Does Trait Rumination Shape Premenstrual Symptoms Trajectories; Preregistered Prospective Analysis

Background Despite the addition of premenstrual dysphoric disorder (PMDD) as a new DSM-5 disorder in 2013, very few studies have examined the cognitive and behavioral constructs that maintain or worsen the emotional symptoms of hormone change sensitivity in PMDD. Several small studies have found that rumination, a maladaptive form of repetitive thought, is associated with PMDD. This archival analysis sought to provide a well- powered, pre-registered test of the association between trait rumination and menstrual cycle emotional changes in a large prospective cohort recruited for high perceived stress, a known risk factor for PMDD. Method Using a prospective daily survey design and multilevel growth modeling, we tested the hypothesis that higher levels of trait rumination would predict (1) higher baseline symptoms, (2) a more rapid premenstrual increase in daily symptoms, and (3) a slower postmenstrual recovery to baseline. 232 naturally cycling females (mean age = 30.93; 59% Caucasian) completed the Rumination Response Scale at baseline, then provided 2-3 months of ratings on the Daily Record of Severity of Problems (i.e., emotional, cognitive, behavioral, and physical symptoms). Results As in prior work, the degree of prospective cyclical mood change was normally distributed in the sample, supporting the feasibility of hypothesis tests as well as the broader scientific concept of individual differences in cyclical emotional hormone sensitivity. Contrary to predictions, higher trait rumination did not predict baseline levels, premenstrual increases, or postmenstrual decreases in any daily symptom. Conclusions This study, which utilized a large sample size and gold-standard daily rating methods for assessing emotional symptom cyclicity, does not support the hypothesis that rumination is a key mechanism in the exacerbation of premenstrual symptoms, and suggests the need to identify other mechanisms. It also highlights the need for well-powered prospective studies to determine which cognitive and behavioral mechanisms could be targeted to improve symptoms among those with premenstrual emotional changes.