1
|
Favaretto E, Bedani F, Brancati GE, De Berardis D, Giovannini S, Scarcella L, Martiadis V, Martini A, Pampaloni I, Perugi G, Pessina E, Raffone F, Ressico F, Cattaneo CI. Synthesising 30 years of clinical experience and scientific insight on affective temperaments in psychiatric disorders: State of the art. J Affect Disord 2024; 362:406-415. [PMID: 38972642 DOI: 10.1016/j.jad.2024.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/17/2024] [Accepted: 07/04/2024] [Indexed: 07/09/2024]
Abstract
The concept of affective temperament has been extensively discussed throughout the history of psychopathology and represents a cornerstone in the study of mood disorders. This review aims to trace the evolution of the concept of affective temperaments (ATs) from Kraepelin's seminal work to the present day. In the 1980s, Akiskal redefined Kraepelin's concept of affective temperaments (ATs) by integrating the five recognized ATs into the broader framework of the soft bipolar spectrum. This conceptualization viewed ATs as non-pathological predispositions underlying psychiatric disorders, particularly mood disorders. Epidemiological and clinical studies have validated the existence of the five ATs. Furthermore, evidence suggests that ATs may serve as precursors to various psychiatric disorders and influence clinical dimensions such as disease course, psychopathology, and treatment adherence. Additionally, ATs appear to play a significant role in moderating phenomena such as suicide risk and stress coping. Incorporating an evaluation of temperamental bases of disorders into the multidimensional psychiatric diagnostic process could enhance treatment optimization and prognosis estimation.
Collapse
Affiliation(s)
- E Favaretto
- Department of Addiction, South Tyrol Health Care, Bressanone, Italy.
| | - F Bedani
- Mercy University Hospital, Cork, IRELAND
| | | | - D De Berardis
- Department of Psychiatry, Azienda Sanitaria Locale 4, Teramo, ITALY.
| | - S Giovannini
- Department of Addiction, South Tyrol Health Care, Bressanone, Italy
| | - L Scarcella
- Department of Psychiatry, South Tyrol Health Care, Bressanone, Italy.
| | - V Martiadis
- Department of Mental Health, Asl Napoli 1 Centro, Naples, Italy
| | - A Martini
- Department of Mental Health, ASL CN2 Alba - Bra, Italy
| | - I Pampaloni
- National OCD and BDD Unit, South West London and St Georges NHS Trust, London, United Kingdom.
| | - G Perugi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
| | - E Pessina
- Department of Mental Health, ASL CN2 Alba - Bra, Italy
| | - F Raffone
- Department of Mental Health, Asl Napoli 1 Centro, Naples, Italy
| | - F Ressico
- Outpatient Unit Department of Mental Health Novara, Borgomanero, Italy
| | | |
Collapse
|
2
|
Kfoury M, Malaeb D, Moubarak P, Sakr F, Dabbous M, Hallit S, Fekih-Romdhane F, Obeid S. Mediating effect of suicidal ideation in the association between child abuse and premenstrual syndrome among female adults. BMC Womens Health 2024; 24:98. [PMID: 38326825 PMCID: PMC10848495 DOI: 10.1186/s12905-024-02949-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/02/2024] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Premenstrual symptoms encompass a range of physical, emotional, and behavioral changes that cyclically occur before menstruation. Childhood abuse has been associated with subsequent mental health challenges, yet its relationship with exacerbating premenstrual symptoms remains an understudied area. Furthermore, suicidal ideation often emerges from traumatic backgrounds such as child abuse, creating another layer of complexity. Given the rising suicide rates in Lebanon, and the concurrent increase in reported child abuse cases, this research focuses on the role of suicidal ideation as a mediator between child abuse and premenstrual syndrome. METHODS This cross-sectional study involved 915 female university students in Lebanon. Participants completed an online questionnaire encompassing demographic details, health lifestyle, the Premenstrual Symptoms Screening Tool (PSST), Columbia-Suicide Severity Rating Scale (C-SSRS), and Child Abuse Self Report Scale (CASRS-12). The mediation analysis was conducted using PROCESS MACRO v3.4 model 4; three pathways derived from this analysis: pathway A from the independent variable to the mediator, pathway B from the mediator to the dependent variable, Pathway C indicating the direct effect from the independent to the dependent variable. RESULTS The results of the mediation analysis showed that suicidal ideation mediated the association between all types of child abuse and the presence of PMS. Higher psychological (Beta = 0.21; p < 0.001), neglect (Beta = 0.02; p = 0.017), physical (Beta = 0.19; p < 0.001) and sexual (Beta = 0.20, p < 0.001) child abuse were significantly associated with higher suicidal ideation, which was significantly associated with the presence of PMS (Beta = 0.38, p = 0.001; Beta = 0.57, p < 0.001; Beta = 0.45, p < 0.001; and Beta = 0.50, p < 0.001) respectively. Finally, higher psychological (Beta = 0.17, p < 0.001), physical (Beta = 0.11, p = 0.024), but not sexual (Beta = 0.07, p = 0.198) child abuse was directly and significantly associated with the presence of PMS, whereas higher neglect (Beta = -0.06, p = 0.007) was significantly associated lower odds of having PMS. CONCLUSION This study highlights the mediating role of suicidal ideation in the complex association between different types of childhood abuse and premenstrual symptoms. The findings emphasize the need for trauma-informed care and tailored interventions to address the diverse impact of these factors. Recognizing the intricate relationships between child abuse, suicidal ideation, and PMS can aid healthcare providers in comprehensively addressing young women's mental and reproductive well-being. Trauma-informed care, tailored interventions and awareness of potential connections between childhood maltreatment are essential in managing these complex challenges.
Collapse
Affiliation(s)
- Maya Kfoury
- School of Arts and Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Perla Moubarak
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| |
Collapse
|
3
|
Laham BJ, Murthy SS, Hanani M, Clappier M, Boyer S, Vasquez B, Gould E. The estrous cycle modulates early-life adversity effects on mouse avoidance behavior through progesterone signaling. Nat Commun 2022; 13:7537. [PMID: 36476469 PMCID: PMC9729614 DOI: 10.1038/s41467-022-35068-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022] Open
Abstract
Early-life adversity (ELA) increases the likelihood of neuropsychiatric diagnoses, which are more prevalent in women than men. Since changes in reproductive hormone levels can also increase the probability of anxiety disorders in women, we examined the effects of ELA on adult female mice across the estrous cycle. We found that during diestrus, when progesterone levels are relatively high, ELA mice exhibit increased avoidance behavior and increased theta oscillation power in the ventral hippocampus (vHIP). We also found that diestrus ELA mice had higher levels of progesterone and lower levels of allopregnanolone, a neurosteroid metabolite of progesterone, in the vHIP compared with control-reared mice. Progesterone receptor antagonism normalized avoidance behavior in ELA mice, while treatment with a negative allosteric modulator of allopregnanolone promoted avoidance behavior in control mice. These results suggest that altered vHIP progesterone and allopregnanolone signaling during diestrus increases avoidance behavior in ELA mice.
Collapse
Affiliation(s)
- Blake J Laham
- Princeton Neuroscience Institute, Princeton, NJ, 08450, USA
| | | | - Monica Hanani
- Princeton Neuroscience Institute, Princeton, NJ, 08450, USA
| | - Mona Clappier
- Princeton Neuroscience Institute, Princeton, NJ, 08450, USA
| | - Sydney Boyer
- Princeton Neuroscience Institute, Princeton, NJ, 08450, USA
| | - Betsy Vasquez
- Princeton Neuroscience Institute, Princeton, NJ, 08450, USA
| | - Elizabeth Gould
- Princeton Neuroscience Institute, Princeton, NJ, 08450, USA.
| |
Collapse
|
4
|
Morishita C, Inoue T, Honyashiki M, Ono M, Iwata Y, Tanabe H, Kusumi I, Masuya J. Roles of childhood maltreatment, personality traits, and life stress in the prediction of severe premenstrual symptoms. Biopsychosoc Med 2022; 16:11. [PMID: 35484626 PMCID: PMC9052504 DOI: 10.1186/s13030-022-00240-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND About 3% to 8% of women of fertile age are thought to have premenstrual dysphoric disorder (PMDD), which is regarded as a serious form of premenstrual syndrome (PMS), although the details of this common condition remain unclear. The aim of this study was to analyze the interrelations of childhood maltreatment, personality traits, and life stress in the etiology of PMS/PMDD. METHODS A total of 240 adult female volunteers from a community in Japan were investigated, using the following 5 questionnaires: Patient Health Quesstionaire-9, Child Abuse and Trauma Scale, Temperament and Character Inventory (TCI), Life Experiences Survey, and premenstrual dysphoric disorder (PMDD) scale. The questionnaire data were subjected to path analyses to clarify the association between childhood maltreatment and the severity of premenstrual symptoms, mediated by personality traits and life stress. RESULTS The 2 path analysis models showed that high harm avoidance (HA) on the TCI and low self-directedness (SD) on the TCI had significant direct effects on the severity of premenstrual symptoms. Moreover, childhood maltreatment was associated with the severity of premenstrual symptoms, both directly and indirectly through personality traits. CONCLUSION Our findings suggest that HA on the TCI might be a risk factor for severe premenstrual symptoms among general women and furthermore that SD on the TCI may be a protective factor. In addition, childhood maltreatment is associated with severe premenstrual symptoms both directly and indirectly through personality traits.
Collapse
Affiliation(s)
- Chihiro Morishita
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Mina Honyashiki
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Miki Ono
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Yoshio Iwata
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hajime Tanabe
- Faculty of Humanities and Social Sciences, Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka, 422-8529, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Jiro Masuya
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| |
Collapse
|
5
|
Yang Q, Þórðardóttir EB, Hauksdóttir A, Aspelund T, Jakobsdóttir J, Halldorsdottir T, Tomasson G, Rúnarsdóttir H, Danielsdottir HB, Bertone-Johnson ER, Sjölander A, Fang F, Lu D, Valdimarsdóttir UA. Association between adverse childhood experiences and premenstrual disorders: a cross-sectional analysis of 11,973 women. BMC Med 2022; 20:60. [PMID: 35184745 PMCID: PMC8859885 DOI: 10.1186/s12916-022-02275-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/24/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Childhood abuse and neglect have been associated with premenstrual disorders (PMDs), including premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). However, the associations of other adverse childhood experiences (ACEs) and the cumulative number of ACEs with PMDs remain to be explored. METHODS To evaluate the associations of the cumulative number and types of ACEs with PMDs, we conducted a cross-sectional analysis with a subsample of menstruating women within the Stress-And-Gene-Analysis (SAGA) cohort, assessed for PMDs and ACEs (N=11,973). The cumulative and individual exposure of 13 types of ACEs was evaluated by a modified ACE-International Questionnaire. A modified version of the Premenstrual Symptom Screening Tool was used to identify probable cases of PMDs, further sub-grouped into PMS and PMDD. Prevalence ratios (PRs) of PMDs in relation to varying ACEs were estimated using Poisson regression. RESULTS At a mean age of 34.0 years (standard deviation (SD) 9.1), 3235 (27%) met the criteria of probable PMDs, including 2501 (21%) for PMS and 734 (6%) for PMDD. The number of ACEs was linearly associated with PMDs (fully-adjusted PR 1.12 per ACE, 95% CI 1.11-1.13). Specifically, the PR for PMDs was 2.46 (95% CI 2.21-2.74) for women with 4 or more ACEs compared with women with no ACEs. A stronger association was observed for probable PMDD compared to PMS (p for difference <0.001). The associations between ACEs and PMDs were stronger among women without PTSD, anxiety, or depression, and without childhood deprivation and were stronger among women a lower level of social support (p for interaction<0.001). All types of ACEs were positively associated with PMDs (PRs ranged from 1.11 to 1.51); the associations of sexual abuse, emotional neglect, family violence, mental illness of a household member, and peer and collective violence were independent of other ACEs. CONCLUSIONS Our findings suggest that childhood adverse experiences are associated with PMDs in a dose-dependent manner. If confirmed by prospective data, our findings support the importance of early intervention for girls exposed to ACEs to minimize risks of PMDs and other morbidities in adulthood.
Collapse
Affiliation(s)
- Qian Yang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden. .,Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Edda Björk Þórðardóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Arna Hauksdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Thor Aspelund
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Jóhanna Jakobsdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Thorhildur Halldorsdottir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland.,Department of Psychology, Reykjavik University, IS-101, Reykjavik, Iceland
| | - Gunnar Tomasson
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Harpa Rúnarsdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Hilda Björk Danielsdottir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland
| | - Elizabeth R Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA-01003, USA.,Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA-01003, USA
| | - Arvid Sjölander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Donghao Lu
- Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden. .,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA-02115, USA.
| | - Unnur Anna Valdimarsdóttir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Center of Public Health Sciences, Faculty of Medicine, University of Iceland, IS-101, Reykjavík, Iceland.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA-02115, USA
| |
Collapse
|
6
|
Younes Y, Hallit S, Obeid S. Premenstrual dysphoric disorder and childhood maltreatment, adulthood stressful life events and depression among Lebanese university students: a structural equation modeling approach. BMC Psychiatry 2021; 21:548. [PMID: 34753455 PMCID: PMC8576788 DOI: 10.1186/s12888-021-03567-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 10/27/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Premenstrual Syndrome (PMS) is a cyclic sequence of physical and behavioral symptoms that arise in the second half of the menstrual cycle. The extreme type of PMS is Premenstrual Dysphoric Disorder (PMDD). The current study aims at examining 1) the effects of childhood maltreatment and current life's stressful events on PMDD, and 2) the mediating role of depression in these associations among Lebanese university female students. METHODS This cross-sectional study was conducted between February and March 2021 during the COVID-19 pandemic. Lebanese students were recruited using a snowball technique from all national universities in Lebanon via an auto-administrated online survey. Structural equation modeling was performed to examine the structural relationship between childhood maltreatment and life's stressful events, depression and PMDD. RESULTS Higher life's stressful events (Beta = 0.18; p < 0.001), physical (Beta = 0.19; p < 0.001), sexual (Beta = 0.18; p < 0.001) and psychological (Beta = 0.33; p < 0.001) abuse were significantly associated with higher depression. Moreover, higher sexual (Beta = 0.11; p = 0.021) and psychological (Beta = 0.11; p = 0.040) abuse and higher depression (Beta = 0.37; p < 0.001) were significantly associated with higher PMDD. The indirect relationships between psychological abuse/sexual abuse, depression and PMDD showed that depression mediated the association between both psychological (Beta = 0.22; p = 0.001) and sexual (Beta = 0.38; p = 0.004) abuse and PMDD. CONCLUSION This work presents a unique analysis using the structural equation model that enlightens the effect of childhood maltreatment, particularly sexual and psychological abuse on PMMD symptoms, with depression playing the role of a mediating factor. It would be interesting to test, in future studies, whether there are other mediating factors besides depression that could be indirect indicators of PMDD.
Collapse
Affiliation(s)
- Yorgo Younes
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Souheil Hallit
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Sahar Obeid
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| |
Collapse
|
7
|
Investigation of the Relationship between Premenstrual Syndrome, and Childhood Trauma and Mental State in Adolescents with Premenstrual Syndrome. J Pediatr Nurs 2021; 61:e65-e71. [PMID: 33931259 DOI: 10.1016/j.pedn.2021.04.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE This study was aimed at investigating the relationship between premenstrual syndrome (PMS), and childhood trauma and mental state in adolescents with PMS. DESIGN AND METHODS This descriptive study was conducted with 702 students between September 2020 and November 2020. An Information Form, the PMS Scale, the Childhood Trauma Questionnaire (CTQ) and Symptom Checklist (SCL)-90 were used as the data collection tools. RESULTS The mean scores the participants with PMS obtained from the Symptom Checklist (SCL)-90 and Childhood Trauma Questionnaire (CTQ) were higher than were those obtained by the participants without PMS. The Pearson correlation analysis revealed a positive and weak statistically significant relationship between the PMS Scale, and SCL-90 and CTQ. CONCLUSIONS The results of the study demonstrated that adolescents with PMS suffered from childhood traumas and mental problems more.
Collapse
|
8
|
Azoulay M, Reuveni I, Dan R, Goelman G, Segman R, Kalla C, Bonne O, Canetti L. Childhood Trauma and Premenstrual Symptoms: The Role of Emotion Regulation. CHILD ABUSE & NEGLECT 2020; 108:104637. [PMID: 32768748 DOI: 10.1016/j.chiabu.2020.104637] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/05/2020] [Accepted: 07/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Women with Premenstrual Dysphoric Disorder (PMDD) are more likely to have a history of childhood trauma, and may experience more severe premenstrual symptomatology. However, the pathway in which childhood trauma affects the prevalence and severity of premenstrual symptoms remains largely unclear. OBJECTIVE To determine whether childhood trauma is associated with increased premenstrual symptoms, and if so, whether emotional dysregulation mediates or moderates this relationship. PARTICIPANTS AND SETTINGS A total of 112 women were recruited for the study among students at the Hebrew University of Jerusalem. METHODS Participants completed the Premenstrual Symptoms Screening Tool (PSST), the Childhood Trauma Questionnaire (CTQ) and the Difficulties in Emotion Regulation Scale (DERS). To test the mediation hypothesis, direct and indirect effects of childhood trauma on premenstrual symptoms were calculated. To test moderation, we performed multiple regression, including the interaction term between childhood trauma and emotion dysregulation RESULTS: Twenty-two women (18.6%) met criteria for premenstrual syndrome (PMS) and sixteen (13.6 %) for PMDD. The number and severity of premenstrual symptoms increased with more childhood trauma (r = .282), and this relationship was completely mediated by emotion regulation difficulties. Specifically, exposure to Sexual abuse (r = .243) and Emotional neglect (r = .198) were significantly associated with premenstrual symptoms. Abuse predicted greater emotion dysregulation (r = .33), whereas, neglect did not. CONCLUSIONS This study contributes to the current knowledge on the long-term effects of childhood trauma. Promoting use of adaptive emotion regulation strategies for women with a history of childhood trauma, could improve their capability to confront and adapt to premenstrual changes.
Collapse
Affiliation(s)
- M Azoulay
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - I Reuveni
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - R Dan
- Edmond and Lily Safra Center for Brain Sciences (ELSC), The Hebrew University of Jerusalem, Israel; Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - G Goelman
- Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - R Segman
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - C Kalla
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - O Bonne
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - L Canetti
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| |
Collapse
|