Introduction: Premenstrual syndrome (PMS) is a prevalent condition among women of reproductive age, significantly impacting their physical, emotional, and interpersonal domains. Mood and emotional fluctuations during this period can exacerbate marital conflicts and diminish the quality of spousal relationships. Acceptance and Commitment Therapy (ACT) focused on compassion, by emphasizing psychological flexibility and self-kindness, represents a novel approach that may enhance women’s ability to manage emotions and reduce marital conflicts.
Methods: This quasi-experimental study employed a pretest-posttest-follow-up design with a control group. The study population consisted of married women with PMS who visited gynecologists in Hamadan between 2023 and 2024. For initial screening, the Premenstrual Symptoms Screening Tool (PSST) was utilized. Forty participants were selected via convenience sampling and randomly assigned (using card draw A and B) into experimental and control groups (n=20 per group). During the intervention, the sample size in each group decreased to 17. The experimental group received eight 60-minute sessions of compassion-focused ACT, while the control group received no intervention. Data regarding the dependent variable were collected using the Marital Conflict Questionnaire (MCQ) and analyzed using repeated measures ANOVA in SPSS version 23.
Results: The results indicated that the compassion-focused ACT group intervention significantly reduced marital conflicts in women with PMS (F(2,32)=36.685, p<0.001, η²=0.526). Mean scores for marital conflict in the experimental group decreased from 135.29 ± 6.13 at pretest to 132.67 ± 6.61 at posttest and 131.58 ± 6.94 at the one-month follow-up, whereas no significant change was observed in the control group. These findings represent a reduction of 2.62 units at posttest and 3.71 units at follow-up compared to the pretest in the experimental group. Furthermore, the differences between pretest and posttest, as well as pretest and follow-up, were statistically significant (p<0.001), and the mean scores remained lower at follow-up, indicating the sustained effect of the treatment over time.
Conclusion: Compassion-focused ACT can contribute to reducing marital conflicts in women with PMS. However, a precise explanation of the underlying mechanisms of this effect, including the role of psychological flexibility and the reduction of negative emotional reactions, requires direct assessment of these variables in future research. Accordingly, incorporating this approach into family counseling centers and women’s health clinics can help improve marital relationship quality and enhance the mental health of women suffering from PMS.
Keyword: Premenstrual syndrome, Marital conflict, Acceptance and Commitment Therapy, Self-compassion, psychological flexibility.