Autocriticismo como mediador entre o stress de infertilidade e a sintomatologia ansiosa e depressiva em mulheres

Micaela Alves; Susana Santos; Juliana Pedro

doi:10.31211/rpics.2023.9.2.307

Autores

Micaela Alves Universidade Portucalense Infante D. Henrique, Departamento de Psicologia e Educação https://orcid.org/0009-0008-0098-0922
Susana Santos Universidade Portucalense Infante D. Henrique, Instituto Portucalense de Psicologia (I2P) https://orcid.org/0000-0002-4196-061X
Juliana Pedro Universidade de Coimbra https://orcid.org/0000-0003-1959-4921

DOI:

https://doi.org/10.31211/rpics.2023.9.2.307

Palavras-chave:

Autocriticismo, Infertilidade Feminina, Stress, Sintomatologia Depressiva, Sintomatologia Ansiosa, Estudo Transversal

Resumo

Objetivo: Explorar o papel mediador do autocriticismo na relação entre o stress da infertilidade e a sintomatologia ansiosa e depressiva em mulheres diagnosticadas com infertilidade ou a tentar conceber há mais de um ano. Métodos: Participaram 130 mulheres, entre 21 e 44 anos, com diagnóstico de infertilidade ou a tentar conceber há mais de um ano, recrutadas por método não probabilístico, através de amostragem por autosseleção. Utilizou-se uma plataforma online para o preenchimento de instrumentos de autorresposta, visando a recolha de dados sociodemográficos, clínicos e avaliação do stress da infertilidade, autocriticismo, e sintomatologia ansiosa e depressiva. Resultados: A análise mediacional mostrou que maiores níveis de stress na infertilidade se associaram a níveis mais elevados de sintomatologia ansiosa e depressiva, sendo esta relação parcialmente mediada pelo autocriticismo. Conclusões: A infertilidade, ao induzir stress, pode levar a um diálogo interno crítico, aumentando a vulnerabilidade para sintomatologia ansiosa e depressiva. Intervenções focadas na compaixão podem ser benéficas para esta população.

Downloads

Não há dados estatísticos.

Referências

Afshani, S. A., Abooei, A., & Abdoli, A. M. (2019). Self-compassion training and psychological well-being of infertile female. International Journal of Reproductive Biomedicine, 17(10), 757–762. https://doi.org/k4mr

Awtani, M., Mathur, K., Shah, S., & Banker, M. (2017). Infertility stress in couples undergoing intrauterine insemination and in vitro fertilization treatments. Journal of Human Reproductive Sciences, 10(3), 221–225. https://doi.org/g53b

Boivin, J., Vassena, R., Costa, M., Vegni, E., Dixon, M., Collura, B., Market, M., Samuelsen, C., Guiglotto, J., Roitmann, E., & Domar, A. (2022). Tailored support may reduce mental and relational impact of infertility on infertile patients and partners. Reproductive BioMedicine Online, 44(6), 1045–1054. https://doi.org/gq84q5

Bose, S., Roy, B., & Umesh, S. (2021). Marital duration, and fertility-related stress as predictors of quality of life: Gender differences among primary infertile couples. Journal of Human Reproductive Sciences, 14(2), 184–190. https://doi.org/k4ms

Cardoso, B., Galhardo, A., Massano-Cardoso, I., & Cunha, M. (2021). O papel da inflexibilidade psicológica na relação entre o stress relacionado com a infertilidade e os sintomas depressivos em mulheres com um diagnóstico de infertilidade. Revista Portuguesa de Investigação Comportamental e Social, 7(2), 61–76. https://doi.org/k4mt

Castilho, P., & Gouveia, J. P. (2011). Auto-criticismo: Estudo de validação da versão portuguesa da Escala das Formas do Auto-Criticismo e Auto-Tranquilização (FSCRS) e da Escala das Funções do Auto-Criticismo e Auto-Ataque (FSCS). Psychologica, (54), 63–86. https://doi.org/h4hj

Castilho, P., Gouveia, J. P., & Bento, E. (2010). Auto-criticismo, vergonha interna e dissociação: a sua contribuição para a patoplastia do auto-dano em adolescentes. Psychologica, 52(3), 331–359. https://doi.org/k57f

Casu, G., Zaia, V., Martins, M. F., Barbosa, C. P., & Gremigni, P. (2019). A dyadic mediation study on social support, coping, and stress among couples starting fertility treatment. Journal of the Division of Family Psychology of the American Psychological Association, 33(3), 315–326. https://doi.org/gpbvfg

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2.ª ed.). Lawrence Erlbaum Associates, Publishers.

Conselho Nacional de Procriação Medicamente Assistida. (2020). Relatório: Atividade desenvolvida pelos centros de PMA em 2020. https://bit.ly/3N0hb31

Cunha, M., Galhardo, A., & Pinto-Gouveia, J. (2016). Experiential avoidance, self- compassion, self-judgment and coping styles in infertility. Sexual & Reproductive Healthcare, 10(8), 41–47. https://doi.org/gp2n8v

Cwikel, J., Gidron, Y., & Sheiner, E. (2004). Psychological interactions with infertility among women. European Journal of Obstetrics & Gynecology and Reproductive Biology, 117(2), 126–131. https://doi.org/csjrk4

Deka, P. K., & Sarma, S. (2010). Psychological aspects of infertility. British Journal of Medical Practitioners, 3(3), Artigo 336. https://bit.ly/3ufzytU

Domar, A. D. (2004). Conquering infertility: Dr. Alice Domar's mind/body guide to enhancing fertility and coping with infertility. Penguin Books.

Farinati, D. M., Rigoni, M. D. S., & Müller, M. C. (2006). Infertilidade: Um novo campo da psicologia da saúde. Estudos de Psicologia, 23(4), 433–439. https://doi.org/c9q2z7

Galhardo, A., Cunha, M., Monteiro, B., & Pinto-Gouveia, J. (2020). Assessing psychological inflexibility in infertility: The development and validation study of the Psychological Inflexibility Scale – Infertility (PIS-I). Journal of Contextual Behavioral Science, 18(6), 239–246. https://doi.org/g53m

Galhardo, A., Cunha, M., Pinto-Gouveia, J., & Matos, M. (2013). The mediator role of emotion regulation processes on infertility-related stress. Journal of Clinical Psychology in Medical Settings, 20(4), 497–507. https://doi.org/gp2n8k

Galhardo, A., Pinto-Gouveia, J., Cunha, M., & Matos, M. (2011b). The impact of shame and self-judgment on psychopathology in infertile patients. Human Reproduction, 26(9), 2408–2414. https://doi.org/dk5fmv

Gilbert, P., Clarke, M., Hempel, S., Miles, J., & Irons, C. (2004). Criticising and reassuring oneself: An exploration of forms, styles and reasons in female students. British Journal of Clinical Psychology, 43(1), 31–50. https://doi.org/bpgch9

Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13(6), 353–379. https://doi.org/fd28t4

Grace, B., Shawe, J., Johnson, S., & Stephenson, J. (2019). You did not turn up… I did not realise I was invited…: Understanding male attitudes towards engagement in fertility and reproductive health discussions. Human Reproduction Open, 2019(3), 1–7. https://doi.org/k4m7

Gradvohl, S. M. O., Osis, M. J. D., & Makuch, M. Y. (2013). Estresse de homens e mulheres que buscam tratamento para infertilidade. Revista Brasileira de Ginecologia e Obstetrícia, 35(6), 255–261. https://doi.org/k4m8

Halamová, J., Kanovský, M., Gilbert, P., Troop, N. A., Zuroff, D. C., Hermanto, N., Petrocchi, N., Sommers-Spijkerman, M., Kirby, J., Shahar, B., Krieger, T., Matos, M. Asano, K., Yu, F., Basran, J., & Kupeli, N. (2018). The factor structure of the forms of Self-Criticising/Attacking & Self-Reassuring Scale in thirteen distinct populations. Journal of Psychopathology and Behavioral Assessment, 40(4), 736–751. https://doi.org/g425

Harlow, A. F., Zheng, A., Nordberg, J., Hatch, E. E., Ransbotham, S., & Wise, L. A. (2020). A qualitative study of factors influencing male participation in fertility research. Reproductive Health, 17(1), Artigo 186. https://doi.org/gm4q9z

Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [White paper]. https://bit.ly/40F2zeP

Hoff, H. S., Crawford, N. M., & Mersereau, J. E. (2015). Mental health disorders in infertile women: Prevalence, perceived effect on fertility, and willingness for treatment for anxiety and depression. Fertility and Sterility, 104(3), Artigo e357. https://doi.org/f3h3p7

Holley, S. R., Pasch, L. A., Bleil, M. E., Gregorich, S., Katz, P. K., & Adler, N. E. (2015). Prevalence and predictors of major depressive disorder for fertility treatment patients and their partners. Fertility and Sterility, 103(5), 1332–1339. https://doi.org/f27tk7

Kiani, Z., Simbar, M., Hajian, S., & Zayeri, F. (2021). The prevalence of depression symptoms among infertile women: A systematic review and meta-analysis. Fertility Research and Practice, 7(1), Artigo 6. https://doi.org/k4m9

Kiani, Z., Simbar, M., Hajian, S., Zayeri, F., Shahidi, M., Naz, M. S. G., & Ghasemi, V. (2020). The prevalence of anxiety symptoms in infertile women: A systematic review and meta-analysis. Fertility Research and Practice, 6, 1–10. https://doi.org/k4nb

Kotera, Y., Dosedlova, J., Andrzejewski, D., Kaluzeviciute, G., & Sakai, M. (2021). From stress to psychopathology: Relationship with self-reassurance and self-criticism in Czech university students. International Journal of Mental Health and Addiction, 20(2321–2332), 1–12. https://doi.org/k4rn

Lakatos, E., Szigeti, J. F., Ujma, P. P., Sexty, R., & Balog, P. (2017). Anxiety and depression among infertile women: A cross-sectional survey from Hungary. BMC Women's Health, 17(1), Artigo 48. https://doi.org/gq976d

Lassri, D., Soffer-Dudek, N., Lerman, S. F., Rudich, Z., & Shahar, G. (2013). Self-criticism confers vulnerability to psychopathology in the face of perceived stress related to missile attacks: Three longitudinal studies. International Journal of Cognitive Therapy, 6(3), 221–234. https://doi.org/f5b72t

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer.

Lopes, V., & Leal, I. (2012). Ajustamento emocional na infertilidade. Placebo.

Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/fwhsp7

Mascarenhas, M., Flaxman, S., Boerma, T., Vanderpoel, S., & Stevens, G. (2012). National, regional, and global trends infertility prevalence since 1990: A systematic analysis of 277 health surveys. Plos Medicine, 9(12), Artigo e1001356. https://doi.org/j58

McQuillan, J., Greil, A. L., White, L., & Jacob, M. C. (2003). Frustrated fertility: Infertility and psychological distress among women. Journal of Marriage and Family, 65(4), 1007–1018. https://doi.org/bck8jj

Newbegin, C. (2015). The stress epidemic. InnovAiT, 8(1), 36–40. https://doi.org/g53h

Newton, C. R., Sherrard, W., & Glavac, I. (1999). The Fertility Problem Inventory: Measuring perceived infertility-related stress. Fertility and Sterility, 72(1), 54–62. https://doi.org/bsbw8j

Njogu, A., Kaburu, F., Njogu, J., Barasa, E., Mutisya, A., & Luo, Y. (2023). The effect of Self-Compassion-Based Programs for Infertility (SCPI) on anxiety and depression among women pursuing fertility treatment: A three-armed, randomised controlled trial. Journal of Assisted Reproduction and Genetics, 40(4), 911–927. https://doi.org/k4rp

Pais-Ribeiro, J., Honrado, A., & Leal, I. (2004). Contribuição para o estudo da adaptação portuguesa das Escalas de Ansiedade, Depressão e Stress (EADS) de 21 itens de Lovibond e Lovibond. Psicologia, Saúde & Doenças, 5(2), 229–239. https://bit.ly/49zdDhu

Pozza, A., Dèttore, D., & Coccia, M. E. (2019). Depression and anxiety in pathways of medically assisted reproduction: The role of infertility stress dimensions. Clinical Practice & Epidemiology in Mental Health, 15, 101–109. https://doi.org/g53g

Qasemi, B., Pordelan, N., & Berjis, K. (2022). The effectiveness of self-compassion training on self-criticism and psychological disturbance in infertile women. Journal of Nursing Education, 11(5), 21–31. https://doi.org/k4rr

Ramazanzadeh, F., Noorbala, A. A., Abedinia, N., & Naghizadeh, M. M. (2009). Emotional adjustment in infertile couples. Iranian Journal of Reproductive Medicine, 7(3), 97–103. https://ijrm.ir/article-1-149-en.html

Ramezanzadeh, F., Aghssa, M. M., Abedinia, N., Zayeri, F., Khanafshar, N., Shariat, M., & Jafarabadi, M. (2004). A survey of relationship between anxiety, depression and duration of infertility. BMC Women's Health, 4(1), Artigo 9. https://doi.org/fgpm75

Ramos, R. (2004). Acontecimentos de vida na infância e perceção de stresse na adultez [Tese de Mestrado, Universidade do Minho]. Repositório da Universidade do Minho. https://bit.ly/465hlfT

Schmidt, L., Christensen, U., & Holstein, B. E. (2005a). The social epidemiology of coping with infertility. Human Reproduction, 20(4), 1044–1052. https://doi.org/bpsj4d

Schmidt, L., Holstein, B. E., Christensen, U., & Boivin, J. (2005b). Communication and coping as predictors of fertility problem stress: Cohort study of 816 participants who did not achieve a delivery after 12 months of fertility treatment. Human Reproduction, 20(11), 3248–3256. https://doi.org/fp5drp

Silva-Carvalho, J. L., & Santos, A. (2009). Estudo Afrodite caracterização da infertilidade em Portugal I – Estudo na comunidade. Universidade do Porto. https://bit.ly/47s49mn

Simões, M. R. (1994). Investigações no âmbito da aferição nacional do teste das Matrizes Progressivas Coloridas de Raven [Tese de Doutoramento não-publicada, Universidade de Coimbra]. Repositório científico da Universidade de Coimbra.

Sobral, M. P., Costa, M. E., Schmidt, L., & Martins, M. V. (2017). COMPI Fertility Problem Stress Scales is a brief, valid and reliable tool for assessing stress in patients seeking treatment. Human Reproduction, 32(2), 375–382. https://doi.org/gffj9p

Vizheh, M., Pakgohar, M., Rouhi, M., & Veisy, A. (2015). Impact of gender infertility diagnosis on marital relationship in infertile couples: A couple based study. Sexuality and Disability, 33(4), 457–468. https://doi.org/f7z9vd

Whelton, W. J., & Greenberg, L. S. (2005). Emotion in self-criticism. Personality and Individual Differences, 38(7), 1583–1595. https://doi.org/fdtxvb

Zegers-Hochschild, F., Adamson, G. D., de Mouzon, J., Ishihara, O., Mansour, R., Nygren, K., Sullivan, E., & Van der Poel, S. (2009). The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary on ART terminology. Fertility and Sterility, 92(5), 1520–1524. https://doi.org/c3nk53

Zegers-Hochschild, F., Adamson, G. D., Dyer, S., Racowsky, C., de Mouzon, J., Sokol, R., Rienzi, L., Sunde, A., Schmidt, L., Cooke, I. D., Simpson, J. L., & Van der Poel, S. (2017). The international glossary on infertility and fertility care, 2017. Human Reproduction, 32(9), 1786–1801. https://doi.org/gh7gqp

Zurlo, M., Volta, M., & Vallone, F. (2019). The association between stressful life events and perceived quality of life among women attending infertility treatments: The moderating role of coping strategies and perceived couple's dyadic adjustment. BMC Public Health, 18(1), Artigo 1548. https://doi.org/k4rs