Authors

1 Mashhad university of Medical science

2 kharazmi university

3 Professor, Department of Epidemiology, Mashhad University of Medical Science (MUMS), Mashhad, Iran.

4 Mashhad university of Medical science(MUMS)

Abstract

Act is one of the third generation therapies in which there is trying to alter the one ̓s relationship with his or her thoughts and feelings instead of changing the cognitions. The aim of this research is to evaluate the efficacy of acceptance and commitment therapy (ACT) on reducing depression and anxiety in infertile women who undergoing In vitro fertilization (IVF). ACT has not used for reducing anxiety and depression in pregnant women before. In this study Quasi-experimental pretest-posttest and follow up with control group was used. Among women who had primary or secondary infertility, undergoing IVF, and were at 14-22 weeks gestational age, available sampling was conducted. 35 women with above feature, assigned to experiment (17) and control (18) groups randomly. SCID and BDI-II and BAI were used for assessing depression and anxiety; before the intervention and after it; and all of them repeated one month after ending the intervention. The experimental group participated in 8sessions of ACT, which lasted 90 minutes weekly; while control group didn't undergo any training. To examine the hypothesis, mixed analysis of variance between - the subjects (SPANOVA) was used. Analysis of mixed variance of the effects between-groups for depression and anxiety showed the significant level was less than 0/05. Thus with 95% reliability, it can be resulted that Act was effective for decreasing of depression and anxiety in experimental group. The results indicated by creating psychological flexibility, ACT decreased depression and anxiety in pregnant women who undergoing IVF significantly. This reduction remained one month after ending of intervention.
It seems acceptance and commitment therapy as a complementary treatment, in addition to medical treatments for infertility, improves the health of the mother and fetus during pregnancy and can have an important role.

Keywords

چهره، هاشمیه. سامانی، لیلا. سیدفاطمی، نعیمه. حسینی، آغافاطمه. (۱۳۹۱)."شدت اضطراب و ارتباط آن با عوامل مامایی و ناباروری در زنان باردار شده با روش‌های کمک باروری". نشریه مرکز تحقیقات مراقبت‌های پرستاری دانشگاه علوم پزشکی تهران (نشریه پرستاری ایران)، دوره ۲۵، شماره ۷۷، ص۸۴-۷۷.
حسن پور ازغدی، بتول. سیمبر، معصومه. (۱۳۹۲). "تبیین تاثیرات روانی نازایی درزنان نابارور: یک مطالعه کیفی". مجله علمی پژوهشی پرستاری مامایی دانشگاه تهران، دوره ۲۳، شماره۸۳، ص۸-۱.
حر، مریم.آقایی، اصغر. عابدی، احمد، عطاری، عباس. (۱۳۹۲)."تاثیر روش درمانی مبتنی بر پذیرش و تعهد بر میزان افسردگی بیماران مبتلا به دیابت نوع ۲". مجله تحقیقات علوم رفتاری، دوره۱۱، شماره۲، ص۱۲۸-۱۲۱.
سهرابی، فرامرز. (1394). "رواندرمانی موج سوم: خاستگاه، حال و چشم انداز، باتاکید ویژه برطرحواره درمانی". فصلنامه مطالعات روانشناسی بالینی دانشگاه علامه طباطبایی، دوره18، شماره5، صص14-1.
شریفی، ونداد. اسعدی، سیدمحمد. محمدی، محمدرضا. امینی، همایون. کاویانی، حسن. سمنانی، یوسف. شعبانی، امیر. شهریور، زهرا. داوری آشتیانی، رزیتا. حکیم شوشتری، میترا. صدیق، ارشیا. جلالی، محسن. (۱۳۸۳). "پایایی و قابلیت اجرای مصاحبه بالینی ساختاریافته تشخیصی بر اساس DSM-IV.". تازه‌های علوم روانشناختی، شماره ۱ و ۲ (پیاپی۲۲)، ص۲۲-۱۰.
شهرستانی، ملیحه. قنبری، بهرامعلی. نعمتی، هاشم. رهباردار، حمید. (۱۳۹۱)." اثربخشی گروه درمانی مبتنی بر ذهن آگاهی (MBCT) بر بهبود استرس ادراک شده نازایی و شناخت‌های غیر منطقی در زنان نابارور تحت درمان IVF". مجله زنان مامایی ونازایی ایران، دوره۱۵، شماره۱۹، ص۳۸-۲۸.
فتحی آشتیانی، علی. (۱۳۸۹). آزمون‌های روانشناختی: ارزیابی شخصیت و سلامت روان. تهران. بشارت.
کاننینگهام، لوانو، بلوم، هاوث، روزو اسپانک. (۱۳۸۹). بارداری و زایمان ویلیامز. ولدان، رزاقی، فغانی، قربانی.جلدسوم. چاپ دوم.تهران. ارجمند.
کاویانی، حسین. موسوی، اشرف سادات. (۱۳۸۸). "ویژگی‌های روانسنجی پرسشنامه اضطراب بک در طبقات سنی و جنسی جمعیت ایرانی". مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران، دوره ۶۶، شماره۲،ص۱۴۰-۱۳۶.
کاویانی، حسین. حاتمی، ندا. شفیع­آبادی، عبداله. (۱۳۸۷)." اثر شناخت­درمانی مبتنی بر ذهن آگاهی بر کیفیت زندگی افراد افسرده (غیر بالینی)". مجله تازه­های علوم شناختی، دوره ده، شماره۴، ص ۴۸- ۳۹. 
Bach, P. Hayes, SC. (2002). "The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial". Journal of consulting and clinical psychology,No. 70. PP:11-29.
Baer, R. A. (2003)." Mindfulness training as a clinical intervention: A conceptual and empirical review" .Clinical Psychology: Science and Practice, No.10. PP: 125- 143. 
Bayrampour, H. McDonald, S. Tough, S. (2015). "Risk factors of transient and persistent anxiety during pregnancy. JournalofMidwifery”, No. 31. PP: 582-589.
Beck, A T. Steer, R A. Garbin, M G. (1988). "Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation". Journal of Clinical Psychology Review, No. 8. PP: 77-100.
Bjørk, M H. Veiby, G. Engelsen, B A. Gilhus, N. (2015). "Depression and anxiety during pregnancy and the postpartum period in women with epilepsy: A review of frequency, risks and recommendations for treatment”. Journal of Seizure, No.28. PP: 39-45.
Bluett, E.J. Homan, K.J. Morrison, K.L. Levin, M.E. Twohig, M.P. (2015). "Acceptance and commitment therapy for anxiety and OCD spectrum disorders: An empirical review" .Journal of Anxiety Disorders, No.28. PP: 612-24.
Branstetter, AD. Wilson, KG. Hilde brand, M. Mutch, D. (2004). "Improving psychological adjustment among cancer patients: ACT and CBT" . Journal of behavior therapy, No.35. PP: 732-748.
Brown, FL. Whittingham, K. Boyd, RN. McKinlay, L. Sofronoff, K. (2015). "Does Stepping Stones Triple P plus Acceptance and Commitment Therapy improve parent, couple, and family adjustment following paediatric acquired brain injury? A randomized controlled trial". Behaviour Research and Therapy, No. 73. PP: 58-6.
Cwikel, J. Gidron, Y. Sheiner, E. (2004)." Psychological interactions with infertility among women". European Journal of Obstetrics & Gynecology and Reproductive Biology,No. 117. PP: 126-131.
Domar, Alice D. Clapp, Diane. Slawsby, Ellen. Dusek, Jeffery. Kessel, Bruce. & Freizinger, Melissa. (2000). "Impact of group psychological interventions on pregnancy rates in infertile women". Fertility and sterility, No.73.PP: 805-811.
Drossman, D A. Morris C, B. Hu ,Y. Toner, B B. Diamant ,N. Whitehead, W E. Dalton, C B, Leserman, J. Patrick, D L. Bangdiwala, S I. (2007). "Characterization of Health Related Quality of Life (HRQOL) for Patients With Functional Bowel Disorder (FBD) and Its Response to Treatment". American Journal of Gastroenterology, No.102. PP: 1442–1453.
Faramarzi, M. Alipour, A. Esmaelzade, S. Kheirkhah, F. Poladi, K. Pash, H. (2008). "Treatment of depression and anxiety in infertile Women: Cognitive behavioral therapy versus fluoxetine”. Journal of Affective Disorders, No.108. PP: 159-164.
Feeli, A. Borjali, A. Sohrabi, F. Farrokhi, N. (2012). "Comparison of CBT and MBCT in rominating thoughts in infertil women" . Armaghane Danesh /Yasouj Research-Scientific journal, No. 67. PP:  14-21.
Foley, E. Baillie, A. Huxter, M. Price, M. Sinclair, E. (2010). "Mindfulness-based cognitive therapy for individuals whose lives have been affected by cancer: a randomized controlled trial". Journal of consulting and clinical psychology, No.78. PP: 72. 79.
Forman, E M. Herbert, J D. Moitra, E. Yeomans ,P D. Geller, PA. (2009). "A randomized controlled effectiveness trialof acceptance and commitment therapy and cognitive therapy for anxiety and depression". Behavior Modification, No.36. PP: 1-28.
Forman, E. M. & Herbert, J. D. (2008). New directions in cognitive behavior therapy: Acceptance based therapies, chapter to appear in wo’donohue, je. Fisher, (eds), cognitive behavior therapy: Applying empirically supported treatments in your practice. 2nd ed. Hoboken, Wiley. PP: 263-265.
Galhardo, A. Cunha, M. Pinto-Gouveia, J. (2013). "Mindfulness-based program for infertility: Efficacy study". Fertility and sterility, No. 100. PP: 1059-1067.
Gutiérrez, O. Luciano, C. Rodríguez, M. Fink, B, C. (2004). "Comparison between an acceptance-based and a cognitive-control-based protocol for coping with pain" . Behavior therapy, No.35. PP: 767-783.
Hayes, S. Luoma, J. Bond, F. Masuda, A. Lillis, J. (2006). "Acceptance and commitment therapy: model, processes and outcomes". Journal of Behaviour Research and Therapy, N.44. PP: 1–25.
Hayes, SC. (2004). "Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies" .Journal ofBehavior therapy,No. 35. PP: 639-665.
Izadi, R. Abedi, MR. (2013). Alleviation of obsessive symptoms in treatment-resistant obsessive compulsive disorder using acceptance and commitment-based therap. Feyz, 3(17), 275-286.

Kabat-Zinn, JLipworth, LBurney, R. (1985). "The clinical use of mindfulness meditation for the self-regulation of chronic pain". J Behav Med, No. 8. PP: 163-90.

Kent, A. (2011). " Psychiatric disorders in pregnancy" . Obstetrics, Gynaecology & Reproductive Medicine, No.21. PP: 317-322.
Li, Jing. Long, Ling. Liu, Yu. He, Wei. Li, Min. (2016). Effects of a mindfulness-based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilization treatment. Behavior Research and Therapy, 77: 96-104.
Lin, J. Lüking, M. Ebert, DD. Buhrman, M. Andersson, G. Baumeister, H. (2015). "Effectiveness and cost-effectiveness of a guided and unguided internet-based Acceptance and Commitment Therapy for chronic pain: Study protocol for a three-armed randomized controlled trial". Journal of Contextual Behavioural Science,No. 2. PP: 7-16.
Lillis, J. Kendra, K E. (2015).  "Acceptance and Commitment Therapy for weight control: Model, evidence, and future directions". Journal of Contextual Behavioural Science, No.3. PP: 1-7.
López, F&Salas, S. (2009). "Acceptance and Commitment Therapy (ACT) in the treatment of panic disorder: Some considerations from the research on basic processes". International  Journal of Psychol Psychological Therapy, No.9. PP:299-315.
Lundgren, T.Dahl, J. Yardi, N. Melin, L. (2008). " Acceptance and commitment therapy and yoga for drug-refractory epilepsy: a randomized controlled trial". Journal ofEpilepsy & Behavior, No. 13. PP: 102-108.
McCallion, E, A. Zvolensky, M, J. (2015). "Acceptance and Commitment Therapy (ACT) for smoking cessation: a synthesis" .Journal of current opinion Psychology, N0.2. PP: 47-51.
Mohabbat-Bahar, S. Maleki-Rizi, F. Akbari, ME. Moradi-Joo, M. (2015). "Effectiveness of Group Training Based on Acceptance and Commitment Therapy on Anxiety and Depression of Women with Breast Cancer". Iranian journal of cancer prevention, No.8. PP: 71-76.
Narimani,M. Alamdari,E. Abolghasemi,A. (2014). "Effectiveness of acceptance and commitment therapy(ACT) on quality of life in infertile women".Quarterly of counselling and family therapy,No.4. PP:387-404.
Orsillo, S. Batten, S, V. (2005). " Acceptance and commitment therapy in the treatment of posttraumatic stress disorder". Behavior Modification, No.29. PP: 95-129.
Pearlstein, T. (2015). "Depression during Pregnancy" . Best Practice & Research Clinical Obstetrics & Gynaecology.PMID: 25976080 .DOI:10.1016/j.bpobgyn.2015.04.004
Peivandi, S. Masoodzadeh, A. Moaodi, P. Babaei. S. (2011)."Association between Anxiety and Depression ofInfertile patients with Their IVF Cycles Success Rate" .Journal of Mazandaran University Medical Science, N0.84. PP: 97-104.
Peterson, BD. Eifert, G H. (2011). "Using acceptance and commitment therapy to treat infertility stress". Cognitive and Behavioral Practice, No.18. PP: 577-587.
Peterson B, D. Eifert G, H. Feingold, T. Davidson, S. (2009). "Using acceptance and commitment
therapy to treat distressed couples: A case study with two couples". Cognitive and Behavioral Practice, No.16. PP: 430–442.
Rajab zadeh, S.Yazdkhasti, F. (2014). "The Effectiveness of Acceptance and Commitment Group Therapy onAnxiety and Depression in Women with MS Who Were Referred tothe MS Association". Journal of Clinical Psychology, No.6. PP: 29-39.
Roemer, L. Orsillo, S M. (2007). "An open trial of an acceptance-based behavior therapy for generalized anxiety disorder". Behavior therapy, No.38. PP: 72-85.
Sami, N. Saeed Ali, T. (2012). "Perceptions and experiences of women in Karachi, Pakistan regarding secondary infertility: results from a community-based qualitative study". Obstetrics and gynecology international.No.2012. Article ID 108756, 7 pages. http:// dx. doi. org/ 10. 1155/ 2012/ 108756
Scott, W. McCracken, L. M. (2015). "Psychological flexibility, acceptance and commitment therapy and chronic pain". Current Opinion in Psychology, No.2. PP: 91-96.
Speca, M. Carlson, L. Goodey, E. et al. (2000). "A randomized, wait-list controlled clinical trial: The effects of mindfulness-based stress reduction program on mood and symptoms of stress in cancer outpatients". Psychosomatic Medicine, No.62. PP: 613-622.
Twohig, M P. (2009). "Acceptance and commitment therapy for treatment-resistant posttraumatic stress disorder: A case study". Cognitive and Behavioral Practice, No.16. PP: 243-252.
Wicksell R, K. Kanstrup, M. Kemani, MK. Holmström, L. Olsson, GL. (2015). "Acceptance and Commitment Therapy for children and adolescents with physical health concerns". Current Oponion in Psychology, No.2. PP: 1-5.
Zettle, RD. (2015). "Acceptance and commitment therapy for depression" .Current Oponion in Psychology, No.2. PP: 65-69.
Zettle, R D. Rains, J C. Hayes, S C. (2011). " Processes of change in acceptance and commitment therapy and cognitive therapy for depression: a mediation reanalysis of Zettle and Rains" . Behavior Modification, No.35. PP: 265-283. doi: 10.1177/0145445511398344.
Zettle, RD. (2007). ACT for depression: A clinician's guide to using acceptance & commitment therapy in treating depression. 1thed. Oakland CA: New Harbinger Publications, 215-30.