Mindfulness-Based Stress Reduction as a Promising Intervention for Amelioration of Premenstrual Dysphoric Disorder Symptoms

Menstrually related mood disorders (MRMDs) are characterized by the cyclic recurrence of affective and somatic symptoms in the luteal phase of the menstrual cycle that result in substantial impairment. Despite the efficacy of SSRIs and a low-dose oral contraceptive, non-response rates are ≥40 %, and the need for a behavioral intervention in this population is warranted. This pilot study was conducted to determine the feasibility and acceptability of an 8-week mindfulness-based intervention for women with a MRMD. Self-report measures assessing pain catastrophizing, mindfulness, depression, anxiety, rumination, and self-compassion were completed before and after the intervention as were laboratory measures of pain sensitivity to a cold pressor and tourniquet procedure and cardiovascular responses to a mental stressor. In addition, premenstrual symptom severity ratings for 11 MRMD symptoms were assessed prospectively. Results indicated that, relative to pre-intervention levels, there was a significant decrease in symptom severity for seven of the 11 premenstrual symptoms, an increase in pain tolerance to the cold pressor, and a decrease in blood pressure reactivity to mental stress. The use of a historical control group supports that the effects for symptoms and pain sensitivity could not be accounted for by habituation to repeat testing. Further, 88 % of participants completed the study and all post-intervention measures, and all women reported that they used the stress reduction skills in the post-lab and in their daily lives. Mindfulness training provides a feasible, well-tolerated behavioral intervention that should be tested for efficacy in a larger randomized trial in women with a MRMD.