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Depressive symptoms in the transition to menopause: the roles of irritability, personality vulnerability, and self-regulation

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Abstract

Although the transition to menopause represents a period of risk for depressive symptoms, there is little research into personality or trait-like factors that may confer vulnerability to depression during the transition to menopause. This study investigated whether the personality trait of self-criticism moderated the effects of irritability on depressive symptoms in women transitioning to menopause and whether these effects were mediated by lower levels of emotional regulation. Participants were 376 women, of whom 157 had entered the transition phase to menopause. These women in the transition phase completed measures of self-criticism, irritable mood, emotional regulation, and depressive symptoms. All analyses controlled for attitudes toward menopause and somatic symptoms. Moderated mediation regression analyses showed that higher levels of irritability were associated with poorer emotional regulation in highly self-critical women, but not in less self-critical women, and poorer emotional regulation was, in turn, related to higher levels depressive symptoms. Findings suggest that the transition to menopause may represent an especially vulnerable period for women with high levels of self-criticism. Although irritability is transitory for most women, for women who are highly self-critical, irritability may tax their ability to self-regulate and lead to more encompassing symptoms of depression.

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References

  • Abela JRZ, Sakellaropoulo M, Taxel E (2007) Integrating two subtypes of depression: Psychodynamic theory and its relation to hopelessness depression in early adolescents. Journal of Early Adolescence 27:363–385. doi:10.1177/0272431607302004

  • Abela JRZ, Taylor G (2003) Specific vulnerability to depressive mood reactions in schoolchildren: the moderating role of self-esteem. Journal of Clinical Child and Adolescent Psychology 32:408–418. doi:10.1586/14737175.7.11s.S93

  • Abela JRZ, Webb CA, Wagner C, Ho MHR, Adams P (2006) The role of self-criticism, dependency, and hassles in the course of depressive illness: a multiwave longitudinal study. Personality and Social Psychology Bulletin (32)328–338. doi:10.1177/0146167205280911

  • Alexander JL, Dennerstein L, Woods NF, McEwen BS, Halbreich U, Kotz K, Richardson G (2007) Role of stressful life events and menopausal stage in wellbeing and health. Expert Rev Neurother 7:S93–S113. doi:10.1586/14737175.7.11s.S93

    Article  PubMed  Google Scholar 

  • American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  • Angst J, Sellaro R, Stolar M, Merikangas KR, Endicott J (2001) The epidemiology of perimenstrual psychological symptoms. Acta Psychiatr Scand 104:110–116

    Article  CAS  PubMed  Google Scholar 

  • Avis NE, Brambilla D, McKinlay SM, Vass K (1994) A longitudinal analysis of the association between menopause and depression results from the Massachusetts women’s health study. Ann Epidemiol 4:214–220. doi:10.1016/1047-2797(94)90099-X

    Article  CAS  PubMed  Google Scholar 

  • Avis NE, Crawford S, Stellato R, Longcope C (2001) Longitudinal study of hormone levels and depression among women transitioning through menopause. Climacteric 4:243–249

    Article  CAS  PubMed  Google Scholar 

  • Baker A, Simpson S, Dawson D (1997) Sleep disruption and mood changes associated with menopause. J Psychosom Res 43:359–369. doi:10.1016/S0022-3999(97)00126-8

    Article  CAS  PubMed  Google Scholar 

  • Baram DA (2005) Physiology and symptoms of menopause menopause: a mental health practitioner’s guide. American Psychiatric Publishing, Inc., Arlington, pp 15–32

    Google Scholar 

  • Baron RM, Kenny DA (1986) The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 51:1173–1182

    Article  CAS  PubMed  Google Scholar 

  • Bastian LA, Smith CM, Nanda K (2003) Is this woman perimenopausal? J Am Med Assoc 289:895–902. doi:10.1001/jama.289.7.895

    Article  Google Scholar 

  • Baumeister RF, Heatherton TF (1996) Self-regulation failure: an overview. Psychoanal Inq 7:1

    Article  Google Scholar 

  • Baumeister RF, Bratslavsky E, Muraven M, Tice DM (1998) Ego depletion: is the active self a limited resource? J Pers Soc Psychol 74:1252–1265. doi:10.1037/0022-3514.74.5.1252

    Article  CAS  PubMed  Google Scholar 

  • Baumeister RF, Zell AL, Tice DM (2007) How emotions facilitate and impair self-regulation? Handbook of emotion regulation. Guilford Press, New York, pp 408–426

    Google Scholar 

  • Beck AT, Steer RA, Brown GK (1996) Manual for the Beck depression inventory-II. Psychological Corporation, San Antonio

    Google Scholar 

  • Blatt SJ (1974) Levels of object representation in anaclitic and introjective depression. Psychoanal Study Child 29:7–157

    Google Scholar 

  • Blatt SJ (2004) Experiences of depression: theoretical, clinical, and research perspectives, vol XIII. American Psychological Association, Washington, DC, 359 pp

    Google Scholar 

  • Blatt SJ, D’Afflitti JP, Quinlan DM (1976) Depressive experiences questionnaire. New Haven, CT: Yale University Press.

  • Blatt SJ, Shichman S (1983) Two primary configurations of psychopathology. Psychoanal Contemp Thought 6:187–254

    Google Scholar 

  • Blatt SJ, Zuroff DC (1992) Interpersonal relatedness and self-definition: two prototypes for depression. Clin Psychol Rev 12:527–562

    Article  Google Scholar 

  • Blatt SJ, Auerbach JS, Levy KN (1997) Mental representations in personality development, psychopathology, and the therapeutic process. Rev Gen Psychol 1:351–374

    Article  Google Scholar 

  • Blatt SJ, D’Afflitti JP, Quinlan DM (1976) Depressive experiences questionnaire. New Haven, CT: Yale University Press.

  • Born LE (2004) A new gender-specific measure of irritability. U Toronto, Canada

    Google Scholar 

  • Born L, Steiner M (1999) Irritability: the forgotten dimension of female-specific mood disorders. Arch Women’s Ment Health 2:153–167

    Article  Google Scholar 

  • Born L, Steiner M, Koren G (2002) 30th annual meeting of north american society for psychosocial obstetrics and gynecology, february 20–23, 2002 Cancun, Mexico. Arch Women’s Ment Health 4:37–65

    Article  Google Scholar 

  • Born L, Koren G, Lin E, Steiner M (2008) A new, female-specific irritability rating scale. J Psychiatry Neurosci 33:344–354

    PubMed Central  PubMed  Google Scholar 

  • Bosworth HB, Bastian LA, Kuchibhatla MN, Steffens DC, McBride CM, Skinner CS, Rimer BK, Siegler IC (2001) Depressive symptoms, menopausal status, and climacteric symptoms in women at midlife. Psychosom Med 63:603–608

    Article  CAS  PubMed  Google Scholar 

  • Bromberger JT, Meyer PM, Kravitz HM, Sommer B, Cordal A, Powell L, Ganz PA, Sutton-Tyrrell K (2001) Psychologic distress and natural menopause: a multiethnic community study. Am J Public Health 91:1435–1442

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Bromberger JT, Assmann SF, Avis NE, Schocken M, Kravitz HM, Cordal A (2003) Persistent mood symptoms in a multiethnic community cohort of pre- and perimenopausal women. Am J Epidemiol 158:347–356

    Article  PubMed  Google Scholar 

  • Brown JP, Gallicchio L, Flaws JA, Tracy JK (2009) Relations among menopausal symptoms, sleep disturbance and depressive symptoms in midlife. Maturitas 62:184–189

    Article  PubMed Central  PubMed  Google Scholar 

  • Buchanan CM, Eccles JS, Becker JB (1992) Are adolescents the victims of raging hormones? Evidence for activational effects of hormones on moods and behavior at adolescence. Psychiatr Bull 111:62–107

    Article  CAS  Google Scholar 

  • Cohen LS, Soares CN, Vitonis AF, Otto MW, Harlow BL (2006) Risk for new onset of depression during the menopausal transition. Arch Gen Psychiatry 63:385–390

    Article  PubMed  Google Scholar 

  • Ehring T, Fischer S, Schnulle J, Bosterling A, Tuschen-Caffier B (2008) Characteristics of emotion regulation in recovered depressed versus never depressed individuals. Personal Individ Differ 44:1574–1584. doi:10.1016/j.paid.2008.01.013

    Article  Google Scholar 

  • Fava GA (1987) Irritable mood and physical illness. Stress Med 3:293–299

    Article  Google Scholar 

  • Fava GA, Tossani E (2007) Prodromal stage of major depression. Early Interv Psychol 1:9–18. doi:10.1111/j.1751-7893.2007.00005.x

    Article  Google Scholar 

  • Fava GA, Grandi S, Canestrari R, Molnar G (1990) Prodromal symptoms in primary major depressive disorder. J Affect Disord 19:149–152

    Article  CAS  PubMed  Google Scholar 

  • Freeman EW, Sammel MD, Liu L, Gracia CR, Nelson DB, Hollander L (2004) Hormones and menopausal status as predictors of depression in women in transition to menopause. Arch Gen Psychiatry 61:62–70

    Article  CAS  PubMed  Google Scholar 

  • Freeman EW, Sammel MD, Lin H, Nelson DB (2006) Associations of hormones and menopausal status with depressed mood in women with no history of depression. Arch Gen Psychiatry 63:375–382

    Article  CAS  PubMed  Google Scholar 

  • Gratz KL, Roemer L (2004) Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess 26:41–54

    Article  Google Scholar 

  • Gross JJ, Munoz RF (1995) Emotion regulation and mental health. Clin Psychol Sci Pract 2:151–164

    Article  Google Scholar 

  • Halbreich U (2010) Women’s reproductive related disorders (RRDs). J Affect Disord 122(1–2):10–13

    Article  PubMed  Google Scholar 

  • Harlow BL, Wise LA, Otto MW, Soares CN, Cohen LS (2003) Depression and its influence on reproductive endocrine and menstrual cycle markers associated with perimenopause: the Harvard study of moods and cycles. Arch Gen Psychiatry 60:29–36

    Article  PubMed  Google Scholar 

  • Harlow SD, Crawford S, Dennerstein L, Burger HG, Mitchell ES, Sowers MF (2007) Recommendations from a multi-study evaluation of proposed criteria for staging reproductive aging. Climacteric 10:112–119

    Article  CAS  PubMed  Google Scholar 

  • Harsh V, Meltzer-Brody S, Rubinow DR, Schmidt PJ (2009) Reproductive aging, sex steroids, and mood disorders. Harv Rev Psychiatry 17:87–102

    Article  PubMed Central  PubMed  Google Scholar 

  • Hunter MS (1990) Psychological and somatic experience of the menopause: a prospective study. Psychosom Med 52:357–367

    Article  CAS  PubMed  Google Scholar 

  • Hunter MS (1992) The women’s health questionnaire: a measure of mid-aged women’s perceptions of their emotional and physical health. Psychol Health 7:45–54

    Article  Google Scholar 

  • Hyde JS, Mezulis AH, Abramson LY (2008) The ABCs of depression: integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression. Psychol Rev 115:291–313

    Article  PubMed  Google Scholar 

  • Hylan TR, Sundell K, Judge R (1999) The impact of pre-menstrual symptomatology on functioning and treatment-seeking behavior: experience from the United States, United Kingdom, and France. J Women’s Health Gend Based Med 8:1043

    Article  CAS  Google Scholar 

  • Iacoviello BM, Alloy LB, Abramson LY, Choi JY (2010) The early course of depression: a longitudinal investigation of prodromal symptoms and their relation to the symptomatic course of depressive episodes. J Abnorm Psychol 119:459–467. doi:10.1037/a0020114

    Article  PubMed Central  PubMed  Google Scholar 

  • Kopala-Sibley DC, Santor DA (2009) The mediating role of automatic thoughts in the personality–event–affect relationship. Cogn Behav Ther 38(3):153–161. doi::10.1080/16506070802694644

  • Kopala-Sibley DC, Zuroff DC (2010) Proximal predictors of depressive symptomatology: perceived losses in self-worth and interpersonal domains and introjective and anaclitic mood states. Cogn Behav Ther 39:270–282. doi:10.1080/16506073.2010.501810

    Article  PubMed  Google Scholar 

  • Kopala-Sibley DC, Zuroff DC, Russell JJ, Moskowitz DS, Paris J (2012) Understanding heterogeneity in borderline personality disorder: differences in affective reactivity explained by the traits of dependency and self-criticism. J Abnorm Psychol 121(3):680. doi:10.1037/a0028513

  • Kumari M, Stafford M, Marmot M (2005) The menopausal transition was associated in a prospective study with decreased health functioning in women who report menopausal symptoms. J Clin Epidemiol 58:719–727

    Article  PubMed  Google Scholar 

  • Luyten P, Sabbe B, Blatt SJ, Meganck S, Jansen B, De Grave C, Maes F, Corveleyn J (2007) Dependency and self-criticism: relationship with major depressive disorder, severity of depression, and clinical presentation. Depress Anxiety 24:586–596

    Article  PubMed  Google Scholar 

  • Maartens LWF, Knottnerus JA, Pop VJ (2002) Menopausal transition and increased depressive symptomatology: a community based prospective study. Maturitas 42:195–200

    Article  CAS  PubMed  Google Scholar 

  • Mahnert FA, Reicher H, Zalaudek K, Zapotoczky HG (1997) P.1.078 Prodromal and residual symptoms in recurrent depression: preliminary data of a long-term study under prophylactic treatment condition. Eur Neuropsychopharmacol 7:S159–S160

    Google Scholar 

  • McKinlay SJ, Brambilla DJ, Posner JG (1992) The normal menopause transition. Am J Hum Biol 4:37–46

    Article  Google Scholar 

  • Mongrain M, Zuroff C (1989) Cognitive vulnerability to depressed affect in dependent and self-critical college women. Journal of Personality Disorders, 3, 240–251. doi:10.1521/pedi.1989.3.3.240

  • Mongrain M, Zuroff DC (1994) Ambivalence over emotional expression and negative life events: mediators of depressive symptoms in dependent and self-critical individuals. Personal Individ Differ 16:447–458

    Article  Google Scholar 

  • Mongrain M, Vettese LC, Shuster B, Kendal N (1998) Perceptual biases, affect, and behavior in the relationships of dependents and self-critics. J Pers Soc Psychol 75:230–241

    Article  CAS  PubMed  Google Scholar 

  • Muller D, Judd CM, Yzerbyt VY (2005) When moderation is mediated and mediation is moderated. J Pers Soc Psychol 89:852–863

    Article  PubMed  Google Scholar 

  • NAMS (2010) Menopause practice: a clinician’s guide, 4th edn. The North American Menopause Society, Ohio

    Google Scholar 

  • Nietzel MT, Harris MJ (1990) Relationship of dependency and achievement/autonomy to depression. Clin Psychol Rev 10:279–297

    Article  Google Scholar 

  • Powell L (1996) Psychological changes in the perimenopausal transition. Maturitas 25:77–77

    Article  Google Scholar 

  • Reed S, Ludman E, Newton K, Grothaus L, Nekhlyudov L, Spangler L, LaCroix A (2009) Depressive symptoms and menopausal burden in the midlife. Maturitas 63:S34–S34

    Article  Google Scholar 

  • Ryff CD (1989) Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J Pers Soc Psychol 57:1069–1081

    Article  Google Scholar 

  • Ryff CD (1991) Possible selves in adulthood and old age: a tale of shifting horizons. Psychol Aging 6:286–295. doi:10.1037/0882-7974.6.2.286

    Article  CAS  PubMed  Google Scholar 

  • Ryff CD (1995) Psychological well-being in adult life. Curr Dir Psychol Sci 4:99–104

    Article  Google Scholar 

  • Santor DA, Zuroff DC, Fielding A (1997a) Analysis and revision of the depressive experiences questionnaire: examining scale performance as a function of scale length. J Personal Assess 69:145–163

    Article  CAS  Google Scholar 

  • Santor DA, Zuroff DC, Mongrain M, Fielding A (1997b) Validating the McGill revision of the depressive experiences questionnaire. J Personal Assess 69:164–182

    Article  CAS  Google Scholar 

  • Schleifer LA (2003) The role of estrogen in the mood-lowering effects of acute tryptophan depletion in postmenopausal women. McGill U, Canada

    Google Scholar 

  • Schmidt PJ, Murphy J, Haq N, Rubinow D, Danaceau M (2004) Stressful life events, personal losses, and perimenopause-related depression. Arch Women’s Ment Health 7:19–26

    Article  CAS  Google Scholar 

  • Schneider HPG, Heinemann LAJ, Thiele K (2002) The menopause rating scale (MRS): cultural and linguistic translation into English. Life Med Sci. doi:10.1072/LO0305326

    Google Scholar 

  • Sommer B, Avis N, Meyer P, Ory M, Madden T, Kagawa-Singer M, Mouton C, Rasor NON, Adler S (1999) Attitudes toward menopause and aging across ethnic/racial groups. Psychosom Med 61:868–875

    Article  CAS  PubMed  Google Scholar 

  • Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian W, Woods N (2001) Executive summary: stages of reproductive aging workshop (STRAW). Fertil Steril 76:874–878

    Article  CAS  PubMed  Google Scholar 

  • Sowers MF, Crawford SL, Sternfeld B, Morganstein D, Gold EB, Greendale GA, Evans D, Neer R, Matthews K, Sherman S, Lo A, Weiss G, Kelsey J (2000) SWAN: a multicenter, multiethnic, community-based cohort study of women and the menopausal transition. In: Lobo RA, Kelsey J, Markus R (eds) Menopause: biology and pathobiology. Academic Press, San Diego, pp 175–188

    Chapter  Google Scholar 

  • Steer RA, Ball R, Ranieri WF, Beck AT (1997) Further evidence for the construct validity of the Beck depression inventory-II with psychiatric outpatients. Psychol Rep 80:443–446

    Article  CAS  PubMed  Google Scholar 

  • Strauman TJ (2002) Self-regulation and depression. Self Identity 1:151–157

    Article  Google Scholar 

  • Thompson RA (1994) Emotion regulation: A theme in search of definition. Monographs of the society for research in child development, 59(2-3), 25–52

  • Tice DM, Bratslavsky E, Baumeister RF (2001) Emotional distress regulation takes precedence over impulse control: if you feel bad, do it! J Pers Soc Psychol 80:53–67

    Article  CAS  PubMed  Google Scholar 

  • van Praag HM (1996a) Faulty cortisol/serotonin interplay. Psychopathological and biological characterisation of a new, hypothetical depression subtype (SeCA depression). Psychiatry Res 65:143–157

    Article  PubMed  Google Scholar 

  • van Praag HM (1996b) Serotonin-related, anxiety/aggression-driven, stressor-precipitated depression. A psychobiological hypothesis. Eur Psychiatry 11:57–67

    Article  PubMed  Google Scholar 

  • Vettese LC, Mongrain M (2000) Communication about the self and partner in the relationships of dependents and self-critics. Cogn Ther Res 24:609–626. doi:10.1023/A:1005587009681

    Article  Google Scholar 

  • Vujanovic A, Zvolensky M, Bernstein A (2008) The interactive effects of anxiety sensitivity and emotion dysregulation in predicting anxiety-related cognitive and affective symptoms. Cogn Ther Res 32:803–817. doi:10.1007/s10608-007-9148-8

    Article  Google Scholar 

  • Werner K, Gross JJ (2010) Emotion regulation and psychopathology: a conceptual framework emotion regulation and psychopathology: a transdiagnostic approach to etiology and treatment. Guilford Press, New York, pp 13–37

    Google Scholar 

  • Wilk CA, Kirk MA (1995) Menopause: a developmental stage, not a deficiency disease. Psychother Theory Res Pract Train 32:233–241

    Article  Google Scholar 

  • Young MA, Watel LG, Lahmeyer HW, Eastman CI (1991) The temporal onset of individual symptoms in winter depression: differentiating underlying mechanisms. J Affect Disord 22:191–197

    Article  CAS  PubMed  Google Scholar 

  • Zuroff DC, Mongrain, M. (1987). Dependency and self-criticism: Vulnerability factors for depressive affective states. J Abnorm Psychol 96:14–22. doi:10.1037/0021-843X.96.1.14

  • Zuroff DC, Igreja I, Mongrain M (1990) Dysfunctional attitudes, Dependency and Self-Criticism as predictors of depressive mood states: A 12-month longitudinal study. J Cogn Ther & Res 14:315–326

  • Zuroff DC, Moskowitz DS, Wielgus MS, Powers TA, Franko DL (1983) Construct validation of the dependency and self-criticism scales of the depressive experiences questionnaire. J Res Personal 17:226–241

    Article  Google Scholar 

  • Zuroff DC, Mongrain M, Santor DA (2004) Conceptualizing and measuring personality vulnerability to depression: comment on Coyne and Whiffen (1995). Psychol Bull 130:489–511

  • Zuroff DC, Blatt SJ, Sanislow CA III, Bondi CM, Pilkonis PA (1999) Vulnerability to depression: reexamining state dependence and relative stability. J Abnorm Psychol 108:76–89

    Article  CAS  PubMed  Google Scholar 

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Mauas, V., Kopala-Sibley, D.C. & Zuroff, D.C. Depressive symptoms in the transition to menopause: the roles of irritability, personality vulnerability, and self-regulation. Arch Womens Ment Health 17, 279–289 (2014). https://doi.org/10.1007/s00737-014-0434-7

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