Exposure to American culture is associated with premenstrual dysphoric disorder among ethnic minority women

Abstract

Background: Ethnic minorities in America will achieve majority by 2042, and due to their younger age distribution, will represent the largest proportion of women at risk for premenstrual dysphoric disorder (PMDD). Research has not addressed ethnic minority women's vulnerabilities to PMDD. The objective of this study was to examine the relationship between acculturation and PMDD.

Methods: An analysis of acculturation and PMDD among 3856 English-speaking, pre-menopausal Asian, Latina, and Black women from the National Latino and Asian American Survey and the National Survey of American Life was performed.

Results: The lifetime prevalence of PMDD was 3.3%. Nativity status, duration of residence, and age at immigration were significantly associated with PMDD. Foreign-born women (OR=0.38; 95% confidence interval (CI)=0.21-0.68) and immigrants arriving to the US after age six (OR=0.33, 95% CI=0.18, 0.62) were less likely to have PMDD, compared to US-born women, and US-born women/immigrants who arrived before age six, respectively. The likelihood of PMDD increased as the duration of residence in the US lengthened.

Limitations: The diagnosis of PMDD was provisional due to retrospective symptom reporting. Statements of causality could not be made because the study was cross-sectional.

Conclusions: A substantial percentage of ethnic minority women suffer from PMDD in their lifetimes. Exposure to American culture appeared to elevate ethnic minority women's likelihood for PMDD. The stressors that are associated with ethnic minority life in America-discrimination, poverty, pressures to assimilate, etc.-may contribute to ethnic minority women's vulnerability to PMDD, and clinicians should be sensitive to the special risks in this population.

Figure 1

Nativity status, duration of residence, age at immigration, and PMDD among ethnic minority women.