Premenstrual syndrome

Premenstrual dysphoric symptoms amongst Brazilian college students: factor structure and methodological appraisal

OBJECTIVES

The present study aims to assess the factor structure of the DSM-IV Premenstrual Dysphoric Disorder (PMDD) symptoms and its relationship with depressive symptoms.

METHODS

We evaluated retrospectively PMDD symptoms in 513 female college students, through a self-reporting questionnaire based on DSM-IV criteria, in addition to the Beck Depression Inventory (BDI). Principal component analysis on PMDD symptom data was performed to assess its dimensional structure.

RESULTS

In this non-clinical sample, the analysis indicated a higher importance of the dysphoric dimension, but physical symptoms as well as "being out of control" or "overwhelmed" should also be viewed as major symptoms of PMDD. Behavioural symptoms are of secondary importance. The mean BDI score of PMDD group was significantly higher (p < 0.05) than non-PMDD group.

CONCLUSION

The factor structure of the total sample was similar to the symptom structure suggested by DSM-IV diagnostic criteria. Depressive symptoms should be viewed as a confounding variable in PMDD.

Psychosocial aspects of selected issues in women's reproductive health: current status and future directions

Emphasizing research published in the past decade, this article presents a summary and evaluation of psychosocial investigations of women's reproductive health, with a focus on selected aspects of menstruation, pregnancy and birth, infertility, and menopause. In some areas, studies have focused on negative physical and psychological concomitants of these health issues. However, research reveals substantial individual variability, with most women adapting well to reproductive health changes. Although methodological and conceptual shortcomings have limited firm conclusions, research has advanced our understanding of the multivariate biological, psychological, and social influences on women's reproductive health and associated outcomes. Understanding and promoting women's reproductive health across the lifespan requires biopsychosocial approaches to research.

Comparison of self-assessment of premenstrual symptoms with scores on the modified Menstrual Distress Questionnaire

Premenstrual symptoms were assessed in a sample of 267 women (M age 31.4 yr.) using a single self-identification question and the modified Menstrual Distress Questionnaire of Clare and Wiggins. The-self-identification question asked to what degree the women experienced premenstrual symptoms. The responses were 34 (13%) for none, 116 (43%) for slight, 99 (37%) for moderate, and 18 (7%) for severe. The mean score on the questionnaire was 23.5 (SD = 17.5). Correlations indicated significant relationships between self-identification and questionnaire scores (rho = .76, p < .001). When the women were classified according to Clare's (1983) criterion, almost a third of them assessed their symptoms differently, i.e., while they classified themselves as "nonsufferers" on the self-identification question, their responses on the questionnaire identified them as "sufferers."

Macronutrient intake, eating habits, and exercise as moderators of menstrual distress in healthy women

The present investigation studied the relationship between symptoms of menstrual distress and macronutrient intake, eating behavior, and exercise in healthy women. Twenty-six normally menstruating women with no complaints of menstrual distress completed a disguised questionnaire on menstrual symptoms and monitored the type and amount of food consumed as well as the type and duration of exercise during a full menstrual cycle. Menstrual cycle phases were determined by the presence of menses, ovarian hormonal assays, and basal temperature monitoring. Reports of pain, water retention, negative affect, behavior change, and arousal were significantly higher (p < .05 or better) in the perimenstruum when compared to the follicular and luteal phases. During the perimenstruum, a higher energy intake of carbohydrate was associated with higher ratings of negative affect (p < .01) and impaired performance/decreased activity (p < .05). Lower energy intake of protein was associated with higher ratings of well being (p < .05). Overeating and dieting behavior were related to greater water retention (p < .01), autonomic reactions (p < .05), and appetite (p < .05). The amount of aerobic exercise in contrast to the intensity was related to lower water retention (p < .01), autonomic reactions (p < .05), and appetite (p < .01). Carbohydrate consumption, eating behavior, and regular exercise are reliably associated with menstrual distress and deserving of experimental evaluation as treatment interventions for menstrual distress.

Body image changes over the menstrual cycle in normal women

Changes in body image across the menstrual cycle and the relationship between these changes and menstrual distress were investigated in an effort to identify determinants of body dissatisfaction. Twenty-six normally cycling women between 18-40 years of age and 90-115% of ideal body weight, with no history of an eating disorder, completed a series of body image measures and a measure of menstrual distress during three menstrual cycle phases: perimenstrual, follicular, and luteal. These phases were identified with serum levels of ovarian hormones and basal body temperature. Results indicated that body dissatisfaction as measured by the number of body-related negative thoughts and anxiety about appearance was significantly highest during the perimenstrual phase. In contrast, measures of body size perception remained stable. Several somatosensory and psychological symptoms of menstrual distress were significantly associated with body dissatisfaction during the perimenstrual phase including, water retention, autonomic reactivity, control, negative affect, and impaired concentration. This association of body dissatisfaction and menstrual distress strongly suggests that menstrual cycle changes play a significant role in body image.

Coping styles in women with premenstrual syndrome

Sixty-five women with a prospectively confirmed diagnosis of premenstrual syndrome (PMS) were subdivided on the basis of their scores on the Beck Depression Inventory (BDI) into high-depression and low-depression groups and compared with 49 non-PMS control women on self-administered measures of coping and anxiety. The high-depression PMS group was found to utilize significantly more avoidant coping styles in dealing with stressors independent of the premenstrual phase. Implications for treatment are discussed.

Random-number generation and the menstrual cycle: preliminary evidence for a premenstrual alteration of frontal lobe functioning

20 women (M age = 30.4 yr.) were given the "Mental Dice Task" (randomization of the numbers from 1 to 6) once during the preovulatory and once during the premenstrual phases of their menstrual cycles. In addition, for both test sessions a premenstrual-symptom score was assessed reflecting self-rated severity of cognitive, affective, and somatic complaints during the preovular and the premenstrual phases. In comparison to series of real dice throws, the Mental Dice sequences of all the subjects showed a relative lack of repetitions and an excess of counting at both times of testing. Counting bias was significantly enhanced in the sequences generated during the premenstrual testing and the size of this bias was positively correlated with the self-rated severity of premenstrual symptoms. Pronounced counting despite the instruction to randomize was interpreted as reflecting decreased ability to suppress task-irrelevant cues and indicating a relative impairment of frontal lobe functioning. Resistance of the Mental Dice Task towards expectation biases renders a sociopsychological interpretation of these results improbable. We conjecture that, like other cognitive processes, frontal lobe functions also fluctuate with hormonal changes.