Construct validation of premenstrual syndrome

This study represents an attempt to validate the construct of premenstrual syndrome. Data were collected over 'two menstrual cycles from 1 1 women who self-defined as premenstrually symptomatic and 24 women who self-defined as either premenstrually asymptomatic or only mildly premenstrually symptomatic. The measures used included both concurrent and retrospective self-reports of affective, cognitive, physical and behavioural symptoms experienced premenstrually, men'strually, and intermenstrually. In addition, an objective measure of cognitive abilities, in the form of short-term memory tasks, was administered at each phase over the two menstrual cycles. Analyses of variance for repeated measures and t-tests were performed to examine interphase differences in symptomology for each group and between-group differences in symptomology at each menstrual phase. Results of the analyses of variance indicate that self-defined symptomatic women do experience significantly increased symptomology during the premenstruum when compared to / the intermenstruum but not when compared to the menstrual phase. No significant interphase differences were evident in cognitive abilities as measured by the short-term memory tasks. In contrast, the control group showed little significant interphase variation in symptomology with the greatest degree of symptomology generally being experienced during the menstrual phase. Significant between-group differences in symptomology were most evident during the premenstruum. However, contrary to expectations, a number of differences observed during both the menstrual and intermenstrual phases reached statistical significance indicating that premenstrually symptomatic women may differ from premenstrually asymptomatic women at all phases of the menstrual cycle rather than only premenstrually. While the results obtained in this study confirm the existence of differences in menstrual cycle symptomology between self-defined symptomatic and asymptomatic women, there is not as clear an emergence of the premenstrual syndrome profile as previous resea,rchers would suggest. ACKNOWLEDGEMENTS The completion of this document would not have been possible without the contributions, in numerous.and varied ways, of many people. Dr. Richard Freeman has given support, encouragement, and extended patience throughout months of data collection and writing. He has also maintained a sense of humour throughout. For displaying these qualities and for his generous assistance when needed, I extend my sincere thanks to him. My thanks also go to Dr. Ray Koopman who, in matters of a statistical nature, has been of invaluable help; to Dr. Vito Modigliani for his assistance with the intricate details of the memory tasks used in this study; to Joan Foster for always giving me the benefit of the doubt in my computing battles; and to Cheryl Thomas for her-persistence in the face of adversity. Special thanks must also go to all of the women in this study who never gave up despite repetitive and time-consuming data collection. Finally, so much more than just thanks go to John for his assistance with the graphics in this document and for his seemingly unlimited patience and understanding. TABLE OF CONTENTS Approval . i i Abstract . iii Acknowledgements . v ~ i s t of Tables . viii List of Figures . x A . Introduction . 1 Menstrual Cycle Terminology . 2 Prevalence . 3 . Symptoms 6 Etiology . 7 Factores Associated with Premenstrual Syndrome . 16 Research Strategies . 35 Current Status of Premenstrual Syndrome Research . 43 . The Current Study 50 . B . Method 54 Subjects . 54 . Measures 56 Procedure . 61 . Statistical Analyses . 65 . C . Results 68 Menstrual History . 68 Interphase Differences in Symptomology Within Groups . 68 Group Differences in Menstrual Phase Symptomology . 80 Concordance Between Retrospective and Concurrent . Reports of Premenstrual Symptomology 92 Differences in Judgement of Performance on Short-Term Memory Tasks . 94 Premenstrual Assessment Form Typological Categories . 99 . D . isc cuss ion 110 Interphase Differences in Symptomology Within Groups 110 . Between-group Differences in Symptomology 112 Concordance Between Concurrent and Retrospective Self-reports . 114 Cognitive Distortion of Performance on Short-term Memory Tasks . 116 Categorization of Women into PAF Typologies . 117 Some Tentative Conclusions . 118 Limitations of the Current Study . 123 . Direct. ions for Future Research 124 . Appendix A 126 I . Menstrual Symptoms Questionnaire: Form A . 127 . I1 . Menstrual Symptoms Questionnaire: Form B 133 I11 . Menstrual Symptoms Questionnaire: Form C . 139 IV . Cognitive Efficiency Measure . 145 V . Performance Questionnaire . 157 VI . Physical and Behavioural Check List . 158 . VII . Premenstrual Symptoms Study document 160 VIII . Consent Form . 161 IX . Background Information questionnaire . 162 Appendix B . 164 . X . Subscales of Premenstrual Assessment Form 165 . XI . Nowlis Mood ~djective Check List Factor Items 171 References . 173