Premenstrual changes: Patterns and correlates of daily ratings

Department of Research Assessment and Training, New York State Psychiatric Institute, 722 W. 168th Street, New York, NY 10032, U.S.A.
Journal of Affective Disorders (Impact Factor: 3.38). 03/1986; 10(2):127-135. DOI: 10.1016/0165-0327(86)90035-2


Daily ratings of 20 measures of mood, behavior, and physical condition made by 64 women for one menstrual cycle were analysed to determine patterns of covariance between the pre- and postmenstrual periods. Five discriminantly different dimensions of premenstrual change were identified. They were found to be differently related to a lifetime diagnosis of effective disorder. These results, and others, support the recommendation that research should be focused upon diversified premenstrual changes rather than a single premenstrual syndrome.

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    • "that the syndrome is principally made up of two types of symptom ; those that are psychological and those that are physical in nature. Although it is widely acknowledged that the use of daily symptom ratings are essential for the accurate diagnosis and assessment of PMS (Connolly, 2001; Freeman, 2003; Johnson, 2004; Steiner and Wilkins, 1996), the difficulty in their interpretation often leads researchers and clinicians to assess symptom change in terms of individual items (Endicott et al., 1986). The use of the psychological and physical factor scores derived from this research, which take into account the relative importance of each item to the subscale, could provide a more practical and clinically relevant means by which to identify and investigate PMS. "
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    ABSTRACT: The purpose of the present study was to modify Freeman et al.'s (1996) Daily Symptom Report (DSR) for premenstrual syndrome (PMS) by adding items depicting aggressive and impulsive symptoms, to explore the component structure of this revised measure (DSR-20) in a sample of PMS sufferers, and to compare their scores with those from controls during the follicular and luteal cycle phases. The DSR-20 was administered to 140 PMS sufferers who were seeking treatment for PMS and 54 controls who considered themselves to be free from premenstrual complaints daily for three menstrual cycles. Cronbach's α was 0.95 for the luteal DSR-20 scores of the PMS sufferers, indicating very high internal consistency of the 20 items. Exploratory Principal Components Analysis (PCA) of the luteal ratings of the PMS sufferers identified two components with high internal consistency (>0.90), describing psychological and physical premenstrual symptoms. PMS sufferers scored significantly higher than the controls on each of these components during the luteal, but not follicular, phase. The DSR-20 total scale score is an internally consistent global measure of the intensity of PMS. The division of PMS symptoms into psychological and physical components, both of which significantly differentiated PMS sufferers from controls during the luteal phase, sheds further light on the description of PMS and provides a clinically relevant and practical means by which to summarise and interpret daily symptom ratings, necessary for the identification and investigation of the syndrome.
    Journal of Affective Disorders 11/2011; 136(3):612-9. DOI:10.1016/j.jad.2011.10.021 · 3.38 Impact Factor
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    • "This modified rating scale (Endicott et al., 1986 "
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    ABSTRACT: Although it's been reported that women with premenstrual dysphoric disorder (PMDD) have increased negative mood, appetite (food cravings and food intake), alcohol intake and cognitive deficits premenstrually, few studies have examined these changes concurrently within the same group of women or compared to women without PMDD. Thus, to date, there is not a clear understanding of the full range of PMDD symptoms. The present study concurrently assessed mood and performance tasks in 29 normally cycling women (14 women who met DSM-IV criteria for PMDD and 15 women without PMDD). Women had a total of ten sessions: two practice sessions, 4 sessions during the follicular phase and 4 sessions during the late luteal phase of the menstrual cycle. Each session, participants completed mood and food-related questionnaires, a motor coordination task, performed various cognitive tasks and ate lunch. There was a significant increase in dysphoric mood during the luteal phase in women with PMDD compared to their follicular phase and compared to Control women. Further, during the luteal phase, women with PMDD showed impaired performance on the Immediate and Delayed Word Recall Task, the Immediate and Delayed Digit Recall Task and the Digit Symbol Substitution Test compared to Control women. Women with PMDD, but not Control women, also showed increased desire for food items high in fat during the luteal phase compared to the follicular phase and correspondingly, women with PMDD consumed more calories during the luteal phase (mostly derived from fat) compared to the follicular phase. In summary, women with PMDD experience dysphoric mood, a greater desire and actual intake of certain foods and show impaired cognitive performance during the luteal phase. An altered serotonergic system in women with PMDD may be the underlying mechanism for the observed symptoms; correspondingly, treatment with specific serotonin reuptake inhibitors (SSRIs) remains the preferred treatment at this time.
    Hormones and Behavior 07/2008; 54(1):185-93. DOI:10.1016/j.yhbeh.2008.02.018 · 4.63 Impact Factor
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    • "Severity of Problems (DRSP; Endicott et al., 1986). Only women who experienced less than a 30% increase in PMDD symptoms during the premenstruum compared to the post-menstrual week took part in the study. "
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    ABSTRACT: Despite behavioral evidence that variation in ovarian hormones is associated with changes in affect, the neural basis of these processes is poorly understood. We combined functional magnetic resonance imaging (fMRI) with quantitative analysis of ovarian hormones in a within-subject design to investigate brain activation patterns during affective response inhibition, comparing activation between the early follicular (low estrogen and progesterone) and mid-luteal (high estrogen and progesterone) phases of the menstrual cycle in healthy women. There was significantly increased activation in the anterior cingulate and dorsolateral prefrontal cortex (DLPFC) while inhibiting response to positive words during the luteal, compared to the follicular phase. Furthermore, luteal phase estradiol level positively correlated with DLPFC activation while inhibiting response to positive words and negatively correlated with activation in several structures while inhibiting response to negative words, supporting estrogen's modulation of affective processing.
    NeuroImage 09/2006; 32(1):457-64. DOI:10.1016/j.neuroimage.2006.03.013 · 6.36 Impact Factor
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