How do rumination and awareness affect mood and stress hormones during the menstrual cycle in PMDD?

Premenstrual Dysphoric Disorder (PMDD) is characterized by a cyclical symptom course. Previous research provides limited findings on possible menstrual-cycle-related psychological and psychoen-docrinological processes in PMDD. By using Ambulatory Assessment (AA), we aimed to compare mood and cortisol cyclicity in women with PMDD and healthy controls (HC), and to assess effects of habitual and momentary repetitive-negative-thinking (RNT) and present-moment-awareness (PMA) on mood and cortisol across the cycle in both groups. Women with PMDD and HCs (n = 60 each) completed baseline questionnaires on habitual RNT and PMA. Momentary rumination and PMA, positive and negative affect, and saliva-cortisol were assessed over four consecutive days during both the follicular and the late-luteal phase. Women with PMDD showed mood cyclicity indi-cating mood worsening while HCs showed cortisol cyclicity indicating decreasing cortisol levels to-ward the late-luteal phase. In women with PMDD, lower habitual RNT and higher habitual PMA predicted better mood only during the follicular phase whereas lower momentary rumination and higher momentary PMA predicted better mood during the late-luteal phase. No effects on cortisol activity were found. In HCs, higher habitual PMA predicted lower negative affect during the late-luteal phase whereas lower momentary rumination and higher momentary PMA predicted strong-er cortisol reduction toward the late-luteal phase. While favorable habitual cognitions might not protect women with PMDD against premenstrual mood deterioration, respective momentary cog-nitions may reflect possible protective factors, suggesting an opportunity for micro-interventions to directly target late-luteal-phase-specific state processes in affected women. The lack of cortisol cyclicity might represent an endocrinological marker for PMDD.

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