Multifactorial models: Moving away from linear models of PMS?

The recent development of multifactorial models, which implicitly integrate the results of a number of different studies, may appear to be a move away from these unilinear model of cause and effect. Following the work of Engel (1977), who attempted to develop ways of integrating the different levels of the human “system”—ranging from the bio-chemical to the socio-cultural through the development of the “bio-psycho-social model”—a number of authors have proposed the adoption of a “bio-psycho-social” or diathesisstressor approach to PMS as a means of overcoming the problem of disciplinary divides and as an attempt to reconcile disparate and apparently contradictory research findings (Alberts & Alberts, 1990; Miota et al., 1991; Ussher, 1991a; Walker, 1993). What each of these models share is a recognition of the importance of both the bio-medical and psycho-social factors in the aetiology of PMS, and implicitly a recognition that these factors will interact in different ways for different women, both across the life cycle and in different socio-cultural situations.