Premenstrual Dysphoric Disorder (PMDD) is proposed as a cluster of severe emotional, physical and behavioral symptoms that affect a small percentage of women during the late luteal phase of their menstrual cycle and cease shortly after the onset of menses. Although some researchers hypothesize there is a difference in the amount of pain actually experienced during the premenstrual phase, others argue that there may be differences in how women interpret the 'normal' fluctuations and bodily changes of the premenstrual phase. Perhaps women who experience severe premenstrual symptoms anticipate their symptoms and become hypervigilant in monitoring normal bodily sensations, which results in increased attention and focus on painful sensations. Catastrophic thinking is related to an inability to divert attention away from pain. Thus, researchers have proposed a relationship between the premenstrual symptom severity associated with PMDD and the tendency to catastrophize. Depression is also shown to be related to PMDD and catastrophizing. Although PMDD is relatively rare, a large percentage of women do experience at least some severe premenstrual symptoms on a monthly basis.

The present study explored the relationship between catastrophizing, general cognitive distortion, depression and self-report of premenstrual symptoms in a sample of undergraduate students at a Midwestern University. As predicted, it was found that catastrophizing was positively associated with severe premenstrual symptoms, specifically pain symptoms, as well as depression. It was also found, as expected, that general cognitive distortion mediated the relationship between depression and severe premenstrual symptoms. However, contrary to predictions, pain catastrophizing was not found to mediate the relationship between depression and severe premenstrual symptoms The results from this study provide insight into why some women may experience extreme premenstrual symptoms and how this affects diagnosis, as well as treatment options.