title: Exploring self-image during hot flushes using a semantic differential scale: associations between poor self-image, depression, flush frequency and flush distress.
abstract: OBJECTIVE
  This study developed a semantic differential scale for assessing self-image during hot flushes, based on a previously published scale (Nursing Res. 35 (1986) 81). The objectives were to explore the sensitivity and validity of this scale, and to examine whether poor self-image during hot flushes is linked to flush distress, perceived control, flush frequency, flush chronicity, self-esteem and depression.
  
  
  METHODS
  Two community samples of women with current experience of hot flushes completed a postal questionnaire.
  
  
  RESULTS
  The semantic differential scale was sensitive to individual differences in self-image, and was validated through its association with measured self-esteem using a standardised scale. Defining the self in negative ways during flushes was highly predictive of flush distress. Poor self-image was also closely associated with depression. Correlations with perceived control, and flush frequency were weaker and did not reach significance in the second, smaller sample.
  
  
  CONCLUSIONS
  The study extends previous findings that women low in self-esteem have more difficulty coping with menopausal changes, by showing that negative self-appraisal during flushes (e.g. defining self as unattractive or dirty) are highly demoralising and associated with distress. The findings suggest that cognitive behavioural strategies of challenging and re-interpreting thoughts about self could be helpful in moderating the discomfort and stressfulness of hot flushes for women not taking HRT. However, the findings are based on relatively small, volunteer samples and require further replication.
authors.affiliation: Department of Health and Social Care, Brunel University, West London, Osterley Campus, Borough Road, Isleworth, Middlesex TW7 5DU, UK. francesreynolds@brunel.ac.uk
authors.forename: Frances
authors.initials: F
authors.lastname: Reynolds
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000523:psychology; D003627:Data Interpretation, Statistical; D003863:Depression / Q000523:psychology*; D005260:Female; D019584:Hot Flashes / Q000523:psychology*; D006801:Humans; D008593:Menopause / Q000523:psychology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012649:Self Concept; D012660:Semantics; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires