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de Arruda GT, Driusso P, de Godoy AG, de Sousa AP, Avila MA. Measurement properties of patient-reported outcome measures for women with dysmenorrhea: A systematic review. J Clin Nurs 2024. [PMID: 38797927 DOI: 10.1111/jocn.17293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/03/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Dysmenorrhea, or menstrual pain, is a subjective experience, and can only be assessed by patient-reported outcomes. These instruments should be reliable, valid and responsive. AIM To identify and critically appraise the available evidence for the measurement properties of specific patient-reported outcome measures used for dysmenorrhea. METHODS The PRISMA statement was used to report this systematic review. Databases searched were PubMed, SCOPUS, CINAHL, Web of Science, ScienceDirect and Google Scholar (April 2021; updated on February 2023). Original studies with primary data collection, with no restriction on language and publication date that reported psychometric properties of one or more dysmenorrhea-related patient-reported outcome measure. The literature searches, selection of studies, data extraction and assessment of the risk of bias were performed independently by two reviewers and followed the COSMIN guidelines. RESULTS Thirty studies were analysed in this review, and 19 patient-reported outcome measures were evaluated. The instruments varied in relation to the measured construct and measurement properties (validity, reliability and responsiveness). The methodological quality of the studies and the quality of evidence of the patient-reported outcome measures were variable. Among the 13 studies that reported the development of patient-reported outcome measures, most had inadequate methodological quality, and the overall rating was insufficient or inconsistent. CONCLUSIONS The Dysmenorrhea Symptom Interference (DSI) scale was the only identified patient-reported outcome measure that has the potential to be recommended because of its sufficient rating combined with moderate quality of evidence for content validity. Future studies should further evaluate the measurement properties of the existing patient-reported outcome measures, or develop new patient-reported outcome measures following the COSMIN methodology. PATIENT OR PUBLIC CONTRIBUTION Not applicable as this is a systematic review. TRIAL REGISTRATION PROSPERO protocol: CRD42021244410. Registration on April 22, 2021.
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Affiliation(s)
- Guilherme Tavares de Arruda
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Post-Graduate Program and Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, Brazil
| | - Patricia Driusso
- Laboratory of Research on Women's Health (LAMU), Physical Therapy Post-Graduate Program and Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, Brazil
| | - Amanda Garcia de Godoy
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Post-Graduate Program and Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, Brazil
| | - Ana Paula de Sousa
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Post-Graduate Program and Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, Brazil
| | - Mariana Arias Avila
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Post-Graduate Program and Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, Brazil
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Li X, Zhang B, Tan P, Chesney MA, Zhang T, Nie G. The cross-cultural adaptation and psychometric properties of the menstrual symptom questionnaire (MSQ) among Chinese women of reproductive age. Heliyon 2023; 9:e20450. [PMID: 37810819 PMCID: PMC10556762 DOI: 10.1016/j.heliyon.2023.e20450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/29/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023] Open
Abstract
Objective This study reports on a translation of the Menstrual Symptom Questionnaire (MSQ) into Chinese, a cross-cultural adaptation among Chinese women of reproductive age, and an assessment of its reliability and validity. Methods Previously published translation guidelines were followed to translate and cross-culturally adapt the English version of MSQ to produce a Chinese version. This Chinese version was then administered to 2800 Chinese women of reproductive age recruited by convenience sampling method. The reliability of the Chinese MSQ was tested for internal consistency and test-retest reliability. The concurrent and construct validity of the questionnaire was evaluated using correlation and factor analysis. Results The Chinese version of the MSQ showed no linguistic or semantic issues. The internal consistency of the Chinese MSQ Cronbach'α = 0.912, and the test-retest reliability r = 0.911. The exploratory factor analysis identified four factors. The confirmatory factor analysis demonstrated that the four factor structure of the Chinese version of the MSQ (Pain Experience, Emotional Changes, Pain Coping Strategies, and Other Physical Symptoms) is reasonable among Chinese women of reproductive age. There was a significant correlation found between these four factors and both the Pittsburgh Sleep Quality Index and the SF-8 Health Survey. Conclusion The Chinese version of the MSQ achieved semantic equivalence in translation and demonstrated good reliability and validity among Chinese women of reproductive age. Thus, it can serve as an effective tool to assess the experience of menstrual symptoms among Chinese women.
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Affiliation(s)
- Xiuxia Li
- Guangxi Medical University, Nanning 530021, China
| | | | - Peixuan Tan
- Guangxi Medical University, Nanning 530021, China
| | - Margaret A. Chesney
- Department of Medicine, University of California San Francisco, San Francisco, CA 94158, USA
| | | | - Guanghui Nie
- Guangxi Medical University, Nanning 530021, China
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Oladosu FA, Tu FF, Hellman KM. Nonsteroidal antiinflammatory drug resistance in dysmenorrhea: epidemiology, causes, and treatment. Am J Obstet Gynecol 2018; 218:390-400. [PMID: 28888592 DOI: 10.1016/j.ajog.2017.08.108] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/14/2017] [Accepted: 08/31/2017] [Indexed: 11/25/2022]
Abstract
Although nonsteroidal antiinflammatory drugs can alleviate menstrual pain, about 18% of women with dysmenorrhea are unresponsive, leaving them and their physicians to pursue less well-studied strategies. The goal of this review is to provide a background for treating menstrual pain when first-line options fail. Research on menstrual pain and failure of similar drugs in the antiplatelet category suggested potential mechanisms underlying nonsteroidal antiinflammatory drug resistance. Based on these mechanisms, alternative options may be helpful for refractory cases. This review also identifies key pathways in need of further study to optimize menstrual pain treatment.
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Abstract
A number of formal questionnaires have been devised to study paramenstrual symptomatology. It has been suggested that women's responses to these questionnaires are vulnerable to forgetting and contaminated by culturally induced expectations. Nevertheless, concurrent reports of experienced symptoms may correlate highly with retrospective judgments, even when the relevance of the menstrual cycle is disguised. They also differentiate between women with and without a self-reported history of premenstrual symptoms, although concurrent reports across several menstrual cycles are impractical to collect and may be inconsistent between successive cycles. A number of methodological criticisms have been directed toward the most commonly used device, the Menstrual Distress Questionnaire. In principle, however, retrospective questions offer a reliable and accurate indication of women's experience during the normal menstrual cycle.
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Chen C, Kwekkeboom K, Ward S. Self‐report pain and symptom measures for primary dysmenorrhoea: A critical review. Eur J Pain 2015; 19:377-91. [DOI: 10.1002/ejp.556] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2014] [Indexed: 11/11/2022]
Affiliation(s)
- C.X. Chen
- School of Nursing University of Wisconsin‐Madison USA
| | | | - S.E. Ward
- School of Nursing University of Wisconsin‐Madison USA
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Negriff S, Dorn LD, Hillman JB, Huang B. The measurement of menstrual symptoms: factor structure of the menstrual symptom questionnaire in adolescent girls. J Health Psychol 2009; 14:899-908. [PMID: 19786516 PMCID: PMC4301608 DOI: 10.1177/1359105309340995] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined the factor structure of the Menstrual Symptom Questionnaire (MSQ) in a sample of 210 adolescent girls (11-17 years). Such an examination has not been carried out with an adolescent sample. In addition, the definitions of menstrual disorders have evolved since the creation of the MSQ. Exploratory factor analysis supported a three factor structure indicating abdominal pain, negative affect/somatic complaints, and back pain. Partial correlations indicated all three MSQ factors were correlated with depressive symptoms, but only the negative affect factor was correlated with trait anxiety. Future research should explore potential associations in multiple areas of functioning as menstrual symptoms may alter healthy developmental processes during adolescence.
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Affiliation(s)
- Sonya Negriff
- Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 4000, Cincinnati, OH 45229, USA.
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Dorn LD, Negriff S, Huang B, Pabst S, Hillman J, Braverman P, Susman EJ. Menstrual symptoms in adolescent girls: association with smoking, depressive symptoms, and anxiety. J Adolesc Health 2009; 44:237-43. [PMID: 19237109 PMCID: PMC2667342 DOI: 10.1016/j.jadohealth.2008.07.018] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2008] [Revised: 07/23/2008] [Accepted: 07/31/2008] [Indexed: 11/28/2022]
Abstract
PURPOSE Dysmenorrhea affects quality of life and contributes to absenteeism from school and work, thereby diminishing opportunities for successful psychosocial and cognitive development during adolescence. In adults, depression, anxiety, and smoking have an impact on menstrual cycles and dysmenorrhea. Associations between these problems have not been examined in adolescents. The purpose of this study was to examine relations between depressive symptoms and anxiety with menstrual symptoms. Smoking was examined as a moderator of this association. METHODS This study enrolled 154 postmenarcheal girls from a sample of 207 girls age 11, 13, 15, and 17 years (mean = 15.4 years [+/-1.9]). Self-reported measures included the Menstrual Symptom Questionnaire (MSQ), Children's Depression Inventory, State-Trait Anxiety Inventory, and smoking behavior. Generalized linear regression modeled MSQ outcomes separately for depressive symptoms and anxiety. RESULTS More depressive symptoms/anxiety were related to higher numbers of menstrual symptoms (r = 0.23-0.44, p < .05). Smoking status (ever) was related to higher MSQ scores. Moderating effects of smoking and depressive symptoms or anxiety on menstrual symptoms were consistent across most MSQ factors where effects were stronger in never smokers. CONCLUSION This is the first study in adolescents showing smoking status and depressive symptoms/anxiety are related to menstrual symptoms, and that the impact of depressive symptoms/anxiety on menstrual symptoms is stronger in never smokers. The dynamic and complex nature of smoking, moods, and dysmenorrhea cannot be disentangled without longitudinal analyses. Efforts to reduce menstrual symptoms should begin at a young gynecological age and include consideration of mood and smoking status.
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Affiliation(s)
- Lorah D. Dorn
- Division of Adolescent Medicine, Cincinnati Children’s Hospital Medical Center
| | - Sonya Negriff
- Division of Adolescent Medicine, Cincinnati Children’s Hospital Medical Center
| | - Bin Huang
- Center for Epidemiology and Biostatistics, Cincinnati Children’s Hospital Medical Center
| | - Stephanie Pabst
- Division of Adolescent Medicine, Cincinnati Children’s Hospital Medical Center
| | - Jennifer Hillman
- Division of Adolescent Medicine, Cincinnati Children’s Hospital Medical Center
| | - Paula Braverman
- Division of Adolescent Medicine, Cincinnati Children’s Hospital Medical Center
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Proctor M, Murphy PA, Pattison HM, Suckling JA, Farquhar C. Behavioural interventions for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev 2007; 2007:CD002248. [PMID: 17636702 PMCID: PMC7137212 DOI: 10.1002/14651858.cd002248.pub3] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Dysmenorrhoea refers to the occurrence of painful menstrual cramps of uterine origin and is a common gynaecological condition with considerable morbidity. The behavioural approach assumes that psychological and environmental factors interact with, and influence, physiological processes. Behavioural interventions for dysmenorrhoea may include both physical and cognitive procedures and focus on both physical and psychological coping strategies for dysmenorrhoeic symptoms rather than modification of any underlying organic pathology. OBJECTIVES To determine the effectiveness of any behavioural interventions for the treatment of primary or secondary dysmenorrhoea when compared to each other, placebo, no treatment, or conventional medical treatments for example non-steroidal anti-inflammatory drugs (NSAIDs). SEARCH STRATEGY We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register (searched April 2005), Cochrane Central Register of Controlled Trials (CENTRAL on The Cochrane Library, Issue 2, 2005), MEDLINE (1966 to April 2005), EMBASE (1980 to April 2005), Social Sciences Index (1980 to April 2005), PsycINFO (1972 to April 2005) and CINAHL (1982 to April 2005) and reference lists of articles. SELECTION CRITERIA Randomised controlled trials comparing behavioural interventions with placebo or other interventions in women with dysmenorrhoea. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial quality and extracted data. MAIN RESULTS Five trials involving 213 women were included. Behavioural intervention vs control: One trial of pain management training reported reduction in pain and symptoms compared to a control. Three trials of relaxation compared to control reported varied results, two trials showed no difference in symptom severity scores however one trial reported relaxation was effective for reducing symptoms in menstrual sufferers with spasmodic symptoms. Two trials reported less restriction in daily activities following treatment with either relaxation of pain management training compared to a control. One trial also reported less time absent from school following treatment wit pain management training compared to a control. Behavioural intervention vs other behavioural interventions: Three trials showed no difference between behavioural interventions for the outcome of improvement in symptoms. One trial showed that relaxation resulted in a decrease in the need for resting time compared to the relaxation and imagery. AUTHORS' CONCLUSIONS There is some evidence from five RCTs that behavioural interventions may be effective for dysmenorrhoea however results should be viewed with caution as they varied greatly between trials due to inconsistency in the reporting of data, small trial size, poor methodological quality and age of the trials.
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Affiliation(s)
- Michelle Proctor
- Department of CorrectionsPsychological ServicePO Box 302457North HarbourAucklandNew Zealand1310
| | - Patricia A Murphy
- University of Utah College of NursingCollege of Nursing10 South 2000 EastSalt Lake CityUtahUSA84112
| | - Helen M Pattison
- Aston UniversitySchool of Life and Health SciencesAston TriangleBirminghamBirminghamUKB4 7ET
| | - Jane A Suckling
- Auckland City HospitalDepartment of Obstetrics and GynaecologyPark RoadGraftonAucklandNew Zealand1142
| | - Cindy Farquhar
- University of AucklandObstetrics and GynaecologyFMHS Park RoadGraftonAucklandNew Zealand1003
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Abstract
The prevalence of common premenstrual symptoms and menstrual period pain were studied in a cohort of 545 Israeli adolescent girls aged 16 to 21 years, and their correlation with biological, behavioral, and sociocultural traits were analyzed. A high proportion of the girls (80%) commonly experienced at least one premenstrual symptom. About 70% experienced menstrual pain in the past and 25% reported pain which severely interfered with daily activities during the last three cycles. Premenstrual symptoms and menstrual pain were positively associated. Oral contraceptive use appeared to reduce the prevalence of menstrual pain, and among smokers who had menstrual pain, heavier smokers experienced more pain. Girls of Asian or African ethnic origin reported consistently higher perimenstrual distress than those of Israeli or Western origin, suggesting that social expectations may affect the perception and reporting of these symptoms.
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Affiliation(s)
- D Shye
- Department of Medical Ecology, School of Public Health and Community Medicine, Hebrew University-Hadassah Medical School, Jerusalem, Israel
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Sigmon ST, Nelson RO. The effectiveness of activity scheduling and relaxation training in the treatment of spasmodic dysmenorrhea. J Behav Med 1988; 11:483-95. [PMID: 3070050 DOI: 10.1007/bf00844841] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The first purpose of this study was to examine the effectiveness of activity scheduling as a treatment for spasmodic dysmenorrhea, compared to relaxation training (a treatment of demonstrated effectiveness) and to a waiting-list control condition. The second purpose was to examine the differential effectiveness of these treatments on different measures. Forty women suffering from spasmodic dysmenorrhea completed six individualized treatment sessions or remained on the waiting list. Results showed that both activity scheduling and relaxation training were effective treatments for spasmodic dysmenorrhea, with both treatments producing improvements on general measures of dysmenorrhea, a symptom severity measure, and an activity measure.
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Affiliation(s)
- S T Sigmon
- Psychology Department, University of North Carolina, Greensboro 27412-5001
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White PA, Wildman BG. Factors related to medical help-seeking in women with menstrual discomfort. Behav Res Ther 1986; 24:471-4. [PMID: 3741312 DOI: 10.1016/0005-7967(86)90012-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Wildman BG, White PA. Assessment of dysmenorrhea using the Menstrual Symptom Questionnaire: factor structure and validity. Behav Res Ther 1986; 24:547-51. [PMID: 3753382 DOI: 10.1016/0005-7967(86)90035-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Abstract
An exploratory study of premenstrual symptomatology, coping strategies, personal and family impact, and alterations in family functioning attributed to premenstrual symptoms was conducted. A sample of 83 women and 32 men completed a questionnaire before an evening lecture on premenstrual syndrome. Women reported a total of 74 different recurrent premenstrual symptoms, with the most frequently reported category being the "tension states." Men used multiple coping techniques to deal with their spouse's symptoms with offering support and expressing anger as the most frequently reported. Recurrent negative family impact themes emerged from the content analysis: increased conflict, decreased family cohesion, and disrupted communication among family members. Nursing implications are discussed.
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Nelson RO, Sigmon S, Amodei N, Jarrett RB. The menstrual symptom questionnaire: the validity of the distinction between spasmodic and congestive dysmenorrhea. Behav Res Ther 1984; 22:611-4. [PMID: 6517825 DOI: 10.1016/0005-7967(84)90123-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Bennink CD, Hulst LL, Benthem JA. The effects of EMG biofeedback and relaxation training on primary dysmenorrhea. J Behav Med 1982; 5:329-41. [PMID: 6215496 DOI: 10.1007/bf00846160] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Fifteen dysmenorrhea sufferers received relaxation training with EMG biofeeddback, relaxation training with no feedback, or no treatment. Participants who received biofeedback training did not differ from participants who received relaxation training in their ability to maintain a reduced level of EMG activity prior to the onset of menstruation. On the first day of menstruation, those receiving biofeeback training were able to maintain reduced EMG activity, whereas those receiving relaxation training showed an elevated level of EMG activity. Subjective reports indicated that the symptoms of dysmenorrhea improved for the biofeedback group during training but did not improve for the relaxation or control groups. Suggestions for further research are noted.
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Abstract
Recent research findings contradict the notion that premenstrual and menstrual symptoms constitute two mutually exclusive categories of perimenstrual distress. The purposes of this study were to describe the prevalence of distress associated with menstruation in a community population and to determine whether perimenstrual distress could be regarded as a single construct. Nonpregnant women (N = 193) between 18 and 35 were selected from five neighborhoods in a southeastern city in a way that allowed for variability in race and income. The women were interviewed in their homes and 179 were asked to complete the Moos Menstrual Distress Questionnaire (MDQ). At least 30% of the women reported weight gain, skin disorders, backache, painful or tender breasts, irritability, depression, headache, cramps, fatigue, swelling, mood swings or tension in the perimenstruum. Cycle phase differences were not found for 31 MDQ symptoms, but were found for: weight gain, crying, lowered school or work performance, taking naps, headache, skin disorders, cramps, anxiety, backache, fatigue, painful or tender breasts, swelling, irritability, mood swings, depression, and tension. Although there were significant differences between the premenstrual and menstrual phases for certain symptoms, the magnitudes of the mean differences were small (less than .3) except for cramps, weight gain, and fatigue. Furthermore, premenstrual and menstrual reports of the same symptoms were highly correlated. Thus, it appears reasonable to study perimenstrual distress as a single construct.
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Hart AD, Mathisen KS, Prater JS. A comparison of skin temperature and EMG training for primary dysmenorrhea. BIOFEEDBACK AND SELF-REGULATION 1981; 6:367-73. [PMID: 7326271 DOI: 10.1007/bf01000661] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Eleven female volunteers completed a 6-month treatment program consisting of a 2-month baseline phase, 2 months of biofeedback training (X number of sessions = 12.9), and 2 months of follow-up data collection. Subjects were assigned to one of two treatment groups: skin temperature training or EMG training of the frontalis muscle. Self-report data were gathered by means of the Symptom Severity Scale. Results, which were analyzed according to a 2 X 3 (treatment X phase) split-plot factorial design, indicate a highly significant overall treatment effect (F = 19.32 p less than .001). There was no significant difference between treatments (F = .47) and no significant interaction effect (F = 1.74).
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