The Effectiveness of Couple Therapy on Depressive Symptoms and Sexual Function in Women Affected by Infidelity

Marital infidelity is one of the most important factors threatening the performance, stability, and continuity of marital relationships. Marital infidelity refers to any sexual or emotional relationship beyond the framework of a committed relationship between two spouses, and research shows that about one-third of men and a quarter of women are likely to have sex at least once in their lifetime. Engage in extramarital affairs. Hidden relationships outside of marriage cause feelings such as depression, anger, frustration, lack of self-confidence, loss of identity, and feelings of worthlessness in a betrayed spouse. Marital infidelity also causes feelings of doubt, depression, and guilt in the unfaithful spouse. Couples who are treated for marital infidelity are more likely to separate and divorce than couples who present with other problems. Marital infidelity is one of the main reasons that bring couples to family counseling clinics for divorce. Research has shown that the harmful consequences of infidelity can last for a long time and may last forever, unless the couple receives proper treatment. One of the most important changes that can be made in the life of couples with extramarital affairs is to reduce the symptoms of depression and improve their sexual function psychologically, and it seems that the scheme of schema therapy can be effective in this regard. Various cognitive factors are influential in marital incompatibilities. One type of cognition that is important in a marital relationship is maladaptive schemas. Incompatible schemas are structures that are formed based on reality or experience and, as mediators, affect individuals' behavioral responses. Schemas are considered undeniable intellectual structures that are used as a framework for processing experiences. These schemas expand over time and define thoughts and relationships with others. According to Beck, early maladaptive schemas are essentially valid examples of traumatic childhood experiences that gradually become patterns of distorted thoughts and dysfunctional behaviors, and since the beginning of life, they are brought up in a habit and remain unquestioned, often forming human self-conceptions and views of the world. Even when there is evidence that schemas are refuted, many people distort their information to preserve the validity of the schemas. The usefulness of schema therapy in the treatment of severe marital problems and common problems in maintaining intimate relationships between couples has been confirmed. Considering the effectiveness of couple therapy based on the schema model and also the lack of research in Iran to evaluate its effectiveness on women affected by infidelity, in this study we tried to evaluate the effect of couple therapy based on the schema model on depressive symptoms and sexual function in women affected by infidelity in Bushehr should be examined.

This research is in the group of quasi-experimental researches which was approved by Bushehr University of Medical Sciences with ethics code IR.BPUMS.REC.1399.169. The statistical population of the present study consisted of all women affected by infidelity in Bushehr who had been referred to counseling and family therapy centers in Bushehr. The sample consisted of 30 people (15 in the experimental group and 15 in the control group). In the present study, the library method was used to review research sources and the field method was used to collect information. Both groups completed the research tools in the pre-test and post-test stages. Research instruments included Beck and Stear's (1996) Depression Inventory and Rosen et al.'s (2000) Sexual Function Questionnaire.

The results of multivariate analysis of covariance showed that couple therapy based on the schema model had a significant effect on reducing depressive symptoms and improving sexual function in women affected by infidelity. Based on the effect size coefficient, 71.1% of the variance of the dependent variables of depressive symptoms and sexual function can be explained by the independent variable of couple therapy based on the schema model.

The use of schema-based couple therapy can play an important role in reducing depression and improving sexual function in women affected by infidelity. Schema-based couple therapy is an approach consisting of cognitive, behavioral, interpersonal, attachment, and experimental approaches in the form of an integrated treatment model that uses four main cognitive, behavioral, relational, and experimental techniques in individuals in addition to questioning maladaptive schemas. This is the main cause of the formation of dysfunctional and irrational thoughts, emotionally drains the buried negative emotions and emotions and often leads to depression. It has been found that there is a theoretical link between early dysfunctional schemas and depressive symptoms. For example, the perfectionist schemas of emotional inhibition, social isolation, self-development, impairment, and emotional deprivation appear to be associated with depressive disorder. Therefore, recognizing these schemas and changing them has important clinical implications. In fact, by identifying depressive schemas in women affected by infidelity, they can be targeted for treatment, and with therapeutic interventions focused on schemas, they can be changed and corrected. Also, in explaining the effect of schema-based couple therapy on improving the sexual function of women affected by infidelity, it should be noted that in schema therapy, through behavioral techniques, clients are allowed to have intimacy with their lives by sharing memories. Bitter and unfortunate and allow the spouse to approach. Therefore, it can be said that couple therapy based on schema model through cognitive, emotional, and behavioral strategies can correct the schemas of the first people that lead to an increased tendency to marital infidelity and decreased marital satisfaction, and as a result, the person acquires enough power to stop marital infidelity and increase intimacy with the spouse. Therefore, it can be said that the couple therapy effected on depressive symptoms and sexual function in women affected by infidelity. It seems that schema-based couple therapy, by affecting intimacy and marital forgiveness, has a positive effect on increasing couples' sexual intimacy and will improve their sexual function. Although in this study, an attempt was made to reduce the disturbing variables and possible biases by randomly assigning the subjects to the experimental and control groups, but the most important limitation of this study was not to use follow-up. Another limitation was the limitation of the sample to couples referring to the Welfare Counseling Center in Bushehr.