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Negative affect and vasomotor symptoms in the Study of Women’s Health Across the Nation Daily Hormone Study

Gibson, Carolyn J. MPH, MS1; Thurston, Rebecca C. PhD2; Bromberger, Joyce T. PhD3; Kamarck, Thomas PhD1; Matthews, Karen A. PhD4

doi: 10.1097/gme.0b013e3182230e42
Original Studies

Objective Vasomotor symptoms (VMS) are common during the menopausal transition. Negative affect is consistently associated with self-reported VMS, but the interpretation of this relationship is limited by the infrequent measurement and retrospective recall of VMS. Using prospective data from daily diaries, we examined the daily association between negative affect and reported VMS, as well as the temporal associations between negative affect and next-day VMS and between VMS and next-day negative affect.

Methods Data were derived from the third wave of the Daily Hormone Study (N = 625). The Daily Hormone Study is a substudy of the Study of Women’s Health Across the Nation, a multisite community-based prospective cohort study of the menopausal transition. Participants reported VMS and affect in daily diaries for 12 to 50 days. Multilevel mixed models were used to determine the associations between reported VMS and negative affect, adjusted by antidepressant use, age, education, menopause status, self-reported health, and race/ethnicity, drawn from annual Study of Women’s Health Across the Nation visits.

Results VMS were reported by 327 women (52.3%). Negative affect was positively associated with VMS (odds ratio [OR], 1.76; 95% CI, 1.43-2.17; P < 0.001) in cross-sectional analyses. Negative affect, adjusted by same-day VMS, was not predictive of next-day VMS (OR, 1.11; 95% CI, 0.85-1.35; P = 0.55), whereas VMS, adjusted by same-day negative affect, was predictive of negative affect for the next day (OR, 1.27; 95% CI, 1.03-1.58; P = 0.01).

Conclusions Negative affect is more likely to be reported on the same day and the day after VMS. Potential mechanisms underlying this relationship include negative cognitive appraisal, sleep disruption, and unmeasured third factors.

From the 1Department of Psychology, University of Pittsburgh, Pittsburgh, PA; 2Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA; 3Departments of Epidemiology and Psychiatry, University of Pittsburgh, Pittsburgh, PA; 4Departments of Psychiatry, Psychology, and Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, PA.

Received April 8, 2011; revised and accepted May 5, 2011.

Funding/support: Carolyn J. Gibson was supported by Cardiovascular Behavioral Medicine training grant NIH T32 HL 007560. The Study of Women’s Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health (ORWH) grants NR004061, AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, and AG012495. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH, or NIH.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Carolyn J. Gibson, MPH, MS, Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213. E-mail:

©2011The North American Menopause Society