Abstract

BackgroundMuch evidence consistent with the Marital Discord Model of Depression (MDMD) suggests that marital discord is associated with depression, but no studies examine the relationship between marital satisfaction and depression at the dyadic level in infertile couples. This study examined the effect of actors’ and partners’ marital satisfaction on depressive symptoms in husband-wife dyads with infertility using an innovative dyadic analysis approach, the Actor–Partner Interdependence Model (APIM).MethodsIn this cross-sectional study, the sample comprised of 141 infertile couples in the evaluation phase of treatment. We collected data in a referral infertility center in Tehran, Iran between February and May 2017. Marital satisfaction and depression were measured using ENRICH marital satisfaction scale and Hospital Anxiety and Depression Scale, respectively, before starting the treatment. Dyadic analysis applying the APIM was used. In this study, actor effect is the impact of a person’s marital satisfaction on his/her own depression. Partner effect is the impact of a person’s marital satisfaction on his/her partner’s depression.ResultsThe APIM analysis revealed that both men and women’s marital satisfaction excreted an actor effect on their own depression (β = − 0.412, P < 0.001; β = − 0.263, P = 0.002, respectively). Furthermore, men’s marital satisfaction exerted a significant partner effect on their wives’ depression symptoms (β = − 0.170, p = 0.047). However, the wives’ marital satisfaction was not related to their husbands’ depressive symptoms (β = − 0.028, P = 0.735).ConclusionsThe findings support that the MDMD is a valid theoretical model for the conceptualization of marital satisfaction and depressive symptoms among infertile couples and suggest that interventions to reduce depressive symptoms should include both men and women.

Highlights

  • Much evidence consistent with the Marital Discord Model of Depression (MDMD) suggests that marital discord is associated with depression, but no studies examine the relationship between marital satisfaction and depression at the dyadic level in infertile couples

  • Marital satisfaction is strongly influenced by sexual functioning

  • The aim of the present study was twofold: (a) to examine whether there were differences in the levels of marital satisfaction and depression between men and women dyads with infertility, and (b) to apply the Actor–Partner Interdependence Model (APIM) framework to elucidate and differentiate actor and partner effects of marital satisfaction on depression in infertile couples

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Summary

Introduction

Much evidence consistent with the Marital Discord Model of Depression (MDMD) suggests that marital discord is associated with depression, but no studies examine the relationship between marital satisfaction and depression at the dyadic level in infertile couples. This study examined the effect of actors’ and partners’ marital satisfaction on depressive symptoms in husband-wife dyads with infertility using an innovative dyadic analysis approach, the Actor–Partner Interdependence Model (APIM). Infertility is medically defined as “the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse” [1]. It is a global public health concern affecting 9% of reproductive-aged couples worldwide [2] with negative psychological consequences. Satisfying marital and sexual functioning protects against the development of psychological distress but is a factor related to depression and anxiety [13, 14]

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