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How Does the Mindfulness-Based Program for Infertility (MBPI) Work in Reducing Depressive Symptoms?

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Abstract

Mindfulness-based approaches have been applied and proved efficient in reducing symptoms related to several health problems. To our knowledge, the Mindfulness-Based Program for Infertility (MBPI) was the first mindfulness program developed specifically to target women facing infertility. This psychological intervention program was previously shown to be effective in reducing depressive symptoms in women facing infertility, but the underlying mechanisms were not clarified. The current study aimed to test whether the decrease of depressive symptoms could be explained by the increase of self-efficacy following the MBPI. The MBPI included 10 weekly sessions, in a group format, with the duration of about 2 h each and was applied to five groups (10 to 15 participants in each group). Fifty-five women completed the MBPI, and 37 women were assigned to a control group. All participants presented an infertility diagnosis and were pursuing medical treatment for this condition. Standardized measures of depression and infertility self-efficacy were collected pre and post MBPI. A significant indirect effect was found, showing that the MBPI intervention reduced the depressive symptoms of women with infertility by increasing their perceptions of self-efficacy. In summary, the promotion of infertility self-efficacy may be considered a key component of psychological interventions targeting depressive symptoms in women facing infertility.

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References

  • Baer, R. A. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125–143.

    Google Scholar 

  • Bandura, A. (1994). Self-efficacy. In Ramachaudran (Ed.), Encyclopedia of human behavior (Vol. 4, pp. 71–81). New York: Academic Press.

  • Beck, A., Ward, C., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.

    Article  PubMed  Google Scholar 

  • Chen, T. H., Chang, S. P., Tsai, C. F., & Juang, K. D. (2004). Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic. Human Reproduction, 19(10), 2313–2318.

    Article  PubMed  Google Scholar 

  • Cole, D. A., & Maxwell, S. E. (2003). Testing mediational models with longitudinal data: questions and tips in the use of structural equation modeling. Journal of Abnormal Psychology, 112(4), 558–577. https://doi.org/10.1037/0021-843X.112.4.55.

  • Cousineau, T. M., Green, T. C., Corsini, E. A., Barnard, T., Seibring, A. R., & Domar, A. D. (2006). Development and validation of the infertility self-efficacy scale. Fertility and Sterility, 85(6), 1684–1696. https://doi.org/10.1016/j.fertnstert.2005.10.077.

  • Covington, S. N., & Adamson, G. D. (2015). Collaborative reproductive healthcare model. In S. N. Covington (Ed.), Fertility counseling: clinical guide and case studies (pp. 1–32). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Craig, A., Tran, Y., Siddall, P., Wijesuriya, N., Lovas, J., Bartrop, R., & Middleton, J. (2013). Developing a model of associations between chronic pain, depressive mood, chronic fatigue, and self-efficacy in people with spinal cord injury. The Journal of Pain, 14(9), 911–920. https://doi.org/10.1016/j.jpain.2013.03.002.

  • Datta, J., Palmer, M. J., Tanton, C., Gibson, L. J., Jones, K. G., Macdowall, W., … Wellings, K. (2016). Prevalence of infertility and help seeking among 15 000 women and men. Human Reproduction, 31(9). https://doi.org/10.1093/humrep/dew123.

  • Davidson, R. J., & Kaszniak, A. W. (2015). Conceptual and methodological issues in research on mindfulness and meditation. The American Psychologist, 70(7), 581–592. https://doi.org/10.1037/a0039512.

  • Domar, A. D., Clapp, D., Slawsby, E. A., Dusek, J., Kessel, B., & Freizinger, M. (2000). Impact of group psychological interventions on pregnancy rates in infertile women. Fertility and Sterility, 73(4), 805–811.

    Article  PubMed  Google Scholar 

  • Domar, A. D., Seibel, M. M., & Benson, H. (1990). The mind/body program for infertility: a new behavioral treatment approach for women with infertility. Fertility and Sterility, 53(2), 246–249.

    Article  PubMed  Google Scholar 

  • Eugster, A., & Vingerhoets, A. J. J. M. (1999). Psychological aspects of in vitro fertilization: a review. Social Science and Medicine, 48, 575–589.

    Article  PubMed  Google Scholar 

  • Faramarzi, M., Pasha, H., Esmailzadeh, S., Kheirkhah, F., Hajian-Tilaki, K., & Salmalian, H. (2014). A survey of correlation infertility self-efficacy with behavioral health scales in infertile women. Health, 6, 943–949. https://doi.org/10.4236/health.2014.610119.

  • Fu, B., Yan, P., Yin, H., Zhu, S., Liu, Q., Liu, Y., Dai, C., Tang, G., Yan, C., Lei, J. (2016). Psychometric properties of the Chinese version of the Infertility Self-Efficacy Scale. International Journal of Nursing Sciences, 3(3), 259–267. https://doi.org/10.1016/j.ijnss.2016.07.008.

  • Galhardo, A., Cunha, M., & Pinto-Gouveia, J. (2013a). Measuring self-efficacy to deal with infertility: psychometric properties and confirmatory factor analysis of the Portuguese version of the infertility self-efficacy scale. Research in Nursing and Health, 36, 65–74. https://doi.org/10.1002/nur.21516.

  • Galhardo, A., Cunha, M., & Pinto-Gouveia, J. (2013b). Mindfulness-based program for infertility: efficacy study. Fertility and Sterility, 100(4), 1059–1067. https://doi.org/10.1016/j.fertnstert.2013.05.036.

  • Galhardo, A., Cunha, M., & Pinto-Gouveia, J. (2016). Acceptability and feasibility of the mindfulness based program for infertility (PBMI). European Psychiatry, 33(Supplement), S519. https://doi.org/10.1016/j.eurpsy.2016.01.1918.

  • Gandoy-Crego, M., Clemente, M., Gomez-Cantorna, C., Gonzalez-Rodriguez, R., & Reig-Botella, A. (2016). Self-efficacy and health: the SEH scale. American Journal of Health Psychology, 40(3), 389–395. https://doi.org/10.5993/AJHB.40.3.11.

  • Gotink, R. A., Chu, P., Busschbach, J. J., Benson, H., Fricchione, G. L., & Hunink, M. G. (2015). Standardised mindfulness-based interventions in healthcare: an overview of systematic reviews and meta-analyses of RCTs. PloS One, 10(4), e0124344. https://doi.org/10.1371/journal.pone.0124344.

  • Greil, A. L. (1997). Infertility and psychological distress: a critical review of the literature. Social Science and Medicine, 45(11), 1679–1704.

    Article  PubMed  Google Scholar 

  • Harris, R. (2009). ACT made simple: a quick-start guide to ACT basics and beyond. Oakland: New Harbinger Publications, Inc..

    Google Scholar 

  • Hayes, A. (2013). Introduction to mediation, moderation, and conditional process analysis: a regression based approach. New York: Guilford.

    Google Scholar 

  • Hayes, A. F., & Rockwood, N. J. (2016). Regression-based statistical mediation and moderation analysis in clinical research: observations, recommendations, and implementation. Behavior Research Therapy. https://doi.org/10.1016/j.brat.2016.11.001.

  • Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy: an experiential approach to behavior change. New York: Guilford Press.

    Google Scholar 

  • Hou, R. J., Wong, S. Y. S., Yip, B. H. K., Hung, A. T. F., Lo, H. H. M., Chan, P. H. S., … Ma, S. H. (2014). The effects of Mindfulness-Based Stress Reduction Program on the mental health of family caregivers: a randomized controlled trial. Psychotherapy and Psychosomatics, 83(1), 45–53.

  • Kabat-Zinn, J. (1990). Full catastrophe living. New York: Delta.

    Google Scholar 

  • Luberto, C. M., Cotton, S., McLeish, A. C., Mingione, C. J., & O’Bryan, E. M. (2014). Mindfulness skills and emotion regulation: the mediating role of coping self-efficacy. Mindfulness, 5(4), 373–380. https://doi.org/10.1007/s12671-012-0190-6.

  • Mackinnon, D. P., Lockwood, C. M., & Williams, J. (2004). Confidence limits for the indirect effect: distribution of the product and resampling methods. Multivariate Behavioral Research, 39(1), 99. https://doi.org/10.1207/s15327906mbr3901_4.

  • Mascarenhas, M. N., Flaxman, S. R., Boerma, T., Vanderpoel, S., & Stevens, G. A. (2012). National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Medicine, 9(12), e1001356. https://doi.org/10.1371/journal.pmed.1001356.

  • Moura-Ramos, M., Gameiro, S., Soares, I., Almeida-Santos, T., & Canavarro, M. C. (2010). Psychosocial adjustment in infertility: a comparison study of infertile couples, couples undergoing assited reproductive technologies and presumed fertile couples. Psicologia, Saúde & Doenças, 11(2), 299–319.

    Article  Google Scholar 

  • Peñacoba, C. P., Velasco, L. F., Écija, C. G., Cigarán, M. M., Bedmar, D. C., & Fernández-de-las-Peñas, C. (2015). Self-efficacy and affect as mediators between pain dimensions and emotional symptoms and functional limitation in women with fibromyalgia. Pain Management Nursing, 16(1), 60–68. https://doi.org/10.1016/j.pmn.2014.04.005.

  • Sejbaek, C. S., Hageman, I., Pinborg, A., Hougaard, C. O., & Schmidt, L. (2013). Incidence of depression and influence of depression on the number of treatment cycles and births in a national cohort of 42 880 women treated with ART. Human Reproduction, 28(4), 1100–1109. https://doi.org/10.1093/humrep/des442.

  • Turner, J. A., Anderson, M. L., Balderson, B. H., Cook, A. J., Sherman, K. J., & Cherkin, D. C. (2016). Mindfulness-based stress reduction and cognitive behavioral therapy for chronic low back pain: similar effects on mindfulness, catastrophizing, self-efficacy, and acceptance in a randomized controlled trial. Pain, 157(11), 2434–2444. https://doi.org/10.1097/j.pain.0000000000000635.

  • Vaz Serra, A., & Abreu, J. (1973). Aferição dos quadros clínicos depressivos: Ensaio de aplicação do Inventário Depressivo de Beck a uma amostra de doentes deprimidos. Coimbra Médica, 20, 623–644.

  • Verhaak, C. M., Lintsen, A. M., Evers, A. W., & Braat, D. D. (2010). Who is at risk of emotional problems and how do you know? Screening of women going for IVF treatment. Human Reproduction, 25(5), 1234–1240. https://doi.org/10.1093/humrep/deq054.

  • Verhaak, C. M., Smeenk, J. M., Evers, A. W., Kremer, J. A., Kraaimaat, F. W., & Braat, D. D. (2007). Women’s emotional adjustment to IVF: a systematic review of 25 years of research. Human Reproduction Update, 13(1), 27–36. https://doi.org/10.1093/humupd/dml040.

  • Volgsten, H., Skoog, S. A., Ekselius, L., Lundkvist, O., & Sundstrom, P. I. (2010). Risk factors for psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Fertility and Sterility, 93(4), 1088–1096. https://doi.org/10.1016/j.fertnstert.2008.11.008.

  • Williams, M., Teasdale, J., Segal, Z., & Kabat-Zinn, J. (2007). The mindfulness way through depression. New York: The Guilford Press.

    Google Scholar 

  • Yong, F. L. (2010). A study on the self-efficacy and expectancy for success of pre-university students. European Journal of Social Sciences, 13(4), 514–524.

    Google Scholar 

  • Zegers-Hochschild, F., Adamson, G. D., de Mouzon, J., Ishihara, O., Mansour, R., Nygren, K., et al. (2009). International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertility and Sterility, 92(5), 1520–1524. https://doi.org/10.1016/j.fertnstert.2009.09.009.

  • Zhang, Y., & Jin, S. (2016). The impact of social support on postpartum depression: the mediator role of self-efficacy. Journal of Health Psychology, 21(5), 720–726. https://doi.org/10.1177/1359105314536454.

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Acknowledgements

We thank all the participants in the study for their contribution. The authors also like to thank the national patients association, APFertilidade, for the support provided.

Funding

This research has been supported by the first author Ph.D. Grant (SFRH/BD/68392/2010), sponsored by FCT—Portuguese national funding agency for science, research and technology.

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Authors

Contributions

AG: designed and executed the study, assisted with the data analyses, and wrote the paper. MMR: analyzed the data and wrote the paper. MC: collaborated with the design and writing of the study. JPG: collaborated with the design and the discussion of results.

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Correspondence to Ana Galhardo.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was obtained from the Scientific Council of the Faculty of Psychology and Educational Sciences of the University of Coimbra.

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The authors declare that they have no conflict of interest.

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Written informed consent was obtained from all individual participants included in the study.

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Galhardo, A., Moura-Ramos, M., Cunha, M. et al. How Does the Mindfulness-Based Program for Infertility (MBPI) Work in Reducing Depressive Symptoms?. Mindfulness 9, 629–635 (2018). https://doi.org/10.1007/s12671-017-0805-z

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