GENDER'S ROLE IN RESPONSES TO INFERTILITY

Infertility is a major life stressor that affects approximately 10% of U.S. married couples. Infertile women and men have reported experiencing depression, helplessness, and marital strain. Given U.S. society's emphasis on women's role as mothers, it has been suggested that women's lives are more disrupted by infertility than those of men. This hypothesis was supported in a survey of 185 infertile couples and 90 presumed fertile couples. Infertile wives, as compared to their husbands, perceived their fertility problem as more stressful, felt more responsible for and in control of their infertility, and engaged in more problem-focused coping. Infertile husbands experienced more home life stress and lower home life performance than did their wives. These differences were not found for presumed fertile couples. Both infertile and presumed fertile wives experienced more depression, more sexual dissatisfaction, and lower self-esteem than did their husbands. Theoretical and counseling implications of these findings are discussed.     

Downward Comparison in Infertile Couples

The tendency of infertile individuals to compare themselves favorably to others with regard to coping efficacy was examined among 61 women and 52 men, including 52 husband-wife pairs. Comparison targets were same-sex infertile others and the spouse. Eighty-three percent of men, but only 45% of women, believed that they were coping better than same-sex others (i.e.,downward comparison). Both men (51%) and women (47%) tended to see no difference between their own and their spouses' coping efficacy. However, comparing themselves to their spouses, men in general compared downward, whereas women compared upward. For both same-sex and spouse comparisons, husbands were significantly more likely to engage in downward comparison than their partners. Analyses testing the correlates of downward comparison revealed that (a) infertile participants who were more likely to engage in downward comparison felt less threatened by infertility, (b) no association emerged between comparison indices and self-esteem, and (c) downward same-sex comparison was more likely for men who had been attempting conception for a longer period.     

The Role of Dyadic Coping on the Marital and Emotional Adjustment of Couples With Infertility

Infertility is a challenging experience, affecting individual and couples’ adjustment. However, the way the members of the couple support each other may affect the experience of infertility and their adjustment. This study aimed to investigate the role of dyadic coping by oneself and by the partner in the association between the impact of infertility and dyadic and emotional adjustment (anxiety and depression) to infertility. In this cross‐sectional study, a total of 134 participants (67 couples with infertility) completed self‐report questionnaires assessing infertility‐related stress, dyadic coping, dyadic adjustment, and depression and anxiety symptoms. A path analysis examined the direct and indirect effects between the impact of infertility in one's life and dyadic and emotional adjustment. There is an indirect effect of the impact of infertility in one's life on dyadic adjustment through men's perceived dyadic coping efforts employed by the self (dyadic coping by oneself) and women's perceived dyadic coping efforts of the partner (dyadic coping by the partner). Regarding the emotional adjustment of infertile couples, infertility stress impact had an indirect effect only on depressive symptoms through men's dyadic coping by oneself. The results highlight the importance of men's dyadic coping strategies for the marital adjustment of couples as well as for men's emotional adjustment. Findings emphasize the importance of involving men in the fertility treatment process, reinforcing the dyadic nature of infertility processes.     

Psychoneuroimmunology and male infertility: A possible link between stress,coping and male immunological infertility

Abstract

This current study investigated a link between stress and coping with some male infertility problems via psychoneuroimmunological theories. The study was carried out on 77 males who came to a fertility clinic for sperm diagnosis. Appraisal and coping with stress reaction to negative life events and to infertility were related to non-sperm cells within the seminal plasma. Those men who had felt strained from external events and from problems of infertility, and had used emotional escape coping strategies, were more prone to have an immunosuppressed reaction, indicated by bacteria within their plasma. Those using task focused control strategies were more prone to have an immunostimulatory reaction, indicated by white blood cells, including in some cases, sperm destroying phagocytes suggesting a possible auto-immunity reaction. When the analyses were done separately on patients with known male fertility problems in comparison with those with unexplained infertility, the two opposing psychoneuroimmunological processes became more pronounced.     

Characteristics of the Biopsychosocial Crisis of Infertility

As many as 5 to 12 million individuals of childbearing age in the United States may now be infertile. For couples who wish to conceive but cannot do so, discovery of physical infertility, coupled with strong expectations about conceiving and raising children, sets the stage for a complex series of reactions labeled here as the crisis of infertility. Infertile couples frequently struggle with strong feelings, ranging from disbelief and denial to isolation, guilt, and grief. Problems coping with infertility are worsened by physical and psychological stresses accompanying medical procedures. The marital relationship may be severely tested as well. For many individuals, the infertility crisis is resolved with virtually no support from anyone. With empathy and understanding, counselors can help infertile individuals to work through this crisis productively.     

Relationships between cognitive coping,self-esteem,anxiety and depression: A cluster-analysis approach

It is important for prevention efforts and for designing appropriate interventions to identify people at risk of depression while considering cognitive coping and individual characteristics. This study with 334 French adults examined the ways in which people may combine the use of several cognitive coping strategies and investigated whether depression, self-esteem, and state- and trait-anxiety would differ across distinctive cognitive coping profiles. A two-phased cluster analytic plan was employed to derive clusters of cognitive coping profiles. We identified three profiles that differed according to the levels of depression, self-esteem, and state- and trait-anxiety. Research should therefore not focus on a single cognitive coping strategy, but on all cognitive coping strategies that are used simultaneously to investigate the relation between cognitive coping and emotional problems. Cognitive coping profiles provided a deeper understanding of how different individuals cope with negative and unpleasant events, and they allowed us to identify targeted groups that are most likely to benefit from specific mental health promotion and prevention campaigns.     

Comparison of dysfunctional attitudes and social adjustment among infertile employed and unemployed women in Iran

This study aims to compare dysfunctional attitudes and social adjustment in infertile employed and unemployed females. Due to the stresses of infertility, infertile females are faced with a variety of sexual and psychological problems, as well as dysfunctional attitudes that can lead to depression. Moreover, infertility problems provoke women into maladjustment and inadvertent corruption of relationships. In this regard, our goal is to consider the effects of employment in conjunction with education on dysfunctional attitudes and social adjustment among infertile women in Iran. In this work, we employed the survey method. We recruited 240 infertile women, utilizing the cluster random sampling method. These women filled out the Dysfunctional Attitudes Scale and the social adjustment part of the California Test of Personality. Next, multivariate analysis of variance was performed to test the relationship of employment status and education with dysfunctional attitudes and social adjustment. Our results indicated that dysfunctional attitudes were far more prevalent in infertile unemployed women than in infertile employed women. Also, social adjustment was better in infertile employed women than in infertile unemployed women. It was shown that education level alone does not have significant effect on dysfunctional attitudes and social adjustment. However, we demonstrated that the employment status of infertile women in conjunction with their education level significantly affects the two dimensions of dysfunctional attitudes (relationships, entitlements) and has insignificant effects on social adjustment. It was revealed that in employed infertile women in Iran, the higher education level, the less dysfunctional were attitudes in relationships and entitlements, whereas in unemployed infertile women, those with a college degree had the least and those with master's or higher degrees had the most dysfunctional attitudes in terms of relationships and entitlements.     

流动儿童歧视知觉与心理健康水平的关系及其心理机制

为了探讨流动儿童所感受到的歧视对他们心理健康水平的影响, 以及应对方式和自尊在其中所起的作用, 从北京市公立学校和打工子弟学校选取1164名流动儿童、从公立学校选取525名北京儿童、从流动儿童主要来源地的农村选取568名农村儿童作为被试, 采用问卷调查的形式, 测查了流动儿童感受到的歧视、他们的心理健康水平(社交焦虑、孤独感、抑郁)、应对方式和自尊。研究发现: (1) 流动儿童所感受到的社会歧视在学校类型、流动性上存在显著的差异, 打工子弟学校的流动儿童得分显著高于公立学校的, 流动性高的儿童得分显著高于流动性低的, 但在性别上不存在显著差异, 也不存在学校类型与性别和流动性的交互作用; (2) 流动儿童的心理健康水平在性别、学校类型和流动性上存在显著的差异, 女孩、来自公立学校的流动儿童、流动性高的儿童的心理健康水平显著差于与之相对应的被试, 除在社交焦虑和抑郁上存在学校类型和性别的交互作用外, 在孤独感上不存在学校类型和流动性的交互作用; (3) 不同类别儿童在心理健康水平上存在显著差异, 流动儿童在社交焦虑、孤独感上最差; (4) 除消极应对与自尊、积极应对与抑郁相关不显著外, 歧视、心理健康水平、应对方式、自尊两两之间都相关非常显著; (5) 歧视知觉对心理健康水平有显著的直接影响, 也通过应对方式和自尊对心理健康水平产生显著的影响。自尊不仅在歧视知觉与心理健康水平之间起到显著的部分中介作用, 在应对方式和心理健康水平之间也起到了显著的部分中介作用。     

Coping with threats to self-esteem: the differing patterns of subjects with high versus low trait self-esteem in first-person accounts

Based on retrospective self-reports, strategies of coping with threats to self-esteem in close relationships were investigated in a sample of 412 adults in south-west Germany. Results indicate that self-esteem was negatively associated with experiencing failure or criticism as a threat to self-esteem. There was a positive association between participants' self-esteem and their self-reported tendency to approach the problem optimistically and act in a rational manner. Self-esteem was negatively associated with feeling dependent on the partner and with treating the partner in a hostile way. As far as women were concerned, self-esteem was also positively related to coping effectiveness. In the case of men the results were less clear. It is suggested that the self-defeating coping style associated with low self-esteem may be self-perpetuating. © 1998 John Wiley & Sons, Ltd.     

Childless in the Land of Imperative Motherhood: Stigma and Coping Among Infertile Israeli Women

Drawing on Goffman's stigma framework, this in-depth study explored the experiences of 26 infertile Jewish women in Israel, the country with a strong pronatalist ideology, both institutional and popular. The findings are in line with the key postulates of the stigma concept: women's coping strategies included selective disclosure, avoidance of exposure of their “hidden disability,” and other information management techniques. Infertility became a “master status” for these women, undermining any other merits and achievements they might have. Most women fully internalized and endorsed the pronatalist discourse by way of pursuing long-term and burdensome infertility treatments, at any personal cost. The paper argues that resistance to stigma of infertility is only possible where women dare question the motherhood imperative, which is clearly not the case with most Israelis. Material and mental resources needed for resisting the stigma of infertility are found among few educated professional women. The paper suggests three theoretical inferences: (a) stigma as a psychological response is graded by the extent of individual's conformity with the dominant norms; (b) the stigma of childlessness is most devastating for the less educated women without career or other nonfamilial aspirations; and (c) in pronatalist societies, the coping and management approach to the study of infertility is more relevant than the resistance approach suggested by some authors.     

The meaning of treatments for infertility: cognitive determinants and structure

Infertility is a life crisis for which modern technologies suggest solutions that themselves are stressful. The purpose of the present study was to determine how treatments for infertility are perceived, and the cognitive structure underlying their perception. Fifty women undergoing in vitro fertilization and 50 fertile women recorded their perceptions of 10 infertility treatments on 15 dimensions. Intergroup comparisons showed that patients generally perceived the treatments more positively than nonpatients, and differences in perceptions focused on female-centered treatments rather than on male-centered and donor-involved treatments. Fertile women tended to be more concerned with the risks to the fetus, whereas infertile patients tended to be more concerned with the social exposure of the treatments. Cluster analysis revealed that patients' conceptions of infertility treatments were organized according to the most salient features of the procedures being applied, whereas fertile women's were organized according to the cause of infertility. The significance of these findings for providing care for infertile couples is discussed.     

Filipino Americans and racism: A multiple mediation model of coping

Although the literature on Asian Americans and racism has been emerging, few studies have examined how coping influences one's encounters with racism. To advance the literature, the present study focused on the psychological impact of Filipino Americans' experiences with racism and the role of coping as a mediator using a community-based sample of adults (N = 199). Two multiple mediation models were used to examine the mediating effects of active, avoidance, support-seeking, and forbearance coping on the relationship between perceived racism and psychological distress and self-esteem, respectively. Separate analyses were also conducted for men and women given differences in coping utilization. For men, a bootstrap procedure indicated that active, support-seeking, and avoidance coping were mediators of the relationship between perceived racism and psychological distress. Active coping was negatively associated with psychological distress, whereas both support seeking and avoidance were positively associated with psychological distress. A second bootstrap procedure for men indicated that active and avoidance coping mediated the relationship between perceived racism and self-esteem such that active coping was positively associated with self-esteem, and avoidance was negatively associated with self-esteem. For women, only avoidance coping had a significant mediating effect that was associated with elevations in psychological distress and decreases in self-esteem. The results highlight the importance of examining the efficacy of specific coping responses to racism and the need to differentiate between the experiences of men and women.     

Psychological interventions for infertile patients: a review of existing research and A new comprehensive approach

The usefulness of psychological support for infertile patients has been highlighted in the literature over the past number of years. This article provides a review of existing research on psychological interventions for infertile patients, and presents the Fertility Group Intervention as an example of the application of existing research. There is clear empirical evidence of high levels of depressive symptoms, anxiety, and distress among infertile patients undergoing assisted reproductive treatment (ART). Infertile patients need and require increased psychological support. Various studies indicate the efficacy of psychological interventions for infertile patients with respect to their mental health and, in part, pregnancy rates. However, many such studies exhibit methodological problems. Therefore, in future research, additional studies of high‐quality design are needed to achieve more definitive answers on the efficacy and indication of psychological interventions for infertile patients. Currently, the Fertility Group Intervention represents a comprehensive therapeutic approach integrating established empirical and theoretical approaches with the aim of helping infertile patients – particularly those undergoing ART – cope with distress related to their infertility and medical treatment. This article further outlines the therapeutic background and structures, treatment goals, practical implications, and feasibility of the Fertility Group Intervention.     

大学生成就需要、自尊水平与应对方式的相关研究

使用测量方法对312名大学生的成就需要、自尊水平和应对方式之间的关系进行了研究。结果发现,大学生总体上趋向于选择问题解决、求助等积极的应对方式而不是自责、退避等消极的应对方式。自尊水平的高低对每项应对方式的选择都有显著影响,而成就需要的高低只对问题解决应对方式有显著影响。除了求助方式外,其他应对方式均不存在性别差异。女大学生比男大学生更倾向于选择求助方式。     

Coping with Job Loss and Reemployment: A Two-Wave Study

Using a national sample, this study investigated the effects of unemployed workers’ coping resources and coping strategy use on reemployment after a three-month period. Based on previous research, it was expected that (1) three types of coping resources (self-esteem, social support, and financial resources) would be positively related to problem-focused coping with job loss, (2) coping resources would be negatively related to emotion-focused coping with job loss, (3) problem-focused coping would be positively related to reemployment, (4) problem-focused coping would be more strongly related to reemployment than emotion-focused coping, and (5) coping strategies would mediate the relationship between the availability of coping resources and obtaining reemployment. Results provided support for the direct effects of coping resources (self-esteem, social support, and, to some extent, financial resources) on coping strategies, and a direct effect of problem-focused coping on reemployment 3 months later. Self-esteem and social support were each indirectly related to subsequent employment status, mediated by problem-focused coping. In other words, individuals with higher levels of self-esteem and social support were not only more likely to engage in problem-focused coping, but having a higher level of self-esteem and social support was also associated with a higher likelihood of being reemployed three months later. Findings are pertinent for the design of more effective interventions that mitigate adverse effects of unemployment and facilitate a successful return to the workforce.     

Extraversion: A “Hidden” Personality Factor in Coping?

Recent evidence suggests a larger role for personality determinants of the coping response than has been traditionally held. In the two studies presented here, we examined the influence of personality on the use of social support and other coping strategies in samples of undergraduate students. The first study surveyed a range of coping responses to naturally occurring stressors and found that Extraversion was related to social support seeking, optimism (identified as germane to coping in prior research) was related to problem solving, and both dispositions were negatively related to avoidance. The second study used an experimental approach and multiple personality measures to correct for possible methodological problems in the first. Extraversion again proved to be associated with help seeking; moreover, this relationship accounted for that of another disposition, self-esteem—a construct considered crucial in the literature. The utility of personality variables, particularly Extraversion, in predicting and explaining the choice of a coping strategy is discussed.     

Treating Faith‐Based Infertile Couples Using Cognitive‐Behavioral Counseling Strategies: A Preliminary Investigation

The authors have found no study that addressed the influence of religious practices, biblical texts, and a spiritual environment on the dynamics of coping with crises often experienced by couples who are infertile and who transition into childlessness. Twenty‐five couples from the greater New York area who were referred by religious leaders participated in an in‐depth interview to share their experiences. This study is a preliminary investigation of the experiences and emotional dynamics of infertile couples. It further illustrates how cognitive‐behavioral approaches may be used as possible intervention strategies.     

Modeling cognitive adaptation: a longitudinal investigation of the impact of individual differences and coping on college adjustment and performance.

Drawing on cognitive adaptation theory, optimism, psychological control, and self-esteem were explored as longitudinal predictors of adjustment to college in a sample of 672 freshmen. Although a direct effect of optimism on adjustment was found, most of the predicted effects were mediated by coping methods. Controlling for initial positive and negative mood, the beneficial effects of optimism, control, and self-esteem on adjustment were mediated by the nonuse of avoidance coping, greater use of active coping, and greater seeking of social support. Alternative models of the causal relations among these variables did not fit the data as well as the a priori mediational model. The results of a 2-year follow-up indicated that self-esteem and control predicted greater motivation and higher grades, controlling for college entrance exam scores. Implications for cognitive adaptation theory and for interventions with populations under stress are discussed.     

人类精子库伦理管理的困惑与对策

建立人类精子库主要用于解决不孕不育问题,在一定程度上解决了男性不育的难题,拓展了生殖医学及发育生物学领域,为许多不孕不育夫妇带来了福音,具有广泛的科学及社会学意义。但是,冷冻精子的使用所涉及的医学、人文、法律、伦理、道德等问题已成为严肃的值得深思熟虑的社会问题。如不加以规范和管理,必将对人类及整个社会造成危害。     

Racial and Ethnic Differences in the Utilization of Prayer and Clergy Counseling by Infertile US Women Desiring Pregnancy

Religion can have a significant influence on the experience of infertility. However, it is unclear how many US women turn to religion when facing infertility. Here, we examine the utilization of prayer and clergy counsel among a nationally representative sample of 1062 infertile US women. Prayer was used by 74.8% of the participants, and clergy counsel was the most common formal support system utilized. Both prayer and clergy counsel were significantly more common among black and Hispanic women. Healthcare providers should acknowledge the spiritual needs of their infertile patients and ally with clergy when possible to provide maximally effective care.