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Arch Womens Ment Health. 2016 Dec;19(6):1063-1070. doi: 10.1007/s00737-016-0656-y. Epub 2016 Aug 18.

Emotional regulation difficulties and premenstrual symptoms among Israeli students.

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Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
MRI/MRS Lab, The Human Biology Research Center, Department of Medical Biophysics, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Edmond and Lily Safra Center for Brain Sciences (ELSC), The Hebrew University of Jerusalem, Jerusalem, Israel.
Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Department of Psychology, Hebrew University, Jerusalem, Israel.


Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) reported to affect 3-8 % of women of reproductive age and resulting in marked emotional and occupational impairment. Despite its prevalence, the etiology of PMDD is largely unknown, and patients remain mostly undiagnosed and poorly treated. It has been suggested that PMDD is a manifestation of underlying depressive disorder which is associated with the inability to regulate emotions in an adaptive manner. Therefore, we hypothesized that women with PMDD would exhibit increased difficulty with emotional regulation. A total of 648 female Israeli college students were assessed by the Premenstrual Symptoms Screening Tool (PSST) and the Difficulties in Emotion Regulation Scale (DERS). Of these women, 166 (25.6 %) met the criteria for PMS. Sixty-four (9.9 %) suffered from PMDD. More emotion regulation deficits were observed in the PMDD and PMS groups compared to the control group. Furthermore, there were more emotional regulation deficits among the predominantly psychological and mixed symptom subtype compared to the predominantly physical symptom subtype group. This is the first study to report an association between emotional dysregulation and PMDD. These findings may lead to development of more individually tailored treatment protocols focused on improving emotional regulation techniques.


Difficulties in Emotion Regulation Scale (DERS); Premenstrual Symptoms Screening Tool (PSST); Premenstrual dysphoric disorder (PMDD); Premenstrual syndrome (PMS)

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