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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
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.

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