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      Marital communication skills training to promote marital satisfaction and psychological health during pregnancy: a couple focused approach

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          Abstract

          Background

          Studies showed that decreased marital satisfaction and increased risk of depression and anxiety were mutually related. Therefore, this study was conducted to evaluate the effect of communication skills training with a couple focused approach on marital satisfaction and psychological symptoms among pregnant women.

          Methods

          This experimental study was performed on 60 pregnant women with low marital satisfaction who were divided into two groups of intervention and control. The women in the intervention group and their husbands participated in a communication training program based on the couple focused approach. The levels of anxiety, depression, and marital satisfaction were evaluated before and then one and three months after the intervention using valid questionnaires.

          Results

          The results indicated that after the intervention, compared to the pre-intervention period, the levels of marital satisfaction increased while the levels of depression and anxiety decreased significantly in the intervention group ( p < 0.05). The comparison of the groups revealed significant differences in the scores of marital satisfaction, depression, and anxiety in the intervention and control groups at the intervals of one month and three months after the intervention (p < 0.05).

          Conclusions

          The research findings indicated that communication skills training program based on the couple focused approach and an emphasis on the needs of pregnant women during the pregnancy can improve the marital satisfaction and psychological health of pregnant women.

          Trial registration

          Iranian Registry of Clinical Trials IRCT2017012932264N2, Date of registration: 2017-06-28 Retrospectively registered.

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          Most cited references12

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          Comorbid depression and anxiety effects on pregnancy and neonatal outcome.

          The effects of comorbid depression and anxiety were compared to the effects of depression alone and anxiety alone on pregnancy mood states and biochemistry and on neonatal outcomes in a large multi-ethnic sample. At the prenatal period the comorbid and depressed groups had higher scores than the other groups on the depression measure. But, the comorbid group had higher anxiety, anger and daily hassles scores than the other groups, and they had lower dopamine levels. As compared to the non-depressed group, they also reported more sleep disturbances and relationship problems. The comorbid group also experienced a greater incidence of prematurity than the depressed, the high anxiety and the non-depressed groups. Although the comorbid and anxiety groups were lower birthweight than the non-depressed and depressed groups, the comorbid group did not differ from the depressed and anxiety groups on birth length. The neonates of the comorbid and depressed groups had higher cortisol and norepinephrine and lower dopamine and serotonin levels than the neonates of the anxiety and non-depressed groups as well as greater relative right frontal EEG. These data suggest that for some measures comorbidity of depression and anxiety is the worst condition (e.g., incidence of prematurity), while for others, comorbidity is no more impactful than depression alone. Copyright 2009 Elsevier Inc. All rights reserved.
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            Enrich marital inventory: a discriminant validity and cross-validation assessment.

            To assess the validity and clinical utility of the marital inventory ENRICH, a discriminant validity study was conducted using a national sample of 5039 married couples. The sample was randomly split in order to form a cross-validation group. ENRICH is a multidimensional scale and two types of analysis were conducted to assess the value of these various scales. Results from discriminant analysis indicated that using either the individual scores or couples' scores, happily married couples could be discriminated from unhappily married couples with 85-95% accuracy. These results were cross-validated with a second sample. Using regression analysis, it was clearly demonstrated that background factors account for little of the variance in discriminating happy from unhappily married couples compared to their relationship dynamics, i.e., scale scores. All ENRICH scales except equalitarian roles proved significant, indicating the validity of a multidimensional inventory.
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              Internet-Delivered Acceptance and Commitment Therapy for Anxiety Treatment: Systematic Review

              Background Anxiety conditions are debilitating and prevalent throughout the world. Acceptance and Commitment Therapy (ACT) is an effective, acceptance-based behavioral therapy for anxiety. However, there are treatment barriers (eg, financial, geographical, and attitudinal), which prevent people from accessing it. To overcome these barriers, internet-delivered ACT (iACT) interventions have been developed in recent years. These interventions use websites to deliver ACT information and skill training exercises on the Web, either as pure self-help or with therapist guidance. Objective This systematic review aimed to examine the therapeutic impact of iACT on all anxiety conditions. Methods The EMBASE, MEDLINE, ProQuest Central, PsycINFO, Scopus, and Web of Science databases were searched up to September 2018. The titles and abstracts of remaining records after deduplication were screened by 2 authors with a total of 36 full-text articles being retained for closer inspection next to eligibility criteria. Empirical studies of all designs, population types, and comparator groups were included if they appraised the impact of iACT treatment on any standardized measure of anxiety. Included studies were appraised on methodological quality and had their data extracted into a standardized coding sheet. Findings were then tabulated, and a narrative synthesis was performed because of the heterogeneity found between studies. Results A total of 20 studies met inclusion criteria. There were 11 randomized controlled trials (RCTs) and 9 uncontrolled pilot studies. Participants across all studies were adults. The anxiety conditions treated were as follows: generalized anxiety disorder (GAD), social anxiety disorder (SAD), illness anxiety disorder (IAD), and general anxiety symptoms, with or without comorbid physical and mental health problems. A total of 18 studies reported significant anxiety reduction after iACT treatment. This was observed in studies that delivered iACT with (n=13) or without (n=5) therapist guidance. The average attrition rate across all included studies during the active iACT treatment phase was 19.19%. In the 13 studies that assessed treatment satisfaction, participants on average rated their iACT experience with above average to high treatment satisfaction. Conclusions These findings indicate that iACT can be an efficacious and acceptable treatment for adults with GAD and general anxiety symptoms. More RCT studies are needed to corroborate these early iACT findings using empirical treatments in active control groups (eg, internet-delivered cognitive behavioral therapy). This would potentially validate the promising results found for SAD and IAD as well as address the full spectrum of anxiety disorders.
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                Author and article information

                Contributors
                kanom_alipour@yahoo.com
                Kazemi@nm.mui.ac.ir
                kheirabadi@bsrc.mui.ac.ir
                eeslami@hlth.mui.ac.ir
                Journal
                Reprod Health
                Reprod Health
                Reproductive Health
                BioMed Central (London )
                1742-4755
                10 February 2020
                10 February 2020
                2020
                : 17
                : 23
                Affiliations
                [1 ]ISNI 0000 0001 1498 685X, GRID grid.411036.1, Student Research Committee, Schools of Nursing and Midwifery, , Isfahan University of Medical Sciences, ; Isfahan, Iran
                [2 ]ISNI 0000 0001 1498 685X, GRID grid.411036.1, Nursing and Midwifery Care Research Center, School Of Nursing and Midwifery, , Isfahan University of Medical Sciences, ; Hezarjerib AV, Isfahan, Iran
                [3 ]ISNI 0000 0001 1498 685X, GRID grid.411036.1, Behavioral Sciences Research Center, , Isfahan University of Medical Sciences, ; Isfahan, Iran
                [4 ]ISNI 0000 0001 1498 685X, GRID grid.411036.1, Department of Health Education and Promotion, , Isfahan University of Medical Sciences, ; Isfahan, Iran
                Author information
                http://orcid.org/0000-0001-7182-0012
                Article
                877
                10.1186/s12978-020-0877-4
                7011212
                32041615
                bc118008-b035-4a22-9e05-3a5998029cff
                © The Author(s). 2020

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 4 November 2018
                : 4 February 2020
                Categories
                Research
                Custom metadata
                © The Author(s) 2020

                Obstetrics & Gynecology
                anxiety,depression,marital satisfaction,pregnancy,communication,couple focused approach

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