--- title: Can flexibility in managing difficult feelings help mothers with PMDD parent better? description: Mothers with higher psychological flexibility (ability to accept and work with difficult feelings) showed more positive parenting even when they had worse PMD url: https://niyora.com/research/papers/psychological-flexibility-as-a-moderator-of-the-association-between-premenstrual-2025/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Can flexibility in managing difficult feelings help mothers with PMDD parent better? Survey study, 2025 # Can flexibility in managing difficult feelings help mothers with PMDD parent better? Mothers with higher psychological flexibility (ability to accept and work with difficult feelings) showed more positive parenting even when they had worse PMDD symptoms. Psychological flexibility also reduced depression and anxiety. Moderate study design 1,538 menstruating mothers with children aged 0-3 years ## What they did Cross-sectional survey of 1,538 menstruating mothers with children aged 0-3 years (227 with newborns, 428 with 1-year-olds, 409 with 2-year-olds, 424 with 3-year-olds). Mothers completed questionnaires measuring PMDD symptoms, psychological flexibility, parenting quality and depression and anxiety. ## What they found Mothers with higher psychological flexibility showed more positive parenting even when they had worse PMDD symptoms. Psychological flexibility also had independent beneficial effects on depression and anxiety, separate from its effects on parenting. ## What it means for you Psychological flexibility (accepting and working with difficult feelings) may help mothers with PMDD improve their mental health and parenting. Interventions to build this skill could help mothers raising young children. This was a cross-sectional study, so we cannot determine causation. 1538 mothers studied 0-3 age of children (years) ## About the study Original title Psychological flexibility as a moderator of the association between premenstrual dysphoric disorder, depression, anxiety, positive parenting, and negative parenting: a cross-sectional study Authors Okajima J, Okajima I Journal BioPsychoSocial medicine Year 2025 Study design Survey study Participants 1,538 Open access Yes Read the paper [doi.org/10.1186/s13030-025-00327-x](https://doi.org/10.1186/s13030-025-00327-x) Original abstract Background: This study aimed to investigate whether psychological flexibility moderates the relationship between premenstrual dysphoric disorder (PMDD) symptoms and depression, anxiety, positive parenting, and negative parenting. Methods: For this study, a sample of 1,538 menstruating mothers with children aged 0 to 3 years (227 with 0-year-olds, 428 with 1-year-olds, 409 with 2-year-olds, and 424 with 3-year-olds) was assessed utilizing the Premenstrual Dysphoric Disorder Scale (PMDDS), Parental Acceptance and Action Questionnaire (PAAQ), and Hospital Anxiety and Depression Scale (HADS). Results: The interaction effects between PMDDS and PAAQ scores were found to be significantly associated with anxiety and positive parenting, after controlling for other variables. Notably, higher PAAQ scores were associated with increased positive parenting, even in the presence of worsened PMDD symptoms. Furthermore, psychological flexibility, as measured by the PAAQ, had an independent effect on both depression and anxiety, though no moderating effect was observed. Conclusions: Interventions aimed at enhancing psychological flexibility may be beneficial for mothers with premenstrual dysphoric disorder who are raising infants and toddlers. Reproduced under CC-BY. ## Topics [Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Anxiety and tension](https://niyora.com/research/topics/symptom-anxiety/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Mindfulness and meditation](https://niyora.com/research/topics/treatment-mindfulness/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Interview study, 2026 Does acceptance and commitment therapy help people with anxiety and PMDD? Systematic review, 2026 Does vitamin D supplementation help PMS symptoms? Systematic review, 2026 Do mindfulness and relaxation techniques help with PMS symptoms? Cohort study, 2025 Do women with PMS or PMDD report lower quality of life than women without these conditions? Non-randomised trial, 2008 Can the Sheehan Disability Scale measure whether treatments work? Systematic review, 2008 What treatments work best for PMS and PMDD? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗