Does psychological distress explain why PMS reduces well-being?

Introduction: Premenstrual syndrome (PMS) is associated with psychological distress and reduced well-being among adolescent girls. However, the extent to which distress statistically accounts for the association between PMS screening status and eudaimonic psychological well-being remains insufficiently examined in Indian adolescents. Aim: To examine whether psychological distress is associated with the indirect statistical pathway linking PMS screening status with psychological well-being among adolescent girls in Bangalore, India. Methods: A cross-sectional study included 350 adolescent girls aged 13–17 years from private schools in Bangalore. PMS screening status was assessed using the PSST-A, while psychological distress and well-being were measured using the DASS-Y and PWBS-SDCP, respectively. A bootstrapped path-analytic indirect-association model was estimated using lavaan in R with 5,000 resamples and bias-corrected 95% confidence intervals. Results: PMS screening status was positively associated with distress (rpb = .46, p < .001) and negatively associated with well-being (rpb = −.26, p < .001). The indirect association through distress was significant (β = −.21, B = −10.46, 95% CI [−13.98, −7.57], p < .001), accounting for 78.7% of the total association. The direct association was not significant (β = −.06, B = −2.82, p = .291). The model explained 23.0% of the variance in well-being. Conclusions: Psychological distress statistically accounted for a substantial proportion of the cross-sectional association between PMS screening status and well-being. Given the cross-sectional design, these findings indicate a statistical indirect association rather than a temporal or causal mediation mechanism and should inform future longitudinal research.

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