Premenstrual dysphoric disorder and childhood maltreatment, adulthood stressful life events and depression among Lebanese university students: a structural equation modeling approach

Abstract

Background Premenstrual Syndrome (PMS) is a cyclic sequence of physical and behavioral symptoms that arise in the second half of the menstrual cycle. The extreme type of PMS is Premenstrual Dysphoric Disorder (PMDD). The current study aims at examining 1) the effects of childhood maltreatment and current life’s stressful events on PMDD, and 2) the mediating role of depression in these associations among Lebanese university female students. Methods This cross-sectional study was conducted between February and March 2021 during the COVID-19 pandemic. Lebanese students were recruited using a snowball technique from all national universities in Lebanon via an auto-administrated online survey. Structural equation modeling was performed to examine the structural relationship between childhood maltreatment and life’s stressful events, depression and PMDD. Results Higher life’s stressful events (Beta = 0.18; p < 0.001), physical (Beta = 0.19; p < 0.001), sexual (Beta = 0.18; p < 0.001) and psychological (Beta = 0.33; p < 0.001) abuse were significantly associated with higher depression. Moreover, higher sexual (Beta = 0.11; p = 0.021) and psychological (Beta = 0.11; p = 0.040) abuse and higher depression (Beta = 0.37; p < 0.001) were significantly associated with higher PMDD. The indirect relationships between psychological abuse/sexual abuse, depression and PMDD showed that depression mediated the association between both psychological (Beta = 0.22; p = 0.001) and sexual (Beta = 0.38; p = 0.004) abuse and PMDD. Conclusion This work presents a unique analysis using the structural equation model that enlightens the effect of childhood maltreatment, particularly sexual and psychological abuse on PMMD symptoms, with depression playing the role of a mediating factor. It would be interesting to test, in future studies, whether there are other mediating factors besides depression that could be indirect indicators of PMDD.

Prevalence of Premenstrual Syndrome and Its Associations with Dietary and other lifestyle factors Among University Female Students in Dubai: A Cross-Sectional Study

“…The PMS was linked to psychological symptoms that ranged from irritability to depression and could depend on cultural perspectives and dealing with menstruation, social, environmental as well as hormonal changes [20][21][22]. Looking to the fact that stressful university study and great repressibilities that the students go through might increase and intensify the psychological symptoms out of the other PMS symptoms which was found in one study in Lebanon among university students [23]. In our study, we found that PMS symptoms were interfering the most with participants' daily routine work or school and relationships, similar to what ndings by Malki as among 274 females, aged from 18 to 57 years, having PMS interfering with their home responsibilities, relationships with their families, social life activities, and work productivity [24].…”

Top 100 Cited Papers on Premenstrual Syndrome/Premenstrual Dysphoric Disorder: A Bibliometric Study

“…For instance, studies showed that the prevalence of PMS among Academics at a University in Midwest Brazil was 46.9% ( 38 ), and 21.1% for university students ( 39 ), which are higher than ever before. Moreover, risk factors for PMS/PMDD include childhood abuse and neglect ( 40 ), childhood maltreatment ( 41 ), and perinatal depression ( 42 ), among others.…”

Mediating effect of suicidal ideation in the association between child abuse and premenstrual syndrome among female adults

“…The total score is calculated by summing the answers to the 17 items (range between 17 and 68). The Arabic version has been previously used [ 39 ]. In this study, the Cronbach’s alpha was 0.94.…”