title: Histories of abuse predict stronger within-person covariation of ovarian steroids and mood symptoms in women with menstrually related mood disorder.
abstract: OBJECTIVE
  Individual differences in sensitivity to cyclical changes in ovarian steroids estradiol (E2) and progesterone (P4) have been implicated in the pathophysiology of menstrually related mood disorder (MRMD). However, no prospective studies have investigated psychosocial risk factors for sensitivity to hormone effects on mood in MRMD. Using a repeated measures approach and multilevel models, we tested the hypothesis that a history of abuse provides a context in which within-person elevations of E2 and P4 prospectively predict daily symptoms.
  
  
  METHODS
  66 women with prospectively-confirmed MRMD recruited for a trial of oral contraceptives provided 1 month of baseline hormone and mood data prior to randomization. Lifetime physical and sexual abuse experiences were assessed. Across one cycle, women completed daily measures of symptoms and provided blood samples on 5 days across the menstrual cycle. Current E2 and P4 were centered within person (CWP) such that higher values represented cyclical elevations in hormones.
  
  
  RESULTS
  Rates of physical (27%) and sexual (29%) abuse were high, consistent with previous work documenting a link between trauma and MRMD. In women with a history of physical abuse, cyclical increases in P4 predicted greater mood and interpersonal symptoms on the three days following that sample. In women with a history of sexual abuse, cyclical increases in E2 predicted greater anxiety symptoms on the three days following that sample.
  
  
  CONCLUSIONS
  Results inform further inquiry into the role of severe life stressors and stress response systems in MRMD. We discuss areas for future research on the psychosocial and physiological pathways through which abuse may influence the link between hormones and symptoms.
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, 2218 Nelson Highway, Suite 3, Chapel Hill, NC 27517, United States. Electronic address: t.eisenlohr.moul@gmail.com.
authors.forename: Tory A
authors.initials: TA
authors.lastname: Eisenlohr-Moul
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, Campus Box 7160, Chapel Hill, NC 27599, United States. Electronic address: david_rubinow@med.unc.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Rubinow
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, 234 Medical School Wing C, Campus Box 7160, Chapel Hill, NC 27599, United States. Electronic address: crystal_schiller@med.unc.edu.
authors.forename: Crystal E
authors.initials: CE
authors.lastname: Schiller
authors.affiliation: Departments of Psychiatry and Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States. Electronic address: jaqueline_johnson@med.unc.edu.
authors.forename: Jacqueline L
authors.initials: JL
authors.lastname: Johnson
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States. Electronic address: jles@med.unc.edu.
authors.forename: Jane
authors.initials: J
authors.lastname: Leserman
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, 2218 Nelson Highway, Suite 3, Chapel Hill, NC 27517, United States. Electronic address: susan_girdler@med.unc.edu.
authors.forename: Susan S
authors.initials: SS
authors.lastname: Girdler
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000097:blood / Q000523:psychology; D011293:Premenstrual Syndrome / Q000097:blood / Q000175:diagnosis / Q000523:psychology*; D011374:Progesterone / Q000097:blood*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D011374:Progesterone; D004958:Estradiol
keywords: Abuse; Estradiol; Ovarian steroid hormones; Premenstrual dysphoric disorder; Progesterone