Objective
Individual differences in sensitivity to cyclical changes in ovarian
steroids estradiol (E2) and progesterone (P4) have been implicated in the
pathophysiology of menstrually related mood disorder (MRMD). However, no
prospective studies have investigated psychosocial risk factors for
sensitivity to hormone effects on mood in MRMD. Using a repeated measures
approach and multilevel models, we tested the hypothesis that a history of
abuse provides a context in which within-person elevations of E2 and P4
prospectively predict daily symptoms.
Method
66 women with prospectively-confirmed MRMD recruited for a trial of
oral contraceptives provided 1 month of baseline hormone and mood data prior
to randomization. Lifetime physical and sexual abuse experiences were
assessed. Across one cycle, women completed daily measures of symptoms and
provided blood samples on 5 days across the menstrual cycle. Current E2 and
P4 were centered within person (CWP) such that higher values represented
cyclical elevations in hormones.
Results
Rates of physical (27%) and sexual (29%) abuse were high, consistent
with previous work documenting a link between trauma and MRMD. In women with
a history of physical abuse, cyclical increases in P4 predicted greater mood
and interpersonal symptoms on the three days following that sample. In women
with a history of sexual abuse, cyclical increases in E2 predicted greater
anxiety symptoms on the three days following that sample.
Conclusions
Results inform further inquiry into the role of severe life stressors
and stress response systems in MRMD. We discuss areas for future research on
the psychosocial and physiological pathways through which abuse may
influence the link between hormones and symptoms.