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The Relationship Between Premenstrual Distress and Anxiety Sensitivity: The Mediating Role of Rumination

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Abstract

Given that premenstrual distress is reported by large numbers of women, research has focused on the identification of biological and psychological factors that influence its severity. Previous research suggests that women who are high in anxiety sensitivity also report greater levels of premenstrual distress and negative affect. According to the menstrual reactivity hypothesis, women who have a tendency to self-focus and catastrophize about physical sensations are more likely to report greater levels of premenstrual distress. Cognitive schemas surrounding the menstrual cycle develop that are influenced by gender roles, cultural stereotypes, and expectations about bodily sensations. Another cognitive process, rumination, may also be linked to increased reports of premenstrual distress. Conceptually, the constructs of anxiety sensitivity and rumination share the tendency to self-focus on internal states. The goal of this study was to investigate how these two constructs relate to the prediction of premenstrual distress in a large sample of healthy undergraduate women (N = 478). Using mediational modeling, support was found for a mediational model; women who reported high levels of rumination and anxiety sensitivity reported the greatest premenstrual distress. These results are discussed within the framework of the menstrual reactivity hypothesis, a diathesis-stress model of premenstrual distress.

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References

  • Barnard, K., Frayne, S. M., Skinner, K. M., & Sullivan, L. M. (2003). Health status among women with menstrual symptoms. Journal of Women’s Health, 12, 911–919.

    Article  PubMed  Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical consideration. Journal of Personality and Social Psychology, 51, 1173–1182.

    Article  PubMed  Google Scholar 

  • Christensen, A. P., & Oei, T. P. (1995). The efficacy of cognitive behaviour therapy in treating premenstrual dysphoric changes. Journal of Affective Disorders, 33, 57–63.

    Article  PubMed  Google Scholar 

  • Cox, B. J., Enns, M. W., & Taylor, S. (2001). The effect of rumination as a mediator of elevated anxiety sensitivity in major depression. Cognitive Therapy and Research, 25, 525–534.

    Article  Google Scholar 

  • Endicott, J., & Halbreich, U. (1982). Retrospective reports of premenstrual depressive changes: Factors affecting confirmation by daily ratings. Psychopharmacological Bulletin, 18, 109–112.

    Google Scholar 

  • Feldner, M. T., Leen-Feldner, E. W., Zvolensky, M. J., & Lejuez, C. W. (2006). Examining the association between rumination, negative affectivity, and negative affect induced by a paced auditory serial addition task. Journal of Behavior Therapy and Experimental Psychiatry, 37, 171–187.

    Article  PubMed  Google Scholar 

  • Frazier, P. A., Tix, A. P., & Barron, K. E. (2004). Testing moderator and mediator effects in counseling psychology research. Journal of Counseling Psychology, 51(1), 115–134.

    Article  Google Scholar 

  • Freeman, E. W. (2003). Premenstrual syndrome and premenstrual dysphoric disorder: Definitions and diagnosis. Psychoneuroendocrinology, 28, 25–37.

    Article  PubMed  Google Scholar 

  • Halbreich, U. (2003). The etiology, biology, and evolving pathology of premenstrual syndromes. Psychoneuroendocrinology, 28, 55–99.

    Article  Google Scholar 

  • Halbreich, U., Borenstein, J., Pearlstein, T., & Kahn, L. S. (2003). The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology, 28, 1–23.

    Google Scholar 

  • Joorman, J., Dkane, M., & Gotlib, I. H. (2006). Adaptive and maladaptive components of rumination? Diagnostic specificity and relation to depressive biases. Behavior Therapy, 37, 269–280.

    Article  Google Scholar 

  • Judd, C. M., & Kenny, D. A. (1981). Process analysis: Estimating mediation in treatment evaluations. Evaluation Review, 5, 602–619.

    Article  Google Scholar 

  • Kenny, D. A., Kashy, D. A., & Bolger, N. (1998). Data analysis in social psychology. In D. T. Gilbert, S. T. Fiske, & G. Lindzey (Eds.), The handbook of social psychology (4th ed., pp. 233–265). New York: Oxford University Press.

    Google Scholar 

  • MacKinnon, D. P. (1994). Analysis of mediating variables in prevention and intervention research. In A. Cazares & L. A. Beatty (Eds.), Scientific methods for prevention intervention research (NIDA Research Monograph 139, DHHS Publication No. 94-3631, pp. 127–153). Washington, DC: U.S. Government Printing Office.

  • MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002). A comparison of methods to test mediation and other intervening variable effects. Psychological Methods, 7, 83–104.

    Article  PubMed  Google Scholar 

  • Moos, R. H. (1968). The development of a menstrual distress questionnaire. Psychosomatic Medicine, 30, 853–867.

    PubMed  Google Scholar 

  • Moos, R. H. (1985). Perimenstrual symptoms: A manual and overview of research with the menstrual distress questionnaire. Stanford, CA: Author.

    Google Scholar 

  • Moulds, M. L., Kandris, E., Starr, S., & Wong, A. C. M. (2007). The relationship between rumination, avoidance, and depression in a non-clinical sample. Behaviour Research and Therapy, 45, 251–261.

    Article  PubMed  Google Scholar 

  • Nolen-Hoeksema, S. (2000). Further evidence for the role of psychosocial factors in depression chronicity. Clinical Psychology: Science and Practice, 7, 224–227.

    Article  Google Scholar 

  • Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and distress following a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 105–121.

    Article  Google Scholar 

  • Nolen-Hoeksema, S., McBride, A., & Larson, J. (1997). Rumination and psychological distress among bereaved partners. Journal of Personality and Social Psychology, 72, 855–862.

    Article  PubMed  Google Scholar 

  • Norton, G. R., Dorward, J., & Cox, B. J. (1986). Factors associated with panic attacks in nonclinical subjects. Behavior Therapy, 17, 239–252.

    Article  Google Scholar 

  • Olasov, B., & Jackson, J. (1987). Effects of expectancies on women’s reports of moods during the menstrual cycle. Psychosomatic Medicine, 49, 65–78.

    PubMed  Google Scholar 

  • Otto, M. W., et al. (1995). Elevated anxiety sensitivity index scores in patients with major depression: Correlates and changes with antidepressant treatment. Journal of Anxiety Disorders, 9, 117–123.

    Article  Google Scholar 

  • Papadakis, A. A., Prince, R. P., & Jones, N. P. (2006). Self-regulation, rumination, and vulnerability to depression in adolescent girls. Development and Psychopathology, 18, 815–829.

    Article  PubMed  Google Scholar 

  • Peterson, R. A., & Heilbronner, R. L. (1987). The anxiety sensitivity index: Construct validity and factor analytic structure. Journal of Anxiety Disorders, 1, 117–121.

    Article  Google Scholar 

  • Peterson, R. A., & Reiss, S. (1987). Test manual for the anxiety sensitivity index. Palos Heights, IL: International Diagnostic Systems.

    Google Scholar 

  • Rapkin, A. (2003). A review of treatment of premenstrual syndrome and premenstrual dysphoric disorder. Psychoneuroendocrinology, 28, 39–53.

    Article  PubMed  Google Scholar 

  • Reading, A. E. (1992). Cognitive model of pre-menstrual syndrome. Clinics in Obstetrics and Gynaecology, 35, 693–700.

    Article  Google Scholar 

  • Reiss, S., & McNally, R. J. (1985). The expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical issues in behavior therapy. New York: Academic Press.

    Google Scholar 

  • Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8.

    Article  PubMed  Google Scholar 

  • Rubinow, D. R. (1985). Premenstrual syndromes: Past and future research strategies. Canadian Journal of Psychiatry, 30, 469–473.

    Google Scholar 

  • Sabin-Farell, R., & Slade, P. (1999). Reconceptualizing pre-menstrual emotional symptoms as phasic differential responsiveness to stressors. Journal of Reproductive and Infant Psychology, 17, 381–390.

    Article  Google Scholar 

  • Schmidt, N. B., Lerew, D. R., & Jackson, R. J. (1999). Prospective evaluation of anxiety sensitivity in the pathogenesis of panic: Replication and extension. Journal of Abnormal Psychology, 108, 532–537.

    Article  PubMed  Google Scholar 

  • Sexton, K. A., Norton, P. J., & Walker, J. R. (2003). Hierarchical model of generalized and specific vulnerabilities in anxiety. Cognitive Behaviour Therapy, 32, 82–94.

    Article  PubMed  Google Scholar 

  • Sigmon, S. T., Fink, C. M., Rohan, K., & Hotovy, L. A. (1996). Anxiety sensitivity and menstrual cycle reactivity: Psychophysiological and self-report differences. Journal of Anxiety Disorders, 10, 393–410.

    Article  Google Scholar 

  • Sigmon, S. T., Dorhofer, D. M., Rohan, K. J., & Boulard, N. E. (2000a). The impact of anxiety sensitivity, bodily expectations, and cultural beliefs on menstrual symptoms reporting: A test of the menstrual reactivity hypothesis. Journal of Anxiety Disorders, 14, 615–633.

    Article  PubMed  Google Scholar 

  • Sigmon, S. T., Rohan, K. J., Boulard, N. E., Dorhofer, D. M., & Whitcomb, S. R. (2000b). Menstrual reactivity: The role of gender-specificity, anxiety sensitivity, and somatic concerns in self-reported menstrual distress. Sex Roles, 43, 143–161.

    Article  Google Scholar 

  • Silverman, W. K., & Weems, C. F. (1999). Anxiety sensitivity in children. In S. Taylor (Ed.), Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety (pp. 239–268). Mahwah, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Strine, T. W., Chapman, D. P., & Ahluwalia, I. B. (2005). Menstrual-related problems and psychological distress among women in the United States. Journal of Women’s Health, 14, 316–323.

    Article  PubMed  Google Scholar 

  • Thomsen, D. K. (2006). The association between rumination and negative affect: A review. Cognition and Emotion, 20, 1216–1235.

    Article  Google Scholar 

  • Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27, 247–259.

    Article  Google Scholar 

  • Veeninga, A. T., & Kraaimaat, F. W. (1995). Causal attributions in premenstrual syndrome. Psychology and Health, 10, 219–228.

    Article  Google Scholar 

  • Wells, A., & Matthews, G. (2006). Cognitive vulnerability to anxiety disorders: An integration. In L. Alloy & G. Matthews (Eds.), Cognitive vulnerability to emotional disorders (pp. 303–325). New Jersey: Lawrence Erlbaum Associates Publishers.

    Google Scholar 

  • Yonkers, K. A., Pearlstein, T., & Rosenheck, R. A. (2003). Premenstrual disorders: Bridging research and clinical reality. Archives of Women’s Mental Health, 6, 287–292.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, University of Maine, 5742 Little Hall, Orono, ME, 04469-5742, USA

    Sandra T. Sigmon, Janell G. Schartel, Barbara A. Hermann, Anna G. Cassel & Geoffrey L. Thorpe

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  1. Sandra T. Sigmon
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  2. Janell G. Schartel
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  3. Barbara A. Hermann
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  4. Anna G. Cassel
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  5. Geoffrey L. Thorpe
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Correspondence to Sandra T. Sigmon.

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Sigmon, S.T., Schartel, J.G., Hermann, B.A. et al. The Relationship Between Premenstrual Distress and Anxiety Sensitivity: The Mediating Role of Rumination. J Rat-Emo Cognitive-Behav Ther 27, 188–200 (2009). https://doi.org/10.1007/s10942-009-0100-6

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