RESEARCH PAPER
Posttraumatic stress symptoms in women with gynaecologic pathology: the role of temperament, self-esteem and mental health
More details
Hide details
1
Faculty of Psychology, University of Warsaw, Warsaw, Poland
2
Institute of Psychology, Kazimierz Wielki University, Bydgoszcz, Poland
3
Department of Gynaecology and Obstetrics, Hospital Medical Centre, Goleniów, Poland
Submission date: 2016-03-18
Final revision date: 2016-06-23
Acceptance date: 2016-07-05
Online publication date: 2016-08-09
Publication date: 2016-12-05
Current Issues in Personality Psychology 2016;4(4):196-205
KEYWORDS
TOPICS
ABSTRACT
Background
Women with gynaecological pathology are affected by diseases associated with their femininity, attractiveness and fertility. Diseases like these can potentially be sources of trauma for women. The aim of this cross-sectional study was to investigate temperament traits, self-esteem and mental health dimensions that may contribute to the intensity of trauma in hospitalized women.
Participants and procedure
The study was conducted on 136 women aged from 18 to 60, hospitalized for a variety of gynaecological diseases. The level of trauma symptoms was assessed with the PTSD-Factorial Version inventory. Temperament traits were assessed with the Formal Characteristics of Behaviour – Temperament Inventory (FCB-TI), self-esteem was measured using the Multidimensional Self-Esteem Inventory, and mental health was diagnosed with the General Health Questionnaire – 28 items.
Results
Emotional reactivity and anxiety symptoms increase trauma symptom intensity in gynaecological patients, whereas briskness, endurance and lovability as a dimension of self-esteem may serve as protective buffers against intensification of trauma symptoms. Together, emotional reactivity, anxiety symptoms and lovability account for 48% of the variance of trauma intensity symptoms.
Conclusions
Emotional reactivity and anxiety symptoms increase trauma symptom intensity in gynaecological patients, whereas lovability as a dimension of self-esteem (and to a lesser extent briskness and endurance as temperament traits) may serve as protective buffers against intensification of trauma symptoms. The findings may have implications for the social support programmes that may be arranged for gynaecological patients.
REFERENCES (60)
1.
American Psychiatric Association, APA. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
2.
Asmundson, G. (2014). The emotional and physical pains of trauma: Contemporary and innovative approaches for treating co-occurring PTSD in chronic pain. Depression & Anxiety, 31, 717–720. doi: 10.1002/da.22285.
3.
Babson, K. A., & Feldner, M. T. (2010). Temporal relations between sleep problems and both traumatic event exposure and PTSD: A critical review of the empirical literature. Journal of Anxiety Disorders, 24, 1–15. doi: 10.1016/j.janxdis.2009.08.002.
4.
Bal, M. D., Yilmaz, S. D., & Beji, N. K. (2013). Sexual health in patients with gynecological cancer: A qualitative study. Sexuality and Disability, 31, 83–92. doi: 10.1007/s11195-012-9263-7.
5.
Besser, A., Weinberg, M., Zeigler-Hill, V., & Neria, Y. (2014). Acute symptoms of posttraumatic stress and dissociative experiences among female Israeli civilians exposed to war: The roles of intrapersonal and interpersonal sources of resilience. Journal of Clinical Psychology, 70, 1227–1239. doi: 10.1002/jclp.22083.
6.
Bradley, R., Schwartz, A. C., & Kaslow, N. J. (2005). Posttraumatic stress disorder symptoms among low-income, African American women with a history of intimate partner violence and suicidal behaviors: Self-esteem, social support, and religious coping. Journal of Traumatic Stress, 18, 685–696. doi: 10.1002/jts.20077.
7.
Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68, 748–766. doi: 10.1037/0022-006X.68.5.748.
8.
Chung, M. C., Berger, Z., Jones, R., & Rudd, H. (2008). Posttraumatic stress and co-morbidity following myocardial infarction among older patients: The role of coping. Aging and Mental Health, 12, 124–133. doi: 10.1080/13607860701366152.
9.
Chung, M. C., Farmer, S., Grant, K., Newton, R., Payne, S., Perry, M., …, Stone, N. (2002). Self-esteem, personality and posttraumatic stress symptoms following the dissolution of a dating relationship. Stress and Health, 18, 83–90. doi: 10.1002/smi.929.
10.
Cipkala-Gaffin, J., Talbott, E. O., Song, M. K., Bromberger, J., & Wilson, J. (2012). Associations between psychologic symptoms and life satisfaction in women with polycystic ovary syndrome. Journal of Women’s Health, 21, 179–187. doi: 10.1089/jwh.2010.2541.
11.
Darwish, M., Atlantis, E., & Mohamed-Taysir, T. (2014). Psychological outcomes after hysterectomy for benign conditions: a systematic review and meta-analysis. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 174, 5–19. doi: 10.1016/j.ejogrb.2013.12.017.
12.
Deeks, A. A., Gibson-Helm, M. E., & Teede, H. J. (2010). Anxiety and depression in polycystic ovary syndrome: a comprehensive investigation. Fertility and Sterility, 7, 2421–2423. doi: 10.1016/j.fertnstert.2009.09.018.
13.
Ehrström, S., Kornfeld, D., & Rylander, E. (2007). Perceived stress in women with recurrent vulvovaginal candidiasis. Journal of Psychosomatic Obstetrics and Gynecology, 28, 169–176. doi: 10.1080/01674820601168176.
14.
Ehrström, S., Kornfeld, D., Rylander, E., & Bohm-Starke, N. (2009). Chronic stress in women with localised provoked vulvodynia. Journal of Psychosomatic Obstetrics and Gynecology, 30, 73–79. doi: 10.1080/01674820802604359.
15.
Elliott, R., McKinley, S., Fien, M., & Elliott, D. (2016). Posttraumatic stress symptoms in intensive care patients: An exploration of associated factors. Rehabilitation Psychology, 61, 141–150. doi: 10.1037/rep0000074.
16.
Fruehstorfer, D. B., Veronie, L., Cremeans-Smith, J. K., & Newberry, B. H. (2012). Predicting illness-related outcomes with the FCB-TI trait pairs: Examining the nonadditive effects of FCB-TI perseveration. Journal of Individual Differences, 4, 248–256. doi: 10.1027/1614-0001/a000070.
17.
Gandyk, A. D., Brenner, I., Tranmer, J., & Van Den Kerkhof, E. (2011). Depressive symptoms before and after elective hysterectomy. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 40, 566–576. doi: 10.1111/j.1552-6909.2011.01278.x.
18.
Gilbert, E., Ussher, J. M., & Perz, J. (2011). Sexuality after gynaecological cancer: A review of the material, intrapsychic, and discursive aspects of treatment on women’s sexual-wellbeing. Maturitas, 70, 42–57. doi: 10.1016/j.maturitas.2011.06.013.
19.
Gold, J. I., Douglas, M. M. K., Thomas, M. L., Elliott, J. E., Rao, S. M., & Miaskowski, C. (2012). The relationship between posttraumatic stress disorder, mood states, functional status, and quality of life in oncology outpatients. Journal of Pain and Symptom Management, 44, 520–531. doi: 10.1016/j.jpainsymman.2011.10.014.
20.
Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139–145.
21.
Gonçalves, V., Jayson, G., & Tarrier, N. (2011). A longitudinal investigation of posttraumatic stress disorder in patients with ovarian cancer. Journal of Psychosomatic Research, 70, 422–431. doi: 10.1016/j.jpsychores.2010.09.017.
22.
Green, T., Neria, Y., & Gross, R. (2016). Prevalence, detection and correlates of PTSD in the primary care setting: A systematic review. Journal of Clinical Psychology in Medical Settings, 23, 160–180. doi: 10.1007/s10880-016-9449-8.
23.
Greimel, E., Dorfer, M., Lambauer, M., Bjelic-Radisic, V., Gramm, S., Lahousen, M., …, Lang, U. (2013). Posttraumatic stress disorder in female cancer patients: An inappropriate diagnosis in oncology? Psychotherapy and Psychosomatics, 82, 271–272. doi: 10.1159/000348610.
24.
Guglietti, C. L., Rosen, B., Murphy, K. J., Laframboise, S., Dodge, J., Ferguson, S., …, Ritvo, P. (2010). Prevalence and predictors of posttraumatic stress in women undergoing an ovarian cancer investigation. Psychological Services, 7, 266–274. doi: 10.1037/a0020338.
25.
Horsham, S., & Chung, M. C. (2013). Investigation of the relationship between trauma and pain catastrophising: The roles of emotional processing and altered self-capacity. Psychiatry Research, 208, 274–284. doi: 10.1016/j.psychres.2012.11.031.
26.
Hutti, M. H., Armstrong, D. S., Myers, J. A., & Hall, L. A. (2015). Grief intensity, psychological well‐being, and the intimate partner relationship in the subsequent pregnancy after a perinatal loss. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 44, 42–50. doi: 10.1111/1552-6909.12539.
27.
IBM Corp. (2012). IBM SPSS Statistics 21 core system user’s guide. Somers, NY: IBM Corp.
28.
Jakšić, N., Brajković, L., Ivezić, E., Topić, R., & Jakovljević, M. (2012). The role of personality traits in posttraumatic stress disorder (PTSD). Psychiatria Danubina, 24, 256–266.
29.
Jones, G., Jenkinson, C., & Kennedy S. (2004). The impact of endometriosis upon quality of life: A qualitative analysis. Journal of Psychosomatic Obstetrics and Gynecology, 25, 123–133. doi: 10.1080/01674820400002279.
30.
Jones, G. L., Hall, J. M., Lashen, H. L., Balen, A. H., & Ledger, W. L. (2011). Health‐related quality of life among adolescents with polycystic ovary syndrome. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 40, 577–588. doi: 10.1111/j.1552-6909.2011.01279.x.
31.
Kandler, C., Held, L., Kroll, C., Bergeler, A., Riemann, R., & Angleitner, A. (2012). Genetic links between temperamental traits of the Regulative Theory of Temperament and the Big Five. Journal of Individual Differences, 33, 197–204. doi: 10.1027/1614-0001/a000068.
32.
Khastgir, G., Studd, J. W., & Catalan, J. (2000). The psychological outcome of hysterectomy. Gynecological Endocrinology, 14, 132–141. doi: 10.3109/09513590009167672.
33.
Laganà, L., Classen, C., Caldwell, R., McGarvey, E. L., Baum, L. D., Cheasty, E., …, & Koopman, C. (2005). Sexual difficulties of patients with gynecological cancer. Professional Psychology: Research and Practice, 36, 391–399. doi: 10.1037/0735-7028.36.4.391.
34.
Lammerink, E. A. G., de Bock, G. H., Pras, E., Reyners, A. K. L., & Mourits, M. J. E. (2012). Sexual functioning of cervical cancer survivors: A review with a female perspective. Maturitas, 72, 296–304. doi: 10.1016/j.maturitas.2012.05.006.
35.
Leppert, P. C., Legro, R. S., & Kjerulff, K. H. (2007). Hysterectomy and loss of fertility: Implications for women’s mental health. Journal of Psychosomatic Research, 63, 269–274. doi: 10.1016/j.jpsychores.2007.03.018.
36.
Livadas, S., Chaskou, S., Kandaraki, A. A., Skourletos, G., Economou, F., Christou, M., …, & Diamanti-Kandarakis, E. (2011). Anxiety is associated with hormonal and metabolic profile in women with polycystic ovarian syndrome. Clinical Endocrinology, 75, 698–703. doi: 10.1111/j.1365-2265.2011.04122.x.
37.
Månsson, M., Holte, J., Landin-Wilhelmsen, K., Dahlgren, E., Johansson, A., & Landén, M. (2008). Women with polycystic ovary syndrome are often depressed or anxious – a case control study. Psychoneuroendocrinology, 33, 1132–1138. doi: 10.1016/j.psyneuen.2008.06.003.
38.
Marmot, M. (2003). Self-esteem and health: Autonomy, self-esteem, and health are linked together. BMJ: British Medical Journal, 327, 574–575. doi: 10.1136/bmj.327.7415.574.
39.
Moye, J., & Rouse, S. (2014). Posttraumatic stress in older adults: When medical diagnoses or treatments cause traumatic stress. Clinics in Geriatric Medicine, 30, 577–580. doi: 10.1016/j.cger.
40.
Nappi, C. M., Drummond, S., & Hall, J. M. H. (2012). Treating nightmares and insomnia in posttraumatic stress disorder: A review of current evidence. Neuropharmacology, 62, 576–585. doi: 10.1016/j.neuropharm.2011.02.029.
41.
O’Brien, E. J., & Epstein, S. (1988). MSEI: The Multidimensional Self-esteem Inventory (2nd ed.). Odessa, FL: Psychological Assessment Resources, Inc.
42.
Oniszczenko, W., & Laskowska, A. (2014). Emotional reactivity, coping style and cancer trauma symptoms. Archives of Medical Science, 1, 110–116. doi: 10.5114/aoms.2013.33069.
43.
Petrelluzzi, K. F. S., Garcia, M. C., Petta, C. A., Grassi-Kassisse, D. M., & Spadari-Bratfisch, R. C. (2008). Salivary cortisol concentrations, stress and quality of life in women with endometriosis and chronic pelvic pain. Stress: The International Journal on the Biology of Stress, 5, 390–397. doi: 10.1080/10253890701840610.
44.
Phifer, J., Skelton, K., Weiss, T., Schwartz, A. C., Wingo, A., Gillespie, C. F., …, & Ressler, K. J. (2011). Pain symptomatology and pain medication use in civilian PTSD. Pain, 152, 2233–2240. doi: 10.1016/j.pain.2011.04.019.
45.
Ratner, E. S., Erekson, E. A., Minkin, M. J., & Foran-Tuller, K. A. (2011). Sexual satisfaction in the elderly female population: A special focus on women with gynecologic pathology. Maturitas, 70, 210–215. doi: 10.1016/j.maturitas.2011.07.015.
46.
Raza, N., Waqas, A., & Jamal, M. (2015). Post-operative anxiety, depression and psychiatric support in patients undergoing hysterectomy: A cross sectional survey. The Journal of the Pakistan Medical Association, 65, 443–445.
47.
Roy-Byrne, P. P., Davidson, K. W., Kessler, R. C., Asmundson, G. J. G., Goodwin, R. D., Kubzansky, L., …, & Stein, M. B. (2008). Anxiety disorders and comorbid medical illness. General Hospital Psychiatry, 30, 208–225. doi: 10.1016/j.genhosppsych.2007.12.006.
48.
Rzeszutek, M., Oniszczenko, W., & Firląg-Burkacka, E. (2012). Temperament traits, coping style and trauma symptoms in HIV+ men and women. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, 24, 1150–1154. doi: 10.1080/09540121.2012.687819.
49.
Safarinejad, M. R., Shafiei, N., & Safarinejad, S. (2013). Quality of life and sexual functioning in young women with early‐stage breast cancer 1 year after lumpectomy. Psycho-Oncology, 22, 1242–1248. doi: 10.1002/pon.3130.
50.
Sepulcri, R., & Amaral, V. (2009). Depressive symptoms, anxiety, and quality of life in women with pelvic endometriosis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 142, 53–56. doi: 10.1016/j.ejogrb.2008.09.003.
51.
Strelau, J. (1996). The regulative theory of temperament: Current status. Personality and Individual Differences, 20, 131–142. doi: 10.1016/0191-8869(95)00159-X.
52.
Strelau, J. (2008). Temperament as a regulator of behavior: After fifty years of research. New York: Eliot Werner Publications, Inc.
53.
Strelau, J., & Zawadzki, B. (1995). The formal characteristics of Behavior–Temperament Inventory (FCB-TI): Validity studies. European Journal of Personality, 9, 207–229. doi: 10.1002/per.2410090304.
54.
Strelau, J., Zawadzki, B., Oniszczenko, W., & Sobolewski, A. (2002). Kwestionariusz PTSD – wersja czynnikowa (PTSDC). Konstrukcja narzędzia do diagnozy głównych wymiarów zespołu stresu pourazowego [The factorial version of the PTSD Inventory (PTSD-F): The development of a questionnaire aimed at assessing basic dimensions of posttraumatic stress disorder]. Przegląd Psychologiczny, 45, 149–176.
55.
Taubman-Ben-Ari, O., Rabinowitz, J., Feldman, D., & Vaturi, R. (2001). Post-traumatic stress disorder in primary-care settings: prevalence and physicians’ detection. Psychological Medicine, 31, 555–560. doi: 10.1017/S0033291701003658.
56.
Tedstone, J., & Tarrier, N. (2003). Posttraumatic stress disorder following medical illness and treatment. Clinical Psychology Review, 23, 409–448. doi: 10.1016/S0272-7358(03)00031-X.
57.
Yen, J. Y., Chen, Y. H., Long, C. Y., Chang, Y., Yen, C.F., Chen, C.C., …, & Ko, C. H. (2008). Risk factors for major depressive disorder and the psychological impact of hysterectomy: a prospective investigation. Psychosomatics, 49, 137–142. doi: 10.1176/appi.psy.49.2.137.
58.
Ying, L. Y., Wu, L. H., & Loke, A. Y. (2015). Gender differences in experiences with and adjustments to infertility: A literature review. International Journal of Nursing Studies, 52, 1640–1652. doi: 10.1016/j.ijnurstu.2015.05.004.
59.
Watson, D., & Naragon-Gainey, K. (2014). Personality, emotions, and the emotional disorders. Clinical Psychological Science, 2, 422–442.
60.
Wright, K. M., Britt, T. W., Bliese, P. D., Adler, A. B., Picchioni, D., & Moore, D. (2011). Insomnia as predictor versus outcome of PTSD and depression among Iraq combat veterans. Journal of Clinical Psychology, 67, 1240–1258. doi: 10.1002/jclp.20845.
Copyright: © Institute of Psychology, University of Gdansk This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (
https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.