Dimensionality of the premenstrual syndrome: confirmatory factor analysis of premenstrual dysphoric symptoms among college students

Y.-P Wang,C Gorenstein,C.-T Teng,L.H Andrade,A.H.G Vieira Filho

doi:10.1590/s0100-879x2007000500006

Abstract

Premenstrual syndrome and premenstrual dysphoric disorder (PMDD) seem to form a severity continuum with no clear-cut boundary. However, since the American Psychiatric Association proposed the research criteria for PMDD in 1994, there has been no agreement about the symptomatic constellation that constitutes this syndrome. The objective of the present study was to establish the core latent structure of PMDD symptoms in a non-clinical sample. Data concerning PMDD symptoms were obtained from 632 regularly menstruating college students (mean age 24.4 years, SD 5.9, range 17 to 49). For the first random half (N = 316), we performed principal component analysis (PCA) and for the remaining half (N = 316), we tested three theory-derived competing models of PMDD by confirmatory factor analysis. PCA allowed us to extract two correlated factors, i.e., dysphoric-somatic and behavioral-impairment factors. The two-dimensional latent model derived from PCA showed the best overall fit among three models tested by confirmatory factor analysis (chi(2)53 = 64.39, P = 0.13; goodness-of-fit indices = 0.96; adjusted goodness-of-fit indices = 0.95; root mean square residual = 0.05; root mean square error of approximation = 0.03; 90%CI = 0.00 to 0.05; Akaike's information criterion = -41.61). The items "out of control" and "physical symptoms" loaded conspicuously on the first factor and "interpersonal impairment" loaded higher on the second factor. The construct validity for PMDD was accounted for by two highly correlated dimensions. These results support the argument for focusing on the core psychopathological dimension of PMDD in future studies.

Highlights

Premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS) are considered to be similar premenstrual conditions, they differ in several respects
Since the American Psychiatric Association (APA) proposed the research criteria for PMDD in 1994, there has been no agreement about the symptomatic constellation that constitutes this syndrome [1]
According to the DSM-IV [1], PMDD presents a characteristic pattern of symptoms, severity and resulting impairment, i.e., PMDD is regarded as an affective syndrome with social and interpersonal impairment

Summary

Introduction

Premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS) are considered to be similar premenstrual conditions, they differ in several respects. Since the American Psychiatric Association (APA) proposed the research criteria for PMDD in 1994, there has been no agreement about the symptomatic constellation that constitutes this syndrome [1]. According to the DSM-IV [1], PMDD presents a characteristic pattern of symptoms, severity and resulting impairment, i.e., PMDD is regarded as an affective syndrome with social and interpersonal impairment. To meet the diagnosis of PMDD, a woman should present a symptomatic pattern change from the follicular to the luteal phase, with the marked presence of at least one affective symptom (depressive mood, anxiety or tension, affect lability, and anger or irritability) among the 5 symptoms required by the DSMIV criteria. Interpersonal and social impairment is a criterion of clinical significance that is mandatory for the diagnosis of PMDD. There is much uncertainty about the nature of self-reported impairment in PMDD

Objectives

Methods

Results

Conclusion