Using a Menstrual Emotional Stroop Task Test (MEST) to Measure Emotional Responses to Menstrual Cycle Pain

Abstract

The purpose of this study was to configure and test a Menstrual-related Emotional Stroop Task (MEST) to assess differences in emotional responsiveness of healthy cycling women in order to identify the effects of pain anticipation, anxiety and depression symptomatology. Participants included 40 healthy women between 21 and 51 years of age, with regular menstrual cycles who completed questionnaires on sociodemographics, menstrual cycle characteristics, nicotine use, and alcohol consumption. The numeric pain rating scale (Visual Analogue Scale or VAS) was used to assess perceived levels of menstrual pain. Twice during their menstrual cycle (follicular phase and premenstrual phase, 3-5 days before menses), we administered the MEST, the VAS, the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory II (BDI-II). Subjects reporting higher levels of pain (VAS score >7, n=7) had the longest reaction time in the MEST, specifically in the premenstrual phase compared to those with mild (VAS score 1-3, n=22) levels of menstrual pain, possibly indicating an "anticipatory stress" emotional response to their impending menses. Linear regression analysis revealed correlations between depression levels and performance in MEST during the premenstrual phase. Overall, our data suggest that emotional responses are deeply affected by the anticipation of menstrual pain and are associated with depression. Moreover, this study indicates that MEST is an effective tool to obtain information about the emotional impact of menstrual pain and identifies associated impairments in attentional processes. These results have implications for the development of pain management skills and psycho-education programs for women suffering from painful conditions such as endometriosis.

The role of catastrophizing in chronic cyclical pelvic pain: A systematic review and meta-analysis

“… 34 , 35 In further support of this anticipatory effect, women with severe CCPP have a stronger emotional reaction to menstrual-related words in a modified version of the Stroop task during the late luteal (premenstrual) phase compared to during the mid-follicular phase (after menstruation). 36 Thus, catastrophizing represents a critical mechanism through which women’s anticipation, expectation, attention, and worry about menstrual pain may be increased, potentially leading to increased experiences of pain.…”