Relationship between childhood adversity and premenstrual syndrome: mediating role of alexithymia and psychological distress in medical students

Objective This study was conducted to identify the psychological factors that predict the severity of Premenstrual Syndrome (PMS) among young women in 2025. Methods In this cross-sectional study, researchers selected 673 female medical students through convenience sampling. They collected data using the Childhood Trauma Questionnaire (CTQ), the Premenstrual Symptoms Screening Tool (PSST), the Toronto Alexithymia Scale (TAS-20), the Kessler Psychological Distress Scale (K10), and a demographic questionnaire. They analyzed the data using Structural Equation Modeling (SEM) in Amos and SPSS (Version 26). Results The SEM model showed a good fit. PMS severity had significant positive relationships with psychological distress (B = 0.64, p < 0.001), childhood adversity (B = 0.262, p < 0.01), and alexithymia (B = 0.35, p < 0.001). A moderate positive correlation existed between alexithymia and PMS severity ( r = 0.409, p = 0.01). Conclusion Childhood adversity, alexithymia, and psychological distress significantly predict PMS severity. These findings highlight the importance of a biopsychosocial approach. We suggest that doctors, especially gynecologists, should consider these psychological factors when assessing and treating patients with PMS.