Thesis Hsf 2018 Sieberhagen S

Investigating relationships between women’s moods and their menstrual cycles – a multi- method study by STEPHANIE SIEBERHAGEN SBRSTE002 SUBMITTED TO THE UNIVERSITY OF CAPE TOWN In fulfilment of the requirements for the degree Doctor of Philosophy Department of Psychiatry and Mental Health - Faculty of Health Sciences UNIVERSITY OF CAPE TOWN 20 August 2018 Prof Colleen Adnams, Department of Psychiatry, University of Cape Town Prof Lillian Artz, Gender Health and Justice Research Unit, University of Cape Town University of Cape Town The copyright of this thesis vests in the author. No quotation from it or information derived from it is to be published without full acknowledgement of the source. The thesis is to be used for private study or non- commercial research purposes only. Published by the University of Cape Town (UCT) in terms of the non-exclusive license granted to UCT by the author. University of Cape Town Declaration I, Stephanie Sieberhagen, hereby declare that the work on which this dissertation/thesis is based is my original work (except where acknowledgements indicate otherwise) and that neither the whole work nor any part of it has been, is being, or is to be submitted for another degree in this or any other university. I empower the University to reproduce for the purpose of research either the whole or any portion of the contents in any manner whatsoever. Signature: Date: 20 August 2018 th Abstract A multi-method study was conducted to investigate the relationships between a woman’s menstrual-cycle and her moods. Twenty eight participants were recruited using convenience sampling. Each participant provided data for two full menstrual cycles by taking part in a pre and post-study in-depth interview; answering a structured daily self-report diary utilising a Likert scale and completing three established research instruments – the Brunel Scale of Moods, the Menstrual Distress Questionnaire and the Born-Steiner Irritability Questionnaire, weekly. Interviews were conducted in person and quantitative data were collected electronically via e-mail. The mixed-methods methodology resulted in quantitative data that were analysed using STATA statistical software and the ecological multivariate data analysis software package known as PRIMER. Results from the statistical software were represented graphically and indicated that there is a relationship between menstrual cycle days and moods, with individual women’s correlations differing from each other to some extent. The data confirmed that there are groups of women who follow a very similar mood pattern and that educational level, vocation, exercise and participation in volunteer work or hobbies defines these groups to some degree. The qualitative data supported these findings and indicated the impact of menstrual cycle related moods on women’s daily functioning. The study concludes that menstrual cycle related moods play a role in overall life satisfaction and that psycho education and awareness can improve overall quality of life. ii Acknowledgements I hereby acknowledge the funding from the KW Johnston Bursary as well as from the Department of Psychiatry and Mental Health at the University of Cape Town (UCT) that assisted in paying for my tuition fees, statistical fees and clinical blood tests. I wish to acknowledge and thank Prof. Lillian Artz (Gender Health and Justice Research Unit) and Prof. Colleen Adnams (Department of Psychiatry and Mental Health), both from UCT, for agreeing to be my supervisors and all the hours of work they dedicated to my research and writing. I wish to thank Prof. Dan Stein of the Department of Psychiatry and Mental Health for agreeing to take me on as a student in his department and assisting me in finding a suitable supervisor. My thanks go to Prof. Jack van Honck who consulted with me at the outset of my research. I would also like to thank the UCT Statistical Sciences Department, especially Prof. Franceska Little and Anneli Hardy for their guidance and input. A word of thanks to Dilshaad Brey (UCT) for her invaluable input in searching for and referencing resources. I would like to acknowledge Prof. Minette Coetzee of the Child Nurse Practice Development Initiative for her support and granting me much needed study leave at critical times during the thesis writing process. My heartfelt thanks goes to Prof Lynn Denny (UCT) for her guidance regarding the gynaecological elements of the study as well as to Dr Malika Patel from UCT and Grootte Schuur Hospital for her invaluable input with all endocrine related matters. Thank you to Dr Karl Reinecke and Rozwe Magoba for their guidance with Primer. I would also like to thank Dr Charles van Wijk with his help with the Brunel Scale of Moods (BRUMS) and Dr Leslie Born for her help with the Born Steiner Irritability Scale (BIQ). A big burden of gratitude belongs to all my participants who dedicated a great deal of time and emotions to completing all aspects of the study with honesty and patience. I would like to acknowledge the support from my family over the last five years, especially the tolerance of my children, Rohen and Connor Le Roux, and the guidance received from my life coach, Anissa Yardley. My greatest debt of gratitude goes to my partner, Prof. Cate Brown, for her full emotional, academic and financial support. iii Table of contents 1 INTRODUCTION .......................................................................................................... 1 1.1 RESEARCH QUESTIONS ............................................................................................................ 3 1.2 STUDY MOTIVATION AND AIMS ................................................................................................. 4 1.3 DISSERTATION OUTLINE ........................................................................................................... 5 2 LITERATURE REVIEW ................................................................................................... 8 2.1 A BACKGROUND ON MENSTRUAL CYCLE PHASES AND PMS ............................................................. 8 2.2 22)LITERATURE ABOUT THE DEVELOPMENT OF RESEARCH METHODS RELEVANT TO THIS STUDY ............ 17 2.3 SHIFTING PARADIGMS WITHIN MENSTRUAL CYCLE RESEARCH ........................................................ 29 2.4 MORE RECENT RESEARCH IN THE FIELD ..................................................................................... 33 3 THEORETICAL FRAMEWORK ..................................................................................... 48 3.1 PHILOSOPHICAL UNDERPINNING.............................................................................................. 48 3.2 METHODOLOGY .................................................................................................................. 52 3.2.1 Disciplinary scope of the research ................................................................................. 54 3.2.2 Multi-methods approach ............................................................................................... 55 3.2.3 Systems Theory .............................................................................................................. 58 3.2.3.1 First Order Systems Theory .................................................................................................. 63 Recursion ....................................................................................................................................... 63 Feedback ....................................................................................................................................... 64 Morphostasis/Morphogenesis ...................................................................................................... 64 Rules and boundaries .................................................................................................................... 64 Openness/Closedness and Entropy/Negentropy .......................................................................... 64 Equifinality/Equipotentiality .......................................................................................................... 65 Communication and information processing ................................................................................ 65 Relationship and wholeness .......................................................................................................... 66 3.2.3.2 In conclusion ........................................................................................................................ 66 4 RESEARCH DESIGN .................................................................................................... 67 4.1.1 Research participants .................................................................................................... 68 4.1.1.1 Defining the research population ........................................................................................ 68 4.1.1.2 The recruitment of research participants ............................................................................ 70 4.2 APPLICATION OF RESEARCH INSTRUMENTS ................................................................................ 76 4.2.1 Research instruments excluded ..................................................................................... 79 4.2.2 Research instruments used ............................................................................................ 83 4.2.2.1 MMSQ .................................................................................................................................

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