Beliefs about emotions, distress tolerance and paranoia across the menstrual cycle in individuals with premenstrual difficulties and controls

Objectives Premenstrual Disorders are characterized by recurrent symptoms associated with clinically significant distress or impairment. There is limited understanding of psychological processes associated with premenstrual difficulties. This study investigated maladaptive beliefs about emotions, distress tolerance and social‐cognitive experiences of paranoia in individuals with premenstrual difficulties and controls across cycle phases. Methods 109 participants provided data at four timepoints across two menstrual cycles. Participants were classified into PSST‐defined provisional PMDD, moderate‐to‐severe PMS and control groups. Psychological outcomes were assessed during perimenstrual (cycle days 1–2) and mid‐follicular (cycle days 4–8) phases across two cycles. Differences across assessment timepoints and groups were examined using linear mixed‐effects models. Results In the provisional PMDD group, maladaptive beliefs about emotions were higher and distress tolerance lower at perimenstrual assessments than at mid‐follicular assessments and controls perimenstrually. Ideas of reference were also higher at perimenstrual assessments than at mid‐follicular assessments and controls perimenstrually. Ideas of persecution did not show the perimenstrual increase in either premenstrual difficulties group. Phase‐related changes were not consistently observed in the moderate‐to‐severe PMS group or controls. Mid‐follicular maladaptive beliefs about emotions and ideas of reference did not differ significantly between premenstrual difficulties groups and controls; however, distress tolerance remained lower in the provisional PMDD group than in controls. Conclusions The provisional PMDD group showed higher perimenstrual maladaptive beliefs about emotions and ideas of reference, alongside lower distress tolerance. These findings suggest these processes may be relevant to more severe premenstrual difficulties. Prospective daily assessments are needed to clarify the temporal relationships between these processes and symptom severity.