The dysmenorrhea personality: Actuality or statistical artifact?

Ser. Sci. Med. Vol. 17. No. 21, pp. 1653-1655. Printed m Great Britain

1983

0277-9536/83 $3.00 + 0.00 Pergamon Press Ltd

RESEARCH NOTE

THE DYSMENORRHEA PERSONALITY: ACTUALITY OR STATISTICAL ARTIFACT? CARMINEU. IACONOand SAM J. ROBERTS Texas Tech University,

Lubbock,

TX 79409, U.S.A.

Abstract-A group of 31 women who were experiencing severe dysmenorrhea were matched by age with a group of 31 women who had no dysmenorrhea symptoms. Women in both groups took the 16PF. Some major methodological and statistical flaws found in previous research of this type were corrected. The results convincingly showed that 16PF personality profiles for the two groups were extremely similar. Finally. there were no indications of any personality abnormalities.

The relationship between dysmenorrhea, defined as severe pain and discomfort during menstruation, and personality remains in dispute. Studies in this area have been based upon the rather questionable assump tion that most women experience a similar level of discomfort during menstruation. Dysmenorrhea, it has been further assumed, may be due to psychological factors which tend to escalate the otherwise tolerable symptoms associated with menstruation. Some investigators contend that dysmenorrhea results from personal maladjustment [I] while others argue that dysmenorrhea is unrelated to personality characteristics [2-4]. Most studies in this area have attempted to resolve this issue by comparing dysmenorrhea subjects with non-dysmenorrhea subjects on a variety of personality measures. Kehoe [4] investigated the relationship of femininity and anxiety to reported menstrual symptoms and found these personality factors to be of little value in predicting severity of menstrual symptomatology. Hurt et ai. [3] also found little relationship between dysmenorrhea and measures of anxiety, neuroticism and introversion-extroversion. Coppen and Kessel [2] also found little relationship between measures of neuroticism and severity of menstrual symptoms. Small but significant personality differences between women who experience dysmenorrhea and women who do not have also been reported. Bloom et al. [l] found that dysmenorrhea sufferers are more depressed, anxious and withdrawn, and less independent, playful and satisfied with themselves than women who do not experience dysmenorrhea. Similar results were reported by Steingarten [5] who found that dysmenorrhea sufferers were more likely to be anxious, depressed and traditionally feminine than non-sufferers. In addition, Woods and Launius [6] have reported a small but significant relationship between dysmenorrhea and measures of masculinity. Although findings in this area are inconsistent, these studies have several methodological problems in common. One problem involves the statistical procedures used to compare the personality profiles of women who experience dysmenorrhea and those who do not. For example, Hurt et al. [3] used standard correlational

methods to assess profile similarity between groups, while Bloom et al. [1] used r-tests to compare overall group profiiles for each personality dimension assessed. According to Wiggins [7], the use of standard Pearson or Spearman correlational methods to assess profile similarity fail to take into account profile scatter and elevation ; only profile shape is considered. The use of individual r-tests as a measure of profile similarity (or dissimilarity) only considers profile elevation and ignores shape and scatter. The present study used a more appropriate statistic for making group profile comparisons, Cattell’s Profile Similarity Coefficient [S]. This statistic takes into account all three dimensions of profile similarity, shape, scatter and elevation. A second problem is that of probabilit_y pyramiding [9]. An illustration.of probability pyramiding can be seen by examining Bloom et al. [l]. Dysmenorrhea and non-dysmenorrhea women were compared on the MMPI, PRF, and Tennessee Self Concept Scales. A total of 64 independent t-tests were calculated; of these, 10 were significant at the 0.05 level or better. Considering the pyramiding of alpha associated with large numbers of comparisons, a very high probability exists (96% in this case) that a Type I error was made. This makes Bloom et aZ.‘s results difficult to interpret. Previous investigations typically have used only subject responses on screening questionnaires to identify dysmenorrhea sufferers from non-sufferers. The present investigation, however, used women who were under a physician’s care for severe menstrual discomfort. Finally, unlike previous studies, dysmenorrhea and non-dysmenorrhea women were matched on age within one year’s difference.

METHOD

Subjects The dysmenorrhea group (D-group) consisted of women (n = 31) for whom traditional gynecological treatment had run its course with no results. It should be noted that these women were a’subset of a group of women who sought biofeedback and relaxation training as last resort for symptom relief. Therefore, 1653

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1654

all of the women had consulted a gynecologist for severe dysmenorrhea symptoms. Gynecological examinations revealed, according to the women, no physical abnormalities. These women complained of severe cramping. nausea, headaches and excessive bloatedness during their menstrual periods. These women also reported that at some time during their menstrual period they had to curtail or suspend their daily activities. All women noted that they had experienced symptoms for at least 5 years. None of the D-group women were using birth control pills, IUDs, or any type of hormonal medication. All of the D-group women had some sexual experience. With respect to marital status the group was mixed with some women married, never married, and divorced. All of the D-group women were either working or enrolled at various educational levels in area universities. The career range ran from secretaries to attorneys. The age range of these women was 20 to 34 (M = 26; SD = 3.6). D-group participants were respondents to advertisements placed upon university bulletin boards and in newsletters of organizations concerned with women’s health issues. No fee was charged for the service. The ND-group was made up from a pool of 140 women graduate students enrolled in a psychological assessment course over a three year period. It was from this pool that 31 women, who declared no menstrual discomfort, were selected randomly and matched with D-group members according to age.

*

D-group M

Procedure

and analysis

Upon initial contact with the treatment service all women were interviewed by a female therapist. It was at this point that the 16PF was assigned. The ND-group completed the 16PF as a part of a class exercise dealing with developing skills for interpreting same. In both situations the use of the 16PF for the purpose of this study was not revealed to the subjects. The mean profiles for the D and ND groups are presented in Fig. 1. The D and ND profiles were analyzed using the profile similarity coefficient (rp) for group to group comparisons. Finally, a measure of general neuroticism was calculated for the D-group [8].

RESULTS AND DISCUSSION

The rp value for 16PF factqrs A though Q4 was 0.79 (P < 0.01). For the second order factors rp = 0.96 (P < 0.01). These results indicate a high degree of similarity between the D and ND personality profiles. The mean neuroticism value for the D-group was 5.7 stens (SD = 1.9). These results lend support to the position that Dgroup women are quite similar to the ND-group in terms of personality characteristics as measured by the 16PF. For the most part, the D and ND personality profiles were decidedly within the average range. Both

ND-group

16 PF 456

factors

t

SD

M

SD

1.7

5.0

I .6

Reserved

6.7

1.8

6.5

1.7

Less

5.2

2.4

5.1

2.1

Affected

7.3

2. I

7.4

I.8

Humble

Asserttve

4.7

Fig.

Note

789 Outgoing More

intelligent

intelligent

Emotionally

by feelings

stable

5.7

2. I

6.4

I.9

Sober

Happy-go-lucky

5.0

1.9

5.0

1.4

Expedient

Conclentlous

6. I

1.9

6. I

2.0

SW

Venturesome Tender -mInded

69

I 9

6.9

2.3

Tough - mmded

64

2.4

59

1.7

Trusting

Suspicious

6.2

1.6

70

I.3

Proct icol

Imogmative Astute

4.9

2.2

4.7

2.2

Forthrlght

5.9

2.3

5.3

2.2

Self -assured

Apprehensive

6.5

I.9

6.0

I.6

Conservative

Experlmentlng

65

I.6

6.2

I6

Group

5.3

I. 9

6.0

2.1

Undisciplined

6. I

2.2

6.2

2.2

8.0

14

82

15

Introverted

Extroverted

6.0

22

57

21

Low anxiety

High

6.5

2.0

6.4

I.8

EmotIonally

7. 3

I 5

7. 7

I.5

Subdued

I. Mean

16PF

profiles ND-group

dependant

Relaxed

. . .,Q2. . .

Self

. . fQ3. . . c. ‘0,.

Control led

. . . .

Tense

Tough

tenderminded . .

. Q,&.

.

sufficient

anxiety

,

poised

Independent

*D- group = dysmenorrhea for D and ND group. = non-dysmenorrhea (---) group. tSten scores.

group

(--_);

Research

groups were slightly elevated with respect to assertiveness, while the ND-group appeared slightly. but not significantly. more imaginative. In terms of neuroticism, as measured by the l6PF, the results again indicated no abnormalities for the D-group. This study sought to address several methodological problems associated with previous research to determine whether reliable differences in personality could be demonstrated between women who suffered from dysmenorrhea and those who did not. In view of the statistical and methodological problems associated with previous studies in this area. it is difficult to determine whether differences in personality profiles were reliable or perhaps were due to statistical artifacts. Considering the number of methodological problems associated with the studies where personality differences were found between D and ND groups, it is highly probable that their findings were due to artifacts. The results obtained from the present study, which used a more appropriate statistic for comparing group personality profiles. indicate that no dysmenorrhea personality, as such, can be demonstrated. From a clinical standpoint, the D-group l6PF personality profile was found to be no different than the profile of the randomly selected and matched NDgroup. Furthermore, the D-group profile showed no psychological abnormalities whatsoever. Considering the data in this area as a whole, it is apparent that little, if any, relationship has been found between personality characteristics and the incidence of dysmenorrhea. Given our present level of inform-

Note

1655

ation. one might speculate that dysmenorrhea may be a bona fide medical disorder that may not be interactive with personality characteristics.

REFERENCES

I. Bloom L. S.. Shelton J. L. and Michaels A. C. Dysmenorrhea and personality. J. Person. Assess. 42, No. 3, 272-276, 1978. 2. Coppen A. and Kessel N. Menstruation and personalitv. Br. J. Psvchiar. 109. 711-721. 1963. 3. Hurt M.. Ku& R. and Ross D. W. The relationship between dysmenorrhea and selected personality variables. Ps.vcho.~omafics 8, 35C353. 1967. 4. Kehoe P. Psychological factors in the experience of premenstrual and menstrual symptomatology. Diss. Absrr. Int. 38, 6161. 1978. 5. Steingarten K. A. The relationship between psychological variables and menstrual distress. Diss. Ahstr. Int. 38, 3912, 1978. A. L. Type of menstrual 6. Woods D. J. and Launius discomfort and psychological mascuhnity in college women. Psvchol. Rep. 44, 257-258, 1979. 7. Wiggins J. Personality and Prediction: Principles of Per%malit.v Assessmen;. Addison-Wesley. CA, i 973. M. M. 8. Cattell R. B.. Ebber W. W. and Tatsuoka Handbook ,for [he Sixleen Personali?,! Factor Questionnaire (16PF). Institute for Personality and Ability Testing, IL, 1970. pyramiding, research error and 9. Neher A. Probability the need for independent replication. Psvchol. Rec. 17, 257-262. 1967