Abstract
Posttraumatic stress disorder (PTSD) is often comorbid with premenstrual dysphoric disorder (PMDD) in women; however, it is unclear whether this relationship is driven by the trauma that may lead to PTSD or if PTSD is uniquely associated with PMDD. In this study, we examine trauma and PTSD as independent correlates of PMDD. Researchers conducted a cross-sectional, secondary data analysis of 3,968 female participants (aged 18–40) of the Collaborative Psychiatric Epidemiology Surveys. Women who had a history of trauma with PTSD (odds ratio, OR = 8.14, 95% confidence interval, CI = 3.56–18.58) or a history of trauma without PTSD (OR = 2.84, 95% CI = 1.26–6.42) were significantly more likely than women with no history of trauma to report PMDD. This graded relationship was also observed in association with premenstrual symptoms. Among trauma survivors, PTSD was independently associated with PMDD, although characteristics of participants' trauma history partially accounted for this association. Our study demonstrated that trauma and PTSD were independently associated with PMDD and premenstrual symptoms. Clinicians should be aware that women who present with premenstrual symptomatology complaints may also have a history of trauma and PTSD that needs to be addressed. This pattern of comorbidity may complicate the treatment of both conditions.
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References
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders DSM-IV. American Psychiatric Association, Washington, DC
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders DSM-IV-TR (fourth edition (text revision)). American Psychiatric Publishing, Inc., Arlington
Brady K, Killeen T, Brewerton T, Lucerini S (2000) Comorbidity of psychiatric disorders and posttraumatic stress disorder. J Clin Psychiatry 61(Suppl 7):22–32
Breslau N (2002) Epidemiologic studies of trauma, posttraumatic stress disorder, and other psychiatric disorders. Can J Psychiatry 47(10):923–929
Breslau N, Kessler R, Chilcoat H, Schultz L, Davis G, Andreski P (1998) Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. Arch Gen Psychiatry 55(7):626–632
Breslau N, Chilcoat HD, Kessler RC, Davis GC (1999) Previous exposure to trauma and PTSD effects of subsequent trauma: results from the Detroit Area Survey of Trauma. Am J Psychiatry 156(6):902–907
Cohen L, Soares C, Otto M, Sweeney B, Liberman R, Harlow B (2002) Prevalence and predictors of premenstrual dysphoric disorder (PMDD) in older premenopausal women. The Harvard Study of Moods and Cycles. J Affect Disord 70(2):125–132
Crowne DP, Marlowe D (1960) A new scale of social desirability independent of psychopathology. J Consult Psychol 24(4):349–354
Deuster P, Adera T, South-Paul J (1999) Biological, social, and behavioral factors associated with premenstrual syndrome. Arch Fam Med 8(2):122–128
Fontana A, Palfai T (1994) Psychosocial factors in premenstrual dysphoria: stressors, appraisal, and coping processes. J Psychosom Res 38(6):557–567
Girdler SS, Thompson KS, Light KC, Leserman J, Pedersen CA, Prange AJ (2004) Historical sexual abuse and current thyroid axis profiles in women with premenstrual dysphoric disorder. Psychosom Med 66(3):403–410
Golding J, Taylor D, Menard L, King M (2000) Prevalence of sexual abuse history in a sample of women seeking treatment for premenstrual syndrome. J Psychosom Obstet Gynaecol 21(2):69–80
Grant, B. F. (2005). Wave 2 national epidemiologic survey of alcohol and related conditions (NESARC)
Halbreich U, Borenstein J, Pearlstein T, Kahn L (2003) The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology 28(Suppl 3):1–23
Karam EG, Andrews G, Bromet E, Petukhova M, Ruscio AM, Salamoun M et al (2010) The role of criterion A2 in the DSM-IV diagnosis of posttraumatic stress disorder. Biol Psychiatry 68(5):465–473
Kessler R, Ustün T (2004) The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 13(2):93–121
Kessler R, Sonnega A, Bromet E, Hughes M, Nelson C (1995) Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry 52(12):1048–1060
Kessler R, Abelson J, Demler O, Escobar J, Gibbon M, Guyer M et al (2004) Clinical calibration of DSM-IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMHCIDI). Int J Methods Psychiatr Res 13(2):122–139
Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62(6):593–602
Kilpatrick DG, Saunders BE (1999) Prevalence and consequences of child victimization. Results from the national survey of adolescents. Medical University of South Carolina, National Crime Victims Center, Charleston
Koci A, Strickland O (2007) Relationship of adolescent physical and sexual abuse to perimenstrual symptoms (PMS) in adulthood. Issues Ment Health Nurs 28(1):75–87
Landén M, Wennerblom B, Tygesen H, Modigh K, Sörvik K, Ysander C et al (2004) Heart rate variability in premenstrual dysphoric disorder. Psychoneuroendocrinology 29(6):733–740
Lawler C, Ouimette P, Dahlstedt D (2005) Posttraumatic stress symptoms, coping, and physical health status among university students seeking health care. J Trauma Stress 18(6):741–750
Löwe B, Kroenke K, Spitzer RL, Williams JB, Mussell M, Rose M et al (2010) Trauma exposure and posttraumatic stress disorder in primary care patients: cross-sectional criterion standard study. J Clin Psychiatry 72:304–312
Matsumoto T, Ushiroyama T, Kimura T, Hayashi T, Moritani T (2007) Altered autonomic nervous system activity as a potential etiological factor of premenstrual syndrome and premenstrual dysphoric disorder. Biopsychosoc Med 1:24
Pearlstein T, Steiner M (2008) Premenstrual dysphoric disorder: burden of illness and treatment update. J Psychiatry Neurosci 33(4):291–301
Pennell B, Bowers A, Carr D, Chardoul S, Cheung G, Dinkelmann K et al (2004) The development and implementation of the National Comorbidity Survey Replication, the National Survey of American Life, and the National Latino and Asian American Survey. Int J Methods Psychiatr Res 13(4):241–269
Perkonigg A, Yonkers K, Pfister H, Lieb R, Wittchen H (2004) Risk factors for premenstrual dysphoric disorder in a community sample of young women: the role of traumatic events and posttraumatic stress disorder. J Clin Psychiatry 65(10):1314–1322
Pietrzak RH, Goldstein RB, Southwick SM, Grant BF (2011) Prevalence and axis I comorbidity of full and partial posttraumatic stress disorder in the United States: results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. J Anxiety Disord 25(3):456–465
Pole N (2007) The psychophysiology of posttraumatic stress disorder: a meta-analysis. Psychol Bull 133(5):725–746
Resnick H, Kilpatrick D, Dansky B, Saunders B, Best C (1993) Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. J Consult Clin Psychol 61(6):984–991
Schnurr PP, Green BL (2004) Understanding relationships among trauma, posttraumatic stress disorder, and health outcomes. In: Schnurr PP, Green BL (eds) Trauma and health: physical health consequences of exposure to extreme stress. American Psychological Association, Washington, DC, pp 247–275
Schnurr P, Jankowski M (1999) Physical health and post-traumatic stress disorder: review and synthesis. Semin Clin Neuropsychiatry 4(4):295–304
Schnurr P, Green B, Kaltman S (2007) Trauma exposure and physical health. In: Friedman MJ, Keane TM, Resick P (eds) Handbook of PTSD. Science and Practice. The Guilford Press, New York, pp 406–424
Sledjeski EM, Speisman B, Dierker LC (2008) Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey-Replication (NCS-R). J Behav Med 31(4):341–349
Stein DJ, Kupfer DJ, Schatzberg AF (2006) The American psychiatric publishing textbook of mood disorders. American Psychiatric Publishing, Inc., Arlington
Steiner M, Macdougall M, Brown E (2003) The premenstrual symptoms screening tool (PSST) for clinicians. Arch Womens Ment Health 6(3):203–209
U.S. Census Bureau (2010) Poverty—how the census bureau measures poverty. http://www.census.gov/hhes/www/poverty/about/overview/measure.html. Accessed 18 Jul 2011
WHO (2009) Death and DALY estimates for 2004 by cause for WHO Member States: females, 3 age groups. In gbddeathdalycountryestimates_female_age_2004.xls (ed.)
Wittchen H, Becker E, Lieb R, Krause P (2002) Prevalence, incidence and stability of premenstrual dysphoric disorder in the community. Psychol Med 32(1):119–132
Wittchen H, Perkonigg A, Pfister H (2003) Trauma and PTSD-an overlooked pathogenic pathway for premenstrual dysphoric disorder? Arch Womens Ment Health 6(4):293–297
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This research was funded by the National Institute on Aging grant 5T32 AG000153 (CEP) as well as the Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, Department of Veterans Affairs (DJL).
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Pilver, C.E., Levy, B.R., Libby, D.J. et al. Posttraumatic stress disorder and trauma characteristics are correlates of premenstrual dysphoric disorder. Arch Womens Ment Health 14, 383–393 (2011). https://doi.org/10.1007/s00737-011-0232-4
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DOI: https://doi.org/10.1007/s00737-011-0232-4