Measurement invariance of the Coparenting Relationship Scale (CRS) across 10 countries.

The purpose of this study was to assess the factor structure and the measurement invariance of the Coparenting Relationship Scale (CRS) across 10 countries based on the seven-factor coparenting model (i.e., Coparenting Agreement, Coparenting Closeness, Exposure to Conflict, Coparenting Support, Endorsement of Partner's Parenting; Division of Labor) proposed by Feinberg (2003). The results of research on coparenting from numerous countries have documented its foundational importance for parent mental health, family relationship quality, child development, and psychopathology. Yet, a cross-country perspective is still lacking. Such a perspective can provide insight into which dimensions of coparenting are universally recognized and which are especially prone to variation. A unique multinational data set, comprised of 15 individual studies collected across 10 countries (Belgium, Brazil, China, Israel, Italy, Japan, Portugal, Switzerland, Turkey, USA) in nine languages was established (N = 9,292; 51.1% mothers). Measurement invariance analyses were conducted. A six-factor structure (original seven factors minus Division of Labor) of the measure was consistent across the different contexts and measurement invariance was achieved at the configural level. There was no support for metric or scalar invariance. These findings provide a basis for the CRS to be used across countries and should inspire future quantitative and qualitative research in cross-country coparenting research to understand what aspects are universal and what aspects of coparenting are linked to specific material, relational, or ideational conditions that underlie high-quality coparenting. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Colorectal cancer survivors' adjustment to permanent colostomy in Switzerland: A qualitative analysis.

Colostomized colorectal cancer survivors present physical, psychological, and social difficulties after treatment, which complicate their return to normal life. Nevertheless, we lack insight into their lived transition experience after treatment in Switzerland. We led nine semi-structured interviews with participants who had a colostomy for a mean of 16.4 years. The participants' mean age was 73.1 years. Through an inductive thematic analysis, we highlighted several adaptation difficulties. Their body image was poor, and they behaved differently than before the surgery. For fear of being rejected, they concealed their colostomy. However, they felt isolated and often wished for more support. They may be in a vicious circle where their difficulties are maintained. We advocate that supporting survivors psychologically beyond the end of their treatment is essential to facilitate adjustment and overcome cancer.

The Interplay Between Maternal and Paternal Senses of Efficacy Moderates the Link Between Perinatal Parental Stress and Family Alliance at 3 Months.

Objective. Both parents may report high levels of stress during the perinatal period with possible negative consequences for parental well-being and child development. Parental sense of efficacy moderates the effect of stress. To date, no studies have assessed links between parental stress and mother-father-infant interactions in terms of family alliance and the extent to which each parent's sense of efficacy moderates these links. Design. In this study, 65 dual-parent families answered a questionnaire about parental stress between 36 and 38 weeks of pregnancy and at 3 months after birth. Families were also observed while playing with their 3-month-old infant in the Lausanne Trilogue Play, and they completed a questionnaire about parental efficacy. Results. Structural equation modeling analyses showed that higher maternal or paternal postnatal stress has a direct link with higher family alliance and the links between stress and family alliance are moderated by complex interaction effects between maternal and paternal senses of efficacy. Conclusions. This study shows the necessity of considering the interaction between the senses of self-efficacy of both parents as moderators of parenting stress.

Three reasons why parental burnout is more prevalent in individualistic countries: a mediation study in 36 countries.

PURPOSE: The prevalence of parental burnout, a condition that has severe consequences for both parents and children, varies dramatically across countries and is highest in Western countries characterized by high individualism. METHOD: In this study, we examined the mediators of the relationship between individualism measured at the country level and parental burnout measured at the individual level in 36 countries (16,059 parents). RESULTS: The results revealed three mediating mechanisms, that is, self-discrepancies between socially prescribed and actual parental selves, high agency and self-directed socialization goals, and low parental task sharing, by which individualism leads to an increased risk of burnout among parents. CONCLUSION: The results confirm that the three mediators under consideration are all involved, and that mediation was higher for self-discrepancies between socially prescribed and actual parental selves, then parental task sharing, and lastly self-directed socialization goals. The results provide some important indications of how to prevent parental burnout at the societal level in Western countries.

Assessment of sexual function before medically assisted procreation: A mixed-methods study among a sample of infertile women and men cared for in a fertility center.

A mixed-methods study was conducted to investigate sexual function among infertile patients undergoing medically assisted procreation for the first time. The study employed an interview and content analysis approach, involving 45 infertile patients prior to their medically assisted procreation procedures. The findings revealed that infertile patients are a group at risk for sexual distress. Furthermore, patients with sexual dysfunctions exhibited lower levels of sexual activity, potentially diminishing their chances of achieving pregnancy. Participants faced challenges in openly discussing their sexual problems and demonstrated limited knowledge of sexual functioning. Among infertile women with sexual dysfunctions, the most frequently reported issues were sexual interest/arousal disorders, with a majority also experiencing pain during sexual activity and associated genital-pelvic pain disorders. In contrast, delayed ejaculation and erectile disorder seem to be more common in infertile men, while sexual desire and excitement disorders and premature ejaculation disorders appeared to be as common as in the general population. While the relationship between infertility and sexuality is complex, our study suggests that sexual dysfunctions or the absence of sexual activity may explain infertility. Therefore, it is imperative for clinicians to evaluate the sexual functioning of both men and women undergoing medically assisted procreation treatment, to increase their chances of procreation and offer them sexological support if needed. Future studies should expand their scope to include a larger sample size and delve into the potential etiological factors associated with sexual dysfunctions.

Parental sensitivity, family alliance and infants' vagal tone: Influences of early family interactions on physiological emotion regulation.

In this study, we investigated the influence of parental sensitivity and family alliance on infants' vagal tone, considered as a physiological indicator of emotion regulation. Studies on mother-infant interactions have shown that vagal tone can be influenced by the quality of the interaction, such as interacting with a sensitive mother. To date, no study has investigated the influence of paternal sensitivity or family alliance on infants' vagal tone. We hypothesized that maternal sensitivity, paternal sensitivity, and family alliance would be associated with infants' vagal tone during dyadic and triadic interactions. We also explored if family alliance would act as a moderator on the association between parental sensitivity and vagal tone and if the sensitivity of both parents would act as a moderator on the association between family alliance and vagal tone. This study took place in Switzerland and included 82 families with their 3-4-month-old infants. Results showed that maternal sensitivity and family alliance were associated with infants' vagal tone, but paternal sensitivity was not. We found no significant moderation effect. However, result tendencies suggested that the contribution of paternal sensitivity to infants' emotion regulation could be influenced by family alliance, whereas maternal sensitivity and family alliance have a unique contribution.

En este estudio, investigamos la influencia de la sensibilidad del progenitor y la alianza de familia sobre el tono vagal del infante, considerado como un indicador fisiológico de regulación de la emoción. Los estudios acerca de las interacciones madre-infante han demostrado que el tono vagal puede ser influido por la calidad de la interacción, tal como el interactuar con una mamá sensible. Hasta hoy, ningún estudio ha investigado la influencia de la sensibilidad paterna o la alianza de familia sobre el tono vagal del infante. Nuestra hipótesis es que la sensibilidad materna, la sensibilidad paterna y la alianza de familia estaban asociadas con el tono vagal del infante durante las interacciones diádicas y triádicas. También exploramos si la alianza de familia actuaba como moderadora en la asociación entre la sensibilidad paterna y el tono vagal y si la sensibilidad de ambos progenitores actuaba como moderadora en la asociación entre la alianza de familia y el tono vagal. Este estudio se llevó a cabo en Suiza e incluyó a 82 familias con sus infantes de 3-4 meses de edad. Los resultados muestran que la sensibilidad materna y la alianza de familia estaban asociadas con el tono vagal del infante, pero que la sensibilidad paterna no lo estaba. No encontramos ningún efecto de moderación significativo. Sin embargo, las tendencias del resultado sugieren que la contribución de la sensibilidad paterna a la regulación de la emoción puede ser influida por la alianza de familia, mientras que la sensibilidad materna y la alianza de familia tienen una contribución particularmente única.

Dans cette étude nous nous sommes penchés sur l'influence de la sensibilité paternelle et de l'alliance de la famille sur le tonus vagal des nourrissons, considéré comme étant un indicateur physiologique de la régulation de l'émotion. Les études sur les interactions mère-nourrisson ont montré que le tonus vagal peut être influencé par la qualité de l'interaction, comme l'interaction avec une mère sensible. Jusqu'à présent aucune étude n'a porté sur l'influence de la sensibilité paternelle ou l'alliance familiale sur le tonus vagal des nourrissons. Nous avons fait l'hypothèse que la sensibilité maternelle, la sensibilité paternelle, et l'alliance familiale peuvent être liées au tonus vagal des nourrissons durant les interactions dyadiques et triadiques. Nous avons également exploré si l'alliance familiale pourrait agir comme modératrice sur le lien entre la sensibilité parentale et le tonus vagal et si la sensibilité des deux parents pourrait agir comme modérateur du lien entre l'alliance familiale et le tonus vagal. Cette étude s'est faite en Suisse et a inclus 82 familles avec des bébés de 3-4 mois. Les résultats ont montré que la sensibilité maternelle et l'alliance familiale étaient liées au tonus vagal des bébés mais la sensibilité de l'était pas. Nous n'avons trouvé aucun effet de modération important. Cependant les tendances des résultats ont suggéré que la contribution de la sensibilité paternelle à la régulation de l'émotion des nourrissons pourrait être influencée par l'alliance familiale alors que la sensibilité maternelle et l'alliance familiale a une contribution unique.

Optimizing the Assessment of Parental Burnout: A Multi-informant and Multimethod Approach to Determine Cutoffs for the Parental Burnout Inventory and the Parental Burnout Assessment.

Parental burnout (PB) is a chronic stress-related condition resulting from long-lasting exposure to overwhelming parenting stress. Previous studies showing the seriousness of this condition stressed the urgent need to provide researchers and practitioners with effective assessment tools. Validated PB measures are the Parental Burnout Inventory (PBI) and the Parental Burnout Assessment (PBA). The good psychometric properties of these instruments have been replicated across different samples and countries, but thresholds for identifying impairing PB levels (i.e., cutoff scores) have not yet been established. The present study aims to fill this gap by adopting a multi-informant and multimethod approach to a sample of 192 burned-out and control parents. PBI and PBA cutoffs were derived from the combination of several PB indicators, based on a preregistered analysis strategy. Results identified a score of 74.6 (95% confidence interval (CI) = [69.48-79.68]) for the PBI and 86.3 (95% CI = [79.49-93.03]) for the PBA as indicators of the most severe PB levels.

When not teaming up puts parents at risk: Coparenting and parental burnout in dual-parent heterosexual families in Switzerland.

Parental burnout refers to loss of energy and pleasure in the parental role. It is predictive of psychopathological outcomes in parents and dysfunctional parenting behaviors. Support of parental duties is central to alleviation of parental burden and prevention of burnout. Coparenting is the concept related to interparental mutual support in rearing a child. However, the links between coparenting and parental burnout have yet to be assessed. We thus aimed in this study to assess which dimensions of coparenting are linked with parental burnout. A total of 306 participants from the French-speaking part of Switzerland (120 fathers, 186 mothers) completed online questionnaires about parental burnout, their coparental relationship, and sociodemographic characteristics. We performed hierarchical regressions, entering sociodemographic characteristics in a first block and coparenting dimensions in a second block. Results showed that (i) a higher number of children and having younger children are linked to higher burnout; (ii) coparenting exposure to conflict is related to higher burnout, whereas endorsement of the partner's parenting is related to lower burnout; and (iii) no interaction effect occurs between sociodemographic characteristics and coparenting variables. Coparenting thus significantly contributes to the occurrence of burnout syndrome. Working on the coparental relationship preventively in parental educational programs or at a relational systemic level in therapy may help prevent burnout. Treating one parent only may not be sufficient to alleviate burnout, as negative coparenting could counter the effect of individual therapy.

Couple therapy with parents: Results from a pragmatic randomized controlled trial testing the Integrative Brief Systemic Intervention (IBSI).

This study aimed to compare the effectiveness of the Integrative Brief Systemic Intervention (IBSI), combining therapeutic work on marital and coparenting relationships with brief systemic therapy (BST-as-usual) for parent couples. Couples were randomly assigned to the IBSI (n = 51) or BST (n = 50). Both treatments were six-session interventions and lasted about 6 months. Questionnaires on individual, marital, coparenting and family-related functioning were completed before and after therapy, and at 6-month follow-up. A significant improvement in all areas of functioning was observed after treatment and maintained at follow-up for both IBSI and BST-as-usual treatments. No significant differences in outcomes were found between the treatments. Additionally, women reported more distress overall than men, and this distress was reduced more significantly after therapy. Last, BST-as-usual couples requested more additional sessions compared to IBSI couples. This study extends the literature on couple therapy with parents.

In-session gaming as a tool in treating adolescent problematic gaming.

For some adolescent gamers, playing online games may become problematic, impairing functioning in personal, family, and other life domains. Parental and family factors are known to influence the odds that adolescents may develop problematic gaming (PG), negative parenting and conflictual family dynamics increasing the risk, whereas positive parenting and developmentally supportive family dynamics protecting against PG. This suggests that a treatment for adolescent PG should not only address the gaming behaviors and personal characteristics of the youth, but also the parental and family domains. An established research-supported treatment meeting these requirements is multidimensional family therapy (MDFT), which we adapted for use as adolescent PG treatment. We report here on one adaptation, applying in-session gaming. In-session demonstration of the "problem behavior" is feasible and informative in PG. In the opening stage of therapy, we use in-session gaming to establish an alliance between the therapist and the youth. By inviting them to play games, the therapist demonstrates that they are taken seriously, thus boosting treatment motivation. Later in treatment, gaming is introduced in family sessions, offering useful opportunities to intervene in family members' perspectives and interactional patterns revealed in vivo as the youth plays the game. These sessions can trigger strong emotions and reactions from the parents and youth and give rise to maladaptive transactions between the family members, thus offering ways to facilitate new discussions and experiences of each other. The insights gained from the game demonstration sessions aid the therapeutic process, more so than mere discussion about gaming.

The influence of the COVID-19 lockdown on infants' physiological regulation during mother-father-infant interactions in Switzerland.

In this study, we investigated the physiological regulation of vagal tone during dyadic and triadic parent-infant interactions in infants born before or around the COVID-19 lockdown in Switzerland. We hypothesized that there would be a decrease in vagal tone in triadic interactions compared with dyadic interactions, as triadic interactions are more complex and therefore more resource demanding. However, we expected this difference to be smaller for infants who experienced the period of confinement, as the lockdown led parents to spend more time at home. We also hypothesized that parents would have less stressful interactional events in the triadic interaction because they would be used to interacting with the child together. This study included 36 parents with their 3 month-old infants. Eighteen families met the study authors before the onset of the pandemic (pre-COVID) and 18 met them after its onset, having experienced a period of confinement during the infants' first 3 months of life (COVID). Results showed that the COVID group had no decrease in vagal tone during triadic interactions, whereas the pre-COVID group did. This difference could not, however, be explained by less stressful interactional events in triadic interactions, as the COVID group showed more stressful interactional events in mother-father-infant interactions.

Interactive synchrony and infants' vagal tone as an index of emotion regulation: associations within each mother- and father-infant dyad and across dyads.

Introduction: Studies have shown that infants' emotion regulation capacities are closely linked to the quality of parent-infant interactions. However, these links have been mostly studied in mother-infant dyads and less is known about how the quality of father-infant interactions contributes to the development of emotion regulation during infancy. In this study, we aimed to investigate the links between interactive synchrony (i.e., an index of the quality of parent-infant coordination of interactive behaviors) and infants' vagal tone (i.e., a physiological index of emotion regulation). To understand the respective contributions of both parents, as well as the interrelations between the functioning of both dyads within a family, we observed mothers and fathers from 84 families interacting with their infants. Methods: Synchrony was assessed by using the CARE-Index; infants' vagal tone was derived from the analysis of infants' electrocardiograms recorded during the interactions. Moreover, to take the play's order into account, we counterbalanced the procedure, so that approximately half of the mothers played first. We specified a first structural equation modeling (SEM) model to investigate the associations between interactive synchrony and the infants' root mean square of successive differences (RMSSD), an index of vagal regulation, in the two successive parts of the play. We conducted a multigroup analysis in a second SEM model to investigate the associations of the first SEM model in two groups based on the order of interaction. Results: The results of the SEM models showed that greater synchrony was related to greater infant RMSSD within mother-infant dyads and across one dyad to the other dyad in the full sample and in the group of fathers who interacted first with the infants. The associations between synchrony and infant vagal tone within father-infant dyads never appeared to be significant, nor did any associations within each dyad and across dyads when mothers interacted first. Discussion: This study highlights that the links between interactions and infants' vagal tone are sensitive to family members' interdependencies and some conditions (the order of interaction).

Quarreling After a Sleepless Night: Preliminary Evidence of the Impact of Sleep Deprivation on Interpersonal Conflict.

Although poor sleep has been found to correlate with deteriorations in romantic relationships, its causal impact on interpersonal conflict has not previously been studied. Therefore, 30 couples were randomly assigned to either a single night of total sleep deprivation or a night of normal sleep to test the effects of sleep deprivation on couples' conflict. After the experimental night, all participants discussed a topic of recurrent conflict for 15 min. We collected pre- and post-conflict measures of cortisol, self-reports of feelings, and satisfaction with the conflictual discussion. Multilevel analyses revealed higher cortisol levels during conflict and less positive affect prior to and after the conflict for sleep-deprived couples compared to couples in the control condition. These findings provide initial evidence for a causal negative impact of sleep deprivation on couples' conflicts. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-021-00076-4.

Emotional and Sexual Adaptation to Colon Cancer: Perceptual Congruence of Dyadic Coping Among Couples.

Context: Colon cancer is the 3rd most common cancer in the world. The diagnosis leads the patient and his relatives into a process of mourning for their health and previous life. The literature highlights the impact of the disease on couples. Cancer can either alter or strengthen the relationship. The disease will directly or indirectly affect both partners. Such impact starts with the diagnosis and lasts long after treatments. No study has analyzed both emotional and sexual interactions between partners throughout the illness so far. Objective: This research aims to identify and describe whether congruence within couples tends to improve emotional and sexual adjustment. Method: Thirteen couples took part in this research by answering a set of questionnaires investigating, in particular, dyadic coping strategies, marital and sexual satisfaction. Non-parametric analyses were performed on the quantitative data. Results: Emotional satisfaction is good among the couples in our study. There are important similarities in partners' emotional adjustment. Patients who are most satisfied with their couple typically have a partner who is also satisfied. This was an expected result based on the literature. Overall, sexual satisfaction is described as average, which is either related to a low frequency of sexual intercourse, or a gap between the ideal and actual frequency of intercourse. In terms of dyadic coping, similarities within couples tend to improve emotional and sexual adjustment. Couples in which communication about stress between the patient and their partner is congruent tend to report good marital satisfaction. We found the same results for delegated coping of both the patient and the partner, and for negative coping of the partner. Sexual adjustment is linked to a similar perception within the couple of a common dyadic coping. Conclusion: Emotional and sexual adjustment is largely linked to the quality of the partner's support. The congruence of couple support strategies has been identified as an important factor in emotional satisfaction. In addition, the more couples implement joint stress management, the better their sexual satisfaction.

Parents in couple therapy: An intervention targeting marital and coparenting relationships.

This article describes the treatment framework and core therapeutic principles of the integrative brief systemic intervention (IBSI), a manualized six-session intervention intended for parents seeking couple therapy. IBSI aims to work on the couple's presenting problem, considering its specific impact in the marital and coparenting domains. The basic premise of IBSI is to consider that, when working with couples who have children, therapeutic work on their coparenting alliance may be used as a lever, as both parents may be particularly motivated to improve their relationship for their children's benefit. Increasing the coparenting alliance may then facilitate work on deeper conflicts within the marital relationship. The core therapeutic principles of IBSI are: (1) joining with the couple as romantic partners and a coparenting team from the start of the therapeutic process; (2) supporting the parents in increasing their awareness regarding their children's behavior and emotional experiences when facing their parents' conflicts; and (3) working on the spill- and cross-over effects between marital and coparenting relationships (i.e., exploring how conflict or positivity spills over from one relationship to the other or crosses over from one partner to the other). Therapeutic work following these main therapeutic principles is expected to improve the quality of both relationships. A clinical case is provided to illustrate the core therapeutic principles of IBSI.

Assessing preoperative hope and expectations related to functional neurosurgery: a new questionnaire.

BACKGROUND: Despite successful functional neurosurgery, patients suffering from epilepsy or Parkinson's disease may experience postoperative psychological distress and social maladjustments. Difficulties in coping with postoperative changes, even positive ones, have shown to be related to patients' presurgery cognitive representations (i.e., expectations, hope). The aim of this study was to develop an instrument assessing various key features of surgery outcomes' representations, namely the Preoperative Hope and Expectations Questionnaire (PHEQ). METHODS: Participants were patients (n = 50) diagnosed with Parkinson's disease (n = 25) or epilepsy (n = 25), candidates for functional neurosurgery (i.e., Deep brain stimulation, anterior temporal lobectomy). Two to three weeks before the planned surgery, they were administrated items assessing their actual state, preoperative expectations, and hope regarding surgery outcomes. They also completed measures assessing optimism, quality of life and mood. RESULTS: Exploratory analysis resulted in a 14-item version of the PHEQ composed of two factors (abstract representations, including psychological well-being and concrete representations, such as direct surgery outcomes). The PHEQ demonstrated high internal consistency and good convergent validity. Patients were more prone to express postoperative improvements in terms of hope rather than expectations. They generally focused on concrete rather than abstract features, although patients with Parkinson's disease had higher abstract future-oriented representations. CONCLUSIONS: The PHEQ presents satisfactory psychometric properties and may be considered as a reliable instrument for research and clinical practice.

Associations between parent-infant interactions, cortisol and vagal regulation in infants, and socioemotional outcomes: A systematic review.

Emotional regulation in early infancy develops mainly through social interactions with caregivers and is a key process in socioemotional functioning. The use of physiological measures such as vagal tone and cortisol can help researchers understand what underlies this association between parent-infant interaction, emotion regulation, and socioemotional functioning. This review integrates 39 studies from four databases. We first examine associations between parent-infant interactions and physiological measures of emotion regulation in children aged 0-24 months. We then examine the association between these physiological measures and children's socioemotional outcomes. The results provide insights into which aspects of parent-infant interactions are associated with the physiological functioning of infants and which socioemotional outcomes in infants may be influenced by this functioning.

Multidimensional family therapy reduces problematic gaming in adolescents: A randomised controlled trial.

BACKGROUND AND AIMS: Social variables including parental and family factors may serve as risk factors for Internet Gaming Disorder (IGD) in adolescents. An IGD treatment programme should address these factors. We assessed two family therapies - multidimensional family therapy (MDFT) and family therapy as usual (FTAU) - on their impact on the prevalence of IGD and IGD symptoms. METHODS: Eligible for this randomised controlled trial comparing MDFT (N = 12) with FTAU (N = 30) were adolescents of 12-19 years old meeting at least 5 of the 9 DSM-5 IGD criteria and with at least one parent willing to participate in the study. The youths were recruited from the Centre Phénix-Mail, which offers outpatient adolescent addiction care in Geneva. Assessments occurred at baseline and 6 and 12 months. RESULTS: Both family therapies decreased the prevalence of IGD across the one-year period. Both therapies also lowered the number of IGD criteria met, with MDFT outperforming FTAU. There was no effect on the amount of time spent on gaming. At baseline, parents judged their child's gaming problems to be important whereas the adolescents thought these problems were minimal. This discrepancy in judgment diminished across the study period as parents became milder in rating problem severity. MDFT better retained families in treatment than FTAU. DISCUSSION AND CONCLUSIONS: Family therapy, especially MDFT, was effective in treating adolescent IGD. Improvements in family relationships may contribute to the treatment success. Our findings are promising but need to be replicated in larger study. TRIAL REGISTRATION NUMBER: ISRCTN 11142726.

Parental Burnout Around the Globe: a 42-Country Study.

High levels of stress in the parenting domain can lead to parental burnout, a condition that has severe consequences for both parents and children. It is not yet clear, however, whether parental burnout varies by culture, and if so, why it might do so. In this study, we examined the prevalence of parental burnout in 42 countries (17,409 parents; 71% mothers; Mage = 39.20) and showed that the prevalence of parental burnout varies dramatically across countries. Analyses of cultural values revealed that individualistic cultures, in particular, displayed a noticeably higher prevalence and mean level of parental burnout. Indeed, individualism plays a larger role in parental burnout than either economic inequalities across countries, or any other individual and family characteristic examined so far, including the number and age of children and the number of hours spent with them. These results suggest that cultural values in Western countries may put parents under heightened levels of stress. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-020-00028-4.

Body image, sexual activity, and side effects of treatments across the first year after surgery in women facing breast cancer: The influence of attachment insecurity.

Objectives: The aim of this study was to assess, across the first year after surgery, the influence of attachment insecurity, that is, avoidant and anxious tendencies, on body image, sexual activity, and side effects of treatments in women diagnosed with breast cancer.Design: A total of 110 women with non-metastatic breast cancer were surveyed 2 weeks (T1), 3 months (T2), and 12 months (T3) after surgery.Methods: Self-reported questionnaires were used to assess attachment tendencies (avoidance and anxiety), medical data (cancer stage, oncological treatment), sociodemographic data (age, socioeconomic level, relational status), and the three outcomes.Results: Generalized linear modeling showed that (1) having more avoidant and anxious attachment tendencies predicted a more negative body image, as did being younger and having undergone a mastectomy; (2) having more avoidant attachment tendencies predicted being sexually inactive, as did having undergone neoadjuvant chemotherapy or adjuvant hormonal therapy, whereas being younger and in a committed relationship predicted being sexually active; and (3) attachment tendencies did not predict the intensity of side effects, whereas a higher cancer stage and being at the beginning of treatment predicted more side effects.Conclusions: Women with avoidant and anxious attachment tendencies may be especially vulnerable to the consequences of oncological treatment, in particular regarding body image and sexual activity.