Barbara Sommer

Psychologic Distress and Natural Menopause: A Multiethnic Community Study

OBJECTIVES This study examined the association between psychologic distress and natural menopause in a community sample of African American, White, Chinese, Hispanic, and Japanese women participating in a national womens health study. METHODS A cohort of 16,065 women aged 40 to 55 years provided information on menstrual regularity in the previous year, psychosocial factors, health, and somatic-psychologic symptoms. Psychologic distress was defined as feeling tense, depressed, and irritable in the previous 2 weeks. RESULTS Rates of psychologic distress were highest in early perimenopause (28.9%) and lowest in premenopause (20.9%) and postmenopause (22%). In comparison with premenopausal women, early perimenopausal women were at a greater risk of distress, with and without adjustment for vasomotor and sleep symptoms and covariates. Odds of distress were significantly higher for Whites than for the other racial/ethnic groups. CONCLUSIONS Psychologic distress is associated with irregular menses in midlife. It is important to determine whether distress is linked to alterations in hormone levels and to what extent a mood-hormone relationship may be influenced by socioeconomic and cultural factors.

Attitudes toward menopause and aging across ethnic/racial groups.

OBJECTIVE Attitudes have a potential role to play in the experience of menopause. The objective of this study was to examine the degree to which attitudes toward menopause and aging vary across ethnic groups and menopausal status (ie, premenopausal through postmenopausal). METHODS More than 16,000 women were interviewed by telephone as part of the Study of Womens Health Across the Nation. They represented five ethnic/racial groups (African American, white, Chinese American, Japanese American, and Hispanic) from seven geographical sites (Boston, MA; Pittsburgh, PA; Chicago, IL; Michigan; New Jersey; and northern and southern California). RESULTS African American women were significantly more positive in attitude. The least positive groups were the less acculturated Chinese American and Japanese American women. Menopausal status was not a consistent predictor of attitude across ethnic groups. CONCLUSIONS In general, womens attitudes toward menopause range from neutral to positive. Ethnic groups within the United States vary slightly, but reliably, in their attitudes toward menopause and aging. Factors other than those directly associated with menopausal status seem to play a role in attitude.

The effect of menstruation on cognitive and perceptual-motor behavior: a review

&NA; The increasing demand of women for a greater role in decision‐making capacities and in professional areas raises persistent questions about the effect of menstrual cycle fluctuation on performance. A critical review of research on nonaffective correlates of the reproductive cycle is provided. The methodological problems inherent in such research, such as phase definition, determination of hormonal state, response bias, and generality of results are discussed. Studies using response measures based on self report and social behaviors indicate a behavioral decrement associated with the premenstrual and menstrual phases. Studies utilizing objective performance measures generally fail to demonstrate menstrual cycle related changes. Socially‐mediated expectations are suggested as a possible basis for these contradictory findings.

A Study Comparing Traditional and Hybrid Internet-Based Instruction in Introductory Statistics Classes

Advances in technology coupled with increasing student enrollment numbers have led some universities to begin offering on-line classes. This paper discusses a study comparing a traditional offering of elementary statistics with a “hybrid” offering. In the hybrid offering the class met once a week, but students were required to learn the material on their own using web-based materials and a textbook. We examined differences in student performance, student satisfaction and investment of both student and instructor time. Performance of students in the hybrid offering equaled that of the traditional students, but students in the hybrid were slightly less positive in their subjective evaluation of the course.

Menstrual cycle changes and intellectual performance.

&NA; Test scores of a large number of female college students were studied in an attempt to determine whether there is an association between intellectual performance and phases of the menstrual cycle. No systematic relationships were found. However, subjects using oral contraceptives showed a higher mean performance on all tests than those not using oral contraceptives.

What's different about truants? A comparison study of eighth-graders

Differences and similarities between 25 eighth-grade truants and 25 nontruants-matched for age, grade, gender, and ethnicity-were explored on four dimensions: family variables, friendship patterns and interests, behavior and attitudes toward school, and cognitive factors including academic ability and achievement. The major differences were in school behavior, attitudes, academic ability, and achievement. The most frequent reasons given for truancy were boredom and dislike of school and teachers. Truancy was associated with highly disruptive classroom behavior. The salience of school variables suggests that truancy prevention and intervention strategies should include improved course content, teaching, and school climate. The necessity of having a comparison group is stressed in order to distinguish characteristics of normal adolescent development from those associated with maladjustment.

Stress and Menstrual Distress

The relationship between stress and menstrual distress is considered in response to three questions: (1) How stressful are menstruation and its associated events? (2) What factors serve to make menstruation stressful? (3) What are the effects of stress upon the menstrual cycle? Included in the analysis are estimates of the incidence of negative symptoms associated with the menstrual cycle, other indicators of the stressfulness of the premenstrual and menstrual phases, adrenal factors, animal studies, and suggested directions for research and practice.

Cognitive Performance and the Menstrual Cycle

The headline on the New York Times declared: “Female sex hormone is tied to ability to perform tasks” (“Female sex hormone...,” 1988). It was on the front page where everyone glancing at a newsstand copy would see it—right next to a photograph of the President of the United States. My own local newspaper announced “Sex hormones, women’s thinking linked in study” (“Sex hormones...,” 1988). The sex hormones in question were those that fluctuate during the menstrual cycle, and the conclusion was based upon a study of women’s performance across the menstrual cycle. Previous reviews had indicated that the menstrual cycle has virtually no impact on objectively measured cognitive performance (Sommer, 1982a, 1983), a conclusion similar to that of Hollingworth’s dissertation in 1914, of Lough’s dissertation in 1937, and of Seward’s 1944 review article in Psychological Bulletin. Nevertheless, at the end of 1988, it was news. This readiness to connect intellectual impairment with the menstrual cycle underscores the point made by John Richardson toward the end of Chapter 1, that there is a persistent and widespread popular belief in the notion of paramenstrual cognitive debilitation.

Social Facilitation Effects in Coffeehouses

Behavioral ecology was used to test facilitation effects in three coffeehouses. Groups spent more time in the settings than did lone individuals, and joined parties stayed longest. Duration is an important dependent variable for social psychological research in natural settings.

Self-defined menopausal status in a multi-ethnic sample of midlife women

OBJECTIVES This study aimed to identify factors associated with womens perceived menopausal status and to evaluate agreement between womens self-designation and a menstrually-based classification in a multi-ethnic sample of women. METHODS A cross-sectional survey was conducted as part of a large, seven-site, multi-ethnic study, the Study of Womens Health Across the Nation (SWAN). All variables were assessed by self-report in 13952 women aged 40-55 years. Multiple linear regression was used to assess determinants of self-defined menopausal status, stratifying by race/ethnicity within three anatomical/hormone use strata. Kappa statistics were used to evaluate agreement between the self-defined and menstrually-based classifications. RESULTS For women with an intact uterus, at least one ovary and not using hormones, menstrual patterns explained about half the variance in self-defined menopause status with older women classifying themselves later in the transition. Disagreement between menstrually-based and self-defined menopausal status was 39, 38, 36, 32 and 29% for Hispanic, African-American, Japanese, Caucasian, and Chinese women, respectively (kappa statistics=0.46, 0.41, 0.40, 0.53 and 0.58). Women with vasomotor symptoms tended to self-designate themselves as being in transition regardless of their menstrual patterns. Age and 12 months of amenorrhea explained about 40% of the variance in self-categorization among women using hormones with an intact uterus. Bilateral oophorectomy, age and time since surgery explained about 20% of the variance among post-surgical women. CONCLUSIONS Menstrual characteristics are strong predictors of womens self-perceived menopausal status. However, additional factors, including symptoms and cultural differences in the meaning of specific bleeding patterns, are also relevant and require further investigation.