{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T21:50:00Z","timestamp":1789509000674,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004160","name":"Mazandaran University of Medical Sciences","doi-asserted-by":"publisher","award":["23676"],"award-info":[{"award-number":["23676"]}],"id":[{"id":"10.13039\/501100004160","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Reproductive\u2010aged breast cancer (BC) survivors face significant distress related to fertility concerns and psychological health, yet interventions specifically targeting these issues are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the effectiveness of a cognitive\u2010behavioral therapy (CBT) intervention on fertility concerns and psychological status in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A quasi\u2010experimental pretest\u2010posttest study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was conducted with 30 premenopausal BC survivors who desired future pregnancy. Participants were recruited via convenience sampling from a hospital and a clinic in Sari, Northern Iran. They underwent a six\u2010week, group\u2010based, face\u2010to\u2010face CBT program delivered by a reproductive health specialist. Fertility concerns were measured using the reproductive concerns after cancer (RCAC) scale, and psychological status was assessed with the depression, anxiety, and stress Scales (DASS\u201021) at baseline and immediately post\u2010intervention. Data were analyzed using paired t\u2010tests and the Bonferroni correction using in SPSS 24.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The CBT intervention resulted in statistically significant reductions in scores across five of the six RCAC subscales: concerns about fertility potential, partner disclosure, child's health, personal health, and becoming pregnant (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Concerns regarding acceptance of possible infertility did not show a significant change (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.628). Furthermore, participants demonstrated significant decreases in symptoms of depression (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), anxiety (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), and stress (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.031) on the DASS\u201021.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A structured CBT intervention is an effective short\u2010term strategy for alleviating specific fertility\u2010related concerns and improving the psychological well\u2010being of premenopausal BC survivors. The findings support the integration of psychological support, particularly CBT, into survivorship care programs to address the complex reproductive and mental health challenges faced by this group. Further research with a control group and long\u2010term follow\u2010up is recommended to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71065","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T15:07:16Z","timestamp":1763132836000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cognitive Behavioral Therapy for Reproductive Concerns and Psychological Status in Reproductive\u2010aged Breast Cancer Survivors: A Pretest\u2010Posttest Intervention Study"],"prefix":"10.1002","volume":"15","author":[{"given":"Maedeh","family":"Rezaei","sequence":"first","affiliation":[{"name":"Department of Midwifery Go.C., Islamic Azad University  Gorgan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamed","family":"Milani","sequence":"additional","affiliation":[{"name":"School of Medicine Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen","family":"Kheiri","sequence":"additional","affiliation":[{"name":"School of Pharmacy Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadis","family":"Tolomehr","sequence":"additional","affiliation":[{"name":"School of Paramedical Sciences Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohreh","family":"Shahhosseini","sequence":"additional","affiliation":[{"name":"Department of Midwifery, Sexual and Reproductive Health Research Center Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzieh","family":"Azizi","sequence":"additional","affiliation":[{"name":"Department of Midwifery, Sexual and Reproductive Health Research Center Mazandaran University of Medical Sciences  Sari 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