Forgiveness and transgression-related rumination in perimenopausal depression: a testable socio-affective hypothesis

The risk of depression increases during the early and late menopausal transition before the final menstrual period, although most women do not experience clinically significant depressive symptoms. Vulnerability appears concentrated in a subgroup with mood sensitivity to reproductive-hormone fluctuations. Sensitivity to estradiol change predicts perimenopausal depressive symptoms, while altered allopregnanolone signaling at γ-aminobutyric acid type A (GABA-A) receptors may contribute to mood symptoms [1, 2].

This literature supports a symptom-profile approach that distinguishes reproductive-hormone sensitivity from perimenopause itself. This hypothesis focuses on perimenopausal depression, in which biological vulnerability occurs alongside persistent stress reactivity and repeated thinking about an interpersonal hurt and its emotional impact. Persistent rumination is associated with difficulty disengaging from negative information and impaired cognitive control involving prefrontal and cingulate systems [3].

These processes may prolong responses to interpersonal stress during the menopausal transition. However, evidence does not establish that forgiveness modifies transgression-related rumination through GABAergic mechanisms. Accordingly, reducing transgression-related rumination is the proposed intervention’s primary objective.

Frontocingulate function and GABAergic measures remain exploratory biomarkers because neither is established as a pathway through which forgiveness reduces symptoms in this population. This is a preview of subscription content, access via your institution Receive 13 print issues and online access We are sorry, but there is no personal subscription option available for your country. Prices may be subject to local taxes which are calculated during checkout Gordon JL, Sander B, Eisenlohr-Moul TA, Sykes Tottenham L.

Mood sensitivity to estradiol predicts depressive symptoms in the menopause transition. Psychol Med. 2021;51:1733–41. Perimenopausal depression: review of recent findings and implications for future research.

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