The effects of rational-emotive therapy and relaxation training on premenstrual syndrome: A preliminary study

Six female subjects who were between 31 and 44 years of age attended a premenstrual syndrome (PMS) clinic and participated in a group therapy program designed to alleviate their premenstrual symptoms. Rational-emotive therapy (RET) and relaxation training were offered in addition to ongoing progesterone treatment in an effort to alleviate severe psychological symptoms thought to be occasioned by the hormonal changes occurring during the premenstrual week. Pre-treatment assessments were carried out using Moos' Menstrual Distress Questionnaire, Broadbent's Cognitive Failures Questionnaire, and Eysenck's Personality Questionnaire. Additionally, levels of self-reported psychological and physical menstrual distress symptoms were estimated by the subjects at each premenstruum throughout the ten-week therapy program. At the end of the ten week therapy program hormone treatment was discontinued. Significant pre-test to post-test differences were found in a number of psychological and physical symptoms of menstrual distress, in cognitive functioning and neuroticism, following the combined group treatment. Improvements in psychological functioning during premenstruum were observed at a one-year follow-up. RET and relaxation together with hormonal therapy produced a substantial reduction in PMS symptoms in comparison with drug treatment alone.     

Perimenopausal mental disorders: epidemiology and phenomenology

Perimenopause, the interval of irregular menstrual activity which directly precedes menopause, is characterized by widely fluctuating hormone levels amidst a large-scale decline in circulating estrogen. This phase in a woman's life is typically accompanied by physical discomforts including vasomotor symptoms, such as headaches, insomnia, and hot flushes, as well as genital atrophy. Not surprisingly, studies suggest a significant increase in mood lability for women during this time. While some evidence points toward an exacerbation of bipolar mood symptoms and an increase in schizophrenic psychosis during perimenopause, the majority of research conducted on perimenopausal mental disorders has focused on unipolar depression. Studies vary widely in methodology, definitions of menopausal status, and degrees of depression among subjects; however, the majority of findings indicate an increased susceptibility to depression during the perimenopausal transition. This greater susceptibility may be due to neuroendocrine effects of declining estrogen levels, the subjective experience of somatic symptoms resulting from this hormonal decline, and/or the more frequent occurrence of "exit" or "loss" events for women during this stage of life. At this time, more research is needed to address questions of prevalence, risk, and etiology for depression and other major mental disorders as related to the physiological and psychosocial changes associated with perimenopause.     

Depression During The Menopausal Transition

The perception that menopause leads to mood disturbances such as depression has a long history. How did these beliefs come about, and are they supported by the scientific literature? This article reviews the theories of menopause and depression, the scientific literature, and the implications of these findings for prevention and treatment. Epidemiologic studies of menopausal status and depression do not provide consistent evidence of an association between the menopausal transition and depression among the general population of women. Depression experienced by women transitioning through menopause may be attributed to factors unrelated to menopause. A subset of women, however, may be more vulnerable to the effects of hormonal changes. For some women, short-term estrogen replacement therapy to relieve vasomotor symptoms may be beneficial, although for others psychotherapy or antidepressants may be more appropriate. Additional research is needed to better understand the association between different stages of the menopausal transition and dysphoric mood or depression, and better identification of women potentially at risk for depression during the menopausal transition.     

MEDICAL PERCEPTIONS OF MENOPAUSAL SYMPTOMS

Thirty-five physicians in family practice or gynecology, 43 practicing nurses, and 35 menopausal or postmenopausal women rated the frequency, severity, and causality of 15 menopausal symptoms commonly reported in the literature. Subjects also rated their degree of preference for four possible menopause treatments (counseling, estrogen therapy, mood-altering medication, and no treatment) and answered an open-ended question asking them what they saw as the major factor in determining whether a woman would experience difficulty at menopause. The results overall suggest that medical persons see menopausal symptoms as more pathological than women who have experienced or are experiencing menopause and that physicians, relative to menopausal women, adhere to a more psychogenic model in which psychological causality and symptoms are given greater emphasis than menopausal women give them.     

Validation of a single-item measure of usual physical activity

The purpose of this study was to assess the reliability and validity of a single-item measure of Usual Physical Activity and to assess its usefulness as a physical activity tool for perimenopausal women. 188 perimenopausal women participated (age: M = 47 yr., SD = 3; range = 40-55). Data were collected using the Women's Health Assessment Scale, the Physical Activity Questionnaire, the Perimenopause-related Quality of Life Scale, a health history and demographic questionnaire, and the rater. Scores were stable over a 2-wk. interval. Convergent validity was supported by a correlation of .66 between ratings on Usual Physical Activity and the Physical Activity Questionnaire. Concurrent validity was supported by the association of the rating of Usual Physical Activity with three parameters of Body Mass Index, psychosomatic symptoms, and perimenopause related quality of life, known to be associated with physical activity. Highly active women had a lower Body Mass Index than less active and inactive women. Active women tended to report fewer and less distressing psychosomatic symptoms and better quality of life. These findings support the use of rating of Usual Physical Activity to classify perimenopausal women into categories of physical activity.     

Cognitive-behavioral intervention among women with slight menopausal symptoms: a pilot study

Menopause is associated with a considerable variety of physical, psychological and social symptoms that can be treated using cognitive-behavioral techniques. In the present study, 21 women took part in an eight-week group intervention consisting of weekly two-hour sessions to address their slight symptoms related to the climacteric stage of life. The intervention included: psycho education on menopause, relaxation techniques, nutrition and fitness exercises, Kegel exercises, and problem-solving techniques. A control group was included that did not receive treatment and consisted of 28 women. The results revealed a significant reduction in most symptoms (including depression and anxiety) after intervention as compared to the baseline period. No changes appeared in the control group. The relevance of this work lies in the potential element of prevention this therapeutic package could offer to relieve various symptoms, slight and incipient, during the perimenopausal stage.     

The association of perimenopausal mood disorders with other reproductive-related disorders

Data regarding the increased incidence of psychiatric illness during midlife in women are still conflicting. However, there is a growing consensus that certain groups of women may in fact be at higher risk for mood symptoms and psychiatric disorders during the perimenopausal transition. Mood symptoms during the perimenopause may be related to mood disorders during other periods of hormonal fluctuation throughout a woman's reproductive lifecycle. Elucidating these associations may advance the understanding of mood disorders during the perimenopausal transition. The epidemiology and treatment of perimenopausal mood symptoms compared with the epidemiology and treatment of mood disorders during the late luteal phase of the menstrual cycle, pregnancy, and postpartum. Common risk factors associated with mood disorders during these periods of hormonal changes or instability include poor lifestyle habits, a history of hormonally related mood disorders, stress and negative life events, ethnicity, and comorbidity. Reproductive-related mood disorders also are subject to an improvement in symptoms in response to treatment with selective serotonin reuptake inhibitors. As the morbidity associated with mood disorders during midlife may be quite significant, and as life expectancy continues to increase, recognition, prevention, and treatment of perimenopausal affective illness is becoming increasingly essential.     

Prospective versus retrospective assessment of Menstrual cycle symptoms and moods: Role of Attitudes and beliefs

Prospective vs. retrospective self-reports of menstrual cycle symptoms and moods in users and nonusers of oral contraceptives were investigated. Subjects, aged from 17 to 27 years, included 56 women on the pill and 47 nonusers. The Menstrual Distress Questionnaire (MDQ) quantified physical symptomatology, while the Differential Emotions Scale (DES-IV) measured emotional states. Prospective reports suggested less discernible symptom and mood effects than did retrospective reports. Physical symptoms were significantly higher menstrually than premenstrually, whereas negative affects increased premenstrually. Women on the pill reported significantly fewer symptoms and negative moods than nonusers, although there were no significant differences in positive mood states. Menstrual Attitude Questionnaire (MAQ) scores suggested that nonusers of oral contraceptives found menstruation more debilitating than those on the pill. Based on a paper presented at the 5th Biennial Conference of the International Society for the Study of Individual Differences, Department of Experimental Psychology, Oxford University, July 22–26, 1991.     

A telehealth intervention for veterans on antiviral treatment for the hepatitis C virus

The standard treatment for chronic hepatitis C (pegylated interferon and ribavirin) causes challenging physical and psychological side effects. The current pilot study evaluated the efficacy of a brief, telephone-based, cognitive-behavioral self-management intervention designed to address mood and quality of life within a sample of veterans on antiviral treatment for hepatitis C. Results from this pilot study support the feasibility of this telehealth intervention, showing that veterans were highly satisfied with the content of the intervention and compliant with the telephone calls. Findings further indicate that symptoms of depression and anxiety and mental health quality of life either remained stable or improved in those participants who received the brief telephone intervention, while those receiving usual care showed significant declines in mood and mental health quality of life. The findings from this study provide evidence that a brief, clinician-administered phone intervention may help individuals on antiviral therapy for hepatitis C to cope more effectively with the negative treatment side effects.     

Menopausal stage and age and perceptions of body image

Abstract

The aim of This study was to investigate the association between menopausal stage and age and women's perception of their body image. Females from a community sample (n = 304. age range from 35 to 65 years) volunteered to complete a structured questionnaire which contained the Multidimensional Body Self Relations Questionnaire (MBSRQ) and the Stunkard Body Shape Figure Scale. One hundred and twenty women were premenopausal, 76 women were perimenopausal and 108 were postmenopausal. The effects of age and menopausal stage could not be separated in ratings of appearance evaluation, fitness evaluation, current, ideal and societal ratings of the Stunkard Body Shape Figure Scale. Premenopausal women (who were likely to be younger) had more positive ratings of appearance evaluation and fitness evaluation than menopausal women (who were likely to be older). Women who were premenopausal nominated smaller figures from the Stunkard Body Shape Figure Scale for ratings of the current, ideal and societal body shape than women who were perimenopausal and postmenopausal. The implications of these findings as they relate to women as they progress through the menopausal transition and as they become older is discussed.     

Perceived social support, self-efficacy, and adjustment to abortion

Prior to their having a 1st trimester abortion, women's perceptions of social support from their partner, family, and friends and self-efficacy for coping were assessed. Depression, mood, physical complaints, and anticipation of negative consequences were measured after the 30-min recovery period. As predicted, perceived social support enhanced adjustment indirectly through its effects on self-efficacy. Women who perceived high support from their family, friends, and partners had higher self-efficacy for coping. Higher self-efficacy, in turn, predicted better adjustment on the psychological measures but not on the physical complaint measure. No direct path between social support and adjustment was observed. In addition, women who told close others of their abortion but perceived them as less than completely supportive had poorer postabortion psychological adjustment than either women who did not tell or women who told and perceived complete support.     

Theobiology: An Analysis of Spirituality, Cardiovascular Responses, Stress, Mood, and Physical Health

The relationships of spirituality and religion to acute cardiovascular responses, physical symptoms of illness, stress and psychological mood were assessed in a community sample of adults. Nineteen men and 61 women participated in a betrayal interview, while their blood pressure and heart rate were monitored. Religious affiliation, frequency of attendance at worship and religiousness were associated with resting diastolic and mean arterial pressure. Spirituality, especially as assessed by the existential scale of the Spiritual Well-being Scale, was related to symptoms of illness, medication use, stress and negative mood states. Spirituality and involvement in organized religion may represent a means to increase the sense of purpose and meaning in life, which is related to greater resiliency and resistance to stress-related illness.     

Relation of perceived emotional intelligence and health-related quality of life of middle-aged women

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 Baby Boomers Meet Menopause: Fertility, Attractiveness, and Affective Response to the Menopausal Transition

The purpose of this study was to identify social factors that affect women’s concerns about menopause. Data from a sample of 1,037 baby-boomer women who took part in two waves of the Midlife in the United States survey (MIDUS) were utilized. Two waves of survey data were collected in 1996 and 2005 from a nationally representative sample of women born between 1946 and 1964 residing in the United States. Women’s concerns about the effects of menopause on attractiveness, fertility, and the cessation of menstruation were examined. Analyses were replicated in Wave I and II of the study. Women who occupied multiple roles had fewer concerns about the loss of fertility. Women who had more symptoms were significantly more concerned about the effects of menopause on attractiveness. Concerns about the effects of menopause were also related significantly to women’s age, education, and financial security.     

Multiple role juggling and daily mood states in working mothers: an experience sampling study

The effects of multiple role juggling (i.e., simultaneously attending to demands of different roles) on daily mood states of employed mothers were examined. Ss completed activity and mood questionnaires 8 times a day for 8 days. Multiple role juggling had immediate negative effects on task enjoyment and mood. However, contrast effects and habituation to role juggling occurred when mood and satisfaction were examined over time. Furthermore, mood states tended to spill over from one episode to the next within a day, but contrast effects were found across days. These results reflect the complex nature of psychological adjustment to multiple role occupancy.     

Associations of Quality of Life,Physical Activity and Mood States in Women with Breast Cancer Treated with Curative Intent

This study aims to investigate the associations between quality of life, physical activity and mood states in women with breast cancer. A total of 354 women (mean age, 51.74?±?8.63 years; body mass index (BMI), 28?±?5.67 kg/m²) completed the Baecke Physical Activity Questionnaire, Profile of Mood States (POMS), European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) and European Organisation for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Pearson’s correlation and multiple linear regressions were used to verify the relations between outcomes and independent variables. Correlations between scores on POMS, Baecke Physical Activity Questionnaire and global health status/quality of life subscale of EORTC QLQ-C30 found associations (p?<?0.01) between physical activity (r?=?0.191), vigour (r?=?0.333) and fatigue (r?=??0.433). Multiple linear regression analysis of the global health status/quality of life subscale of the EORTC QLQ-C30 showed significant differences for vigour (p?<?0.001), social function (p?=?0.003), side effects of systemic therapy (p?=?0.019), arm and breast symptoms (p?<?0.001) and Baecke physical activity score (p?=?0.006). Physical activity is an independent factor related to the quality of life in women with breast cancer. Understanding these variables may influence clinical decisions during treatment and allow positive interventions regarding symptoms, functions and lifestyle.     

The Contextual Role of Depression within Couples Experiencing Partner Violence

Despite previous research suggesting a link between intimate partner violence (IPV) and depression within romantic relationships, few studies have examined the role of depression in couples experiencing violence. Using dyadic data of 129 heterosexual couples seeking couples therapy for high conflict including physical IPV, depressive symptoms were evaluated as a moderator in the association between psychological and physical IPV. Results indicated that moderate and high reports of women's depressive symptoms provided a context, while men's psychological abuse toward them moved from low to high, for women to be more physically abusive toward their partners. Further, low reports of women's depressive symptoms provided a context, while men's psychological abuse toward them moved from low to high, for women to be less physically abusive toward their partners. Better understanding the role of depression and how it may offer a context for physical violence assists helping professionals in holistically addressing violence within romantic relationships.     

A study of diurnal patterns of depressed mood

The study investigated diurnal patterns of depressed mood in a sample of normal subjects. In all, 105 college undergraduates were followed for a period of 10 days, using a self-administered psychological diary. Eighty-four percent of the days in which feelings of depressed mood were reported involved some type of mood swing. The most frequent pattern of mood shift was a pattern of gradually increasing depressed mood, reaching its peak in the evening. Persons who reported days of constant depressed mood reported higher levels of physical symptoms and less pleasure in social interactions than persons who reported only depressed days involving mood swing.     

Writing About Upsetting Family Events: A Therapy Analog Study

This therapy analog study investigated whether a writing intervention based on contextual therapy would have positive effects on physical, mental, and relational health. One-hundred-and-three college students were randomly assigned to write about either an upsetting family event/issue from childhood or a trivial event during a four-day period. As anticipated, relative to the control participants, those in the experimental condition reported an increase in negative mood and physical symptoms immediately after writing each day. Also as anticipated, the experimental participants also reported feeling better about themselves and their topics at post-test. Unexpectedly, there were either no significant differences or differences in the unpredicted direction between the control and experimental groups in physical, psychological, and relational functioning at posttest and follow-up. However, post-hoc analyses revealed differential changes within the experimental group as a function of the personal relevance and the degree of previous disclosure of the topics. Limitations of written expression as a therapeutic tool are discussed.