Social workers' knowledge of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD): implications for assessment practices with mothers

Barry, Lynn (2016) Social workers' knowledge of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD): implications for assessment practices with mothers. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

Some women experience premenstrual syndrome (PMS), and its more severe presentation as premenstrual dysphoric disorder (PMDD), which seriously limits their coping ability in daily life, including their parenting ability. Social workers routinely assess parenting ability, giving rise to the question, “How does the premenstrual knowledge of social workers influence whether and what they ask in their assessment practices with mothers?” The heavily debated premenstrual literature rests on four approaches. After these perspectives, an enhanced biopsychosocial framework (BPS-E) is used to examine the premenstrual knowledge of social workers and their conversations about PMS/PMDD as they assess women’s parenting. This exploratory study used a triangulated convergence design, generating data from both quantitative and qualitative methodologies. In the first phase, 521 social workers completed a Premenstrual Experience Knowledge Questionnaire (PEKQ) created for this research. In the qualitative phase, inspired by an interpretative phenomenological approach, 16 social workers described in interviews their premenstrual knowledge and its impact, if any, on their assessment practices with mothers. Most social workers had limited knowledge of PMS/PMDD, most crucially a) the PMDD DSM-V classification, b) increased suicide attempts during the premenstruum, and c) the effectiveness of SSRI anti-depressants in moderating the symptoms of PMDD. Also, the greater the interference of social workers’ own premenstrual symptoms on their daily living and the more premenstrual training they had received, the higher their premenstrual knowledge scores. Very few social workers in this study (5.1%) addressed premenstrual symptoms with their female clients. However, a statistically significant relationship existed in this sample between asking female clients about PMS/PMDD and social workers’ (a) age, (b) premenstrual knowledge scores, (c) premenstrual training, and (d) the degree to which the premenstrual symptoms of female social workers interfered in their own daily living. These results can direct social work education and practice. Not asking about PMS/PMDD symptoms could have negative outcomes, particularly in child protection, where the safety needs of children could remain unaddressed. Conversely, women who tell uninformed or disapproving social workers about their premenstrual symptoms might be further subjected to mother-blame, stigmatization, or punitive interventions.

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