Examining the Effectiveness of Cognitive-Behavioral Therapy (CBT) on Anxiety, Psychological Wellbeing, and Marital Satisfaction of First-Time Pregnant Women

Shahtaheri, Elahe; Jomehri, Farhad; Niknam, Mojgan; Rafieipour, Amin

doi:10.29252/mejds.0.0.193

Volume 13 - Articles-1402 MEJDS (2023) 13: 32 | Back to browse issues page

‎ 10.29252/mejds.0.0.193

‎ 20.1001.1.23222840.1399.0.0.204.3

Mendeley

Zotero

RefWorks

Shahtaheri E, Jomehri F, Niknam M, Rafieipour A. Examining the Effectiveness of Cognitive-Behavioral Therapy (CBT) on Anxiety, Psychological Wellbeing, and Marital Satisfaction of First-Time Pregnant Women. MEJDS 2023; 13 :32-32
URL: http://jdisabilstud.org/article-1-2164-en.html

Examining the Effectiveness of Cognitive-Behavioral Therapy (CBT) on Anxiety, Psychological Wellbeing, and Marital Satisfaction of First-Time Pregnant Women

Elahe Shahtaheri¹

, Farhad Jomehri ^*²

, Mojgan Niknam³

, Amin Rafieipour⁴

1- Department of Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran
2- Assistant Professor, Department of Psychology, Allameh Tabataba'i University, Tehran, Iran
3- Assistant Professor, Department of Psychology, Roodehen Branch, Islamic Azad University, Roodehen, Iran
4- Assistant Professor, Department of Psychology, Payame Noor University of Tehran, Tehran, Iran

Abstract: (2934 Views)

Abstract
Background & Objectives: Pregnancy and childbirth are evolutionary stages in a woman's life. Because not every woman is emotionally balanced, she may react differently to pregnancy and childbirth. The experience of women in this period profoundly affects their children and families and had long–term effects on society. Fear and poor knowledge cause anxiety in expectant mothers and increase the secretion of stress hormones in mothers. It is necessary to help pregnant women to solve pregnancy–related problems by recognizing the factors affecting anxiety, psychological wellbeing, marital satisfaction, and maternal and neonatal outcomes of these individuals. This study aimed to determine the effectiveness of cognitive–behavioral therapy (CBT) on anxiety, psychological wellbeing, and marital satisfaction of first–time pregnant women.
Methods: This applied quasi–experimental research employed a pretest–posttest and follow–up design with a control group. The study's statistical population consisted of all first–time pregnant women 20–35 years old at 20–24 weeks of gestation. They were referred to Tehran health centers, Tehran City, Iran, for monthly pregnancy examinations in 2019, and their Beck anxiety score according to the Beck Anxiety Inventory (Beck & Steer, 1991) was moderate (higher than 20). The study sample comprised 30 people, including the experimental and control groups (15 people in each group). The inclusion criteria were as follows: being Iranian, aged 20–35 years, being first–time pregnant (according to the statements of the participants), being in the 20^th to 24^th week of pregnancy (based on the documents in the medical file), having literacy, being singleton pregnant, lacking a history of abortion or intrauterine death and infertility (based on the documents in the medical file), not having pregnancy problems (blood pressure, bleeding, diabetes, thyroid diseases, placenta previa, fetal anomalies) (based on the documents in the medical record), lacking any accidents during the last 6 months (according to the statements of the participants), not having addiction (based on the documents in the medical record), and not receiving treatment due to psychiatric disorders (based on the documents in the medical record). The exclusion criteria included not following the group's rules in the first meeting and being absent for more than two sessions. The study data were obtained using the Beck Anxiety Inventory (Beck & Steer, 1991), Ryff Psychological Wellbeing Scale (Ryff & Keyes, 1995), and ENRICH Marital Satisfaction Scale (Fowers & Olson, 1989). Group training was administered to the CBT for 8 weekly 90–minute sessions. The obtained data were analyzed with descriptive (mean and standard deviation) and inferential statistics (variance analysis with repeated measurements and Bonferroni post hoc test) using the SPSS version 22 software. The significance level of the tests was considered 0.05.
Results: The results showed that in the variables of anxiety, psychological wellbeing, and marital satisfaction, analysis of variance for the time factor (p<0.001), the group factor (p<0.001), and the interaction between group and time (p<0.001) were significant. In the experimental group, the scores of anxiety, psychological wellbeing, and marital satisfaction variables in the posttest and follow–up stages were significantly different from the pretest stage (p<0.001). However, no significant difference was observed in the mentioned variables between the posttest and follow–up stages, indicating that the CBT effect remained constant until the follow–up stage (p>0.05).
Conclusion: Based on the findings of this study, CBT was effective in anxiety, psychological wellbeing, and neonatal marital satisfaction of first–time pregnant women. This method can be used to improve the mental health problems of expectant mothers.

Keywords: Cognitive behavioral therapy, Anxiety, Psychological wellbeing, Marital satisfaction, Primiparous pregnant mothers

Full-Text [PDF 646 kb] (297 Downloads)

Type of Study: Original Research Article | Subject: Psychology

References

1. Fathi A, Rostami H, Pourfathiyeh A, Mohammadi S, Khanalizadeh R. Investigating the relationship between marital satisfaction and pregnancy concerns in pregnant women. Nursing And Midwifery Journal. 2020;18(1):11-9. [Persian] [Article]

2. Christian LM, Carroll JE, Teti DM, Hall MH. Maternal sleep in pregnancy and postpartum part I: mental, physical, and interpersonal consequences. Current Psychiatry Reports. 2019;21(3):1-8. [DOI]

3. Bhatia P, Chhabra S. Physiological and anatomical changes of pregnancy: Implications for anaesthesia. Indian Journal of Anaesthesia. 2018;62(9):651. [DOI]

4. Cai C, Vandermeer B, Khurana R, Nerenberg K, Featherstone R, Sebastianski M, Davenport MH. The impact of occupational activities during pregnancy on pregnancy outcomes: a systematic review and metaanalysis. American Journal of Obstetrics and Gynecology. 2020;222(3):224-38. [DOI]

5. Khodakarami B, Masoomi S Z, Asadi R. The status and marital satisfaction factors in nulliparous pregnant females attending clinics in Asadabad city during Years 2015 and 2016. Scientific Journal of Hamadan Nursing & Midwifery Faculty. 2016;25(1):52-9. [Persian]. [DOI]

6. Talaizadeh F, Bakhtiyarpour S. The relationship between marital satisfaction and sexual satisfaction with couple mental health. Journal of Thought & Behavior in Clinical Psychology. 2016. 9(40): 37-46. [Persian]. [Article]

7. Zaree E, Taheri M, Izadni N, Mansouri Sh, Younesi SJ, Davarmanesh A, Salehi M. Comparison of marital satisfaction of teachers of mentally retarded and normal children. Education and Social Behavior Scholar. 2011;45:61-71. [Persian]. [Article]

8. Habibi S, Fazel A, Fouladchang M. The relationship between marital satisfaction, general health and psychological stress in culturally employed women and non-employed women in Shiraz. Indian Journal of Health & Wellbeing. 2021;12(2):221-5.

9. Wilson SJ, Bailey BE, Malarkey WB, Kiecolt-Glaser JK. Linking marital support to aging-related biomarkers: Both age and marital quality matter. The Journals of Gerontology: Series B. 2021;76(2):273-82. [DOI]

10. Kazemi A, Ranaei F, Moradi G. Related factors for marital satisfaction in primigravida women referred to Sanandaj comprehensive health centers in 2018. Scientific Journal of Nursing, Midwifery and Paramedical Faculty. 2021;6(3):25-35. [Persian]. [Article]

11. Mortazavi F, Mehrabadi M, KiaeeTabar R. Pregnant women's wellbeing and worry during the COVID-19 pandemic: a cross-sectional study. BMC Pregnancy and Childbirth. 2021;21:59. [DOI]

12. Shahtaheri E, Jomehri F, Niknam M, Rafieipour A. Effectiveness of mindfulness-based stress reduction program on anxiety, and psychological wellbeing of nulliparous pregnant women. Journal of Health Research in Community. 2021;7(1):46-56. [Persian]. [Article]

13. Rahimi F, Ahmadi M, Rosta F, Alavimajd H, Valiani M. Investigating the effect of progressive muscle relaxation training on infants outcome in high risk pregnant women. Journal of Ilam University of Medical Sciences. 2018;25(6):10-20. [Persian]. [Article]

14. Akhlaghi F. Relation between depression, anxiety, self-esteem, marital satisfaction, demographical factor and maternal complications with fear of childbirth in nulliparous women. Journal of Fundamentals of Mental Health. 2012;14(54):31-122. [Persian]. [Article]

15. Nasiri Kanari F, Alivandi Vafa M. The prediction of pregnancy anxiety on the basis of subjective wellbeing and happiness of pregnant women in Tabriz. Depiction of Health. 2017;8(1):34-43. [Article]

16. Otte C. Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues Clin Neurosci. 2011;13(4):413-21. [DOI]

17. Webb CA, Auerbach RP, Bondy E, Stanton CH, Appleman L, Pizzagalli DA. Reward-related neural predictors and mechanisms of symptom change in cognitive behavioral therapy for depressed adolescent girls. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. 2021;6(1):39-49. [DOI]

18. Mokrivala M, Farahbakhsh K, Salimi Bajestani H, Yunesi Burujeni J. The effectiveness of gestalt therapy exclusively and in combination with cognitive-behavioral therapy on hope and pain intensity in women with breast cancer. Journal of Client-Centered Nursing Care. 2022;8(3):199-208. [Persian]. [Article]

19. Carpenter JK, Andrews LA, Witcraft SM, Powers MB, Smits JA, Hofmann SG. Cognitive behavioral therapy for anxiety and related disorders: a meta‐analysis of randomized placebo‐controlled trials. Depression and anxiety. 2018;35(6):502-14. [DOI]

20. Calandri E, Graziano F, Borghi M, Bonino S. Improving the quality of life and psychological wellbeing of recently diagnosed multiple sclerosis patients: preliminary evaluation of a group-based cognitive behavioral intervention. Disabil Rehabil. 2017;39(15):1474–81. [DOI]

21. Toosi K, Amiri M. The efficacy of cognitive-behavioral therapy on depression and life satisfaction in mothers with children admitted to psychiatric hospital. Journal of Fundamentals of Mental Health. 2018;20(4):263–70. [Persian] [DOI]

22. Beck AT, Steer RA. Relationship between the Beck Anxiety Inventory and the Hamilton anxiety Rating Scale with anxious outpatients. Journal of Anxiety Disorders. 1991;5(3):213-23. [DOI]

23. Ryff CD, Keyes CL. The structure of psychological wellbeing revisited. J Pers Soc Psychol. 1995;69(4):719–27. [DOI]

24. Fowers BJ, Olson DH. ENRICH Marital Inventory: a discriminant validity and cross-validation assessment. J Marital Fam Ther. 1989;15(1):65–79. [DOI]

25. Beck AT, Epstein N, Brown G, Steer RA. An Inventory for Measuring Clinical Anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893-7. [DOI]

26. Kaviani H, Mousavi A S. Psychometric property of the Persian version of Beck Anxiety Inventory (BAI). Tehran University Medical Journal. 2008;66(2):136–40. [Persian] [Article]

27. Sadati Firozabdi S, Moltafet GH. Investigating the psychometric indicators of Ryff's Psychological Wellbeing Scale in high school students of gifted schools: reliability, validity and factor structure. Educational Measurement Quarterly. 2017;7(27):103-19. [Persian] [DOI]

28. Bayani AA, Mohammad Koochekya A, Bayani A. Reliability, and validity of Ryff's Psychological Wellbeing Scales. Iranian Journal of Psychiatry and Clinical Psychology. 2008;14(2):146–51. [Persian] [Article]

29. Arab Alidousti A, Nakhaee N, Khanjani N. Reliability and validity of the Persian versions of the ENRICH marital satisfaction (Brief version) and Kansas marital satisfaction scales. Health and Development Journal. 2015;4(2):158–67. [Persian] [Article]

30. Arch JJ. Cognitive behavioral therapy and pharmacotherapy for anxiety: treatment preferences and credibility among pregnant and non-pregnant women. Behav Res Ther. 2014;52:53–60. [DOI]