{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:05:38Z","timestamp":1777467938248,"version":"3.51.4"},"reference-count":42,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2009,6,10]],"date-time":"2009-06-10T00:00:00Z","timestamp":1244592000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behav. Cogn. Psychother."],"published-print":{"date-parts":[[2009,7]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Utero-vaginal agenesis, also called the Mayer-Rokitansky-K\u00fcster-Hauser Syndrome (MRKH), is a congenital abnormality of the female genital tract, characterized by the non-formation of the vagina and the uterus. It is a common cause of primary amenorrhoea. Little is known about the psychological impact and management of this condition. <jats:bold>Method:<\/jats:bold> We describe a specific model of the core negative psychological impact of diagnosis and medical treatment of MRKH and a cognitive-behavioural therapy of MRKH based on the model (CBT-MRKH). The Medical Research Council's (2002) framework for the development and evaluation of complex health interventions was used for intervention development and evaluation. <jats:bold>Results:<\/jats:bold> Evidence from a recent cross-sectional study and a small randomized controlled trial (RCT) provides preliminary support for the model and treatment (Heller-Boersma, Schmidt and Edmonds, in press; Heller-Boersma, Schmidt and Edmonds, 2007), and this is further validated by extensive qualitative material gathered over the course of the RCT from participants. <jats:bold>Conclusions:<\/jats:bold> The model and treatment described may also be applicable to a number of other congenital or acquired gynaecological conditions such as premature ovarian failure, breast cancer, early onset endometrial cancer, female genital mutilation, Turner's Syndrome, ovarian dys\/agenesis or, Complete Androgen Insensitivity Syndrome, all of which have a psychological impact not dissimilar to MRKH in terms of these women's sense of self and femininity.<\/jats:p>","DOI":"10.1017\/s1352465809990051","type":"journal-article","created":{"date-parts":[[2009,6,10]],"date-time":"2009-06-10T05:55:10Z","timestamp":1244613310000},"page":"449-467","source":"Crossref","is-referenced-by-count":28,"title":["A Cognitive Behavioural Model and Therapy for Utero-Vaginal Agenesis (Mayer-Rokitansky-K\u00fcster-Hauser Syndrome: MRKH)"],"prefix":"10.1017","volume":"37","author":[{"given":"Jacoline G.","family":"Heller-Boersma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. Keith","family":"Edmonds","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike H.","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2009,6,10]]},"reference":[{"key":"S1352465809990051_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2004.11.008"},{"key":"S1352465809990051_ref21","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-197905000-00004"},{"key":"S1352465809990051_ref18","unstructured":"Heller-Boersma J. G. , Edmonds D. K. and Schmidt U. H. (submitted). A systematic review of the psychological impact of utero-vaginal agenesis."},{"key":"S1352465809990051_ref41","first-page":"192","article-title":"The Mayer-Rokitansky-K\u00fcster-Hauser syndrome, without and with associated features: two separate entities?","volume":"3","author":"Strubbe","year":"1994","journal-title":"Clinical Dysmorphology"},{"key":"S1352465809990051_ref40","volume-title":"Pubertal Maturation in Female Development","author":"Stattin","year":"1990"},{"key":"S1352465809990051_ref3","volume-title":"Frontiers of Cognitive Therapy","author":"Beck","year":"1996"},{"key":"S1352465809990051_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2004.03.006"},{"key":"S1352465809990051_ref36","volume-title":"Traumatic Stress: the effects of overwhelming experience on mind and body.","author":"Rothbaum","year":"1996"},{"key":"S1352465809990051_ref20","unstructured":"Heller-Boersma J. G. , Schmidt U. H. and Edmonds D. K. (in press). 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