Menstrual cycle-dependent variations in mood, rumination, and cortisol: a comparison between women with and without Premenstrual Dysphoric Disorder

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Premenstrual Dysphoric Disorder (PMDD, DSM-5) is characterized by emotional, physical and behavioral changes during the premenstrual phase of the menstrual cycle, associated with clinically significant distress and/or marked impairment of psychosocial functioning. The disorder’s potential pathomechanisms have so far been insufficiently clarified; amongst other factors a pathological dysregulation of the endocrinological stress axis is being discussed. In the first funding phase we compared the spontaneous course of subjective and physiological processes during daily life in women with and without PMDD over the menstrual cycle within the context of an Ambulatory Assessment (AA) study. Our results achieved so far point to significant cycle-related alterations in subjective experiences, the interplay of affective and cognitive processes, and with regard to subjective and endocrinological stress reactivity in affected women. In the second funding phase we want to assess a) group- and cycle-dependent effects of induced self-focused attention foci (rumination, mindfulness) during daily life in a newly recruited sample of women with (n=65) and without (n=65) PMDD. For this purpose, AA measurements will take place at 2*4 days during one menstrual cycle (follicular phase, late luteal phase) with respective inductions on 2 out of 4 days per cycle phase each. We expect differential effects of the two induction modalities on mood, cognitions, and cortisol secretion during daily life, especially on women with PMDD during the late luteal phase. B) within the context of a measurement burst design we will repeat the 2*4 day AA period at a 4-month FU in women with PMDD. Besides the prediction of the clinical course of the PMDD symptomatology by means of these AA variables assessed during daily life (level and variability of mood, cognition, reactivity to differential induction modalities, subjective and physiological stress reactivity) this will allow to investigate these so-called AA-phenotypes per se longitudinally together with their possible cycle-dependence and determinants on different time scales (momentary level, burst level, person level). The present AA-study together with the intended measurement burst design will render a new approach to menstrual cycle research. The results of the study will provide important evidence on potential stress-related subjective and endocrinological mechanisms in PMDD, facilitating the further investigation of preventive and therapeutic interventions for women affected by PMDD.