Relationship between the NEO personality inventory revised neuroticism scale and prospectively reported negative affect across the menstrual cycle

Mid-Luteal Progesterone Is Inversely Associated with Premenstrual Food Cravings

It is not clear whether progesterone and estradiol associate with premenstrual food cravings, which significantly contribute to cardiometabolic adverse effects associated with obesity. We sought to investigate this question in the present study based on the prior literature showing a protective effect of progesterone on drug craving and extensive neurobiological overlaps between food and drug cravings. We enrolled 37 non-illicit drug- or medication-using women in the study to provide daily ratings of premenstrual food cravings and other symptoms across two-three menstrual cycles, based on which we classified them as premenstrual dysphoric disorder (PMDD) or control participants. In addition, the participants provided blood samples at eight clinic visits across the menstrual cycle. We aligned their mid-luteal progesterone and estradiol using a validated method which relies upon the peak serum luteinizing hormone and analyzed estradiol and progesterone using ultraperformance liquid chromatography tandem mass spectrometry. Hierarchical modeling, adjusted for BMI, showed a significant inverse effect of progesterone (p = 0.038) but no effect of estradiol on premenstrual food cravings. The association was not unique to PMDD or control participants. Results of research to date in humans and rodents showing that progesterone has dampening effects on the salience of the reinforcer translate to premenstrual food cravings.

Weak associations between personality and contraceptive choice

Prospective randomized controlled trials on hormonal contraceptive (HC) effects on the brain are rare due to a number of methodological challenges. Thus, much of the evidence on HC effects on the brain comes from cross-sectional studies comparing HC-users to non-users. In interpreting these findings, it is of importance to be aware of potential confounds associated with women's contraceptive choices. Previous studies have discussed age, education, social status, sexual orientation, relationship status, and tolerability of HC. Given the current trend toward a reduction in HC use and increased skepticism toward HC it seems relevant to also identify variables associated with women's attitudes toward HC and whether they may represent confounds for neuroscientific studies. In the present study, we investigated whether women's personality characteristics were associated with their choice to use or not use HC in the present, past and future and the type of HC chosen. 1,391 females aged 18-45 years participated in an online survey including the HEXACO-60 personality questionnaire, as well as two different measures of gender role, and provided information about their current and previous contraceptive status, as well as experiences with and attitudes toward contraceptive use. We compared (i) current, previous and never-users of HC, (ii) prospective users of HC to women who opposed future HC use, and (iii) current users of IUDs to current users of oral contraceptives. Results revealed that associations between personality and the decision to use or not use HC were negligible, while differences in personality were observed corresponding to contraceptive type. Current users of IUDs showed higher agreeableness and extraversion compared to current users of oral contraceptives. The results suggest that personality is more strongly associated to the choice of contraceptive type rather than the choice between hormonal and non-hormonal options.

Hormonal contraceptive usage influences stress hormone effects on cognition and emotion

Men and women partially differ in how they respond to stress and how stress in return affects their cognition and emotion. The influence of hormonal contraceptives (HCs) on this interaction has received little attention, which is surprising given the prevalence of HC usage. This selective review illustrates how HC usage modulates the effects of stress hormones on cognition and emotion. As three examples, we discuss stress hormone effects on episodic memory, fear conditioning and cognitive emotion regulation. The identified studies revealed that stress effects on cognitive-emotional processes in women using HCs were at times reduced or even absent when compared to men or naturally cycling women. Especially striking were the few examples of reversed effects in HC women. As underlying neuroendocrine mechanisms, we discuss influences of HCs on the neuroendocrine stress response and effects of HCs on central glucocorticoid sensitivity. The summarized findings emphasize the need for additional translational research.

Association between Neuroticism and Premenstrual Affective/Psychological Symptomatology

Neuroticism and premenstrual conditions share pleiotropic loci and are strongly associated. It is presently not known which DSM-5 symptoms of premenstrual syndrome/premenstrual mood disorder are associated with neuroticism. We enrolled 45 study participants to provide prospective daily ratings of affective ("depression", "anxiety, "anger", "mood swings") and psychological ("low interest", "feeling overwhelmed", and "difficulty concentrating") symptoms across two-three menstrual cycles (128 total cycles). Generalized additive modeling (gam function in R) was implemented to model the relationships between neuroticism and the premenstrual increase in symptomatology. Significance level was adjusted using the False Discovery Rate method and models were adjusted for current age and age of menarche. Results of the association analysis revealed that "low interest" (p ≤ 0.05) and "difficulty concentrating" (p ≤ 0.001) were significantly associated with neuroticism. None of the remaining symptoms reached statistical significance. The late luteal phase of the menstrual cycle is characterized by complex symptomatology, reflecting a physiological milieu of numerous biological processes. By identifying co-expression between neuroticism and specific premenstrual symptomatology, the present study improves our understanding of the premenstrual conditions and provides a platform for individualized treatment developments.

Psychiatric Symptoms Across the Menstrual Cycle in Adult Women: A Comprehensive Review

LEARNING OBJECTIVE

After participating in this activity, learners should be better able to:• Discuss and outline the general and overlapping effects of the menstrual cycle on women's mental health.

ABSTRACT

A growing body of research demonstrates menstrual cycle-dependent fluctuations in psychiatric symptoms; these fluctuations can therefore be considered as prevalent phenomena. Possible mechanisms underlying these fluctuations posit behavioral, psychological, and neuroendocrine influences. Recent reviews document cyclic exacerbation of symptoms and explore these mechanisms in the context of specific and often single disorders. The question remains, however, as to whether there are general and overlapping effects of the menstrual cycle on women's mental health. To address this gap, we synthesized the literature examining the exacerbation of a variety of psychiatric symptoms across the menstrual cycle in adult women. Results show that the premenstrual and menstrual phases are most consistently implicated in transdiagnostic symptom exacerbation. Specifically, strong evidence indicates increases in psychosis, mania, depression, suicide/suicide attempts, and alcohol use during these phases. Anxiety, stress, and binge eating appear to be elevated more generally throughout the luteal phase. The subjective effects of smoking and cocaine use are reduced during the luteal phase, but fewer data are available for other substances. Less consistent patterns are demonstrated for panic disorder, symptoms of posttraumatic stress disorder, and borderline personality disorder, and it is difficult to draw conclusions for symptoms of generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and trichotillomania because of the limited data. Future research should focus on developing standardized approaches to identifying menstrual cycle phases and adapting pharmacological and behavioral interventions for managing fluctuations in psychiatric symptoms across the menstrual cycle.

Psychometric properties of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) in Chinese undergraduates and depressive patients

BACKGROUDS

The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) is a widely self-report questionnaire to assess resilience in different populations, including adolescents, elderly individuals and psychiatric patients. Considering the application of the CD-RISC-10 in depression patients, the present study aimed to evaluate the psychometric properties, especially the measurement invariance, of the CD-RISC-10 in depressive patient sample.

METHODS

A total of 2230 undergraduates from Hunan Province and 293 patients with major depressive disorder (MDD) from psychological clinics participated in our study. Confirmatory factor analysis (CFA) was conducted to evaluate the single-factor model of the CD-RISC-10 and the measurement equivalence of the CD-RISC-10 across the clinical (MDD) and non-clinical (undergraduate) samples, as well as gender invariance in the non-clinical sample.

RESULTS

The findings implied that the CD-RISC-10 showed good reliability and validity, including favorable internal consistency and criterion-related validity. The CFA results showed that the strong model fit for a unidimensional structure of the CD-RISC-10 was supported in the clinical (eg., CFI >0.910, TLI >0.900, RMSEA < 0.080) and non-clinical (eg., CFI >0.950, TLI >0.940, RMSEA < 0.060) groups, respectively. Moreover, the scalar invariance of the CD-RISC-10 was supported across the clinical and non-clinical samples (eg., △CFI < 0.009, △TLI < 0.005, ΔRMSEA < 0.003). Similarly, the strict gender invariance was also established in the male (n = 1035) and female (n = 1195) undergraduate samples (eg., △CFI < 0.008, △TLI < 0.004, ΔRMSEA < 0.002).

LIMITATIONS

The inclusion of Chinese individuals only and the absence of depressive patients with comorbidities were our major limitations.

CONCLUSIONS

Overall, these psychometric findings not only supported the stability and validity of the CD-RISC-10 for application with different samples in resilience study, but also indicated that the CD-RISC-10 could be an effective instrument for research in depression.

No personality differences between oral contraceptive users and naturally cycling women: Implications for research on sex hormones

Oral contraceptives (OCs) are the most widely used contraception method, and there is increasing interest in their effects on cognition, affect, and brain structure and function. Since women are not randomly assigned to OC use or non-use, it is unclear if previously-reported differences between OC users and naturally cycling (NC) women are due to sex hormones or to personal characteristics associated with pill use. The aim of this study was to fill this knowledge gap by comparing OC users and NC women on the Big Five personality factors. Participants came from two independent, large samples. The first contained 148 OC users and 93 NC women, and the second contained 247 OC users and 148 NC women. Consistent across both samples, multivariate analyses of covariance (with the five personality factors as dependent variables and age as a covariate) revealed no significant differences between OC users and NC women in personality, with absolute values of univariate effect sizes averaging d = .09. The pattern of results did not change when reason for OC use was considered, and users of different types of OCs did not differ from each other in personality. This well-powered study did not find personality differences between OC users and NC women in two independent samples, suggesting that previously-reported differences in cognition, affect, and the brain may be linked to neuroendocrinology.

Negative affect is unrelated to fluctuations in hormone levels across the menstrual cycle: Evidence from a multisite observational study across two successive cycles

BACKGROUND

Female sex hormones may play a crucial role in the occurrence of cycle-related mood disorders. However, the literature is inconsistent and methodologically stringent observational studies on the relationship between sex hormones and negative affect are lacking.

METHODS

In this longitudinal multisite study from Hannover, Germany, and Zurich, Switzerland, we examined oestrogen, progesterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone serum levels in association with negative affect as measured with the Positive and Negative Affect Schedule (PANAS). Negative affect and hormone assays were collected at four consecutive time points comprising menstrual, pre-ovulatory, mid-luteal and premenstrual phase across two cycles (n=87 and n=67 for the first and second cycles). The Beck Depression Inventory (BDI) was assessed once prior to the first cycle and included as a secondary measure.

RESULTS

Mean negative affect scores did not significantly fluctuate across both cycles and there was in particular no symptom increase premenstrually. No sex hormone consistently related to repeated measures of negative affect across two consecutive cycles. The BDI sum-score assessed at baseline was not related to hormone levels across the first cycle.

CONCLUSIONS

This is the first multisite longitudinal study on the association between negative affect and sex hormone levels encompassing two consecutive menstrual cycles. Negative affect did not fluctuate across the cycle and there was no direct and uniform association between sex hormones and self-reported negative affect. These findings suggest that moderators such as personality traits and epigenetics should be considered in future research.

Novelty seeking and reward dependence-related large-scale brain networks functional connectivity variation during salience expectancy

A salience network (SN) anchored in the anterior insula (AI) and dorsal anterior cingulate cortex (dACC) plays a key role in switching between brain networks during salience detection and attention regulation. Previous fMRI studies have associated expectancy behaviors and SN activation with novelty seeking (NS) and reward dependence (RD) personality traits. To address the question of how functional connectivity (FC) in the SN is modulated by internal (expectancy-related) salience assignment and different personality traits, 68 healthy participants performed a salience expectancy task using functional magnetic resonance imaging, and psychophysiological interaction analysis (PPI) was conducted to determine salience-related connectivity changes during these anticipation periods. Correlation was then evaluated between PPI and personality traits, assessed using the temperament and character inventory of 32 male participants. During high salience expectancy, SN-seed regions showed reduced FC to visual areas and parts of the default mode network, but increased FC to the central executive network. With increasing NS, participants showed significantly increasing disconnection between right AI and middle cingulate cortex when expecting high-salience pictures as compared to low-salience pictures, while increased RD also predicted decreased right dACC and caudate FC for high salience expectancy. Our findings suggest a direct link between personality traits and internal salience processing mediated by differential network integration of the SN. SN activity and coordination may therefore be moderated by novelty seeking and reward dependency personality traits, which are associated with risk of addiction. Hum Brain Mapp 38:4064-4077, 2017. © 2017 Wiley Periodicals, Inc.

Progesterone mediates the late positive potentials evoked by affective pictures in high neuroticism females

BACKGROUND

Neuroticism, which is a personality trait characterized by the tendency to experience negative affect, is associated with premenstrual negative emotion changes. The present ERP study intended to investigate how neuroticism and the menstrual cycle influence the evaluation of emotion as a function of the tested levels of ovarian hormones.

METHOD

Forty-two healthy females with regular menstrual cycles were grouped by neuroticism (N): 16 were included in the high-N group, and 26 were included in the low-N group. Each female performed an emotion evaluation task in the early follicular phase, late follicular phase and luteal phase while the ERPs, hormone samples and Pleasure-Arousal-Dominance (PAD) mood ratings were measured.

RESULTS

The PAD and behavioral data did not differ between the two groups during the three phases. However, the mean amplitude of the Late Positive Potentials (LPP, 300-1000ms post-stimulus) of ERPs was significantly larger in the high-N group than that in the low-N group. Moreover, the interaction between the group and phase was significant 2000-4000ms post-stimulus: for the high-N group, the LPP of the luteal phase was the largest, followed by the late follicular phase and the early follicular phase; whereas the LPP of the luteal phase was the largest, followed by the early follicular phase and the late follicular phase for the low-N group. More importantly, the LPP (300-4000ms post-stimulus) evoked by positive pictures from the central or parietal area was significantly negatively correlated with the progesterone level in the early follicular phase.

CONCLUSIONS

The present study provides electrophysiological evidence showing that both the menstrual cycle and neuroticism modulate the LPP evoked by emotional pictures. Furthermore, the negative correlation between progesterone and the amplitude of the LPP suggests that the effect of the menstrual cycle on the LPP may be primarily a function of progesterone. These findings suggest that the LPP evoked by emotional pictures for high and low neuroticism females change throughout the menstrual cycle and that this change is in part mediated by progesterone.

Estrogen receptor alpha (ESR-1) associations with psychological traits in women with PMDD and controls

Premenstrual Dysphoric Disorder (PMDD) is a mood disorder affecting about 5% of women and is associated with substantial morbidity. Albeit inconsistently, PMDD is described as being characterized by heritable personality traits. Although PMDD is a heritable disorder, it is unclear whether any of the heritable susceptibility to PMDD resides in heritable personality traits. In groups of carefully characterized women with PMDD (n=68) and controls (n=56), we attempted to determine whether diagnosis-related traits could be confirmed, as well as to determine whether such traits were associated with SNPs in estrogen receptor alpha (ESR-1) that we previously demonstrated were associated with PMDD. We observed 7/25 traits to be significantly different in patients and controls and further showed that 11/12 significant associations observed between these 7 traits and 16 ESR-1 SNPs involved the intron 4 SNPs previously shown to be the locus of the association with PMDD. While several interactions between genotype and diagnosis were observed, the effect of genotype in most instances was in the same direction in patients and controls. These data demonstrate affective state-independent personality traits that distinguish patients with PMDD from controls and further support the relevance of ESR-1 polymorphic variants in the regulation of non-reproductive behaviors.

The possible protective role of personality dimensions against premenstrual syndrome

Previous studies suggest that women with premenstrual syndrome (PMS) differ from those without PMS in personality dimensions, but it is not clear what role personality plays in the background of premenstrual symptomatology. Our purpose was to examine personality dimensions measured by the Tridimensional Character Inventory (TCI) in psychiatrically healthy women not suffering from premenstrual dysphoric disorder (PMDD) in relation to the severity of distressing and impairing mental and physical symptoms experienced in the late luteal phase of the menstrual cycle. Forty healthy women completed the prospective record of the Impact and Severity of Menstrual Symptoms (PRISM) calendar every evening through three consecutive menstrual cycles and were assigned into LPS (luteal phase symptom) vs. non-LPS groups. Our grouping did not reflect categorization according to the presence of PMS, since we investigated healthy women. Personality characteristics were evaluated using the TCI. LPS subjects scored significantly higher in subscales associated with novelty seeking (NS), self-directedness (S), cooperation (C) and self-transcendence (ST), and lower in the harm avoidance (HA) scale. Elevated scores of women with higher symptom severity in the late luteal phase in NS, S, ST and C scales and lower HA scores are in contrast with previous results on personality traits associated with PMS. However, we investigated psychiatrically healthy women. Therefore, our results suggest that this personality profile is a protective factor against developing serious psychiatric symptoms when experiencing a distressing and more marked symptomatology associated with the late luteal phase of the reproductive cycle.

Do the emotional side-effects of hormonal contraceptives come from pharmacologic or psychological mechanisms?

Hormonal preparations have become one of the most popular methods used for controlling fertility. The literature over the last 40 years continues to reveal how their numerous side effects negatively impact many users and even society at large. Three large cohort trials were the first to demonstrate, on a grand scale, certain emotional and behavioral associations with contraceptive use. Current contraceptive use was associated with an increase rate in depression, divorce, tranquilizer use, sexual dysfunction, and suicide and other violent and accidental deaths. Despite the advent of more "user friendly" contraceptives, the discontinuation rate secondary to side effects has changed little through the years. While in rare cases hormonal preparations can be deadly to the user, there is substantial evidence that their negative effect issues more from their emotional and behavioral properties. This paper reviews the results of over seven studies which further characterize these prominent associations, particularly with hormonal contraception, in an attempt to demonstrate their association with the intrinsic pharmacologic properties of hormonal preparations. Hormonal contraceptive users, in contrast with non users, were found to have higher rates of depression, anxiety, fatigue, neurotic symptoms, sexual disturbances, compulsion, anger, and negative menstrual effects. The question of whether the association of these maladies is directly due to the effect of taking exogenous hormones versus the psychological impact of the contraceptive behavior itself had yet to be studied. Seven small randomized-controlled trials were found in a review of the literature which studied this hypothesis in a direct way. They do not support the origination of these side effects being from the pharmacological properties of hormones. No association was found between hormone levels and emotional functioning in females. Psychiatric evaluations among IUD and oral contraceptive pill (OCP) users reveal no significant differences. Women who were given an OCP placebo experienced a similar side effect profile of OCP users. Different hormonal concentrations and combinations made no significant difference in the side effect profile. A study of women who were given either "weak female hormones" or a placebo failed to duplicate the side effect profile found in all of the other studies where the hormones were labeled as contraceptives. The evidence suggests that most of the side effects of hormonal contraception are a result of a psychological response to the practice of contraception. More study is warranted to further understand this psychological phenomenon, especially now that an effective non-contraceptive method of fertility regulation and more reliable psychological instruments are available. Furthermore, it is reasonable to hypothesize, given the present data, that contraceptive activity itself is inherently damaging to women.