title: The association between somatization and perceived ability: roles in dysmenorrhea among Israeli Arab adolescents.
abstract: OBJECTIVE
  The aim of this study was to investigate whether somatization and attitudes toward menstruation predict the incidence of pain intensity and dysmenorrhea among Israeli Arab adolescent females.
  
  
  METHODS
  Participants were 160 Israeli Arab adolescents, including 50 Muslims, 50 Christians, and 60 Druze. A 20-item questionnaire was used to assess attitudes regarding menstruation. The short version of the Brief Symptom Inventory was used to measure the level of somatization.
  
  
  RESULTS
  Factor analysis of the Attitudes Toward Menstruation Instrument revealed two significant composites: perceived ability and impurity during menstruation. High levels of somatization predicted pain intensity and low levels of perceived ability predicted the prevalence of dysmenorrhea. Although the Israeli Muslim adolescents revealed higher levels of somatization as compared with their Christian and Druze counterparts and the Druze revealed the lowest levels of perceived ability compared with the other subgroups, no significant role for ethnicity and impurity was found. No differences were found between groups in scores of menstrual pain and prevalence of dysmenorrhea. Higher levels of somatization and lower levels of perceived ability, as well as a greater portion of Muslim and Druze and higher levels of religiosity, were found among rural residents.
  
  
  CONCLUSIONS
  The role of cultural variables and personality traits in the complexity of dysmenorrhea as a socio-bio-psychological phenomenon is proposed in light of contemporary interactive models. It is suggested that within the Israeli Arab minorities the impact of cultural background on health affects more the perceptual and cognitive levels and are not generalized to overt behavior and morbidity such as dysmenorrhea.
authors.affiliation: Department of Nursing, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel. sarig@research.haifa.ac.il
authors.forename: Sari
authors.initials: S
authors.lastname: Goldstein-Ferber
authors.forename: Michal
authors.initials: M
authors.lastname: Granot
mesh_terms: D000293:Adolescent; D001076:Aptitude; D018912:Arabs; D001294:Attitude to Health; D003431:Cross-Cultural Comparison; D004412:Dysmenorrhea / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D007557:Israel; D008598:Menstruation / Q000523:psychology*; D010146:Pain / Q000209:etiology / Q000523:psychology*; D012068:Religion and Medicine; D012424:Rural Population; D013001:Somatoform Disorders / Q000150:complications / Q000523:psychology*