal women. The dependent variable was a menopausal complaint. This study used primary data provided by questionnaires and interviews. The data were analyzed using Spearman’s Rho.
Results: There was strong correlation between lifestyle (p=0.000; r=-0.424), stress levels (p=0.000; r=0.535), and complaint in a menopausal woman.
Conclusion: A healthy lifestyle, stress-controlled to minimize complaints in menopausal women. Further research is needed on factors that increase stress in postmenopausal women.
... In this respect, Elavsky and McAuley [31] suggested that optimism influences the shaping of cognitive schemata, leading to differences in the awareness and reporting of menopausal symptoms. Regarding mental and physical health outcomes, emotional stability [27] and emotional intelligence [32,33] seem to be significant resilience factors during the end of a woman's fertile life phase. Coronado et al. [34] showed that general intelligence, as defined by a higher educational level, was related to higher resilience in middle-aged women compared to those with a lower educational level. ...
... Therefore, we propose that cognitive appraisal and emotional experience influence the coping strategies employed for symptom adjustment in perimenopausal women. Regarding these coping strategies, the adaptation to perimenopausal symptoms lies on a continuum from adjustment, which is defined by life satisfaction and well-being, to maladjustment, which includes negative mood states, symptom burden and physical complaints [27,33,41,42]. ...
... The fourth subcategory concerns "Optimism", which was measured using the LOT-R in three studies [15,27,31]. The fifth subcategory, "Emotion", includes the two emotion-based resilience factors emotional intelligence [32,33] and emotional stability [27,42,49]. The sixth subcategory of resilience factors during the menopausal transition can be summarized as "Self-related resilience". ...
The menopausal transition is a critical phase for psychological disorders such as depression and anxiety, with prevalence rates of depression ranging up to 20% during the menopause. Nevertheless, the majority of women cope adequately with this reproductive transition phase and thus appear to be resilient. We assert that a variety of psychological factors influence the menopausal transition and result in an individual state on a continuum from successful adjustment to maladjustment. The purpose of this review is to offer a conceptual framework of resilience factors during the menopausal transition and to reveal which dimensions of resilience have already been verified for a healthy menopausal transition.
We searched the databases PubMed and PsycINFO for studies investigating resilience factors during the menopausal transition which influence psychological and physical adjustment or maladjustment. A total of 23 articles were included.
Altogether, we identified 15 different resilience factors, assessed with 23 different questionnaires. These factors can be grouped into six categories: core resilience, spirituality, control, optimism, emotion and self-related resilience. They are associated with a better adjustment to menopausal symptoms, milder physical symptoms, a better quality of and satisfaction with life, better well-being, less perceived stress and fewer depressive symptoms compared with women with lower levels of the respective resilience factors.
Our conceptual framework includes resilience factors which have already been verified by empirical data. Further research is needed to determine whether these resilience factors can be assigned to a common factor and to incorporate biological resilience markers.
... As such, stress has causally been associated with a greater risk of cardiovascular disease (Steptoe & Kivimaki, 2012), faster progression of HIV (Leserman et al., 2000), delayed wound healing Marucha et al., 1998), decreased receptivity to the influenza vaccine (Kiecolt-Glaser et al., 1996), and a greater risk of upper respiratory tract infection (Cohen et al., 1991;Cohen et al., 1998). Moreover, a number of studies have found that increased stress (both perceived stress and stressful experiences) can worsen the frequency and severity of menopause symptoms (Gold et al., 2006;Bauld & Brown, 2009;Nosek et al., 2010;Sood et al., 2019;Jalava-Broman et al., 2020); however, the causal pathway underlying this particular association is currently unclear (Falconi et al., 2016). ...
... Existing research has shown that stress associates with more severe and more frequent vasomotor symptoms (Gold et al., 2006;Bauld & Brown, 2009;Nosek et al., 2010;Sood et al., 2019;Jalava-Broman et al., 2020), and some research has ...
... However, there is some research showing that support tailored to the menopausal transition can have detrimental effects. Many women attend support groups or 'menopause cafes' as a means of managing menopause through leaning on other women who are at the same life stage; but research has shown that in some cases support groups/increased discussion about menopause symptoms can cause women to anticipate and expect negative symptoms, leading to a higher reporting of them (Bauld & Brown, 2009). Therefore, while support in some studies has been shown to have a beneficial effect on menopause symptoms (Ayers et al., 2010;Yazdkhasti et al., 2012;Zhao et al., 2019), as shown in this chapter it is not a universal phenomenon, and in some cases specific support around the menopausal transition can cause women to perceive their symptoms to be worse (Bauld & Brown, 2009). ...
Despite appearing to be maladaptive, the human menopause and prolonged post-reproductive lifespan are thought to have been shaped in our evolutionary history by natural selection. As a result, there has been a great deal of research looking at the inclusive fitness benefits of a post-reproductive lifespan. However, there are still many things we do not know about menopause, such as whether current variation in menopause timing is the result of evolutionary trade-offs, whether menopause symptoms require an evolutionary explanation, and how post-reproductive care functions in a sample of women from the United Kingdom. This thesis focuses on trying to fill these identified gaps in the literature using data from the United Kingdom, United States, and China. I find no evidence for menopause symptoms being facultative, nor that menopause timing varies in the way predicted by current evolutionary models. However, I do find that a later menopause is predicted by an increased likelihood of pregnancy, suggesting an energetic trade-off. Further, I show that menopause symptoms predictably vary relative to one’s ecology, with a more stressful environment predicting worse symptoms. When looking at caring behaviour, I found evidence in favour of it being facultative relative to fecundity status, with pre-menopausal women caring more for their parents, while post-menopausal women spent more time caring for their grandchildren. Finally, I present evidence for an earlier menopause predicting a greater number of grandchildren, suggesting that women are able to offset the costs of being post-reproductive by increasing indirect fitness. Results from this thesis suggest that many aspects of the menopausal transition are plastic, and often vary in a way predicted by evolutionary theory. Through understanding these trends, it may those who experience menopause more autonomy over the transition. Further, my research on fecundity status and caring behaviours demonstrates the behavioural implications of energetic trade-offs.
... This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited U n c o r r e c t e d P r o o f Azizi M et al. depression during the menopausal stages (3,(30)(31)(32)(33). Al- though there are some review articles regarding depres- sion in menopausal women all over the world, there is no review article in this background in Iran (13,27,34). ...
... Several studies claim that biological factors play a role in the onset of depression in the menopausal period (10,28,34,36,37). The biological risk factors of depression in- clude decreased reproductive hormonal level changes (10,26,28,34,38,39), a long premenopausal period (more than 27 months) (31,40,41), severe menopausal symptoms in- cluding long-term vasomotor symptoms (i.e., hot flashes and night sweats) (1,10,25,26,31,40), type of menopause (surgical vs. natural menopause) (10,26,28), premature menopause (29,41,42), decreased physical health, chronic medical diseases (13,21,26,40,(43)(44)(45)(46), use of antidepres- sants (28,42,(47)(48)(49), and history of PMS (5,21,31,39,47). While some studies have demonstrated a strong associa- tion between the presence of vasomotor symptoms and depression (10, 12, 21, 38, 47), others indicated depression as an indirect outcome of sleep disruption that occurs when experiencing hot flashes or night sweats (5,21,50). ...
... Several studies claim that biological factors play a role in the onset of depression in the menopausal period (10,28,34,36,37). The biological risk factors of depression in- clude decreased reproductive hormonal level changes (10,26,28,34,38,39), a long premenopausal period (more than 27 months) (31,40,41), severe menopausal symptoms in- cluding long-term vasomotor symptoms (i.e., hot flashes and night sweats) (1,10,25,26,31,40), type of menopause (surgical vs. natural menopause) (10,26,28), premature menopause (29,41,42), decreased physical health, chronic medical diseases (13,21,26,40,(43)(44)(45)(46), use of antidepres- sants (28,42,(47)(48)(49), and history of PMS (5,21,31,39,47). While some studies have demonstrated a strong associa- tion between the presence of vasomotor symptoms and depression (10, 12, 21, 38, 47), others indicated depression as an indirect outcome of sleep disruption that occurs when experiencing hot flashes or night sweats (5,21,50). ...
... A l'inverse, beaucoup d'auteurs ont cherché à tester l'impact du niveau trait de l'IE sur la santé mentale et physique (pour revue, Martins et al., 2010). Ainsi, l'IE trait évaluée à l'aide exclusivement de CE (« Narrow models ») est associée à une meilleure santé mentale et physique, plus précisément à une meilleure santé mentale et un meilleur bien-être mental (e.g., Costa, Ripoll, Sánchez, & Carvalho, 2013;Fernández-Abascal & Martín-Díaz, 2015;Haver, Akerjordet, Caputi, Furunes, & Magee, 2015;Lingling, Xuhui, Cunrui, & Fei, 2014;Lizeretti & Extremera, 2011;Lizeretti, Extremera, & Rodríguez, 2012;Schmitz & Schmitz, 2012), à moins de symptômes anxieux-dépressifs et de détresse émotionnelle (e.g., Aradilla-Herrero, Tomás-Sábado, & Gómez-Benito, 2014;Chow, Chiu, & Wong, 2011;Kennedy et al., 2010;Lizeretti & Extremera, 2011;Lizeretti et al., 2012;Ng, Järvinen, & Bellugi, 2014;Nolidin, Downey, Hansen, Schweitzer, & Stough, 2013;Schmitz & Schmitz, 2012;Trickey, Farhall, Wertheim, Hinch, & Ong, 2011;Yusoff et al., 2013), à une meilleure santé physique et un meilleur fonctionnement physique (Augusto-Landa & Montes-Berges, 2009;Bauld & Brown, 2009), à moins de plaintes et symptômes somatiques comme les douleurs ou encore la fatigue (Augusto-Landa & Montes-Berges, 2009;Bauld & Brown, 2009;Brown & Schutte, 2006). Ces effets semblent d'autant plus forts en situations stressantes liées à un examen ou à la maladie par exemple Teques, Carrera, Ribeiro, Teques, & Ramón, 2016). ...
... A l'inverse, beaucoup d'auteurs ont cherché à tester l'impact du niveau trait de l'IE sur la santé mentale et physique (pour revue, Martins et al., 2010). Ainsi, l'IE trait évaluée à l'aide exclusivement de CE (« Narrow models ») est associée à une meilleure santé mentale et physique, plus précisément à une meilleure santé mentale et un meilleur bien-être mental (e.g., Costa, Ripoll, Sánchez, & Carvalho, 2013;Fernández-Abascal & Martín-Díaz, 2015;Haver, Akerjordet, Caputi, Furunes, & Magee, 2015;Lingling, Xuhui, Cunrui, & Fei, 2014;Lizeretti & Extremera, 2011;Lizeretti, Extremera, & Rodríguez, 2012;Schmitz & Schmitz, 2012), à moins de symptômes anxieux-dépressifs et de détresse émotionnelle (e.g., Aradilla-Herrero, Tomás-Sábado, & Gómez-Benito, 2014;Chow, Chiu, & Wong, 2011;Kennedy et al., 2010;Lizeretti & Extremera, 2011;Lizeretti et al., 2012;Ng, Järvinen, & Bellugi, 2014;Nolidin, Downey, Hansen, Schweitzer, & Stough, 2013;Schmitz & Schmitz, 2012;Trickey, Farhall, Wertheim, Hinch, & Ong, 2011;Yusoff et al., 2013), à une meilleure santé physique et un meilleur fonctionnement physique (Augusto-Landa & Montes-Berges, 2009;Bauld & Brown, 2009), à moins de plaintes et symptômes somatiques comme les douleurs ou encore la fatigue (Augusto-Landa & Montes-Berges, 2009;Bauld & Brown, 2009;Brown & Schutte, 2006). Ces effets semblent d'autant plus forts en situations stressantes liées à un examen ou à la maladie par exemple Teques, Carrera, Ribeiro, Teques, & Ramón, 2016). ...
Le diagnostic de cancer et les traitements associés vont entrainer un bouleversement de la vie du patient mais aussi de son entourage, et en particulier des proches-aidants. Ces derniers devenant « aidant » doivent assumer de nouvelles responsabilités qui peuvent entrainer des problèmes de santé, une altération de leur qualité de vie et ainsi de manière générale des difficultés d’ajustement face à la maladie (e.g., altération du fonctionnement émotionnel, physique, social et professionnel, symptômes somatiques, détresse émotionnelle). Les proches-aidants ont ainsi besoin du soutien des professionnels de santé pour faire face à leur rôle d’aidant mais ils rapportent souvent des besoins en soins de support insatisfaits. Ce travail de thèse, inscrit dans un programme de recherche plus global, vise ainsi à mieux appréhender les besoins en soins de support des proches-aidants de patients atteints d’un cancer et leurs déterminants, à travers notamment l’implication des processus émotionnels. La première étude de ce travail a consisté à valider en français une échelle évaluant les besoins en soins de support des proches-aidants de patients atteints d’un cancer. La deuxième étude visait à déterminer des profils de proches-aidants plus à risques d’avoir au moins un besoin en soins de support insatisfait moyen ou fort selon des facteurs intrapersonnels (i.e., symptômes anxieux-dépressifs) et sociodémographiques et médicales (e.g., âge des patients et des proches-aidants, cancer métastatique ou non). Enfin, la troisième étude visait à tester le modèle théorique, validé en amont auprès des patients, selon lequel les compétences émotionnelles des proches-aidants auraient un effet bénéfique sur leurs besoins en soins de support insatisfaits via moins de symptômes anxieux-dépressifs. Ces résultats montrent l’importance de dépister et prendre en charge les besoins en soins de support des proches-aidants, surtout liés à la prise en charge du patient, à l’information et au soutien psychologique et émotionnel. Certains profils de proches-aidants pourraient représenter une population particulièrement à risques de difficultés qui nécessiteraient une attention particulière des professionnels de santé. Enfin, tenir compte des processus émotionnels, notamment des compétences émotionnelles et des symptômes anxieux-dépressifs, parait important pour la prise en charge en soins de support des proches-aidants.
... As compared to Caucasian women, women in Malaysia experience more frequent somatic and psychological symptoms of menopause (Binfa et al. 2004). The variation in the frequency and intensity of menopausal symptoms in women of different races and nationalities prompted researchers to examine in detail the role of psychological, social and cultural factors in the experiencing of symptoms of menopause (Hunter and Rendall 2007;Binfa et al. 2004;Utian 2005;Utian 2007;Blake 2006;Bauld and Brown 2009). ...
... Fourthly, in the planning of future studies, psychological variables (e.g. mood, self-esteem, coping with stress) and cultural variables (attitude toward menopause) should be included in greater quantity, as it has been shown that they can be related to experiencing symptoms of menopause (Bauld and Brown 2009). ...
The aim of this study was to elucidate the relationship between menopausal symptoms and personality traits. 212 Polish women were administered the Big Five Factor personal inventory. Participants also completed the Polish version of the Menopause Symptom List. I found that personality traits correlated with symptoms of menopause. Neuroticism showed the strongest correlation with the frequency of psychological symptoms of menopause (r = .46, p = .000) and their intensity (r = .45, p = .000). The remaining personality traits demonstrated a negative correlation with menopausal symptoms. No correlation was found between openness to experience and the frequency of vasomotor (r = −.07, p = .268) and somatic (r = −.12, p = .059) symptoms, as well as intensity of vasomotor symptoms of menopause (r = −.10, p = .144). Openness to experience did not differentiate the sample in the frequency of experienced vasomotor symptoms of menopause (p = 0.205). Neuroticism was a significant predictor of the frequency of psychological (β = .486, p = .000), vasomotor (β = .342, p = .000) and somatic (β = .366, p = .000) symptoms, as well as intensity of psychological (β = .470, p = .000), vasomotor (β = .250, p = .008) and somatic (β = .287, p = .001) symptoms of menopause. This study provides further data on the association between menopausal symptoms and personality traits. Neuroticism is shown to be a significant predictor of the frequency and intensity of psychological, vasomotor and somatic symptoms of menopause.
... Resulta especialmente preocupante encontrar que el 73% de las personas mayores de 40 años realiza actividad física por debajo de las recomendaciones mínimas durante su tiempo libre; este dato es particularmente alto en mujeres, donde las recomendaciones no son alcanzadas por el 83% de la población (Macías et al., 2014). Algunos estudios afirman, además, que el sedentarismo podría relacionarse con un alto riesgo de aparición de enfermedades en poblaciones adultas como el cáncer, la hipertensión o la obesidad, aumentando el riesgo de padecer depresión, reducción de libido, estrés, o insomnio entre otras afecciones (Artero et al., 2011;Bauld & Brown, 2009). Combatir esta inactividad se ha convertido, por lo tanto, en un objetivo prioritario a nivel mundial (Blair, 2009). ...
... It is particularly worrisome to find that 73% of people over the age of 40 do less physical activity in their free time than the recommended minimums; this figure is particularly high in women, where the recommendations are not reached by 83% of the population (Macías et al., 2014). Some studies also claim that sedentarism can be related to a high risk of disease in adult populations, including cancer, hypertension and obesity, and that it can increase the risk of suffering from depression, lower libido, stress or insomnia, among other disorders (Artero et al., 2011;Bauld & Brown, 2009). Combatting inactivity has therefore become a priority objective worldwide (Blair, 2009) Recent studies have found a direct relationship between the practice of sports and the generation of positive emotional states associated with psychological wellbeing (Carrasco, Brustad, & Mas, 2007;Jiménez, Martínez, Miró, & Sánchez, 2008). ...
... However, some participants revealed that it was not a problem for their daily activities. This finding is comparable with Bauld & Brown (2009) who showed that difficulty in concentrating and loss of confidence often affect working life. ...
... They talked freely with the researchers about the frustration they felt about their lives. Bauld & Brown (2009) found that psychological changes which resulted from menopause could lead to frustration, anxiety, irritability, mood swings and depression which often have an impact on personal relationships and the quality of life. ...
... Resulta especialmente preocupante encontrar que el 73% de las personas mayores de 40 años realiza actividad física por debajo de las recomendaciones mínimas durante su tiempo libre; este dato es particularmente alto en mujeres, donde las recomendaciones no son alcanzadas por el 83% de la población (Macías et al., 2014). Algunos estudios afirman, además, que el sedentarismo podría relacionarse con un alto riesgo de aparición de enfermedades en poblaciones adultas como el cáncer, la hipertensión o la obesidad, aumentando el riesgo de padecer depresión, reducción de libido, estrés, o insomnio entre otras afecciones (Artero et al., 2011;Bauld & Brown, 2009). Combatir esta inactividad se ha convertido, por lo tanto, en un objetivo prioritario a nivel mundial (Blair, 2009). ...
... It is particularly worrisome to find that 73% of people over the age of 40 do less physical activity in their free time than the recommended minimums; this figure is particularly high in women, where the recommendations are not reached by 83% of the population (Macías et al., 2014). Some studies also claim that sedentarism can be related to a high risk of disease in adult populations, including cancer, hypertension and obesity, and that it can increase the risk of suffering from depression, lower libido, stress or insomnia, among other disorders (Artero et al., 2011;Bauld & Brown, 2009). Combatting inactivity has therefore become a priority objective worldwide (Blair, 2009) Recent studies have found a direct relationship between the practice of sports and the generation of positive emotional states associated with psychological wellbeing (Carrasco, Brustad, & Mas, 2007;Jiménez, Martínez, Miró, & Sánchez, 2008). ...
Resumen El objetivo de este estudio fue detectar los motivos de prác-tica en jugadores regulares de pádel. Se accedió a un total de 77 participantes (43 hombres y 34 mujeres) de la Comunidad Autónoma de Extremadura (España). Se utilizó la versión va-lidada al español de la escala de medida de los motivos para la actividad física, revisada (MPAM-R). Se realizaron cálculos de comparación de medias a través del anova de un factor para estudiar las diferencias dentro de cada género, y la t-Student para conocer las diferencias entre hombres y mujeres. Los re-sultados revelan diferencias en los motivos de práctica dentro del género femenino en relación con el rango de edad, tiempo de práctica, días de práctica y nivel de juego. Destacan las elevadas puntuaciones otorgadas a la competencia (F = 8.677; R 2 adj = 0.48) y al aspecto social (F = 4.253; R 2 adj = 0.28) en mu-jeres de más de 40 años, y al fitness/salud en jugadoras con una práctica regular de 6 meses a 3 años (F = 23.553; R 2 adj = 0.73). Se observaron también diferencias entre hombres y mujeres, siendo relevantes las controversias en los motivos que mueven a practicantes con menos de 6 meses de experiencia. Dichos resultados ofrecen información relevante sobre los motivos de práctica del pádel, siendo de utilidad para el desarrollo de planes de actuación que potencien la adherencia al deporte, la mejora de la salud y calidad de vida de las personas, evitando el abandono de la práctica de actividad física y el sedentarismo, especialmente en adultos de más de 35 años.
... 1,2 It has physical and psychological consequences. [3][4][5][6][7][8] Thus, young women with POI are more prone to present alterations in their sexuality [9][10][11] and quality of life (QoL), 12,13 causing tremendous damage to their relationships and self-esteem. The QoL of women with POI mainly affects their physical and psychological health; 11,13 however, the influence of impaired sexual function (SF) on the QoL of women with POI is empirical and based on population studies of menopausal women at normal term age and/or presenting chronic diseases. ...
... Among the factors that influence QoL, sexuality should be regarded as a high-complexity factor. 6,7 Considering that a poor SF (characterized by a sexual dysfunction) may negatively influence the QoL, and that the lack of knowledge limits the possibility of structuring specialized medical and psychological care for POI patients, this study aims to provide information about the aspects of sexuality that can influence different domains of QoL and how they are interrelated. ...
Objective To evaluate the impact of sexual function (SF) in the quality of life (QoL) of women with premature ovarian insufficiency (POI).
Methods Case-control study in which 80 women with POI were evaluated using estrogen plus progestogen therapy, compared with 80 women matched by age (±2 years) and presenting preserved gonadal function. Sexual function was evaluated using the Female Sexual Function Index (FSFI), and the QoL was evaluated using the World Health Organization's (WHO) QoL assessment instrument (WHOQoL-BREF).
Results The mean age of the women with POI and of the control group was 38.4 ± 7.3 years and 38.1 ± 7.3 years respectively. The QoL, was worse among the POI group, and there were significant differences in the physical (63.4 ± 17.4 and 72.7 ± 15.2 respectively, p = 0.0004) and psychological (63.2 ± 14.6 and 69.3 ± 13.9 respectively, p = 0.0075) domains among this group when compared with the control group. Women with POI presented significantly lower arousal, lubrication, orgasm and satisfaction, more dyspareunia and a worse FSFI scores when compared with the control group. All aspects of SF correlate directly with the worsening of the QoL regarding social relationships.
Conclusion Women with POI showed worse QoL and SF than the control group. The psychological aspects (desire, excitement, orgasm and sexual satisfaction) of SF had greater influence on the parameters of the QoL, while the physical aspects (pain and lubrication) had a low impact on the QoL. The poor SF in women with POI is directly correlated with a worsening across multiple domains of the QoL; however, the negative impact is particularly important in the social domain. These results suggest that the improvement in sexuality can improve the social interactions of women with POI.
... During perimenopause and early postmenopause, women experience a number of systemic and psychological changes [1][2][3]. The symptoms reported by women are classified as vasomotor and involve the urogenital system, central nervous system, musculoskeletal system and cardiovascular system [1][2][3][4]. ...
... During perimenopause and early postmenopause, women experience a number of systemic and psychological changes [1][2][3]. The symptoms reported by women are classified as vasomotor and involve the urogenital system, central nervous system, musculoskeletal system and cardiovascular system [1][2][3][4]. In the present study, the most meaningful symptoms are related to the influence of the menopausal period on the pelvic floor (PF) and pelvic organs. ...
Background:
Shear wave elastography is an effective method for studying the condition of various musculoskeletal soft tissues. The primary aim of this study was the objective elastographic and electromyographic assessment of the pelvic floor during the rest and contraction of the pelvic floor muscles (PFM) in postmenopausal women.
Methods:
This was a prospective observational study that was carried out at the University Hospital in Wroclaw, Poland, between January 2017 and December 2019.
Patients:
The target group of the study included postmenopausal women with stress urinary incontinence. The primary outcomes were the features of the elastographic assessment of the pelvic floor during rest and contraction of the PFM obtained using shear wave elastography.
Results:
Based on the inclusion and exclusion criteria for the study, 14 patients took part in the measurements. There was a significant difference between the elastographic assessment of the pelvic floor during rest and contraction of the PFM at all locations in front of the urethra. No statistically significant correlation was found between the results of elastography and the bioelectrical activity of PFM.
Conclusion:
The elasticity of the periurethral structures is higher during active pelvic floor muscle contraction than at rest, it seems that shear wave elastography is an effective test that objectively assesses the strength of PFM contraction.
... Life events seem to be more related to mental symptoms during menopause than to vasomotor symptoms [15]. In addition, various studies have shown that a negative attitude towards menopause and ageing as well as increased stress perception are associated with a higher physical burden of symptoms [10] and a more negative experience of menopause [16,17]. Two systematic reviews show associations between depressive symptoms, vasomotor symptoms, symptom severity, and negative attitudes towards menopause and ageing as well as negative life events [18,19]. ...
... Women who feel less self-efficacious and potentially at the mercy of symptoms experience a stronger association between stress and symptom severity. In a cross-sectional study, Bauld et al. were able to show that high emotional intelligence is related to more positive attitudes to menopause and less severe stress, psychological distress and menopause symptoms and better physical health [16]. A review also confirmed the connection between negative attitudes towards the menopause and symptoms during this transition [18]. ...
Objectives
To investigate the influence and specificity of sociodemographic and psychological factors on the perception of symptoms associated with menopause.
Study design
Data are based on a nationwide cross-sectional survey study in Germany. A representative sample of 1,350 females aged 14 to 95 years was examined. Sociodemographic factors, perceived stress, and self-efficacy were assessed. Women were divided into three age groups (young women ≤44 years; perimenopausal women 45–60 years; older women ≥61 years), and the Menopause Rating Scale (MRS) was used over the entire life span.
Main outcome measures
Total score on the Menopause Rating Scale (MRS) and hot flushes/sweating assessed via the MRS.
Results
The MRS total score increased with age. Both MRS total score and hot flushes were positively associated with perceived stress in all three age groups. The MRS total score was negatively associated with self-efficacy; for hot flushes, this association could be shown for perimenopausal women only. Furthermore, interaction effects between perceived stress and self-efficacy were found: in perimenopausal and older women, the association between perceived stress and the MRS total score was stronger the lower self-efficacy was. This interaction effect was not observed in younger women. No interaction effect was found in any age group for hot flushes.
Conclusions
Our data indicate that self-efficacy influences the severity of symptoms measured with the MRS. Interventions aimed to reduce stress and strengthen self-efficacy could lead to a lower symptom burden in perimenopausal women.
... With menopause, women experience various health problems such as hot flashes, night sweats, vaginal dryness, headache, insomnia, and osteoporosis. Postmenopausal women are often considered as a risk population for chronic diseases such as cardiovascular disease and metabolic diseases including diabetes mellitus and obesity (4)(5)(6). Likewise, menopause was associated with impaired lung function along with respiratory symptoms (7)(8)(9)(10)(11)(12). ...
Correspondence to: Hye Yun Park, MD, PhD. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea. Email: hyeyunpark@skku.edu; Juhee Cho, PhD. Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea. Email: Jcho@skku.edu.
Background:
Both age of menarche and menopause are associated with impaired lung function. However, there is limited data on the association between reproductive lifespan (RL) and lung function. This study aims to evaluate the association between RL and lung function among postmenopausal women.
Methods:
In the Korean National Health and Nutrition Examination Survey (2010-2015), an annual cross-sectional survey of a national representative sample of non-institutionalized Korean population, the postmenopausal women aged 40-64 years who underwent spirometry were included. Spirometry was performed according to the recommendations of the American Thoracic Society and European Respiratory Society, and RL (years) was calculated by subtracting the age at menarche from age at menopause.
Results:
Among 3,410 postmenopausal women, the mean RL were 34.91 (standard error 0.07). In spline regression models, shorter RL was associated with reduced predicted forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1), and the associations were linear. In multivariable-adjusted models, the prevalence ratios (95% confidence interval) for abnormal lung function (restrictive or obstructive ventilatory disorder) comparing women with RL ≤30 years and >30 to <39 years to women with RL ≥39 years were 1.83 (1.15, 2.50) and 1.42 (1.01, 1.84), respectively. Women with RL ≤30 years showed a 2.13 (1.28, 3.54) times higher prevalence of restrictive ventilatory disorder than women with RL ≥39 years.
Conclusions:
In postmenopausal women, a shorter RL was associated with abnormal lung function, particularly with a restrictive ventilatory disorder.
... [1][2][3][4] The perception and experiences associated with the menopause have been related to many factors, such as cultural differences 5,6 , age and educational level 7 , personality vulnerability/traits 8,9 , physical conditions 5 , life style 10 , attitude towards menopause 11 and attitude towards menopause mediated by emotional intelligence (EI). 12 Although some studies suggest muscle and joint problems/discomfort are the most prevalent symptoms 7 , psychological alterations are also experienced by a large number of the women during the climacteric stage. 4,13 Indeed, anxiety and depression are highly prevalent in middle-age women 14 , and they become even more prevalent and intense in climacteric 15 , affecting their QoL. ...
Objective:
The aim of the study was to evaluate the accuracy of the Menopause Rating Scale (MRS) and the Menopause Quality of Life Questionnaire (MENQOL) to discriminate women suffering from anxiety (AD) and depression disorder (DD).
Methods:
A cohort of 416 women aged 45 to 65 years (51.7 ± 3.8) completed the MRS, MENQOL and Hospital Anxiety and Depression Scale, plotting receiver operator curves to assess the diagnostic accuracy of the MRS and MENQOL items related to anxiety and depression.
Results:
Both the MRS6 (area under the ROC curve [AUC] 0.773, 95% confidence interval [CI] 0.721-0.824) and MENQOL5 (AUC: 0.772, 95% CI 0.723-0.822) proved to be accurate tools to identify individuals with anxiety or with a likelihood to develop AD. Likewise, the items MRS4 (AUC: 0.771, 95% CI 0.625-0.797) and MENQOL8 (AUC: 0.744, 95% CI 0.668-0.821) appeared to be suitable to discriminate individuals with DD. Two cut-off points were established for each item in the different scales to optimize their capacity to detect and discriminate problems of anxiety and depression. Lower cut-off values (MRS ≥ 1; MENQOL ≥ 2) were established to detect AD and DD, the sensitivity of which varied between 76.0% and 84.6%% and a negative predictive value varying between 86.7% and 95.3%. A more specific cut-off was established for the discrimination of AD and DD (MRS ≥ 2; MENQOL ≥ 7), with a specificity ranging from 86.2% to 99.4% and a positive predictive value varying between 68.6% and 92.6%.
Conclusions:
The MRS and MENQOL display moderate accuracy in discriminating menopausal women with symptoms of anxiety and depression. The intensity of the symptoms appears to be related to the probability of detecting a probable or definitive disorder.
... At this stage, fertility and reproduction cease, ovaries stop functioning, and a new phase of women's life begins (Yücel & Eroğlu, 2013). Exposing them to extensive changes, menopause is one of the evolutionary stages that all women experience as they grow old (Bauld & Brown, 2009). Traditional medicine considers menopause a problem associated with ovarian dysfunction, loss of fertility, and hormone deficiency that needs treatment, while in the psychosocial model of menopause, it is a natural phenomenon in the evolutionary process. ...
Inviting husbands to come to terms with women’s adaptation to the phenomenon of menopause is beneficial. The aim of this research was to uncover the effect of couples education on marital satisfaction. This study was performed on 80 menopausal women accompanied by their husbands. The intervention group received four sessions of couples education. The results showed that the mean increase in the rate of marital satisfaction after couples education in the intervention group was significantly higher than the control. Short-term couples education has a significant positive effect on marital satisfaction. Therefore, this counseling strategy can be integrated into health-care programs.
... The study concluded that, Women with high emotional intelligence appear to hold more positive attitudes to menopause and experience less severe stress, psychological distress and menopause symptoms and better physical health. These results suggest that women who expect menopause to be a negative experience or are highly stressed or distressed may be more likely to experience a more negative menopause [3] . This study supported by Prof Dr. Alakananda1, (2015), A study conducted on "Age of Menopause and Menopausal Symptoms among women attending Gauhati Medical College and Hospital, Guwahati, Assam,A cross sectional study included 200 postmenopausal women attending Gynaecology outpatient department to evaluate the age at menopause and prevalence of menopausal symptoms, also to determine the awareness and attitude towards menopause and the treatment seeking behavior among these women. ...
Purpose: To explore the experiences of women who have attained menopause.
... Older autistic people are less likely than non-autistic peers to maintain optimal physical and cognitive fitness, and more prone to reclusiveness (Hwang, Foley, & Trollor, 2018). Within this demographic, quality of life declines most in those with poor mental health (Mason et al., 2019b), consistent with the greater impact of menopausal symptoms on non-autistic women with mental illnesses (Bauld & Brown, 2009). Whilst the present data did not directly examine mental ill-health as an outcome, this qualitative foundation in autism menopause research may provide a springboard for further investigations. ...
Objectives:
The menopause is a major transition marked by considerable challenges to health and well-being. Its impact on autistic women has been almost largely ignored but is of significant concern, given the poorer physical and mental health, emotion regulation and coping skills, and the common social isolation of this group. We aimed to explore awareness and perception of the menopause; menopausal experiences and their impact across each individual's life; ways that menopause with autism might differ from a non-autistic menopause; and what optimal support might look like.
Design:
A qualitative interview study.
Methods:
Comprehensive interviews were conducted with 17 autistic participants (16 of whom identified as cisgender women). Inductive thematic analysis was used, guided by IPA principles and literature.
Results:
Four major themes were identified: (1) covering the long journey of our participants to recognizing autism in adulthood; (2) menopausal awareness and perceptions; (3) symptoms and their impact; and (4) ways that a neurodiverse menopause might differ from the norm. Menopausal experiences varied greatly and some participants experienced marked deterioration in daily function and coping skills, mental health, and social engagement. Menopausal awareness was often low, so too was confidence in help from health care professionals.
Conclusions:
These findings implicate the potential for menopause to severely compromise health and well-being of autistic people and indicate an area of underserved support needs.
... Persons with EI usually have good psychological and physical health, because they have ability to adapt their selves with the challenges of their life, and therefore manage their emotions towards these challenges properly. Generally, many empirical studies have proved significant negative relationship between TEI and PD as well as between TEI and PD sub-dimensions (Bauld & Brown, 2009;Besharat, 2007). ...
The study aimed to reveal levels of psychological distress and maladaptive perfectionism at the students of secondary stages in Kuwait schools, and to determine the relationship between those two factors under the effect of trait emotional intelligence. The study sample was composed of (255) students from six schools located in different areas in Kuwait city. A self- administered questionnaire was used as the study instrument for collecting data. It was found that both psychological distress and maladaptive perfectionism were found at medium level, whereas trait emotional intelligence was found at the high level, Moreover it was found that trait emotional intelligence as a mediator affects the psychological distress- maladaptive perfectionism relationship.
... In literature, various empirical studies have well documented the significant negative relationship between trait emotional intelligence and psychological distress and its sub dimensions e.g. depression and anxiety (Besharat, 2007;Bauld & Brown, 2009;Chan & David, 2005) and with negative affect (Kafetsios & Zampetakis, 2008;Sevdalis, et al., 2007). ...
This paper presented a historical review of India and Pakistan relations on water dispute in the period from 1948-1960. The researchers conducted this research to check the coverage given by the print media on Indus Basin Treaty. The focus of research remained on responsible journalism regarding different disputes specifically Indus Basin Treaty. It defines the importance of water resources for human life of both countries (India & Pakistan). It also analyzes synchronization of events which would ultimately lead to solution of other problems confronting the two nations. As in those days media was judicially commented upon for the efforts to achieve a comprehensive settlement of other disputes between the two states.
... 8 Some women cope well with their menopausal symptoms and seem to embrace this time of change, while others struggle psychologically to adjust to the changes in their body and body function. 9 Culture has been shown to greatly influence women's perception of menopausal symptoms and is in turn underpinned by the value placed on fertility, sexuality and role within society. 10 In traditional cultures, there is often a positive attitude towards menopause as women acquired certain privileges such as the 'wise woman status' and freedom from periods and pregnancy. ...
The menopause presents many challenges for middle-aged women worldwide, often highly productive women who are in the prime of their lives juggling busy careers and family responsibilities, when good quality of life and functional ability is an imperative. Some women cope well with their menopausal symptoms and seem to embrace this time of change, while others struggle psychologically to adjust to the changes. Mindfulness-based interventions have a robust evidence base in relation to their efficacy in both physical and psychological conditions. Both programs have been adapted for conditions where difficulties in psychological adjustment to change and/or loss are amongst the core mechanisms that maintain distress. I explored the potential aetiology of distress in the menopause and evaluated existing empirical literature to ascertain whether there is a role for mindfulness-based interventions to facilitate optimal psychological adjustment to changes in the menopause, paying particular attention to the mechanisms that lend themselves to mindfulness training being efficacious. Current available evidence is promising and supports the hypothesis that mindfulness-based interventions may have a role in facilitating psychological adjustment during the menopause transition. The dearth of literature specific to mindfulness-based interventions and the menopause was noted.
... Menopause is a natural stage of the sexual life of women, which is associated with numerous issues (1,2). Women's fertility begins to decline with menopause, marking the end of their reproductive age. ...
Background: Menopause is associated with physical and psychological as well as sleep problems that cause disruption in quality of life in women. Objectives: The question of whether the severity of physical and psychological symptoms correlated with the severity of insomnia in postmenopausal women is investigated in this study. Methods: This cross-sectional study was performed on 214 postmenopausal women referred to health centers in Kermanshah city between May 2019 and May 2020. Data collection tools included demographic and social characteristics questionnaires, Menopausal Rating Scale (MRS) and Insomnia Severity Index (ISI). Data were analyzed using ANOVA and Pearson correlation test using SPSS software. Results: The mean total score of insomnia severity was 14.3 ± 5. Also, according to the severity of insomnia, 22 women had no insomnia, but 88 and 87 women had mild and moderate insomnia and 17 women had severe insomnia, respectively. Comparing the mean scores of 11 MRS items in different insomnia severities showed a significant difference in the rate of symptoms, so that in the physical domain, hot flashes and sleep problems, and in the psychological domain, depression items, irritability, anxiety, poor memory and lack of concentration were higher in the sever insomnia, but none of the items of the genitourinary domain were associated with the severity of insomnia. Conclusions: Our study showed that in postmenopausal women, the rate of physical and psychological symptoms increases with higher severity of insomnia. Insomnia should be considered as a disorder that requires special attention and treatment in postmenopausal women.
... For aging women, sources of anxiety include preconceived attitudes toward aging, deterioration of health and function, perceived lack of support, and body image (Barrett & Robbins, 2008;Bauld & Brown, 2009;Ramírez & Palacios-Espinosa, 2016). In older adults, higher anxiety levels are associated with trouble falling asleep, increased nighttime awakenings, and poor social and daily life functioning, even when anxiety levels are subclinical (Spira et al., 2008). ...
Anxiety is common, yet often under-treated, among women in postmenopause. This study examined the effect of a hypnotic intervention designed to reduce hot flashes, on anxiety levels of postmenopausal women. Anxiety was assessed using the State-Trait Anxiety Inventory, the Hospital Anxiety and Depression Scale-Anxiety subscale, and a visual analog scale. Additionally, hypnotizability was tested as a moderator of anxiety reductions. Significant reductions in anxiety were found from baseline to endpoint and follow-up and hypnosis was superior to the control condition. Additionally, ratings of Current Anxiety decreased from pre-session to post-session at each weekly visit and the pre-session scores reduced continuously. Hypnotizability was found to moderate anxiety reductions, but regardless of hypnotizability level participants, on average, experienced significant symptom improvement from baseline scores. These data provide initial support for the use of hypnosis to reduce symptoms of anxiety among postmenopausal women.
Trial registration: This study was registered at ClinicalTrials.gov on February 11, 2011 under Identifier number NCT01293695 (https://clinicaltrials.gov/ct2/show/NCT01293695?term=Elkins&cond=hot+flashes&draw=2&rank=2).
... In particular, Trait EI is negatively associated with anxiety and depression. Suicidal thoughts related to depression disorder was found to be decreased in individuals with a high ability to understand emotions and a good self-control (Bauld and Brown, 2009;Armstrong et al., 2011). Depressed persons have a lower ability to understand, to express emotions and to manage negative emotions (Fernández-Berrocal et al., 2006;Sergi et al., 2012). ...
Recent epidemiological data show an increase of depression and anxiety that cause a loss of about 3–4% of the gross domestic product in Europe, as a consequence of a reduced productivity and a premature death of people. Gender differences in both psychopathologies were found from mid-to-late adolescence until 55 years, and data indicate an increase of depression in women. Considering these data, new interventions focused on promoting psychological well-being were designed. A predictive factor of psychological disorders is Emotional Intelligence (EI), the ability to understand and regulate our own emotions, as well as those of others. EI is associated with psychological well-being, as well as with the treatment of mental illness, but gender differences in the association among EI, anxiety and depression remains unclear. The present study aims at analyzing the nomological associations among EI, anxiety and depression. Furthermore, the possible moderating role of gender in the relation between EI, depression and anxiety is investigated in a sample of 1725 healthy participants. Our results show that the ability to recognize and to control emotions in the social context helps us to reduce the risk to be affected by depression and anxiety. Moreover, our study shows that the association of EI with anxiety and depression wasn’t gender moderated. In conclusion, the findings highlight that EI can help people to manage emotions linked to negative events and to successfully understand emotions in others. In addition, we found no moderation role of gender in the association between EI, anxiety and depression.
... Finally, interactions between EI and physical health and healthy behaviors [24][25][26] have been focused on young and middle aged adults. These findings indicate that higher EI is linked to better physical health; both subjectively and objectively reported [25][26]. ...
... Menopausal symptoms can cause discomfort, insomnia and low self-esteem (4). High stress, anxiety and depression are also associated with increased severity of menopausal symptoms (17). Since the result of strengthening selfawareness skills are identification and management of emotions, including anger, sadness, stress and the ability to control behavior, increase self-confidence, restore self-esteem and reduce depression (18), it seems that self-awareness can be effective in controlling symptoms and improving the quality of life of menopausal women by addressing various personal and social issues associate with it. ...
Background: Counseling interventions are among the available strategies to improve the menopausal quality of life and self-awareness counseling is effective in improving adaptation, self-confidence and quality of life. Therefore, the present study aimed to examine effects of self-awareness counseling on quality of life of menopausal women in Gorgan, Iran.
Methods: In this clinical trial, we examined 52 menopause women referred to health centers of Gorgan, Iran in 2018. Data collection tools included a demographic characteristics form and the menopause-specific quality of life questionnaire. First, the control group completed the data collection tools at the beginning of the study and 6 and 10 weeks after the first session. Then the intervention group completed the tools at base line and participated in six 45-60-minute self-awareness-based group counseling sessions, once a week. After that, they were completed questionnaire, immediately and a month after the end of the intervention. Data were expressed as mean ± standard deviation.
Results: In the intervention group, the baseline mean scores of menopausal quality of life and its vasomotor, physical, psychosocial and sexual domains were 55.69±19.47, 5.30±4.57, 30.26±12.24, 12.15±6.64 and 7.96±5.34, respectively. A month after the intervention, the mean scores of menopausal quality of life (30.42±19.64) and its vasomotor (2.65±2.33), physical (16.38±8.64), psychosocial (7.19±4.63) and sexual (4.19±3.42) domains increased significantly in the intervention group (p=0.001). In between group comparison, except for the psychosocial domain, the mean scores of quality of life and its various domains showed a statistically significant difference in one month after the intervention (P=0.001).
Conclusion: The menopausal quality of life and its various domains improved one month after the end of self-awareness counseling. Therefore, we recommend offering self-awareness counseling in health centers for improving the quality of life of menopausal women.
... Finally, interactions between EI and physical health and healthy behaviors [24][25][26] have been focused on young and middle aged adults. These findings indicate that higher EI is linked to better physical health; both subjectively and objectively reported [25][26]. ...
Nowadays ageing in a healthy way is one of the greatest challenges of our era. There are several factors associated with the emotional functioning of an individual which are necessary for managing and regulating emotional life, such as perceiving and understanding emotions and being able to regulate them. Such abilities are well encompassed by the Emotional Intelligence (EI) construct. An impressive body of literature indicates that EI has a significant influence on psychological, social and physical health. However, to date, such evidence cannot be extended accurately to the older population as the vast majority of studies have been focused on samples composed of adolescents and young adults. Therefore the aim of the current review is to analyze what extent is linked to psychosocial and physical functioning among older people.
... In addition to hormonal changes, other factors are effective in causing and exacerbating mood changes. These factors are the adverse effect of vasomotor symptoms on mood (domino theory), bad events in social life such as illness, previous history of depression, retirement, death of a spouse, care of elderly parents, empty nest syndrome, how women feel about menopause, prolonged menopause, chronic pain and disability, changes in sexual function, the level of emotional intelligence, and menopausal symptoms such as flushing, night sweats, and secondary sleep disorders can also affect mood changes [15,16]. It is reported that the prevalence of sleep problems is up to 65% in menopausal women. ...
Background:
One of the most critical periods in a woman's life is menopause. During menopause, depression and anxiety are among the most common mood changes. Sleep disorders also increase during menopause, which leads to quality of life disorders. Different methods such as medication, psychotherapy, or a combination of them are used to treat these disorders. Acceptance and commitment-based therapy is one of the newest methods in psychotherapy that recently has been used a lot. Therefore, this study was conducted to determine the effect of acceptance and commitment therapy (ACT) on mood (primary outcome), sleep quality, and quality of life (secondary outcomes) of menopausal women.
Methods:
This randomized controlled trial was performed on 86 menopausal women in Tabriz, Iran in 2021. Using the blocking method, participants were randomly assigned into the intervention and control groups. The intervention group received counseling based on ACT approach in 8 sessions of 60 to 90 min. The control group received only routine health care. Depression, Anxiety, Stress Scale-21 (DASS 21), Menopause Quality of Life (MENQOL), and Pittsburgh Sleep Quality Index (PSQI) questionnaires were completed before intervention and immediately after the intervention. Independent t-test and Mann-Whitney U test were used to compare the outcomes between the two groups.
Results:
In terms of sociodemographic characteristics and baseline values of the studied variables, there was no statistically significant difference between the study groups before the intervention. At the end of the intervention, the mean (SD: standard deviation) scores of anxiety, stress, and depression in the counseling group were 2.66 (1.28), 2.91 (1.62), and 1.98 (1.59) and in the control group were 4.19 (1.85), 5.61 (1.49) and 3.59 (1.91). In the intervention group, the mean score of all three variables was significantly lower than the control group (P < 0.001). After the intervention, the mean (SD) of the total sleep quality score was 4.04 (2.52) in the counseling group and 4.13 (2.63) in the control group. In addition, the mean (SD) of the total quality of life score was 23.47 (20.13) in the counseling group and 23.14 (17.76) in the control group. Between the study groups, there were no statistically significant differences in the mean of the overall score of sleep quality (P = 0.867) and the overall score of quality of life (P = 0.759).
Conclusion:
Using ACT-based counseling can improve the mood of menopausal women. However, further randomized clinical trials are needed before making a definitive conclusions.
Trial registration:
Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N65. Date of registration: 2/19/2021. Date of first registration: 2/19/2021. URL: https://en.irct.ir/user/trial/53544/view; Date of recruitment start date: 2/22/2021.
... For example, prior literature has shown that middle-aged women with high EI reported better physical and social functioning, better mental health, greater vitality, better general health and less bodily pain than peers with low EI (Extremera and Fernández Berrocal 2002). Similarly, middle-aged women (45-55 years) with high EI appear to have more positive attitudes towards menopause and experience less stress, less psychological distress, fewer menopausal symptoms and better physical health than peers with low EI (Bauld and Brown 2009). More recently, in a large sample of older people (aged 50 to 80 years) high scores for emotional competence were positively associated with physical and emotional health and negatively associated with medication consumption (Fantini-Hauwel and Mikolajczak 2014). ...
Although emotional intelligence (EI) and social support are important predictors of well-being in adolescents and adults, there has been little research on their combined effects on well-being in older people. From a developmental perspective, it would be premature to assume similar models for EI, social support and well-being for older adults as were established for adolescents and adults. This study investigated sources of perceived social support as potential mediators of the relationship between EI and well-being indicators (life satisfaction and happiness) in older people. A Spanish sample of 383 older people aged 55 years and older completed a self-report survey regarding perceived emotional intelligence, perceived social support, life satisfaction, and subjective happiness. We found EI scores to be moderately and significantly related to different sources of perceived social support, life satisfaction and subjective happiness measures. Using path analyses, results showed that perceived social support from both family members and friends partially mediated the relationships between EI scores and life satisfaction and happiness (only for social support from friends). That is, emotionally intelligent older people reported higher level of perceived support from friends and family which resulted in higher well-being indicators. These findings suggest that EI may play a role in the well-being of older people with the benefit depending on the sources of perceived social support.
... According to epidemiological surveys, when perplexed by menorrhagia and/or dysmenorrhea, premenstrual tension and other gynecological symptoms, nearly half of premenopausal women are so much affected physically and psychologically by the diseases that they would feel nervous, depressed, annoyed and distressed, and may have psychiatric symptoms such as irritability, crying, anxiety, depression, etc. These diseases can considerably affect the quality of life and living conditions of the patients, and may even lead to social dysfunction [9,10]. Hysterectomy is the primary treatment method for these diseases [11]. ...
... Menopausal symptoms can cause discomfort, insomnia and low self-esteem (4). High stress, anxiety and depression are also associated with increased severity of menopausal symptoms (17). Since the result of strengthening selfawareness skills are identification and management of emotions, including anger, sadness, stress and the ability to control behavior, increase self-confidence, restore self-esteem and reduce depression (18), it seems that self-awareness can be effective in controlling symptoms and improving the quality of life of menopausal women by addressing various personal and social issues associate with it. ...
Background: Counseling interventions are among the available strategies to improve the menopausal quality of life and self-awareness counseling is effective in improving adaptation, self-confidence and quality of life. Therefore, the present study aimed to examine effects of self-awareness counseling on quality of life of menopausal women in Gorgan, Iran. Methods: In this clinical trial, we examined 52 menopause women referred to health centers of Gorgan, Iran in 2018. Data collection tools included a demographic characteristics form and the menopause-specific quality of life questionnaire. First, the control group completed the data collection tools at the beginning of the study and 6 and 10 weeks after the first session. Then the intervention group completed the tools at base line and participated in six 45-60-minute self-awareness-based group counseling sessions, once a week. After that, they were completed questionnaire, immediately and a month after the end of the intervention. Data were expressed as mean ± standard deviation. Results: In the intervention group, the baseline mean scores of menopausal quality of life and its vasomotor, physical, psychosocial and sexual domains were 55.69±19.47, 5.30±4.57, 30.26±12.24, 12.15±6.64 and 7.96±5.34, respectively. A month after the intervention, the mean scores of menopausal quality of life (30.42±19.64) and its vasomotor (2.65±2.33), physical (16.38±8.64), psychosocial (7.19±4.63) and sexual (4.19±3.42) domains increased significantly in the intervention group (p=0.001). In between group comparison, except for the psychosocial domain, the mean scores of quality of life and its various domains showed a statistically significant difference in one month after the intervention (P=0.001). Conclusion: The menopausal quality of life and its various domains improved one month after the end of self-awareness counseling. Therefore, we recommend offering self-awareness counseling in health centers for improving the quality of life of menopausal women.
... It should be mentioned that that several symptoms which have been associated with menopause are not necessarily due to the endocrinological changes characteristic of perimenopause. These symptoms may be related to other variables, among which the psychosocial ones stand out, such as attitudes, personality, self-perception, and emotional intelligence (Bauld & Brown, 2009;Grochans et al., 2018;Marván et al., 2018;Terauchi et al., 2017;Zhao et al., 2019). Moreover, it has been proposed that optimism and sense of coherence have a protective function for menopausal transition (Caltabiano & Holzheimer, 1999). ...
We studied the influence of meaninglessness and life satisfaction on menopause-related symptoms in 342 middle-aged Mexican women. They completed the Greene Climacteric Scale, the Dimensional Scale of the Meaning of Life, and the Satisfaction with Life Scale. Psychological symptoms were predicted by meaninglessness and life satisfaction; somatic symptoms only by meaninglessness; and the sexual symptom by meaninglessness and by the menopausal status. These findings may be useful in designing strategies to help women find meaning and satisfaction in their lives and thereby enable them to experience menopause under optimum conditions.
Vulnerability to depression is increased across the menopause transition and in the early years after the final menstrual period. Clinicians should systematically screen women in this age group; if depressive symptoms or disorder are present, treatment of depression should be initiated. Potential treatments include antidepressants for moderate to severe symptoms, psychotherapy to target psychological and interpersonal factors, and hormone therapy for women with first-onset major depressive disorder or elevated depressive symptoms and at low risk for adverse effects. Behavioral interventions can improve physical activity and sleep patterns.
Objective: This study aimed to predict mental well-being and general health based on perceived stress and body image with mediating the role of self-compassion in women athletes in Tehran. Methods: This descriptive correlational study was performed using structural equations. The statistical population included all female athletes who referred to sports clubs in Tehran. In this study, 250 women were selected by the convenience sampling method. Participants responded to questionnaire forms specified for measuring mental well-being, general health, self-compassion, body image, and perceived stress scale using a website link. The obtained data were analyzed by descriptive analysis, Pearson correlation, and path analysis using SPSS and PLS software statistical packages. Results: In general, path analysis showed that self-compassion could not mediate the path between perceived stress and mental well-being. However, it mediated the path of body image to well-being. Besides, self-compassion did not mediate the perceived ester pathway to public health and body image to public health. Conclusion: According to the results, it is concluded that strategies reducing self-compassion are able to provide a better body image and increase the mental well-being of women athletes.
Aims: Aging is associated with a phenomenon of menopause in women that is a very broad concept due to the coincidence with the appearance of aging symptoms. Menopause may affect women’s quality of life and especially their health. The aim of this study was to explain the self-concept of postmenopausal women.
Participants & Methods: The present study is a qualitative phenomenological research that was conducted among 23 menopausal women referred to Sanandaj health clinics in 2018 using semi-structured in-depth interviews. Participants were selected by purposive sampling method. Sampling continued until having achieved informational redundancy or saturation. The data were analyzed using MAXQDA 10 software and according to van Manen’s six steps to guide phenomenological research.
Findings: Five main themes were identified: intellectual ability, occupational efficiency, physical attractiveness, social skills, and virtues/vices, which is consistent with Beck self-concept test. In addition, the theme "physical health" was extracted from the participants' statements which are not part of the Beck test.
Conclusion: Postmenopausal women, with the exception of intellectual ability and occupational efficacy, have problems in other themes such as physical attractiveness, social skills, and exercise, mood, and physical problems, which indicates inappropriate self-concept after menopause.
Objectives:
The aims of this study were to examine the relationships between menopausal symptoms, sense of coherence (SOC), coping strategies, and quality of life, and to test the mediating effects of SOC and coping strategies on the relationships between menopausal symptoms and quality of life among Chinese women during menopausal transition.
Methods:
Two hundred one women aged 40 to 60 years and currently undergoing menopausal transition were recruited at community centers between June and August 2017. Menopausal symptoms, SOC, coping strategies, and quality of life were assessed by the Menopause Rating Scale, the Sense of Coherence Scale, the Brief COPE Inventory, and the Medical Outcomes Study Short-Form-36, respectively. Data were analyzed by path analysis.
Results:
Menopausal symptoms were associated with poorer quality of life, and both SOC and maladaptive coping were found to mediate the effects of menopausal symptoms on quality of life. The results suggest that SOC might alleviate the adverse effects of menopausal symptoms on quality of life, whereas maladaptive coping strategies might aggravate the adverse effects of menopausal symptoms on quality of life.
Conclusions:
The results provide new insights into the importance of considering SOC and coping strategies and their interactions with menopausal symptoms and quality of life in the situation of menopausal transition.
RESUMO: Esta pesquisa tem por objetivo investigar as consequências do climatério no comportamento da mulher no seu lócus laboral. É um trabalho ancorado no método de levantamento de dados e caracteriza-se por ser de natureza descritiva e exploratória. As informações foram categorizadas, pré-codificadas e organizadas qualitativamente, com base na análise de conteúdo proposta por Bardin. Os sujeitos do estudo foram 15 mulheres entre 40 e 60 ou mais anos, profissionais da saúde em uma unidade de saúde da família, em uma cidade do Extremo Norte do Brasil. Dentre as estratégias de enfrentamento utilizadas estão: as atividades físicas (caminhadas na praça, passeio de bicicleta), hábitos alimentares adequados (produtos naturais, tais como soja, linhaça, alimentação sem gordura, pouco sal), religiosidade (Deus, Bíblia, orações, ir à igreja) e a busca por assistência médica (visitas ao ginecologista e a procura pelo serviço médico na unidade de saúde). Observou-se que o climatério é um período importante, porém nem sempre compreendido e atendido de maneira adequada, e que essa fase ainda é vista como um período negativo, que pode alterar a vida conjugal e familiar. Palavras-chave: Menopausa; Comportamento; Trabalho.
Die Wechseljahre der Frau stellen eine natürliche Lebensphase dar. In dieser Phase auftretende Beschwerden müssen differenziert diagnostiziert und dürfen weder vorschnell der Hormonveränderung zugeschrieben noch bagatellisiert werden.
Objective:
Little is known about the prevalence and treatment of premature and early menopause among people with HIV. We described premature and early menopause and subsequent hormonal treatment in a longitudinal cohort of women living with or at risk for HIV in the US.
Methods:
Data from the Women's Interagency HIV Study between 2008 and 2020 were analyzed to describe premature and early menopause among cohort participants under the age of 51.
Results:
Of 3,059 eligible women during the study period, 1% (n = 35) underwent premature menopause before age 41, 3% (n = 101) underwent menopause between ages 41 and 46, and 21% (n = 442) underwent menopause between ages 46 and 50, inclusive. Of participants who experienced menopause before age 41, between age 41 and 45, and between ages 46 and 50, 51%, 24%, and 7% (respectively) received either menopausal hormone therapy or hormonal contraception.
Conclusion:
These findings suggest that disparities in receipt of recommended hormone therapy for premature and early menopause may contribute, in part, to evident health disparities, such as cardiovascular disease, osteoporosis, and overall mortality. They also suggest a substantial need for education among people experiencing early menopause and their providers, with the goal of improving access to hormone therapy based on guidelines to address health disparities and minimize future health consequences.
La perimenopausia se caracteriza por riesgo incrementado
para patología urogenital, cardiovascular y ósea. No
obstante, también afecta el sistema nervioso central. Por
ello se realizó una revisión teórica orientada al análisis de la
incidencia de depresión y dificultades cognitivas en mujeres
perimenopáusicas. Se procedió mediante el reporte de
resultados de artículos originales localizados en las bases
de datos Pubmed, Wiley Online Library y Sciencedirect. Una
posible mayor susceptibilidad a depresión y/o problemas
cognitivos en perimenopausia sería el resultado de una
reducción de los efectos cerebrales benéficos garantizados
hasta ese momento por las hormonas ováricas (mecanismos
neuroendocrinos), como así también, consecuencia de una
valoración negativa de la menopausia y cambios sociales
disruptivos. Además, si bien la perimenopausia aumenta la
vulnerabilidad a la depresión, los porcentajes son difíciles
de precisar debido a que los estudios adoptan metodologías
de medición disímiles. En el plano cognitivo, son frecuentes
las quejas de memoria. Sin embargo, las evidencias de
una merma en el rendimiento cognitivo objetivo no son
concluyentes. Se sugiere mayor investigación al respecto.
Many women going through the menopausal transition experience vasomotor symptoms (VMS), and research has shown that there is a large amount of variation in their frequency and severity. Many lifestyle factors have been found to co-vary with VMS, including the level of social support received by the woman, and how stressed she is. Stress is well documented to worsen menopause symptoms, and there is some evidence that support eases them; however, there is little research into whether support is an effective buffer against the negative effects of stress on VMS. Using nine years of data from the Study of Women’s Health Across the Nation (n = 2718), we use multilevel Poisson regression with random effects to test: 1) if more social support is associated with decreased VMS frequency, 2) if increased life stress worsens VMS, and 3) if support acts as a buffer against stress. After adjusting for age, marital status, smoking, self-perceived overall health, ethnicity, and menopausal status, we find that stress increases the frequency of VMS. Contrary to our hypothesis, we did not find strong evidence that emotional support led to lower VMS frequency, or that support buffers against the effects of stress. Experience of a stressful event, but not amount of social support, was included in the best fitting model; with the degree to which the woman was upset by the life stressor having the largest effect on menopause symptoms. Here, women who said they were currently upset by a stressful event experienced 21% more VMS than women who had experienced no life stressor. This research highlights that social factors may impact the menopausal transition.
This study aimed to examine the relationship between menopausal symptoms and perceived stress in middle-aged women during the COVID-19 pandemic. In this cross-sectional study, data were collected online from 239 middle-aged women using the Personal Information Form, Menopause Rating Scale (MRS) and Perceived Stress Scale-14 (PSS-14). A positive correlation was found between the total MRS score and the total PSS-14 score. The COVID-19 pandemic usually restrict access to healthcare visit. The COVID‐19 pandemic has created an urgent need to implement specific menopausal programs to promote the psychological health of middle-aged women and reduce stress during this or similar crises.
Sleep disturbance is one of the most commonly reported and most bothersome symptoms of the menopausal transition, and menopause is a unique contributor to the greater prevalence of sleep disorders and general sleep dissatisfaction in midlife women. Sleep is a complex process affected by physiological, psychological, social, and cultural factors. The purpose of this chapter is to describe the consequences and characteristics of sleep in the menopausal timeframes—the quantity, quality, and prevalence of disorders. Additionally, we consider the broader biopsychosocial context affecting sleep in the menopause transition. Lastly, we end with a discussion of the assessment and treatment of sleep disturbance.
The skin is a target-organ for systemic and local reactions to stress, and hair loss may indeed occur after acutely stressful conditions, such as trauma and severe disease.
Introduction: Menopause is associated with a variety of physical
and mental issues. It’s critical to pay attention to postmenopausal
women’s health issues and develop prevention strategies.
Aim: To evaluate association between physical activity and physical
and mental health problems in postmenopausal women.
Materials and Methods: In the present systematic review, relevant
studies were searched in international electronic databases such
as, Cochrane Central Register of Controlled Trials (CENTRAL),
PubMed and Google Scholar from 2004 to 2021. Terms like physical
activity, physical health, mental health, bone mineral density,
exercise training, and postmenopausal women were searched. All
papers were screened for eligibility. Inclusion criteria of the study
was, studies with atleast one exercise group versus one control
group, should include women who were postmenopausal at the
time of the study, studies that examined effect of physical activity
on physical and mental health of postmenopausal women, full text
articles written in English language.
Results: Total 27 studies were included in the present review.
The results revealed that resistance, aerobics, walking, pilates
and aquatic exercises have shown benefits in improving physical
and mental health parameters of postmenopausal women.
Conclusion: Physical activity plays a great role in maintaining
overall health and Quality of Life (QOL) of Women. To avoid
fractures, these women should engage in workouts with prudence.
Physical and mental fitness can be achieved by incorporating
exercise into daily routine of postmenopausal women.
Physical activity (PA) is a promoter of health in general. Its benefits include maintaining proper weight, providing stress relief, increasing muscle strength, improving balance and coordination, increasing bone strength, and increasing mental focus. In addition, PA improves the evolution of diseases such as hypertension, diabetes, osteoporosis, and dementia. We can infer that PA is more than a lifestyle; it constitutes a form of therapy in itself. The aim of this chapter is to analyse the perimenopausal and postmenopausal impact of healthy PA, to determine the PA-associated improvements in the symptoms and processes that emerge during this period, and to identify the optimal PA recommendations for those purposes.
In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators. (46 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This series of studies describes the development of a measure of emotional intelligence based on the model of emotional intelligence developed by Salovey and Mayer [Salovey, P. & Mayer, J. D. (1990). Emotional intelligence. Imagination, Cognition and Personality, 9, 185–211.]. A pool of 62 items represented the different dimensions of the model. A factor analysis of the responses of 346 participants suggested the creation of a 33-item scale. Additional studies showed the 33-item measure to have good internal consistency and testretest reliability. Validation studies showed that scores on the 33-item measure 1.(a) correlated with eight of nine theoretically related constructs, including alexithymia, attention to feelings, clarity of feelings, mood repair, optimism and impulse control;2.(b) predicted first-year college grades;3.(c) were significantly higher for therapists than for therapy clients or for prisoners;4.(d) were significantly higher for females than males, consistent with prior findings in studies of emotional skills;5.(e) were not related to cognitive ability and6.(f) were associated with the openness to experience trait of the big five personality dimensions.
The factor structure, reliability, and validity of the Depression Anxiety Stress Scales (DASS; S. H. Lovibond & P. F. Lovibond, 1995) and the 21-item short form of these measures (DASS–21 ) were examined in nonclinical volunteers (
n = 49) and patients with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnoses of panic disorder (
n = 67), obsessive-compulsive disorder (
n = 54), social phobia (
n = 74), specific phobia (
n = 17), and major depressive disorder (
n = 46). This study replicates previous findings indicating that the DASS distinguishes well between features of depression, physical arousal, and psychological tension and agitation and extends these observations to the DASS–21. In addition, the internal consistency and concurrent validity of the DASS and DASS–21 were in the acceptable to excellent ranges. Mean scores for the various groups were similar to those in previous research, and in the expected direction. The implications of these findings are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Depression in a middle aged woman should not automatically be blamed on the menopause
The linking of the menopause with depression is pervasive in lay and medical discourse, despite limited supporting evidence. Historically, myths relating to menstrual taboos, as well as attitudes towards fertility and aging, have produced an image of the menopause as a time of physical and emotional decline. In the 19th century the menopause was thought to cause insanity, and it was only as recently as 1980 that the diagnosis of involutional melancholia was removed from the third edition of the Diagnostic and Statistical Manual of Mental Disorders.1 With the development of hormone replacement therapy, treatment of menopausal women shifted from the domains of psychiatry and psychoanalysis to gynaecology and endocrinology.
Initially prescribed for the treatment of vasomotor symptoms, hormone replacement therapy is now recommended for preventing osteoporosis and cardiovascular disease and improving quality of life.2 In the past few years interest has increased in the possible psychoactive properties of hormone replacement therapy. It has been proposed that oestrogen might cure “menopausal depression” and that it might offer an additional bonus of increased wellbeing or quality of life for non-depressed, healthy women.
Defining the menopause as an oestrogen deficiency disease implies that the cause of depression lies in a woman's hormones. This has important implications for the way middle aged and older women's views and behaviours are perceived in …
We sought to determine the relationship between emotional competence and willingness to seek help for emotional problems and suicidal ideation. A survey of 300 university undergraduates assessed emotional competence (skill at emotion perception, managing self-relevant emotions, and managing others' emotions), hopelessness, willingness to seek help from health professionals (e.g. counsellor) and nonprofessionals (friends, family), and perceived usefulness of past help-seeking experience. Those who reported feeling less skilled at managing emotions were less willing to seek help from family and friends for both emotional problems and suicidal ideation and less willing to seek help from health professionals for suicidal ideation. These relationships held even after controlling for hopelessness, sex, and past help-seeking experience. Mediational analysis suggested that people low in managing others' emotions were less willing to seek help from professionals because they had had poorer experiences with mental health professionals in the past. There was no significant relationship between emotion perception skill and willingness to seek help. People most likely to be in need of help (those poor at managing emotions) were the least willing to seek it, and if they did seek it, were the least likely to benefit from it.
In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators.
This paper presents findings from the Massachusetts Women's Health Study (MWHS), one of the largest population-based studies of mid-aged women. A longitudinal study that followed a population-based cohort of women as they proceeded through menopause, the MWHS's goal was to describe their responses and to identify health-related, life-style, and other social factors that affect this transition. Findings indicate that natural menopause appears to have no major impact on health or health behavior. The majority of women do not seek additional help concerning menopause, and their attitudes toward it are, overwhelmingly, positive or neutral. Physicians treating mid-aged women must be careful not to confuse "menopausal" symptoms with indicators of underlying disease or conditions unrelated to menopause.
We focused on the computer-mediated communication (CMC) of social support in an electronic health discussion group dealing with menopause and midlife transition to show how vital support is to women who are trying to make sense of the change in their lives. We analyzed 2,000 messages, examining the type and frequency of support messages, how support was demonstrated, and how support was recognized by participants. We then provided evidence to show that a community of support had developed.
This study examined the relationship between perceived emotional intelligence and health-related quality of life in middle-aged women. 99 middle-aged Spanish women, who studied in two adult schools, volunteered to participate. 49 were premenopausal and 45 were postmenopausal. These women completed the Trait Meta-Mood Scale and Health Survey SF-36. Scores were analyzed according to social, physical, and mental health, menopausal status, and scores on perceived emotional intelligence. Then, the data regarding the mental and physical health of the premenopausal and postmenopausal women were compared after controlling for age. No associations between menopausal status and health-related quality of life were found. Perceived skill at mood repair was significantly associated with scores on health-related quality of life in these middle-aged women. These findings provide empirical evidence that aspects of perceived emotional intelligence may account for the health-related quality of life in midlife including social, physical, and psychological symptoms.
The majority of women diagnosed with early-stage breast cancer have an excellent long-term prognosis, but many will undergo temporary or permanent chemotherapy-induced amenorrhea.
While breast cancer is more common in older women, about 1 in 200 women under the age of 40 is at risk to develop breast cancer. Many of these women benefit from chemotherapy but are afraid to risk the opportunity to bear children. The authors review the current studies on the impact of adjuvant chemotherapy on amenorrhea and fertility in women with breast cancer.
The likelihood of amenorrhea is based on the specific adjuvant chemotherapy regimen administered and the age of the patient. Future childbirth is a viable option for women treated for breast cancer at an early stage. While the use of tamoxifen as a hormonal therapy in premenopausal breast cancer is now the standard of care, no conclusive data confirm the benefit of GnRH agonists in adjuvant therapy after treatment with chemotherapy followed by tamoxifen.
As more women over the age of 35 consider pregnancy, fertility issues are becoming important areas of investigation for the adjuvant treatment of breast cancer. Whether chemotherapy-induced amenorrhea has a prognostic effect remains unclear, and further studies are warranted.
Background
Symptom scales for aging women have clinically been used for years and the interest in measuring health-related quality of life (HRQoL) has increased in recent years. The Menopause Rating Scale (MRS) is a formally validated scale according to the requirements for quality of life instruments. The aim of this paper is to review the current state of the instrument particularly concerning versions of the scale in different languages.
MRS versions available
The translations were performed following international methodological recommendations for the linguistic & cultural adaptation of HRQoL instruments. The first translation was done from the German original scale into English (UK & USA). The English version was used as the source language for the translations into French, Spanish, Swedish, Mexican/Argentine, Brazilian, Turkish, and Indonesian languages (attached as additional PDF files).
Conclusion
The MRS scale is obviously a valuable tool for assessing health related quality of life of women in the menopausal transition and is used worldwide. The currently available 9 language versions have been translated following international standards for the linguistic and cultural translation of quality of life scales. Assistance is offered to help interested parties in the translation process.
This paper compiles data from different sources to get a first comprehensive picture of psychometric and other methodological characteristics of the Menopause Rating Scale (MRS) scale. The scale was designed and standardized as a self-administered scale to (a) to assess symptoms/complaints of aging women under different conditions, (b) to evaluate the severity of symptoms over time, and (c) to measure changes pre- and postmenopause replacement therapy. The scale became widespread used (available in 10 languages).
A large multinational survey (9 countries in 4 continents) from 2001/ 2002 is the basis for in depth analyses on reliability and validity of the MRS. Additional small convenience samples were used to get first impressions about test-retest reliability. The data were centrally analyzed. Data from a postmarketing HRT study were used to estimate discriminative validity.
Reliability measures (consistency and test-retest stability) were found to be good across countries, although the sample size for test-retest reliability was small.Validity: The internal structure of the MRS across countries was astonishingly similar to conclude that the scale really measures the same phenomenon in symptomatic women. The sub-scores and total score correlations were high (0.7-0.9) but lower among the sub-scales (0.5-0.7). This however suggests that the subscales are not fully independent. Norm values from different populations were presented showing that a direct comparison between Europe and North America is possible, but caution recommended with comparisons of data from Latin America and Indonesia. But this will not affect intra-individual comparisons within clinical trials. The comparison with the Kupperman Index showed sufficiently good correlations, illustrating an adept criterion-oriented validity. The same is true for the comparison with the generic quality-of-life scale SF-36 where also a sufficiently close association has been shown.
The currently available methodological evidence points towards a high quality of the MRS scale to measure and to compare HRQoL of aging women in different regions and over time, it suggests a high reliability and high validity as far as the process of construct validation could be completed yet.
Psychosocial influences have been found to impact on the symptoms a woman may experience as she moves through the menopause transition. Consequently any assessment of the menopausal woman should include an exploration and understanding of how the many psychosocial factors influence the experience of menopause and midlife.
This article describes the many psychosocial factors that influence the experience of menopause including midlife issues, role and purpose in life, interpersonal relationships, libido, personality, psychological history and present psychological functioning, body image and sociocultural issues. Case studies are included to illustrate the importance of including psychosocial factors in the assessment and treatment of the menopausal woman.
Any assessment of the menopause experience should include psychosocial influences and the context of women's lives. In a consultation where both the physical and psychosocial issues are explored, we come closer to addressing the true needs of each patient.
Menopause is a physiological event occurring in women at about the age of 50. It signals the end of the reproductive years and is associated with signs of estrogen deficiency having a considerable impact on women's health-related quality of life (HRQoL). The most common form of treatment is hormone replacement therapy (HRT). Studies have shown negative events can arise from long-term use of HRT. The aim of this review is to determine if there are any HRQoL instruments that address the impact of menopausal symptoms including positive and negative effects of HRT.
The following eight instruments were identified: Greene Climacteric Scale, Women's Health Questionnaire (WHQ), Qualifemme, Menopause-Specific QOL Questionnaire (MENQOL), Menopausal Symptoms List (MSL), Menopause Rating Scale (MRS), Menopausal Quality of Life Scale (MQOL), and the Utian Quality of Life Scale (UQOL).
All instruments reviewed proved to be reasonably structured and have their place in applied research. None were found that addressed all aspects of the impact of HRT on HRQoL.
In order to capture the possible short-term side effects of HRT on HRQoL, it is necessary to modify one or more of the existing instruments or develop a new instrument applicable in many different countries and languages.
In recent years, innovative schools have developed courses in what has been termed emotional literacy, emotional intelligence, or emotional competence. This volume evaluates these developments scientifically, pairing the perspectives of psychologists with those of educators who offer valuable commentary on the latest research. It is an authoritative study that describes the scientific basis for our knowledge about emotion as it relates specifically to children, the classroom environment, and emotional literacy. Key topics include: historical perspectives on emotional intelligence neurological bases for emotional development the development of social skills and childhood socialization of emotion. Experts in psychology and education have long viewed thinking and feeling as polar opposites reason on the one hand, and passion on the other. And emotion, often labeled as chaotic, haphazard, and immature, has not traditionally been seen as assisting reason. All that changed in 1990, when Peter Salovey and John D. Mayer coined the term emotional intelligence as a challenge to the belief that intelligence is not based on processing emotion-laden information. Salovey and Mayer defined emotional intelligence as the ability to monitor one’s own and others’ feelings and emotions, to discriminate among them, and to use motivated scientists, educators, parents, and many others to consider the ways in which emotions themselves comprise an intelligent system. With this groundbreaking volume, invited contributors present cutting-edge research on emotions and emotional development in a manner useful to educators, psychologists, and anyone interested in the unfolding of emotions during childhood. In recent years, innovative schools have developed courses in “emotional literacy” that making; these classes teach children how to understand and manage their feelings and how to get along with one another. Many such programs have achieved national prominence, and preliminary scientific evaluations have shown promising results. Until recently, however, there has been little contact between educators developing these types of programs and psychologists studying the neurological underpinnings and development of human emotions. This unique book links theory and practice by juxtaposing scientific explanations of emotion with short commentaries from educators who elaborate on how these advances can be put to use in the classroom. Accessible and enlightening, Emotional Development and Emotional Intelligence provides ample evidence about emotional intelligence as well as sound information on the potential efficacy of educational programs based on this idea.
The increase in the number of older people and the functional disability associated with increasing age have caused concern regarding the consequences of large numbers of elderly people who are limited in their functional ability. One of the psychological factors that should be related to functional disability in the elderly is the way they cope with stress. The present study examines the use of proactive coping in the elderly in relation to their depression and their functional ability. Results of structural equation modeling showed that proactive coping was negatively associated with functional disability and with depression. Social support was positively associated with proactive coping and negatively with depression. Depression was positively associated with functional disability. A significant implication of the results is the importance of studying the combined relationship of social support and coping to elderly functioning.
Two studies leading to the development of a short form of the Social Support Questionnaire (SSQ) are reported. In Study 1 three items selected for high correlations with the total score (SSQ3) were administered to 182 university students together with several personality measures. SSQ3 had acceptable test-retest reliability and correlations with personality variables similar to those of the SSQ. Internal reliability was marginal although acceptable for an instrument with so few items. Study 2 employed three sets of data in developing a six-item instrument (SSQ6). The SSQ6 had high internal reliability and correlated highly with the SSQ and similarly to it with personality variables. The research findings accompanying the development of the short form social support measure suggest that perceived social support in adults may be a reflection of early attachment experience.
Both theory and previous research suggest a link between emotional intelligence and emotional well-being. Emotional intelligence includes the ability to understand and regulate emotions; emotional well-being includes positive mood and high self-esteem. Two studies investigated the relationship between emotional intelligence and mood, and between emotional intelligence and self-esteem. The results of these studies indicated that higher emotional intelligence was associated with characteristically positive mood and higher self-esteem. The results of a third study indicated that higher emotional intelligence was associated with a higher positive mood state and greater state self-esteem. The third study also investigated the role of emotional intelligence in mood and self-esteem regulation and found that individuals with higher emotional intelligence showed less of a decrease in positive mood and self-esteem after a negative state induction using the Velten method, and showed more of an increase in positive mood, but not in self-esteem, after a positive state induction. The findings were discussed in the light of previous work on emotional intelligence, and recommendations were made for further study.
Although some research has linked emotional intelligence (EI) and psychological health, little research has examined EI's ability to predict health outcomes after controlling for related constructs, or EI's ability to moderate the stressor–strain relationship. The present study explored the relationships among EI (as assessed by a trait-based measure, the EQ-i), Big Five personality factors, Type A Behaviour Pattern (TABP), daily hassles, and psychological health/strain factors (in terms of perceived well-being, strain, and three components of burnout). The EQ-i was highly correlated with most aspects of personality and TABP. After controlling for the impact of hassles, personality, and TABP, the five EQ-i subscales accounted for incremental variance in two of the five psychological health outcomes. However, the EQ-i scales failed to moderate the hassles–strain relationship. Copyright © 2005 John Wiley & Sons, Ltd.
Associations amongst personality, coping, health locus of control, emotional intelligence (EI) and health behaviours were examined in a group of 364 Canadian students. Consistent associations with health behaviours were found for Conscientiousness, with the correlation pattern for other measures being more variable. EI, coping and health locus of control scales were intercorrelated, and a scale-level factor analysis suggested the extraction of a superordinate Coping/EI factor. This was found to mediate the relationship between personality and both taking regular exercise and healthy diet strategy. These findings suggest that associations between coping and EI, and the ways in which EI can act as a coping resource, should be investigated further.
Most empirical tests of mediation utilize cross-sectional data despite the fact that mediation consists of causal processes that unfold over time. The authors considered the possibility that longitudinal mediation might occur under either of two different models of change: (a) an autoregressive model or (b) a random effects model. For both models, the authors demonstrated that cross-sectional approaches to mediation typically generate substantially biased estimates of longitudinal parameters even under the ideal conditions when mediation is complete. In longitudinal models where variable M completely mediates the effect of X on Y, cross-sectional estimates of the direct effect of X on Y, the indirect effect of X on Y through M, and the proportion of the total effect mediated by M are often highly misleading.
Menopause is a reproductive milestone in a woman's life around which many different myths have developed. We reviewed three sets of myths that middle-aged premenopausal women hold and evaluated those myths according to scientific data from our own work and that of others. First, middle-aged women expect to experience depression, irritability, and vasomotor symptoms during the menopause. It appears that the vast majority of postmenopausal women do not experience depression, but do experience vasomotor symptoms that are uncomfortable and may have secondary effects on psychological well being, especially during the perimenopause. Second, middle-aged women believe that holding negative expectations about the menopause affects the quality of the menopausal experience. Indeed, that appears to be the case, perhaps because myths can function as self-fulfilling prophecy. The third myth is that there are no important changes that occur during the menopause. That is incorrect. Estrogen deficiency during the menopause sets the stage for substantial changes in risk for CHD, which becomes clinically apparent later in life. We discussed how estrogen deficiency may influence both lipids and lipoprotein levels and the magnitude of neuroendocrine and cardiovascular respond to mental stress. That latter pathway is of particular interest because middle-aged women may be exposed more often to interpersonal stress and may respond more emotionally to it, relative to men, suggesting a potential interactive effect of the decline in reproductive hormones and co-occurring social and psychological changes during the menopausal period. This discussion of the myths and realities of the menopause has deliberately not been exhaustive.(ABSTRACT TRUNCATED AT 250 WORDS)
A semantic differential instrument that measures adult women's attitudes toward menopause was constructed and validated. A volunteer sample of 504 women, 18 years or older, completed the pilot instrument of 45 bipolar adjective scales. A principal components factor analysis revealed 20 scales that loaded on one dominant factor; this factor accounted for 60% of the variance for the 20 scales. Cronbach alpha reliability was .96. The revised 20-scale instrument was called the Menopause Attitude Scale (MAS). A second sample of 419 women completed the MAS and one additional instrument for assessment of convergent and discriminant validity. Convergent validity was demonstrated by a correlation of r = .63 for the MAS with the Attitudes Toward Menopause Scale. Discriminant validity was demonstrated by a correlation of r = .42 for the MAS with the Attitudes Toward Old People Scale and a correlation of r = -.04 for the MAS with the Attitudes Toward Women Scale. Factor analysis of MAS scores revealed that one factor accounted for 61.5% of the variance for the 20 scales. The test-retest reliability for 39 subjects was .87. Multiple regression analysis identified age and menopausal status as significant explanatory variables for MAS scores.
It has been hypothesized that irrational belief is a prime cause of maladjustment. Existing measures of irrational belief appear to lack construct validity in that they contain many items that ask about anxiety reactions. In this article we describe the development of a 20-item measure of irrational belief that asks only about irrational belief. Two studies of the scale produced evidence that it has good internal consistency and good test-retest reliability. Three additional studies of the scale found evidence of validity.
Recent studies suggest that health care utilisation by women during menopause transition in general is highly idiosyncratic, despite the widespread advocation of prophylactic hormone therapy and increased health vigilance. The Melbourne Women's Midlife Health Study, a community-based cross-sectional study of 2001 urban Australian-born women aged 45-55 years, evaluated women's physical and emotional experiences, past and present health status, attitudes and beliefs about menopause, health behaviours and current menopausal status in a 30-min telephone interview. This paper reports on those factors related to help-seeking and health care utilisation. Findings show that treatment utilisers, in contrast to non-utilisers, reported a wider range of general symptoms, but reports on vasomotor symptoms did not contribute to the regression analysis. Treatment utilisers were further identified as problem-related or prevention-related utilisers. In three-way analyses, the past and present social and physical health of the problem-related treatment user was reportedly worse than either the prevention-related utiliser or non-utiliser. These findings suggest that medical and societal views about the health of middle-aged women during menopausal transition are likely to be based on the experiences of a particular segment of the population only. It is proposed that biased views of menopause as a time of considerable distress and ill-health are being perpetuated and over-generalised. This perspective appears to have little relevance for the majority of middle-aged women.
Hormonal changes as well as sociocultural and personal factors account for climacteric symptoms. The aim of this study is to investigate in a clinical population the correlation between the severity of hot flashes and vaginal dryness and the 'coping-ineffectiveness of coping' construct. Out of 120 women consecutively referring to the University Menopause Clinic, 85 subjects were evaluated for their climacteric complaints including anxiety and depression and for their coping style assessed with the Italian version of the Utrechtse Coping Lijst. Daily hot flashes and severe vaginal dryness were reported by almost half of the studied population, regression analyses were performed in order to investigate how much of the variance in such symptoms was explained by the psychosocial variables and by the coping mechanisms. A more recent menopause, a lower educational level and an active coping predict a higher severity of hot flashes; a longer time since last menstrual period and a coping of avoidance predict a higher severity of vaginal dryness. The present study suggests that the severity of hot flashes and vaginal dryness among a clinical sample of postmenopausal women is not only determined by biological and social variables, but personal resources also explain part of the variance of such climacteric complaints.
Menopause is diagnosed after 12 months of amenorrhoea resulting from the permanent cessation of ovarian function. The mean age at menopause is 51 years. The perimenopause, a time of changing ovarian function, precedes the final menses by several years. The physiology and clinical manifestations of this transition to menopause are not well understood; however, some symptoms, such as hot flashes, certainly begin in the perimenopause. Causal associations between menopause and several symptoms and diseases are proposed. The evidence for these associations varies and is reviewed. Hormone replacement therapy can be directed at symptom relief or at prevention or treatment of chronic diseases. Doses and routes of hormone replacement therapy vary by indication. Complications of hormone replacement therapy depend on the regimen used. Knowing the expected vaginal bleeding pattern for each hormone replacement therapy regimen is important, since unexpected bleeding may signal endometrial hyperplasia. Postmenopausal hormone therapy is a complex intervention that produces positive and negative specific health effects. Overall, based on observational studies, postmenopausal women who use hormones have a 30-50% lower all-cause mortality rate than those who do not use hormones. It is important to recognise that the value that individual women place on various health outcomes associated with hormone replacement therapy may differ. Thus, the decision to use hormone replacement therapy should be made jointly by each woman and her health-care provider, after careful consideration of possible benefits, risks, and her personal preferences.
To explore a possible association between climacteric symptoms and ways of coping with stress, a comparative study was conducted among 19 menopausal women who sought treatment for climacteric symptoms (the study group) and 44 healthy menopausal women (the control group). Life stress was assessed using a life event method in which factor analysis extracted four ways that women cope with stress: avoidance-oriented coping, consultation-oriented coping, aggression-expression coping, and problem-solving coping. The study group had a higher symptom score and was more prone to avoidance-oriented coping than the control group despite experiencing the same number of undesirable life events. The severity of climacteric symptoms correlated positively with the number of undesirable life events and the degree of avoidance-oriented coping and correlated negatively with the degree of aggression- expression coping for the study group. These results suggest that vulnerability to stress contributes to worsening climacteric symptoms caused by stress.
In 7 studies, the authors examined the link between emotional intelligence and interpersonal relations. In Studies 1 and 2, the participants with higher scores for emotional intelligence had higher scores for empathic perspective taking and self-monitoring in social situations. In Study 3, the participants with higher scores for emotional intelligence had higher scores for social skills. In Study 4, the participants with higher scores for emotional intelligence displayed more cooperative responses toward partners. In Study 5, the participants with higher scores for emotional intelligence had higher scores for close and affectionate relationships. In Study 6, the participants' scores for marital satisfaction were higher when they rated their marital partners higher for emotional intelligence. In Study 7, the participants anticipated greater satisfaction in relationships with partners described as having emotional intelligence.
The objective of the study was to examine the direct and indirect influences of dispositional factors, namely optimism, health-related hardiness (HRH) and sense of coherence (SOC), on the symptom experiences of peri- and postmenopausal women. Indirect effects of dispositional factors were examined via attitudes to the menopause and coping (emotion-versus problem-focused). A survey methodology was employed to assess the research objective for 176 peri- and postmenopausal women recruited from menopause clinics and family planning centers in Queensland, Australia. Emotional stability of the subjects was statistically controlled to eliminate any possible confounding effect on symptom reporting. The results indicated that optimism and SOC affect menopausal health directly, as evidenced by fewer symptoms reported by women scoring highly on these dispositions. Any indirect effect of HRH, optimism and SOC appears to be exerted via problem-focused coping rather than emotion-focused coping or through attitudes. It was concluded that dispositional factors are important to the experience of the menopause and how women adapt to their midlife transition. Psychologists and professionals working in menopause clinics may need to promote feelings of optimism and a sense of coherence in menopausal women, to facilitate better adaptation to this important transitional phase in women's lives.
The Ohio Midlife Women's Study was longitudinal with measurements occurring at three, 9-month intervals. Our purpose in doing this research was to examine predictors, moderators, and outcome variables associated with the transition to midlife in Caucasian and African American women. Predictor variables included loss and gain of resources. Moderators included menopause symptoms, menopausal status, attitude toward menopause, coping, and demographic characteristics. Outcome variables included anxiety, depression, and health promoting activities. To obtain the proposed final sample of 160 midlife women, an initial sample of 103 African American and 105 Caucasian "healthy" women were recruited in the community. Consistent predictors of anxiety were loss of resources, coping effectiveness, and education. Consistent predictors of depression were loss of resources and education. Health promoting activities were consistently predicted by attitude toward menopause and coping effectiveness. Stress is a better predictor of negative health outcomes than menopausal status.
The midlife period in the lifespan is characterized by a complex interplay of multiple roles. The goal of this chapter is to summarize research findings on the central themes and salient issues of midlife such as balancing work and family responsibilities in the midst of the physical and psychological changes associated with aging. The field of midlife development is emerging in the context of large demographic shifts in the population. A section on the phenomenology of midlife development presents images and expectations including the seemingly disparate views of midlife as a time of peak functioning and a period of crisis. Conceptual frameworks useful for studying the multiple patterns of change in midlife are presented. Findings demonstrating patterns of gains and losses are reviewed for multiple domains: cognitive functioning, personality and the self, emotions, social relationships, work, and physical health. The need for future research to illuminate and integrate the diverse aspects of midlife is highlighted.
Researchers often conduct mediation analysis in order to indirectly assess the effect of a proposed cause on some outcome through a proposed mediator. The utility of mediation analysis stems from its ability to go beyond the merely descriptive to a more functional understanding of the relationships among variables. A necessary component of mediation is a statistically and practically significant indirect effect. Although mediation hypotheses are frequently explored in psychological research, formal significance tests of indirect effects are rarely conducted. After a brief overview of mediation, we argue the importance of directly testing the significance of indirect effects and provide SPSS and SAS macros that facilitate estimation of the indirect effect with a normal theory approach and a bootstrap approach to obtaining confidence intervals, as well as the traditional approach advocated by Baron and Kenny (1986). We hope that this discussion and the macros will enhance the frequency of formal mediation tests in the psychology literature. Electronic copies of these macros may be downloaded from the Psychonomic Society's Web archive at www.psychonomic.org/archive/.
To examine the impact of participation in a psycho-educational program on women's attitudes toward menopause, the perceived severity of their symptoms, and the association between the two.
Quasi-experimental. Data were gathered at baseline and 3 months after termination of the program.
Two health maintenance organization clinics.
Eighty-two healthy 40- to 60-year-old women who chose to participate in the study. Thirty-six women participated in the program, and 46 women comprised the control group.
Program participants met for 10 weekly sessions to receive information from a professional team on subjects related to menopause and to share and discuss their experiences.
Attitudes toward menopause and severity of menopause symptoms.
The more negative the attitudes, the higher was the severity of symptoms. Participants reported significant improvements in attitudes and reductions in symptom severity compared to their own baseline scores and compared with the control group.
Participation in a program that combines delivery of information and processing of experiences on the cognitive, emotional, and social levels may improve women's attitudes toward menopause and ease the perceived severity of their symptoms, thereby increasing quality of life.
Transition to menopause has long been considered a period of increased risk for depressive symptoms. However, it is unclear whether this period is one of increased risk for major depressive disorder, particularly for women who have not had a previous episode of depression.
To examine the association between the menopausal transition and onset of first lifetime episode of depression among women with no history of mood disturbance.
Longitudinal, prospective cohort study.
A population-based cross-sectional sample.
Premenopausal women, 36 to 45 years of age, with no lifetime diagnosis of major depression (N = 460), residing in 7 Boston, Mass, metropolitan area communities. Main Outcome Measure Incidence of new onset of depression based on structured clinical interviews, Center for Epidemiologic Studies Depression Scale scores, and an operational construct for depression.
Premenopausal women with no lifetime history of major depression who entered the perimenopause were twice as likely to develop significant depressive symptoms as women who remained premenopausal, after adjustment for age at study enrollment and history of negative life events. The increased risk for depression was somewhat greater in women with self-reported vasomotor symptoms.
The current study suggests that within a similarly aged population of women with no lifetime history of depression, those who enter the menopausal transition earlier have a significant risk for first onset of depression. Further studies are needed to determine more definitively whether other factors, such as the presence of vasomotor symptoms, use of hormone therapy, and the occurrence of adverse life events, independently modify this risk. Physical symptoms associated with the menopausal transition and mood changes seen during this period may affect many women as they age and may lead to a significant burden of illness.