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Individual Three Minute Open Paper

Mood Disorders and Suicidality

Transdiagnostic Processes and Culturally Adapted Interventions in Mood and Anxiety Disorders

1 - (3-MIN 2) A Pilot Trial of Brief Tailored Online Treatment for Rumination and Worry in Premenstrual Dysphoric Disorder

Friday, June 26, 2026

11:35 AM - 11:46 AM PDT

Location: Yerba Buena Salon 2, B3 Level

Keywords: Women's Health, Rumination, Treatment
Recommended Readings: Kaluve, A. M., & Graham, B. M. (2025). The role of emotion dysregulation and rumination in predicting premenstrual symptom severity in premenstrual disorders and elevated anxiety or depression. Journal of Affective Disorders, 119705., Eisenlohr-Moul, T. (2019). Premenstrual disorders: a primer and research agenda for psychologists. The Clinical Psychologist, 72(1), 5., Joubert, A. E., Grierson, A. B., Li, I., Sharrock, M. J., Moulds, M. L., Werner-Seidler, A., Stech, E. P., Mahoney, A. E., & Newby, J. M. (2023). Managing Rumination and worry: A randomised controlled trial of an internet intervention targeting repetitive negative thinking delivered with and without clinician guidance. Behaviour research and therapy, 168, 104378., ,

Author(s)

Emily L. Upton, PsyM

PhD Candidate, Clinical Psychologist, Clinical Research Officer
UNSW Sydney, The Black Dog Institute
Newstead, Queensland, Australia

Co-Author(s)

AM

Alison Mahoney, Ph.D.

Senior Clinical Psychologist, Director of Clinical Research
Clinical Research Unit for Anxiety and Depression, St Vincents Hospital
Sydney, New South Wales, Australia
MM

Michelle Moulds, Ph.D.

Professor
UNSW Sydney
Sydney, New South Wales, Australia
Aliza Werner-Seidler, Ph.D.

Professor
Black Dog Institute
Randwick, New South Wales, Australia
JN

Jill M. Newby, Ph.D. (she/her/hers)

Professor
UNSW Sydney at the Black Dog Institute
Randwick, New South Wales, Australia

Background: Premenstrual Dysphoric Disorder (PMDD) is an under-researched disorder characterised by severe mood changes across the menstrual cycle, affecting up to 8% of menstruating individuals. Accessible psychological treatments are needed as current biological treatment options only offer modest relief. Evidence shows that Repetitive Negative Thinking (i.e., rumination and worry; RNT) is implicated in the onset and severity of PMDD symptoms, and therefore may be an important but untested psychological treatment target.

Methods: This single group pilot trial evaluated the outcomes, feasibility and acceptability of a brief, online, CBT treatment targeting rumination and worry in participants (N=38) with probable PMDD or moderate-severe Premenstrual Syndrome (PMS) and elevated levels of RNT (RTQ-10 score of ≥ 28). Participants received a 4-module clinician-supported online treatment delivered over 4 weeks.

Outcomes were evaluated at pre-, mid- and post-treatment (week 5) and follow-up (week 10; allowing for one menstrual cycle post-treatment) evaluating participants’ PMDD symptoms (PSST), RNT (RTQ-10, RRS-Brooding, PSWQ-A), depression and suicidality (PHQ-9), anxiety (GAD-7), distress (DQ-5), mental wellbeing (SWEMWBS), and functioning (WSAS), as well as treatment satisfaction and feedback. Qualitative interviews explored further treatment feedback and suggestions for improvement.

Results:
Data collection was finalised in December 2025 and analysis currently underway (expected completion February 2026). We expect that the sample will improve significantly on measures of PMDD, RNT and other outcomes (e.g., functioning), and the program will be feasible and acceptable to participants. Initial results show positive participant feedback, with 93% of the sample rating being Mostly to Very satisfied with the program, and all reporting they would recommend it to a friend.

Conclusion:
This is the first pilot trial to examine an online, RNT-focused intervention specifically tailored for individuals with PMDD. It has potential to serve as an accessible and scalable treatment for a population who currently lack psychological treatment options.

Clinical practice implications:
• PMDD is an under-researched mood disorder; few evidence-based psychological treatments exist.
• This brief, online intervention targeting Repetitive Negative Thinking may be an effective treatment option either alone or combined with biological treatments.
• Qualitative treatment feedback can help inform program improvements and more comprehensive future psychological treatments for PMDD.

Learning Objectives:

describe how a novel, brief, online intervention that targets Repetitive Negative Thinking (rumination and worry) can be an effective and accessible psychological treatment for Premenstrual Dysphoric Disorder.