Wu Liuliu, Sun Lijing, Wang Juan, Sun Yaoyao, Zhang Xuan, Huang Yongqi, Lu Yan'e, Cao Fenglin
Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Front Psychol. 2023 Jan 5;13:1095365. doi: 10.3389/fpsyg.2022.1095365. eCollection 2022.
Women undergoing fertilization-embryo transfer (IVF-ET) treatment were generally found to experience varying degrees of psychological distress across the treatment. Existing studies focused on total scores and diagnostic thresholds to characterize the symptoms' severity, which might hinder scientific progress in understanding and treating psychological distress.
We aimed to investigate (a) how depression and anxiety symptoms are interconnected within a network, and (b) the changes of the network (symptom connections and network centralities) over time, in women undergoing fertilization-embryo transfer.
A 4-wave longitudinal study was designed with 343 eligible women recruited from the Reproductive Medicine Center of a tertiary hospital in China. The network models were created to explore the relationship and changes between psychopathology symptoms both within and across anxiety and depression, with anxiety measured by the Generalized Anxiety Disorder-7 and depression measured by the Patient Health Questionnaire-9. Symptom network analysis was conducted to evaluate network and network properties, network centrality, and bridge centrality, as well as change trajectory network.
For the strength centrality, "inability to control worry" and "worrying too much" were the most central symptoms at T1; however, these symptoms decreased. The centrality of "sadness" and "guilt" tended to increase steadily and became dominant symptoms. For bridge centrality indices, several bridge symptoms were identified separately from T1 to T4: "irritability," "concentration difficulties," "nervousness," and "restlessness;" "guilt" exhibited increased bridge symptoms. Furthermore, the change trajectory network indicated that "suicide ideation" became more closely related to guilt but not to worrying too much over time.
This study provides novel insights into the changes in central features, connections, and bridge symptoms during IVF-ET treatment and identified several bridge symptoms separately at different stages, which could activate the connection between psychopathology symptoms. The results revealed that sense of guilt was associated with worsening psychopathology symptoms, indicating that future psychological interventions should target guilt-related symptoms as a priority.
一般发现接受体外受精 - 胚胎移植(IVF - ET)治疗的女性在整个治疗过程中会经历不同程度的心理困扰。现有研究集中于总分和诊断阈值来表征症状的严重程度,这可能会阻碍在理解和治疗心理困扰方面的科学进展。
我们旨在调查(a)在接受体外受精 - 胚胎移植的女性中抑郁和焦虑症状在一个网络中是如何相互关联的,以及(b)随着时间推移该网络(症状联系和网络中心性)的变化情况。
设计了一项4波纵向研究,从中国一家三级医院的生殖医学中心招募了343名符合条件的女性。创建网络模型以探索焦虑和抑郁内部及之间精神病理学症状的关系和变化,焦虑用广泛性焦虑障碍量表 - 7测量,抑郁用患者健康问卷 - 9测量。进行症状网络分析以评估网络及网络属性、网络中心性和桥梁中心性,以及变化轨迹网络。
对于强度中心性,“无法控制担忧”和“过度担忧”在T1时是最核心的症状;然而,这些症状有所减少。“悲伤”和“内疚”的中心性趋于稳步增加并成为主要症状。对于桥梁中心性指标,从T1到T4分别识别出几个桥梁症状:“易怒”“注意力难以集中”“紧张”和“坐立不安”;“内疚”表现出桥梁症状增加。此外,变化轨迹网络表明随着时间推移“自杀意念”与内疚的关系变得更紧密,而与过度担忧的关系并非如此。
本研究为体外受精 - 胚胎移植治疗期间核心特征、联系和桥梁症状的变化提供了新的见解,并在不同阶段分别识别出几个桥梁症状,这些症状可能激活精神病理学症状之间的联系。结果表明内疚感与精神病理学症状恶化有关,这表明未来的心理干预应优先针对与内疚相关的症状。