Comparison of the effect of individual and couple Emotion Focused Therapy on the severity of premenstrual symptoms on Women with premenstrual Disorders

Document Type : Research Paper


1 Department of Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.

2 Assistant Professor, Department of General Psychology, Islamic Azad University, Central Tehran Branch, Tehran, Iran.

3 4. Assistant Professor, Department of Psychology, Tehran Branch, Islamic Azad University, Tehran, Iran


Introduction: Most women experience one of the symptoms of PMS and these symptoms affect the quality of life and relationships of women in the family, workplace and community. The aim of this study was to investigate the effect of individual and couple Emotion Focused Therapy on the severity of premenstrual symptoms.
Method: The research design was quasi-experimental pre-test and post-test with three experimental groups and control group. The statistical population of the study consisted of all married women in Tehran. From this population, 54 people were selected as a statistical sample by the available method and randomly replaced in three groups (two experimental groups and one control group). The required findings were collected using the Premenstrual Syndrome Questionnaire (Steiner et al., 2003) in three rounds: pre-test, post-test and follow-up test, and using repeated measures analysis of variance test Was analyzed.
Results: The results showed that the mean severity of premenstrual symptoms in individual and couple Emotion Focused Therapy groups decreased compared to the pretest and the results of repeated measures analysis of variance showed that the effect of therapies on The reduction in the severity of premenstrual symptoms was significant and stable (p≤0.001) and the results of comparing individual and couple Emotion Focused Therapy showed that there was no significant difference between individual and couple Emotion Focused Therapy approaches.
Conclusion: Considering the effectiveness of individual and couple Emotion Focused Therapy, this approach can be used as one of the intervention methods by marriage counselors and family therapists.


  1. Marjoribanks J, Brown J, O'Brien PM, Wyatt
    K. Selective serotonin reuptake inhibitors for
    premenstrual syndrome. Cochrane Database of
    Systematic Reviews. 2013(6).
    2. El‐Gizawy ZA, O'Brien PS. Premenstrual
    Syndrome. Dewhurst's Textbook of Obstetrics
    & Gynaecology. 2018 Sep 24:663-71.
    3. Ogebe O, Abdulmalik J, Bello-Mojeed MA,
    Holder N, Jones HA, Ogun OO, Omigbodun O.
    A comparison of the prevalence of
    premenstrual dysphoric disorder and
    comorbidities among adolescents in the United
    States of America and Nigeria. Journal of
    pediatric and adolescent gynecology. 2011 Dec
    4. Cao S, Jones M, Tooth L, Mishra G. Does
    premenstrual syndrome before pregnancy
    increase the risk of postpartum depression?
    Findings from the Australian Longitudinal
    Study on Women's Health. Journal of Affective
    Disorders. 2021 Jan 15; 279:143-8.
    5. Cirillo PC, Passos RB, Bevilaqua MC, López
    JR, Nardi AE. Bipolar disorder and
    Premenstrual Syndrome or Premenstrual
    Dysphoric Disorder comorbidity: a systematic
    review. Brazilian Journal of Psychiatry. 2012
    6. Qiao M, Zhang H, Liu H, Luo S, Wang T,
    Zhang J, Ji L. Prevalence of premenstrual
    syndrome and premenstrual dysphoric disorder
    in a population-based sample in China.
    European journal of obstetrics & gynecology
    and reproductive biology. 2012 May
    7. Reed SC, Levin FR, Evans SM. Alcohol
    increases impulsivity and abuse liability in
    heavy drinking women. Experimental and
    clinical psychopharmacology. 2012
    8. Kucukkelepce DS, Unver H, Nacar G, Tashan
    ST. The effects of acupressure and yoga for
    coping with premenstrual syndromes on
    premenstrual symptoms and quality of life.
    Complementary Therapies in Clinical Practice.
    2021 Feb 1; 42:101282.
    9. Chandra-Mouli V, Patel SV. Mapping the
    knowledge and understanding of menarche,
    menstrual hygiene and menstrual health among
    adolescent girls in low-and middle-income
    countries. Reproductive health. 2017
    10. Ziomkiewicz A, Wichary S, Bochenek D,
    Pawlowski B, Jasienska G. Temperament and
    ovarian reproductive hormones in women:
    evidence from a study during the entire
    menstrual cycle. Hormones and behavior. 2012
    Apr 1;61(4):535-40.
  2. 11. Wu M, Liang Y, Wang Q, Zhao Y, Zhou R.
    Emotion dysregulation of women with
    premenstrual syndrome. Scientific reports.
    2016 Dec 6;6(1):1-0.
    12. Rubinow DR, Smith MJ, Schenkel LA,
    Schmidt PJ, Dancer K. Facial emotion
    discrimination across the menstrual cycle in
    women with premenstrual dysphoric disorder
    (PMDD) and controls. Journal of affective
    disorders. 2007 Dec 1;104(1-3):37-44.
    13. Lin F, Han X, Wang Y, Ding W, Sun Y, Zhou
    Y, Lei H. Sex-specific effects of cigarette
    smoking on caudate and amygdala volume and
    resting-state functional connectivity. Brain
    imaging and behavior. 2021 Feb;15(1):1-3.
    14. Hartlage SA, Freels S, Gotman N, Yonkers K.
    Criteria for premenstrual dysphoric disorder:
    secondary analyses of relevant data sets.
    Archives of general psychiatry. 2012 Mar
    15. Sut HK, Mestogullari E. Effect of premenstrual
    syndrome on work-related quality of life in
    Turkish nurses. Safety and health at work. 2016
    Mar 1;7(1):78-82.
    16. Karimian Kakolaki Z, Mazloomy
    mohmoodabad S S, Gerayllo S, Heidari F,
    Motaghi B, Sharifi F. Path Analysis to
    Determine the Relationship Between Marital
    Dissatisfaction, Premenstrual Syndrome and
    Emotional Dimension of Quality of Life in
    Women. JCHR. 2018; 7 (3) :140-146
    17. Asuero AM, Queraltó JM, Pujol‐Ribera E,
    Berenguera A, Rodriguez‐Blanco T, Epstein
    RM. Effectiveness of a mindfulness education
    program in primary health care professionals: a
    pragmatic controlled trial. Journal of
    continuing education in the health professions.
    2014 Jan;34(1):4-12.
    18. Wyatt KM, Dimmock PW, Frischer M, Jones
    PW, O'Brien SP. Prescribing patterns in
    premenstrual syndrome. BMC women's health.
    2002 Dec;2(1):1-8.
    19. Peters W, Freeman MP, Kim S, Cohen LS,
    Joffe H. Treatment of premenstrual
    breakthrough of depression with adjunctive
    oral contraceptive pills compared with placebo.
    Journal of clinical psychopharmacology. 2017
    Oct 1;37(5):609-14.
    20. Craner JR, Sigmon ST, Martinson AA,
    McGillicuddy ML. Premenstrual disorders and
    rumination. Journal of clinical psychology.
    2014 Jan;70(1):32-47.
    21. Ivanova I, Watson J. Emotion-focused therapy
    for eating disorders: enhancing emotional
    processing. Person-Centered & Experiential
    Psychotherapies. 2014 Oct 2;13(4):278-93.
    22. Johnson SM, Hunsley J, Greenberg L,
    Schindler D. Emotionally focused couple’s
    therapy: Status and challenges. Clinical
    psychology: Science and practice. 1999
    23. Feng C, Becker B, Huang W, Wu X, Eickhoff
    SB, Chen T. Neural substrates of the emotionword and emotional counting Stroop tasks in
    healthy and clinical populations: A metaanalysis of functional brain imaging studies.
    NeuroImage. 2018 Jun 1; 173:258-74.
    24. Pos AE, Greenberg LS, Elliott R. Experiential
    therapy. Twenty-first century psychotherapies:
    Contemporary approaches to theory and
    practice. 2008 Mar 28:80-122.
    25. Greenberg LS. Emotion-focused therapy of
    depression. Person-Centered & Experiential
    Psychotherapies. 2017 Apr 3;16(2):106-17.
    26. Timulak L, McElvaney J, Keogh D, Martin E,
    Clare P, Chepukova E, Greenberg LS.
    Emotion-focused therapy for generalized
    anxiety disorder: An exploratory study.
    Psychotherapy. 2017 Dec;54(4):361.
    27. Greenberg LJ, Warwar SH, Malcolm WM.
    Differential effects of emotion-focused therapy
    and psychoeducation in facilitating forgiveness
    and letting go of emotional injuries. Journal of
    Counseling Psychology. 2008 Apr;55(2):185.
    28. Steiner, M., Macdougall, M., & Brown, E.
    (2003). The premenstrual symptoms screening
    tool (PSST) for clinicians. Archives of
    Women’s Mental Health, 6(3), 203-209.
    29. Yen, J.-Y., Chang, S.-J., Long, C.-Y., Tang, T.-
    C., Chen, C.-C., & Yen, C.-F. (2012). Working
    memory deficit in premenstrual dysphoric
    disorder and its associations with difficulty in
    concentrating and irritability. Comprehensive
    Psychiatry, 53(5), 540-545.
    30. Siahbazi Sh, Hariri FH, Montazeri A,
    Moghaddam Banaem L. Translation and
    psychometric properties of the Iranian version
    of the Premenstrual Symptoms Screening Tool
    (PSST). Payesh. 2011; 10 (4) :421-427
    31. Dehkordi A, Dehkhodaei S. The effectiveness
    of emotion-based relationship enrichment
    training based on emotion-based approach on
    psychosocial adjustment and social health of
    married women with multiple sclerosis. Social
    Psychology Research. 2020; 10 (38): 101-116.
    32. Kowal J, Johnson SM, Lee A. Chronic illness
    in couples: A case for emotionally focused
    therapy. Journal of Marital and Family
    Therapy. 2003 Jul;29(3):299-310.
    33. Connolly-Zubot A, Timulak L, Hession N,
    Coleman N. Emotion-focused therapy for
    anxiety and depression in women with breast cancer. Journal of Contemporary
    Psychotherapy. 2020 Jun;50(2):113-22.
    34. Greenberg LS, Goldman RN. Clinical
    handbook of emotion-focused therapy.
    American Psychological Association; 2019.
    35. Emran A, Iqbal N, Dar IA. ‘Silencing the
    Self’and Women’s Mental Health Problems: A
    Narrative Review. Asian Journal of Psychiatry.
    2020 Jun 5:102197.