Psychological Flexibility as a Moderator of the Association Between Premenstrual Dysphoric Disorder, Depression, Anxiety, Positive Parenting, and Negative Parenting: A Cross-Sectional Study

Abstract Background This study investigated whether psychological flexibility moderates the relationship between premenstrual dysphoric disorder (PMDD) symptoms and depression, anxiety, positive parenting, and negative parenting. Methods 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 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.