Date of Award

8-2014

Level of Access

Campus-Only Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Advisor

Sandra T. Sigmon

Second Committee Member

Michael A. Robbins

Third Committee Member

Geoffrey L. Thorpe

Abstract

Although the majority of women report menstrual cycle-related changes in mood, behavior, and/or physical symptoms, these changes are unusually severe in women with premenstrual disorders, including premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Premenstrual disorders involve clinically significant distress and impairment due to cyclical premenstrual symptoms. However, as the majority of research has focused on biological contributions to premenstrual symptoms, the role of psychological factors has not been adequately addressed. Maladaptive forms of selffocused attention (SFA) on somatic and affective changes has been demonstrated to play an instrumental role in symptoms and distress across a range of physical and emotional problems (e.g., depression, anxiety, chronic pain, asthma). It is possible that some women tend to respond to physiological premenstrual changes with increased SFA, and this leads to the development and/or maintenance of premenstrual disorders. Questionnaire data linking SFA and premenstrual distress supports this model; however, the role of SFA in premenstrual disorders has not been investigated in laboratory settings or through assessment of responses to actual premenstrual changes.

In the current study, the relationship between SFA and premenstrual disorders was examined using trait measures of SFA and premenstrual distress, in response to laboratory stress induction occurring during the premenstrual phase, and finally, in response to menstrual cycle-related symptoms. Participants included women who met criteria for premenstrual disorders based on retrospective report and confirmed through 30-days of prospective symptom monitoring (n = 29), and women without significant premenstrual symptoms (n - 32). Women were excluded if they met criteria for a current Axis I psychological disorder (excluding specific phobia). Self-reported negative affect and distress ratings, as well as responses (i.e., emotional SFA, somatic SFA, distraction), were assessed before and after two laboratory stressor tasks designed to elicit psychological and physiological symptoms. Participants completed additional questionnaires to assess various forms of SFA, coping, mood/anxiety, and menstrual cycle-related distress. Next, participants completed a daily diary for 30 days, during which time they reported daily symptoms, attributions for symptoms, and responses (i.e., SFA and distraction).

Results indicated that: 1) women with premenstrual disorders reported greater trait levels of SFA and maladaptive coping styles than controls, as well as more menstrual cycle-related distress, impairment, and negative menstrual attitudes; 2) there were no group differences in negative affect in response to the laboratory stressor tasks; 3) women with premenstrual disorders did not elect to end laboratory tasks earlier than controls; 4) women with premenstrual disorders responded to the laboratory-induced stress with increased levels of emotional and physical SFA compared to controls; 5) women with premenstrual disorders endorsed more SFA in response to naturally occurring premenstrual symptoms compared to controls, and more SFA during the premenstrual compared to intermenstrual menstrual cycle phases; 6) SFA during the premenstrual phase was a significant predictor of premenstrual symptoms; and 7) women with premenstrual disorders made more menstrual attributions for their symptoms, which was accounted for the experience of more premenstrual symptoms. The results of this study represent an important step in the understanding of psychological contributions to premenstrual distress and disorders.

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