The effectiveness of individual cognitive behavioral therapy on fear of delivery in Extroverted & Neuroticism women

Document Type : Research Paper

Authors

Abstract

Fear of giving birth today is one of the important problems in women's pregnancy. The aim of this study was to investigate the effect of cognitive-behavioral therapy on the fear of delivery process considering the two personality dimensions of neuroticism and extroversion in pregnant women. The statistical population included all pregnant women in Tehran .Using a randomized controlled trial, a sample of 50 pregnant women were selected using available sampling method and randomly divided into two control and experimental groups each containing 25 persons. The research investment was the Hartmann fear of delivery Questionnaire , reasons of fear of delivery Questionnaire, and the NEO Personality Questionaire. questionnaires for fear of delivery and fear of delivery of Hartman. Data were extracted from questionnaires and analyzed by covariance analysis
.The results of covariance test showed that cognitive-behavioral therapy reduced the fear of delivery in pregnant women compared to the control group. The results showed that the pain component had the highest reduction and the premature delivery component had the least reduction. Also, the results showed that cognitive-behavioral therapy did not affect personality traits (neuroticism &extroversion). Based on the results, we can say that cognitive-behavioral education during pregnancy can be effective in reducing fear of delivery process.

Keywords


Aben I, Denollet J, Lousberg R, Verhey F, Wojcie Chowski F, Honig A. Personality andvulnerability to depression in stroke patients: A 1-yearprospective follow-up study. Stroke2008; 33: 2391-5.
Akbarzade M,Toosi M,Zare N ,Sharif F.Effect of Relaxation and attachment behaviors training on anxiety in first-time mothers in shiraz city :A randomized clinical trial.Qom univ med SCIJ .2013;6(4):14-23[In Persian]..
Akhlaghi, F; Mokhber,N; Shakeri, M; Shamsa, F.(2012). Relationship between depression, anxiety, self-esteem, marital satisfaction and demographic factors with fear of delivery in primiparous women.Principles of Mental Health.summer ,. 4 )54( . 122 -131.[In Persian].
Alehagen S, Wijma B, Wijma K. Fear of childbirth before, during, and after childbirth. Acta Ob Gyn Scan. 2011;85(1):56-62.
Arch JJ, Dimidjian S, Chessick C. Are exposure-basedcognitive behavioral therapies safe during pregnancy?Arch Womens Ment Health. 2012;15(6):445-57. DOI:10.1007/s00737-012-0308-9 PMID: 22983422
Bahmani B, Etemadi A, Shafiabadi A, Delavar A, GhanbariMotlagh A. Cognitiveexistential group therapy and cognitive instructional therapy for breast cancer. Developmental Psychology: Iranian Psychologists 2010; 6: 201-214. [In Persian].
Beck, A. T. (2010).A social beliefs as predictors of antisocial behavior in schizophrenia. Journal of psychiatry research, 177(1): 65-70..
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Depression inventory formeasuring depression. Journal of arch gen psycho, 56(4): 571-585.
Berlanga C, Heinze G, Torres M, Apiquian R, Caballero A. Personality and clinicalpredictors of recurrence of depression. J Psychiatr Ment Health Serv 1999; 50: 80-376
Bosworth HB, Bastian LA, Rimer BK, Siegler IC. Coping style and personality domains related to menopausal stress. Women’s Health Issues 2003 Jan;13(1):32–8. 28
 Curtis, Kathryn  Weinrib, Aliza and  Katz Joel Systematic Review of Yoga for Pregnant Women: Current Status and Future Directions Department of Psychology, Faculty of Health, York University, Toronto, (2012). ON, Canada M3J 1P3
Dareshouri Mohammadi Z, Bosaknejad S, SarvghadS. [A survey on the effectiveness of stressmanagement training with cognitive-behavioral grouptherapy approach on state/trait anxiety, pregnancyanxiety and mental health of primiparous women].Jentashapir. 2013; 3(4): 495-504. [In Persian].
Davidson, K.; Norric, J.; Tyrer, P.; Gumley, A.; Tata, P.; Murray, H.; & Palmers (2007). The effectiveness of cognitive behaviour therapy for borderline personality disorder: Result from the Boscot trial; University of Glasgow, Gart Navel R oyal Hospital, Glasgow G12 OXH.20(5)431-449.
Delaram M, Soltanpour F. [The Effect of Counseling in Third Trimester on Anxiety of Nulliparous Women at the Time of Admission for Labor]. Zahedan J Res Med Sci. 2012; 14(2): 61-5. [In Persian].
Dobson KS, Dozois DJA.Historical and philosophicalbases of the Cognitive-Behavioral Therapies. In:Dobson K, editor. Handbook of Cognitive-BehavioralTherapies. 3rd ed. New York: The Guilford Press;2010. P. 3-38.
Eriksson C, Westman G, Hamberg K.Content of childbirth related fear in Swedishwomen and men-Analysis of an open endedquestion. Journal of midwifery & women’shealth 2006; 51(2): 112-118.
Escott D, Slade P, Spiby H. Preparation for pain management during childbirth: the psychological aspects of coping strategy development in antenatal education. Clin Psychol Rev 2009; 29(7):617–22.
FathiAshtiani A, Dastani M. [Psychological tests]. Tehran:Besat Publication;1388 Autumn:18. [In Persian].
Firouzbakht M, Nikpour M, Asadi Sh. [The Effect of Prenatal Education Classes on the Process of Delivery]. J Health Breeze. 2014; 2(1): 45-54. [In Persian].
Gallagher DJ. Extraversion, neuroticism, and appraisal of stressful academic events.PersIndivi Differ 1990;11:1053–7.
Haines H, Pallant J, Karlstorm A, Hildingsson I. Cross-cultural comparison of levels of childbirth-related fear in an Australian and Swedish sample. Midwifery 2011; 27(4):560-7.
Hamzeh Pour T. The effect of cognitive behavioural therapy on anxiety in infertile women. Eur J Exp Biol. 2014; 4(1): 415-9.
Hamzeh Pour T. The effect of cognitive behaviouraltherapy on anxiety in infertile women. Eur J Exp Biol.2014; 4(1): 415-9
Hassan Pour A, Masoudi R, Salehi Tali SH, Forouzandeh N, Naderi Pour A, Pour Mirza Kalhori R, et al. The effect of progressive muscle relaxation on anxiety and stress in nursing students at the beginning of the internship. J Shahrekord Univ Med Sci. 2009;11:71–7.R
Heimstad R, Dahloe R, Laache I, Skogvoll E, Schei B. Fear of childbirth and history of abuse:Implications for pregnancy and delivery. Acta Obstet Gynecol Scand 2006; 85: 435-40.
Hirsh AT, George SZ, Riley JL 3rd, Robinson ME.An evaluation of the measurement of pain catastrophizing by the coping strategies questionnaire. Eur J Pain 2007; 11(1):75-81
Hosein khanzade,A; Rostampoor,A; Nedaei,N;KHosro javid,M; The Effect of Cognitive-Behavioral Education on Pregnancy Anxiety and the Choice of Delivery Method for Pregnant Women. Nursing Education Journal, ( 2016). 5(6).24-32.[In Persian].
Hosseinninasab SD,Taghavi S .The Effectiveness of Prenatal Education in Decreasing the Childbirth Pain and Anxiety.Med J Tabriz Univ Med Sci2010 ;31(4):24-30. [In Persian].
Jafarnejad P, Farzad V, Moradi A, Shokri O.[Relationship of personality, coping styles and mental health in university students] .J Psychol Edu 2004;35(1):51-74. [In Persian].
Jamshidi Manesh M. Oskouie F, Jouybary L, Sanagoo A. [The process of women’s decision making for selection of cesarean delivery]. Iranian journal of nursing 2001; 21: 55-68. [In Persian].
Karimi A, Moradi O, Shahoei R. The effect ofTeasdale`s cognitive therapy on anxiety reductionduring pregnancy. Int J Hum Cult Stud. 2016; SpecialIssue: 1170-80. [In Persian].
Khorsandi,M; Ghofrani pour,F; Heidarniya,A; Faghiye zade,S;Vafaei,M; Rosta,F;Aminshokro,F.(2008).The effect of relaxation on reducing fear and natural delivery in primiparous women. Journal of Arak University of Medical Sciences, 11(3).29-36. [In Persian].
Kohl A, Rief W, Glombiewski JA.Acceptance, cognitive restructuring and distraction as coping strategies for acute pain. J Pain 2013; 14(3):305-15
Larsen RJ, Ketelaar T. Personality and susceptibilityto positive and negative emotional states. Journal of Personalityand Social Psychology. 1991;61(1):132-140.
Lowe NK. Self-efficacy for labor and childbirth fears in nulliparous pregnant women. J PsychosomObstet Gynaecol 2000; 21: 219-24.
Lowe NK. Self-efficacy for labor and childbirth fears in nulliparous pregnant women. J PsychosomObstet Gynaecol 2000; 21: 219-24.
McCrae, R. R. & Costa ,P. T.  A five­factor theory ofersonality.  In  L.  A.  Pervin  &  O.  P.  John  (Eds.),Handsbook  of  personality:  Theory  and research. (2 nd ed), (1999).  New York: Guilford.
Mohammadi Sh, Kiani A, Heidari M. [Review desires to select the type of delivery in primiparous women]. Journal of Babul University of Medical Sciences 2009; 11(3): 54-9[In Persian].
Mulder RT. Personality pathology and treatment outcome in major depression: a review.Am J Psychiatry 2002; 159: 71-359..
Nasiri,F; Sharifi,SH.(2013). Relationship between fear of childbirth and personality type in pregnant women. Iranian Journal of Women.16(66). 25-18.[In Persian].
 Nieminen K, Malmquist A, Wijma B, Ryding E-L, Andersson G, Wijma K. Nulliparous pregnant women’s narratives of imminent childbirth before and after internet-based cognitive behavioural therapy for severe fear of childbirth: a qualitative study. BJOG 2015;122:1259–1265.
Nobar,SH,(2012). The effect of counseling on reducing the fear of delivery in 20-30 year-old mothers in Yasouj, Azad University, B.Sc. thesis. [In Persian].
Norton PJ, Asmundson GJ. Amending the fear-avoidance model of chronic pain: what is the role of physiological arousal? Behav Ther 2003; 34(1):17-30.
Okour AM,Badarneh R.Spousal Violence Against Pregnant women from a Bedouin Community in Jordan .J Womens Health (Larchmt). 2011;20(12):1853-9.
O'Mahen, H., Fedock, G., Henshaw, E., Himle, A. J., Forman, J., & Flynn, A. H. (2012). Modifying CBT for perinatal depression: What do women want? A qualitative study.Journal of cognitive and behavioral practice. 19(2): 359–371
O'Mahen, H., Fedock, G., Henshaw, E., Himle, A. J., Forman, J., & Flynn, A. H. Modifying CBT for perinatal depression: What do women want? A qualitative study.Journal of cognitive and behavioral practice. (2012).19(2): 359–371.
Peveler RC, Johnston DW.Subjective and cognitiveeffects of elaxation.Behav Res Ther.1986;24(4):413-9. PMID: 3527138
Poikkeus, T. et al. (2013) A mixed-method systematic review: Support for ethical competence of nurses,  Journal of Advanced Nursing 70(2).
Roberts SB, Kendler KS. Neuroticism and self-esteem as indices of the vulnerability tomajor depression in women. Psychol Med 1999; 29: 91-110..
Roykulcharoen V, Good M. Systematic relaxation torelive postoperative pain. J Adv Nurs 2012; 48(2): 140-50.
Sadock BJ, Sadock VA. Kaplan and Sadock's synopsisof psychiatry: Behavioral sciences/clinical psychiatry(10th ed). Philadelphia: Lippincott Williams &Wilkins; 2007.
Saisto T, Toivanen R, Salmela-Aro K,Halmesmaki E. Therapeutic grouppsychoeducation and relaxation in treating fearof childbirth. Acta Obstetricia et GynecologicaScandinavica 2006; 85(11): 1315 – 1319.
Salmela-Aro K, Read S, Rouhe H, Halmesmaki E, Toivanen RM, Tokola M, et al. Promoting positive motherhood among nulliparous pregnant women with an intense fear of women with intense fear of childbirth: RCT intervention. J Health Psychol 2011; 17(4):520-34
Scotf JR, Gibbs RD, Karlan BY, Haney AF.Danforth’s obstetrics and gynecology. 9 th edition 2003. Philadelphia: Lippincoot,Williams and wilkins
Sjogren B. [Reasons for anxiety about childbirth in 100 pregnant women]. J Psychosom Obstet Gynaecol 1997; 18(4): 266-72.
Taylor, S., & Rachman, S. J. (1991). Fear of sadness. Journal of anxiety disorders, 5(4): 375-381.
Teasdale, J. D. (1997). The relationship between cognition and emotion: The mind-in-place in mood disorder. In D. M. Clark & C. G. Fairburn(Eds.).Science and practice cognitive behavioral therapy. Oxford UniversityPress. (pp. 67-93).
Zafarghandi N, Hadavand Sh, Torkestani F,Zaeri F, Variji M. [Evaluation of anxiety andfear of labor in postpartum period]. Journal ofmedical council of Islamic Republic of Iran2005; 2(23): 160-155. [In Persian].