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Open Access 11-03-2023 | Original Article

Associations of premenstrual symptoms with daily rumination and perceived stress and the moderating effects of mindfulness facets on symptom cyclicity in premenstrual syndrome

Authors: Sibel Nayman, Desiree Tina Konstantinow, Isabelle Florence Schricker, Iris Reinhard, Christine Kuehner

Published in: Archives of Women's Mental Health | Issue 2/2023

Abstract

Subthreshold premenstrual symptoms can be impairing even if the diagnostic criteria for premenstrual dysphoric disorder (PMDD) are not reached. Previous research suggests shared psychological risk factors without a clear differentiation of premenstrual syndrome (PMS) from PMDD. This study focuses on a sample with a wide range of premenstrual symptoms not reaching PMDD-criteria and aims to investigate within-person associations of premenstrual symptoms with daily rumination and perceived stress during the late luteal phase as well as cycle-phase specific associations of habitual mindfulness including present-moment-awareness and acceptance with premenstrual symptoms and impairment. Fifty-six naturally cycling women with self-reported premenstrual symptoms completed an online diary on premenstrual symptoms, rumination and perceived stress over two consecutive menstrual cycles, and baseline questionnaires on habitual present-moment-awareness and acceptance. Multilevel analyses revealed cycle-related variations in premenstrual symptoms and impairment (all ps < .001). Higher within-person levels of core and secondary premenstrual symptoms during the late luteal phase predicted increased daily rumination and perceived stress (all ps < .001) and increased somatic symptoms predicted increased rumination (p ≤ .018). Higher habitual present-moment-awareness was linked to lower premenstrual symptom and impairment levels toward the late luteal phase whereas higher habitual acceptance was associated with lower premenstrual functional impairment (p ≤ .015). Premenstrual symptom increases during the late luteal phase in women with PMS seem to be linked to increased daily rumination and perceived stress. Trait present-moment-awareness and acceptance in turn seem to reflect protective factors against premenstrual distress and may represent useful targets for interventions.

All reported Cronbach’s alpha values (α) in this paper refer to the present sample.

American College of Obstetricians and Gynecologists (2014) Guidelines for Women’s Health Care: A Resource Manual, 4th edn. DC, Washington

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. ArlingtonCrossRef

Armstrong RA (2014) When to use the Bonferroni correction. Ophthalmic Physiol Opt 34:502–508. https://doi.org/10.1111/opo.12131CrossRefPubMed

A-Tjak JGL, Davis ML, Morina N, Powers MB, Smits JAJ, Emmelkamp PMG (2015) A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychother Psychosom 84:30–36. https://doi.org/10.1159/000365764CrossRefPubMed

Beddig T, Reinhard I, Kuehner C (2019) Stress, mood, and cortisol during daily life in women with Premenstrual Dysphoric Disorder (PMDD). Psychoneuroendocrinology 109:104372. https://doi.org/10.1016/j.psyneuen.2019.104372CrossRefPubMed

Beddig T, Reinhard I, Ebner-Priemer U, Kuehner C (2020) Reciprocal effects between cognitive and affective states in women with premenstrual dysphoric disorder: an ecological momentary assessment study. Behav Res Ther 131:103613. https://doi.org/10.1016/j.brat.2020.103613CrossRefPubMed

Bentz D, Steiner M, Meinlschmidt G (2012) SIPS – Screening-Instrument für prämenstruelle Symptome. Die deutsche Version des Premenstrual Symptoms Screening Tool zur Erfassung klinisch relevanter Beschwerden [SIPS – screening instrument for premenstrual symptoms. The German version of Premenstrual Symptoms Screening Tool to assess clinically relevant disturbances. Nervenarzt 83(1):33–39. https://doi.org/10.1007/s00115-010-3210-6CrossRefPubMed

Bluth K, Gaylord S, Nguyen K, Bunevicius A, Girdler S (2015) Mindfulness-based stress reduction as a promising intervention for amelioration of premenstrual dysphoric disorder symptoms. Mindfulness 6:1292–1302. https://doi.org/10.1007/s12671-015-0397-4CrossRefPubMedPubMedCentral

Bosman RC, Jung SE, Miloserdov K, Schoevers RA, aan het Rot M (2016) Daily symptom ratings for studying premenstrual dysphoric disorder: a review. J Affect Disord 189:43–53. https://doi.org/10.1016/j.jad.2015.08.063CrossRefPubMed

Brown KW, Ryan RM (2003) The benefits of being present: Mindfulness and its role in psychological well-being. J Pers Soc Psychol 84(4):822–848. https://doi.org/10.1037/0022-3514.84.4.822CrossRefPubMed

Craner JR, Sigmon ST, Young MA (2016) Self-focused attention and symptoms across menstrual cycle phases in women with and without premenstrual disorders. Cogn Behav Ther 40:118–127. https://doi.org/10.1007/s10608-015-9721-5CrossRef

Dawson DN, Eisenlohr-Moul TA, Paulson JL, Peters JR, Rubinow DR, Girdler SS (2018) Emotion-related impulsivity and rumination predict the perimenstrual severity and trajectory of symptoms in women with a menstrually related mood disorder. J Clin Psychol 74:579–593. https://doi.org/10.1002/jclp.22522CrossRefPubMed

Ditzen B, Nussbeck F, Drobnjak S, Spörri C, Wüest D, Ehlert U (2011) Validierung eines deutschsprachigen DSM-IV-TR basierten Fragebogens zum prämenstruellen Syndrom [Validation of a German DSM-IV-TR-based questionnaire for the screening of premenstrual symptoms]. Z Kl Psych Psychoth 40(3):149–159. https://doi.org/10.1026/1616-3443/a000095CrossRef

Eisenlohr-Moul T (2019) Premenstrual disorders: a primer and research agenda for psychologists. Clin Psychol 72(1):5–17. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193982/)PubMedPubMedCentral

Halbreich U, Borenstein J, Pearlstein T, Kahn LS (2003) The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology 28:1–23. https://doi.org/10.1016/s0306-4530(03)00098-2CrossRefPubMed

Hartlage SA, Freels S, Gotman N, Yonkers K (2012) Criteria for premenstrual dysphoric disorder: secondary analyses of relevant data sets. Arch Gen Psychiatry 69(3):300–305. https://doi.org/10.1001/archgenpsychiatry.2011.1368CrossRefPubMedPubMedCentral

Hayes SC, Strosahl K, Wilson KG (2012) Acceptance and commitment therapy. Guilford Press, New York

Hofmeister S, Bodden S (2016) Premenstrual syndrome and premenstrual dysphoric disorder. Am Fam Physician 94(3):236–240PubMed

Ismaili E, Walsh S, O’Brien PMS, Bäckström T et al (2016) Fourth consensus of the International Society for Premenstrual Disorders (ISPMD): auditable standards for diagnosis and management of premenstrual disorder. Arch Womens Ment Health 19:953–958. https://doi.org/10.1007/s00737-016-0631-7CrossRefPubMed

Izadpanah S, Barnow S, Neubauer AB, Holl J (2019) Development and validation of the Heidelberg form for emotion regulation strategies (HFERST): factor structure, reliability, and validity. Assessment 26(5):880–906. https://doi.org/10.1177/1073191117720283CrossRefPubMed

Janda C, Kues JN, Andersson G, Kleinstäuber M, Weise C (2017) A symptom diary to assess severe premenstrual syndrome and premenstrual dysphoric disorder. Women Health 57(7):837–854. https://doi.org/10.1080/03630242.2016.1206055CrossRefPubMed

Kabat-Zinn J (2003) Mindfulness-based interventions in context: past, present, and future. Clin Psychol Sci Pract 10(2):144–156. https://doi.org/10.1258/mi.2012.012017CrossRef

Kadian S, O’Brien S (2012) Classification of premenstrual disorders as proposed by the International Society for Premenstrual Disorders. Menopause Int 18(2):43–47. https://doi.org/10.1258/mi.2012.012017CrossRefPubMed

Kappen M, Raeymakers S, Weyers, S, Vanderhasselt MA (2022) Stress and rumination in premenstrual syndrome (PMS) identifying stable and menstrual cycle-related differences in PMS symptom severity. Preprint. https://doi.org/10.31234/osf.io/nhvb2

Kirtley OJ, Hiekkaranta AP, Kunkels YK et al (2022, October 11). The experience sampling method (ESM) item repository. https://doi.org/10.17605/OSF.IO/KG376

Kleinstäuber M, Schmelzer K, Ditzen B, Andersson G, Hiller W, Weise C (2016) Psychosocial profile of women with premenstrual syndrome and healthy controls: a comparative study. Int J Behav Med 23:752–763. https://doi.org/10.1007/s12529-016-9564-9CrossRefPubMed

Lami MJ, Martínez MP, Miró E, Sánchez AI, Guzmán MA (2018) Catastrophizing, acceptance, and coping as mediators between pain and emotional distress and disability in fibromyalgia. J Clin Psychol Med Settings 25:80–92. https://doi.org/10.1007/s10880-018-9543-1CrossRefPubMed

Löwe B, Spitzer RL, Zipfel S, Herzog W (2002) PHQ-D Gesundheitsfragebogen für Patienten, 2. Auflage. Manual: Komplettversion und Kurzform [PHQ-D Patient health questionnaire, 2nd edn. Manual: full version and short version]. Pfizer

Lustyk MKB, Gerrish WG, Douglas H, Bowen S, Marlatt GA (2011) Relationships among premenstrual symptom reports, menstrual attitudes, and mindfulness. Mindfulness 2(1):37–48. https://doi.org/10.1007/s12671-011-0041-xCrossRefPubMedPubMedCentral

Mattina GF, Steiner M (2020) Premenstrual dysphoric disorder. In Rennó J, Valadares G, Cantilino A, Mendes-Ribeiro J, Rocha R, Geraldo da Silva A (ed) Women's mental health. Springer, Cham, pp 73–93.

MazaheriAsadi D, Zahedi Tajrishi K, Gharaei B (2022) Mindfulness training intervention with the Persian version of the mindfulness training mobile app for premenstrual syndrome: a randomized controlled trial. Front Psychiatry 13:922360. https://doi.org/10.3389/fpsyt.2022.922360CrossRef

Michelini G, Palumbo IM, DeYoung CG, Latzman RD, Kotov R (2021) Linking RDoC and HiTOP: a new interface for advancing psychiatric nosology and neuroscience. Clin Psychol Rev 86:102025. https://doi.org/10.1016/j.cpr.2021.102025CrossRefPubMedPubMedCentral

Murayama K, Usami S, Sakaki M (2022) Summary-statistics-based power analysis: a new and practical method to determine sample size for mixed-effects modeling. Psychol Methods 27(6):1014–1038. https://doi.org/10.1037/met0000330CrossRefPubMed

Myin-Germeys I, Kuppens P (2022) The open handbook of experience sampling methodology: a step-by-step guide to designing, conducting, and analyzing ESM studies (2nd edn). The Center for Research on Experience Sampling and Ambulatory Methods Leuven (REAL)-Belgium.

Nayman S, Beddig T, Reinhard I, Kuehner C (2022) Effects of cognitive emotion regulation strategies on mood and cortisol in daily life in women with premenstrual dysphoric disorder. Psychol Med 1–11. https://doi.org/10.1017/S0033291722002495

Panahi F, Faramazi M (2016) The effects of mindfulness-based cognitive therapy on depression and anxiety in women with premenstrual syndrome. Depress Res Treat 2016:9816481. https://doi.org/10.1155/2016/9816481CrossRefPubMedPubMedCentral

Read JR, Perz J, Ussher JM (2014) Ways of coping with premenstrual change: development and validation of a premenstrual coping measure. BMC Womens Health 14(1):1–15. https://doi.org/10.1186/1472-6874-14-1CrossRefPubMedPubMedCentral

Schmalenberger KM, Eisenlohr-Moul TA, Surana P, Rubinow DR, Girdler SS (2017) Predictors of premenstrual impairment among women undergoing prospective assessment for premenstrual dysphoric disorder: a cycle-level analysis. Psychol Med 47(9):1585–1596. https://doi.org/10.1017/S0033291716003524CrossRefPubMedPubMedCentral

Schweizer-Schubert S, Gordon JL, Eisenlohr-Moul TA, Meltzer-Brody S, Schmalenberger KM, Slopien R et al (2021) Steroid hormone sensitivity in reproductive mood disorders: on the role of the GABAA receptor complex and stress during hormonal transitions. Front Med 7:479646. https://doi.org/10.3389/fmed.2020.479646CrossRef

Shankman SA, Lewinsohn PM, Klein DN, Small JW, Seeley JR, Altman SE (2009) Subthreshold conditions as precursors for full syndrome disorders: a 15-year longitudinal study of multiple diagnostic classes. J Child Psychol Psychiatry 50(12):1485–1494. https://doi.org/10.1111/j.1469-7610.2009.02117.xCrossRefPubMedPubMedCentral

Tomlinson ER, Yousaf O, Vittersø AD, Jones L (2018) Dispositional mindfulness and psychological health: a systematic review. Mindfulness 9:23–43. https://doi.org/10.1007/s12671-017-0762-6CrossRefPubMed

Tschudin S, Bertea PC, Zemp E (2010) Prevalence and predictors of premenstrual syndrome and premenstrual dysphoric disorder in a population-based sample. Arch Womens Ment Health 13:485–494. https://doi.org/10.1007/s00737-010-0165-3CrossRefPubMed

Van Os J (2013) The dynamics of subthreshold psychopathology: implications for diagnosis and treatment. Am J Psychiatry 170(7):695–698. https://doi.org/10.1176/appi.ajp.2013.13040474CrossRefPubMed

Wrzus C, Neubauer AB (2022) Ecological momentary assessment: a meta-analysis on designs, samples, and compliance across research fields. Assessment 1–22. https://doi.org/10.1177/10731911211067538

Yonkers KA, McCunn KL (2007) Comorbidity of premenstrual syndrome and premenstrual dysphoric disorder with other psychiatric conditions. In: O’Brien PM, Rapkin A, Schmidt J (eds) The premenstrual disorders: PMS and PMDD. CRC, Boca Raton, pp 49–54

Yonkers KA, Simoni MK (2018) Premenstrual disorders. Am J Obstet Gynecol 218(1):68–74. https://doi.org/10.1016/j.ajog.2017.05.045CrossRefPubMed

Title: Associations of premenstrual symptoms with daily rumination and perceived stress and the moderating effects of mindfulness facets on symptom cyclicity in premenstrual syndrome
Authors: Sibel Nayman
Desiree Tina Konstantinow
Isabelle Florence Schricker
Iris Reinhard
Christine Kuehner
Publication date: 11-03-2023
Publisher: Springer Vienna
Published in: Archives of Women's Mental Health / Issue 2/2023
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI: https://doi.org/10.1007/s00737-023-01304-5

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Associations of premenstrual symptoms with daily rumination and perceived stress and the moderating effects of mindfulness facets on symptom cyclicity in premenstrual syndrome

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