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状态和特质认知会对经前期烦躁障碍患者和非患者的情绪和皮质醇的周期性产生不同影响。

State and trait cognitions differentially affect cyclicity of mood and cortisol in individuals with and without premenstrual dysphoric disorder.

机构信息

Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg.

Department of Biostatistics, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg.

出版信息

J Psychopathol Clin Sci. 2024 May;133(4):309-320. doi: 10.1037/abn0000894. Epub 2024 Apr 18.

Abstract

Premenstrual dysphoric disorder (PMDD) is characterized by a cyclical symptom course. Previous research provides limited findings on possible menstrual-cycle-related psychological and psychoendocrinological processes in PMDD. By using ambulatory assessment (AA), we aimed to compare mood and cortisol cyclicity in individuals with PMDD and healthy controls (HC), and to assess effects of habitual and momentary repetitive negative thinking (RNT) and present moment awareness (PMA) on mood and cortisol across the cycle in both groups. Individuals with PMDD and HC ( = 60 each) completed baseline questionnaires on habitual RNT and PMA. Momentary rumination and PMA, positive and negative affect (NA), and saliva-cortisol were assessed over four consecutive days during both the follicular and the late-luteal phase. Individuals with PMDD showed mood cyclicity indicating mood worsening while HC showed cortisol cyclicity indicating decreasing cortisol levels toward the late-luteal phase. In individuals with PMDD, lower habitual RNT and higher habitual PMA predicted better mood only during the follicular phase whereas lower momentary rumination and higher momentary PMA predicted better mood during the late-luteal phase. No effects on cortisol activity were found. In HC, higher habitual PMA predicted lower NA during the late-luteal phase whereas lower momentary rumination and higher momentary PMA predicted stronger cortisol reduction toward the late-luteal phase. While favorable habitual cognitions might not protect individuals with PMDD against premenstrual mood deterioration, respective momentary cognitions may reflect possible protective factors, suggesting an opportunity for microinterventions to directly target late-luteal-phase-specific state processes in affected individuals. The lack of cortisol cyclicity might represent an endocrinological marker for PMDD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

经前期烦躁障碍 (PMDD) 的特征是周期性的症状发作。先前的研究对 PMDD 中可能与月经周期相关的心理和心理内分泌过程提供了有限的发现。通过使用动态评估 (AA),我们旨在比较 PMDD 患者和健康对照组 (HC) 之间的情绪和皮质醇周期性,并评估习惯性和即时重复消极思维 (RNT) 和当前时刻意识 (PMA) 对两组周期中情绪和皮质醇的影响。PMDD 患者和 HC(每组 60 人)完成了关于习惯性 RNT 和 PMA 的基线问卷。在卵泡期和黄体晚期的连续四天中,评估了即时的沉思和 PMA、积极和消极情绪 (NA) 以及唾液皮质醇。PMDD 患者表现出情绪周期性,表明情绪恶化,而 HC 则表现出皮质醇周期性,表明皮质醇水平在黄体晚期下降。在 PMDD 患者中,较低的习惯性 RNT 和较高的习惯性 PMA 仅在卵泡期预测情绪更好,而较低的即时沉思和较高的即时 PMA 预测黄体晚期情绪更好。皮质醇活性没有影响。在 HC 中,较高的习惯性 PMA 预测黄体晚期的 NA 较低,而较低的即时沉思和较高的即时 PMA 预测黄体晚期皮质醇下降幅度更大。虽然有利的习惯性认知可能无法保护 PMDD 患者免受经前期情绪恶化的影响,但各自的即时认知可能反映了可能的保护因素,这表明有机会进行微观干预,直接针对受影响个体的黄体晚期特定状态过程。皮质醇周期性的缺乏可能代表 PMDD 的内分泌标志物。(PsycInfo 数据库记录(c)2024 APA,保留所有权利)。

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