Objective
Despite evidence for the validity of premenstrual dysphoric disorder (PMDD) and its recent inclusion in DSM-5, variable diagnostic practices compromise the construct validity of the diagnosis and threaten the clarity of efforts to understand and treat its underlying pathophysiology. In an effort to hasten and streamline the translation of the new DSM-5 criteria for PMDD into terms compatible with existing research practices, we present the development and initial validation of the Carolina Premenstrual Assessment Scoring System (C-PASS). The C-PASS is a standardized scoring system for making DSM-5 PMDD diagnoses using 2 or more menstrual cycles of daily symptom ratings using the Daily Record of Severity of Problems (DRSP).
Method
Two hundred women recruited for retrospectively-reported premenstrual emotional symptoms provided 2–4 menstrual cycles of daily symptom ratings on the DRSP. Diagnoses were made by expert clinician and the C-PASS.
Results
Agreement of C-PASS diagnosis with expert clinical diagnosis was excellent; overall correct classification by the C-PASS was estimated at 98%. Consistent with previous evidence, retrospective reports of premenstrual symptom increases were a poor predictor of prospective C-PASS diagnosis.
Conclusions
The C-PASS (available as a worksheet, Excel macro, and SAS macro) is a reliable and valid companion protocol to the DRSP that standardizes and streamlines the complex, multilevel diagnosis of DSM-5 PMDD. Consistent use of this robust diagnostic method would result in more clearly-defined, homogeneous samples of women with PMDD, thereby improving the clarity of studies seeking to characterize or treat the underlying pathophysiology of the disorder.
Significant racial health disparities persist between Black and White individuals in the United States. Psychological science has contributed much to understanding how the interpersonal consequences of racism shape the short-and long-term health of Black Americans across the lifespan. The field has understood experiences of racism as individual-level psychosocial risk and examined stress and coping processes used to alleviate resulting distress. However, the authors argue that the traditionally ahistorical, acontextual, risk-based, and individual approach of psychological science may hamper its ability to reduce racial health disparities. They discuss ways in which a Critical Race Theory framework may further strengthen psychological science's ability to orient toward equitable practices in the reduction and prevention of racial health disparities. As currently available psychological science approaches are compatible with a Critical Race Theory framework, they discuss the merits and implications of employing this framework.
What is the significance of this article for the general public?If psychological science aims to reduce racial health disparities, it must seek to intervene upon racism as a system impacting Black Americans' health rather than merely intervening upon the ways in which individual Black Americans perceive racism. Centering the strengths of the Black community through counter storytelling and capacity building while employing a Critical Race Theory approach in practice, policy, and research provides concrete ways to intervene upon racism and restore power to oppressed communities. Such restorative justice is necessary to eliminate racial health disparities.
Females with BPD may be at elevated risk for perimenstrual worsening of emotional symptoms. Longitudinal studies with fine-grained hormonal measurement as well as hormonal experiments are needed to determine the pathophysiology of perimenstrual exacerbation in BPD.
While the literature examining physical intimate partner violence (IPV) is extensive, the impact of psychological IPV on mental health during highrisk times such as the period following childbirth is not well understood. The current study examined associations between psychological IPV and the course and severity of women's postnatal mental health symptoms (depression, anxiety, and trauma symptoms). Both main effects of psychological IPV exposure and possible exacerbation by broader social victimization (i.e., gender discrimination) were considered. Participants were 76 mothers from a larger longitudinal study, who completed selfreport measures of IPV, gender discrimination, and affective symptoms at 3, 6, 12, and 18 months postnatal. Hierarchical linear modeling revealed a main effect of psychological IPV on the course of trauma symptoms only. As hypothesized, gender discrimination moderated the effect of psychological
Both rumination and emotion-related impulsivity may be important treatment targets in cognitive behavioral interventions aimed at reducing symptom severity and cyclicity in MRMDs.
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