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Relationships between catastrophic thoughts, perceived control and distress during menopausal hot flushes: exploring
1Department of Health Studies, Brunel University, Borough Road, TW7 5DU, Isleworth, UK.
Insights
Negative thoughts about hot flushes increase distress and lower control for menopausal women. Challenging these catastrophic thoughts may improve coping and tolerance for hot flush experiences.
Area of Science:
- Psychology
- Women's Health
- Menopause Research
Background:
- Negative appraisals of chronic health issues correlate with increased distress and reduced self-efficacy.
- Catastrophic thinking about health problems is linked to depression and lower coping abilities.
Purpose of the Study:
- To investigate the association between catastrophic appraisals of hot flushes and distress levels.
- To examine the relationship between negative hot flush thoughts and perceived control during menopause.
Main Methods:
- A postal survey with a 12-month follow-up was conducted.
- 61 women experiencing hot flushes completed questionnaires, including the Catastrophic Thoughts Questionnaire (CTQ).
- 39 women with persistent hot flushes were followed up after one year.
Main Results:
- Higher catastrophic thoughts correlated with lower perceived control over hot flushes.
- Distress during hot flushes was more strongly linked to negative thought frequency than to control or flush frequency.
- Catastrophic thoughts and their link to distress remained stable over 12 months.
Conclusions:
- Cognitive appraisal of hot flushes is crucial for understanding menopausal distress.
- Challenging negative interpretations of hot flushes may enhance women's tolerance and coping mechanisms.
Objectives:
Many studies have established that highly negative or catastrophic thoughts about chronic health problems such as pain are associated with greater distress, lower self-efficacy for dealing with the problem and depressed mood. This study examined whether highly negative (or 'catastrophic') appraisals of hot flush experiences were associated with greater distress and lower perceived control regarding this menopausal problem.
Design:
A postal survey was carried out, with a follow-up 12 months later.
Methods:
Two questionnaires were initially completed by a volunteer sample of 61 women currently experiencing hot flushes. A mixture of qualitative and quantitative data were collected, including a Catastrophic Thoughts Questionnaire (CTQ) measure of catastrophic thoughts, based in part on Rosenstiel AK and Keefe FJ. The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain 1983;17:33-44. Thirty nine women who continued to report hot flushes were followed up 12 months later.
Results:
Ratings to each item of the CTQ were highly intercorrelated. Women reporting more catastrophic thoughts tended to be lower in perceived control over flushes. Respondents' reported distress during hot flushes was more closely related to their frequency of negative thoughts about the problem, than to perceived control, flush chronicity or daily frequency of flushes. Over 12 months, respondents showed a highly stable pattern of catastrophic thoughts, and continued links with levels of distress during flush episodes.
Conclusions:
Cognitive appraisal processes that undermine coping with other chronic health problems seem also relevant to understanding the distress triggered by intermittent, unpredictable flush episodes. The findings imply that women may develop improved tolerance for menopausal flushing through challenging negative interpretations of the experience.