Evaluating the relative efficacy of a self-help and minimal psycho-educational intervention for moderate premenstrual distress conducted from a critical realist standpoint

Previous research suggests that mild to moderate premenstrual symptoms (PMS) can be ameliorated by self-help psycho-educational support. However, it is unknown as to whether face-to-face contact with a clinician, through a minimal psycho-educational intervention, can significantly increase the benefits of PMS self-help packages, or whether self-help packages can be effective on their own. In this pilot study, 32 women were randomized to one of two groups, self-help pack alone, or self-help pack with minimal psycho-educational intervention. Twenty women completed the pre- and post-intervention measures (11 self-help group; nine psycho-education group). Fourteen women, seven in each group, were randomly selected for pre- and post-interviews. Both groups reported reduced anxiety and reduced life interference from PMS post-intervention. The minimal intervention group reported a broader range of improvements, including significant reductions in depression and the extent to which PMS caused distress, and significant improvements in ability to cope with symptoms. Premenstrual change was still present post-intervention, however, women reported reductions in distress, improvements in coping, and repositioning of PMS as something that could be ameliorated through changes in behaviour or thought patterns. This confirms the significant role played by the construction, attribution and appraisal of premenstrual changes on the development and course of premenstrual distress.