Exploring the long-term experience of vasomotor instability: A 5 year follow-up study of distress, perceived control and catastrophizing

Abstract

Some women experience vasomotor instability for many years post-menopause, but little is known about their appraisals of this health problem, their levels of distress or their coping strategies, and whether these change over time. This study followed up a group of women over 5 years, to examine changes and consistencies in frequency of flushing, flush-related distress/ discomfort, control beliefs and catastrophic thoughts. A further aim was to examine the validity of previously developed measures of perceived control and catastrophizing against conceptually relevant standardized scales. A questionnaire of 20 women (average age 53 years) was carried out, with follow-up 5 years later. Measures of flush distress, flush frequency, perceived control over hot flushes, and catastrophic thoughts about flushing was compared at Time 1 and Time 2. Additionally, multidimensional health locus of control (MHLC) and depression (CES-D) scores were taken at follow-up. All measure showed improvements in well-being. Nevertheless, there were many individual consistencies in scores on most variables at Time 1 and 2. Flush distress at Time 2 was most related to catastrophic thinking, and was slightly elevated in more depressed women. Flush distress was completely unrelated to health locus of control. Psychological responses to hot flushes seem to improve over a 5-year period, yet women show some consistency in their appraisals of this mid-life health problem. Counsellors may find that cognitive re-framing strategies are helpful for alleviating flush distress in women who are continue to be distressed by chronic vasomotor instability, as distress is so closely related to catastrophic thinking.