Hospital Practices and Research

Abstract Background: By recognizing the profound influence of premarital patterns and vulnerabilities on long-term marital outcomes, there is a compelling need for robust premarital education programs tailored to diverse cultural contexts.
Objectives: This study aimed to assess how premarital education, specifically approaches based on Dialectical Behavior Therapy (DBT) and acceptance-based approaches in a caregiving relationship, impacted premarital patterns and reduced vulnerabilities among young adults aged 20-40 years in Isfahan, Iran.
Methods: A three-group quasi-experimental design evaluated two distinct premarital education approaches—DBT and acceptance -based approaches in a caregiving relationship—alongside a control group. Data were collected via pre-test, post-test, and a one-month follow-up from a convenience sample of 90 young adults (30 per group) approaching marriage, attending psychological centers in Isfahan during spring and summer 2023. Participants were randomly assigned, and the Premarital Patterns and Vulnerabilities Assessment Questionnaire was used. Both intervention groups received eight 90-minute sessions. Data were analyzed using SPSS 26 with descriptive statistics and repeated measures ANOVA.
Results: Both interventions significantly improved all five premarital patterns and vulnerabilities (maladaptive communication patterns, maladaptive management patterns, couples’ value system, schematic mindset, and detrimental effects of family of origin) at post-test (P<0.01). DBT outperformed acceptance-based approaches in mitigating detrimental effects of family of origin at post-test (P = 0.001, η² = 0.41). At the one-month follow-up stage, DBT showed superior efficacy in addressing maladaptive communication patterns (P = 0.009, η² = 0.12) and detrimental effects of family of origin (P = 0.001, η² = 0.41) compared to acceptance-based approaches, with moderate to large effect sizes.
Conclusion: Both DBT and acceptance-based interventions effectively reduce premarital vulnerabilities and improve relational patterns in young adults. DBT demonstrated superior and sustained efficacy, particularly in addressing maladaptive communication patterns and detrimental effects of family of origin, highlighting its potential for fostering healthier relationship foundations in the Iranian cultural context.