The study participants were drawn from a randomized controlled clinical trial conducted in 2021, focusing on students experiencing mild to moderate premenstrual syndrome (PMS) who were residing in dormitories affiliated with the esteemed Zanjan University of Medical Sciences. The researchers carefully evaluated the severity of PMS symptoms using the Premenstrual Symptoms Screening Tool (PSST), a recognized instrument for assessing such conditions. Those participants whose PSST scores indicated the presence of severe PMS or premenstrual dysphoric disorder (PMDD) were excluded from the study, ensuring that individuals requiring more specialized psychiatric care were referred to appropriate mental health services.
To determine the sample size necessary for the study, a meticulous estimation process was employed, targeting 14 individuals per group to achieve a 95% confidence level (Z1−α/2 = 1.96) and an 80% power for the tests (Z1-β = 0.84). The mean and standard deviation (SD) of PMS severity from a prior study by Eshaghi were considered in this calculation, utilizing the Sample Size Formula for Two-Group Comparison with a Z-test methodology. To account for potential dropouts, the sample size was ultimately adjusted to 20 participants per group, factoring in a 20% attrition rate.
Participants were selected through convenience sampling and were randomly assigned to either the intervention or control groups, employing a block size of four to ensure a balanced distribution, resulting in two allocations to each group across a total of six randomizations. To maintain the integrity of the allocation process, sealed opaque envelopes containing a random sequence were utilized, with the random number generation based on established methodologies. The study adhered strictly to CONSORT (Consolidated Standards of Reporting Trials) guidelines to promote transparency and robustness in reporting the randomized controlled trial’s findings.
Prior to the intervention, the research objectives were thoroughly explained to the participants, and their written informed consent was duly obtained. The intervention group engaged in six weekly online positive-oriented group counseling sessions. Each session lasted between 60 to 90 minutes and was conducted through WhatsApp, effectively combining voice messages and slide-based materials to enhance both accessibility and flexibility. Educational content was carefully prepared, with PowerPoint slides transformed into PDFs for mobile-friendly access, allowing participants to review the materials before each session. Key points were reiterated during the sessions through voice messages, fostering dynamic group discussions.
To encourage practical application of positive psychology principles, participants were assigned homework that allowed them to integrate these concepts into their everyday lives. The researcher, certified after attending a workshop on Martin Seligman’s positive psychotherapy protocol, facilitated these counseling sessions. In contrast, the control group received virtual training on menstrual hygiene management that encompassed essential hygiene practices, an understanding of the menstrual cycle, and the recognition of signs indicative of menstrual disorders after completing the study.
To gauge the participants’ mental health status, both the PSST and the General Health Questionnaire (GHQ) were administered. Students aged 18 and above residing in dormitories were included if they exhibited mild to moderate PMS symptoms as per the PSST, maintained a regular menstrual cycle of 21-35 days lasting between 2 to 7 days, and scored ≤ 24 on the GHQ. Exclusion criteria highlighted participants unwilling to continue or those who had recently undergone significant stressors, such as the death of loved ones or other traumatic events, which could skew results.
The study employed a range of research tools for data collection, including a demographic questionnaire, GHQ, and PSST, which were all completed in a self-reported format. The demographic questionnaire sought detailed information about the participants’ age, educational background, occupation, marital status, family income, and characteristics of their menstrual cycle. The PSST comprised two main sections: one addressed physical and psychological symptoms through 14 questions, while the other focused on the impact of these symptoms on daily functioning with five questions. All responses were measured on a four-point Likert scale, allowing for quantitative and qualitative interpretations.
The presence of moderate or severe PMS was diagnosed based on specific conditions met by the PSST responses, ensuring a rigorous assessment. Participants were requested to complete the PSST twice, with initial and follow-up assessments conducted during the early days of their menstrual cycles to track symptom changes. The Iranian version of this questionnaire was translated and psychometrically validated by Hariri et al. in 2009, achieving a reported Cronbach’s alpha of 0.93 alongside commendable content validity statistics.
The study’s primary endpoints focused on identifying significant changes in the mean severity of PMS symptoms across three domains: emotional-psychological, physical, and the overall impact of symptoms on participants’ lives after their engagement in the six-session intervention program.
Analyzing the collected data involved utilizing SPSS 16 software for statistical procedures. The normal distribution of variables was verified using the Kolmogorov-Smirnov test, with continuous and qualitative data presented as means (with standard deviation) and frequencies (with percentages), respectively. Paired comparisons were conducted utilizing t-tests for continuous variables and Chi-square tests for qualitative variables. Repeated measures ANOVA and Bonferroni’s post hoc test facilitated the evaluation of intervention effects between groups and the interaction between time and group. The threshold for statistical significance was set at a p-value of less than 0.05.
**Interview with Dr. Nasrin Ahmadi, Lead Researcher of the PMS Study at Zanjan University of Medical Sciences**
**Interviewer:** Thank you for joining us today, Dr. Ahmadi. Can you tell us about the motivation behind your recent study on premenstrual syndrome (PMS) among students at Zanjan University?
**Dr. Ahmadi:** Thank you for having me. The primary motivation for this study stemmed from observing how many students experience PMS symptoms that can significantly affect their daily lives, academic performance, and overall well-being. We aimed to explore psychological interventions as a potential remedy for mild to moderate PMS rather than medications which sometimes come with side effects or are not adequately addressed in this demographic.
**Interviewer:** Interesting. You mentioned in your study that you utilized the Premenstrual Symptoms Screening Tool (PSST) for evaluating participants. Why did you choose this specific tool?
**Dr. Ahmadi:** The PSST is a reliable and recognized instrument for assessing PMS and its severity. It allows us to effectively identify individuals who may benefit from our intervention while also ensuring that those with more severe symptoms, like premenstrual dysphoric disorder (PMDD), were referred for specialized care.
**Interviewer:** It sounds very thorough. Can you explain what kind of psychological intervention participants in your study received?
**Dr. Ahmadi:** Certainly! Participants in the intervention group attended six weekly online group counseling sessions focused on positive psychology principles. These sessions were designed to be interactive and engaging, combining voice messages and slide presentations via WhatsApp. Homework assignments were also given, encouraging participants to apply positive psychology concepts in their daily lives.
**Interviewer:** That sounds innovative! How did you ensure that your study design was robust and scientifically sound?
**Dr. Ahmadi:** We adhered strictly to CONSORT guidelines in our study design and reporting. This includes randomizing participants into intervention and control groups using a careful selection process and ensuring balanced allocation through sealed opaque envelopes. We also estimated our sample size meticulously to account for potential dropouts, which is crucial for the integrity of our findings.
**Interviewer:** You mentioned also offering a control group training on menstrual hygiene management. How does this fit into the study’s overall goals?
**Dr. Ahmadi:** The control group received essential training on menstrual hygiene as it is a fundamental aspect of health education for young women. While the primary focus of our study was to address psychological factors impacting PMS, we believed that combining this with practical hygiene education could provide a comprehensive approach to the well-being of the participants.
**Interviewer:** Before we conclude, what kind of outcomes are you hoping to measure from your study, and what impact do you expect these results to have?
**Dr. Ahmadi:** We are particularly interested in measuring improvements in mental health status, specifically through changes in PSST and General Health Questionnaire (GHQ) scores among participants in the intervention group compared to the control group. Our hope is that positive psychological interventions can serve as an effective, accessible resource for young women managing PMS, ultimately contributing to healthier academic environments and improved quality of life.
**Interviewer:** Thank you, Dr. Ahmadi, for sharing your insights and work with us today. We look forward to the results of your research and the potential benefits it could bring to many students.
**Dr. Ahmadi:** Thank you for having me. We’re excited about the potential impact of our findings!