Determining the Effectiveness of Acceptance and Commitment Therapy on Depression and the Quality of Marital Relationships in Women with Premenstrual Symptoms

One of the most common menstrual disorders is premenstrual syndrome. Premenstrual symptoms are recurrences of periods of physical, psychological, or behavioral symptoms that appear after ovulation and resolve within a few days of the onset of menstruation (the first week of the follicular phase). One of the significant problems with premenstrual symptoms is mood swings that affect women's feelings about themselves, the world in which they live, and those who interact with them. In this regard, depression is one of the major problems in women with premenstrual syndrome. The premenstrual syndrome includes a wide range of emotional, mood, and physical changes, leading to a decline in the quality of the marital relationship and, as a result, marital dissatisfaction among women with this syndrome. New non–pharmacological treatments include acceptance and commitment therapy (ACT). This study aimed to determine the effectiveness of treatment of acceptance and commitment on depression and the quality of the marital relationship of women with premenstrual syndrome.

The present research method was quasi–experimental with a pretest–posttest design with a control group. The statistical population included all women with premenstrual syndrome referred to the Obstetrics and Gynecology Clinic of Razavi Hospital in Mashhad City, Iran, from September 2018 to February 2019 for 6 months. Among them, 30 eligible candidates were selected by the available sampling method and randomly assigned to the experimental and control groups. The inclusion criteria were as follows: meeting the diagnostic criteria of premenstrual syndrome (PMS) based on the conditions mentioned in the Premenstrual Symptoms Screening Tool (Steiner et al., 2003), not receiving medical or psychological treatments, being married, being between 20 and 45 years old, having education more than junior high school, not suffering from physical and mental diseases, and having a regular menstrual cycle for the past six months. The exclusion criteria were non–cooperation during the research and absence from therapy sessions. The experimental group was trained in 8 one–hour ACT sessions, but the control group did not receive any training. The groups completed the Beck Depression Inventory–II (Beck et al., 1996) and Marital Relationship Quality Scale (Rust et al., 1990) in the pretest and posttest. Data analysis was done in SPSS version 24 using descriptive statistics (mean and standard deviation). Also, at the level of inferential statistics, univariate covariance analysis was used. The Chi–square test was used to compare the age distribution of the two groups. The significance level of the tests was considered 0.05.

The results showed that the depression scores of women with premenstrual symptoms after ACT significantly decreased in the experimental group compared to the control group (p<0.001). Also, ACT increased the quality of the marital relationship of women with premenstrual syndrome (p<0.001).

Based on the research results, counselors and therapists can use ACT as a complementary treatment to reduce depression and increase the quality of the marital relationship.