Purpose
Dysmenorrhea affects quality of life and contributes to absenteeism from school and work 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 potential problems have not been examined in adolescents. The purpose of this study was to examine relationships between depressive symptoms and anxiety with menstrual symptoms. Smoking was examined as a moderator of this relationship.
Methods
This study enrolled 154 post-menarcheal girls from a sample of 207 girls age 11, 13, 15, and 17 years [M = 15.4 years (± 1.9)]. Self-reported measures included the Menstrual Symptom Questionnaire (MSQ), Children’s Depression Inventory (CDI), 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.
Older women victims have difficulty initiating discussions about IPV with their providers. Providers are encouraged to identify signals of potential abuse and to create privacy with all patients to discuss difficult issues, such as IPV, and to be knowledgeable about appropriate referrals.
Theoretically, the measurement of cytokines in saliva may have utility for studies of brain, behavior, and immunity in youth. Cytokines in saliva and serum were analyzed across three annual assessments in healthy adolescent girls (N = 114, 11-17 years at enrollment). Samples were assayed for GM-CSF, IFNγ, IL-1β, IL-2, IL-6, IL-8, IL-10, IL-12p70, TNFα, adiponectin, and cotinine. Results revealed: (1) cytokine levels, except IFNγ and IL-10, were detectable in saliva, and salivary levels, except IL-8 and IL-1β, were lower than serum levels; (2) salivary cytokine levels were lower in older girls and positively associated with adiponectin; (3) compared to serum levels, the correlations between salivary cytokines were higher, but salivary cytokines were less stable across years; and (4) except for IL-1β, there were no significant serum-saliva associations. Variation in basal salivary cytokine levels in healthy adolescent girls reflect compartmentalized activity of the oral mucosal immune system, rather than systemic cytokine activity.
Thirty-eight women who were in abusive relationships since age 55 years were interviewed to understand their abuse stories, ways of coping, and health care experiences. In responding to these questions, women described the nature of the abuse perpetrated by their elderly partners and tried to "make sense" of what they had experienced and to define "who" these men were. This took various forms, from personal theories about aging, to labels (ethnic stereotyping, demonizing, pathologizing) to characterizations of the abuser's private versus public behaviors. The authors explore the implications these findings have for assisting the elderly victim and perpetrator.
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