Abstract
Many studies cite infertility as highly stressful, yet women's responses to infertility are quite variable. Lazarus and Folkman's cognitive phenomenological theory of stress, coping, and appraisal may explain this variability. Gender role identity, career role salience, and societal pressure for motherhood are variables hypothesised to affect a woman's cognitive appraisal of infertility, thus influencing distress level. Female participants (N = 119) were recruited through the NYU Fertility Clinic and Resolve, a support organisation for individuals faced with infertility. Participants completed questionnaires assessing gender characteristics, career role salience, social pressure for motherhood, cognitive appraisal, and distress. Many respondents (42%) reported clinically significant levels of distress. A path analysis assessed the effects of gender‐role identity, career role salience, social pressure for motherhood, and cognitive appraisal on distress. The model accounted for 32% of the variance in distress. Women experiencing social pressure for motherhood viewed infertility as more stressful, women identifying with more positively valued instrumental gender role traits reported less distress, and women who endorsed more negatively valued instrumental gender role traits and cognitively appraised infertility as stressful reported greater distress.
Notes
1. Abbey et al., Citation1991, Citation1992; Adams, Citation2002; Adler & Boxley, Citation1985; Anderson et al., Citation2003; Andrews, Abbey, & Halman, Citation1991; Beaurepaire et al., Citation1994; Benazon, Wright, & Sabourin, Citation1992; Berg & Wilson, Citation1991; Berg, Wilson, & Weingartner, Citation1992; Brothers & Maddux, Citation2003; Callan & Hennessey, Citation1989; Connolly, Edelmann, & Cooke, Citation1987; Connolly, Edelmann, Cooke, & Robinson, Citation1992; R. Cook, Citation1993; R. Cook, Parsons, Mason, & Golombok, Citation1989; Daniluk, Citation1988; Daniluk, Leader, & Taylor, Citation1987; Demyttenaere, Nijs, Evers‐Kiebooms, & Koninckx, Citation1991; Domar et al., Citation1992, Citation1993; Edelmann & Connolly, Citation1998, Citation2000; Edelmann et al., Citation1994; Greil, Leitko, & Porter, Citation1986; Harrison, O'Moore, & O'Moore, Citation1984; Hynes, Callan, Terry, & Gallois, Citation1992; Jordan, 2003; La Joie, Citation2003; Lalos, Lalos, Jacobson, & Von Schoultz, Citation1986; Leiblum, Kemmann, & Lane, Citation1987; McEwan, Costello, & Taylor, Citation1987; Morrow, Thoreson, & Penny, Citation1995; Murphy, Citation2001; Perkel, Citation1985; Raval, Slade, Buck, & Lieberman, Citation1987; Schroder, Citation1996; Stanton, Tennon, Affleck, & Mendola, Citation1991, Citation1992; Wright, Bissonnette, Duchesne, Benoit, Sabourin, & Girard, Citation1991.
2. Abbey et al., Citation1991; Adams, Citation2002; Anderson et al., Citation2003; Andrews et al., Citation1991; Beaurepaire et al., Citation1994; Benazon et al., Citation1992; Berg & Wilson, Citation1991; Berg et al., Citation1992; R. Cook et al., Citation1989; Daniluk, Citation1988; Daniluk et al., Citation1987; Demyttenaere et al., Citation1991; Domar et al., Citation1992, Citation1993; Greil et al., Citation1986; Harrison et al. Citation1984; Hynes et al., Citation1992; Jordan, 2003; La Joie, Citation2003; Lalos et al., Citation1986; Leiblum et al., Citation1987; McEwan et al., Citation1987; Morrow et al., Citation1995; Murphy, Citation2001; Raval et al., Citation1987; Schroder, Citation1996; Stanton et al., Citation1991, Citation1992; Wright et al., Citation1991.
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The prevalence and predictability of depression in infertile women.
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A. D.
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P. C.
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Lane
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Taylor
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P. J.
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K. A.
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Thoreson
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R. W.
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Penny
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L. L.
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Journal of Consulting and Clinical Psychology
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Raval
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H.
,
Slade
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P.
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Buck
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P.
and
Lieberman
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B. E.
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(Doctoral Dissertation, Fordham University, 1996.) Dissertation Abstracts International
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58
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Stanton
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A. L.
,
Tennon
,
H.
,
Affleck
,
G.
and
Mendola
,
R.
1991
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Cognitive appraisal and adjustment to infertility.
.
Women and Health
,
17
:
1
–
15
.
Stanton
,
A. L.
,
Tennon
,
H.
,
Affleck
,
G.
and
Mendola
,
R.
1992
.
Coping and adjustment to infertility.
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Journal of Social and Clinical Psychology
,
11
:
1
–
13
.
Wright
,
J.
,
Bissonnette
,
F.
,
Duchesne
,
C.
,
Benoit
,
J.
,
Sabourin
,
S.
and
Girard
,
Y.
1991
.
Psychological distress and infertility: Men and women respond differently.
.
Fertility and Sterility
,
55
:
100
–
108
.
Abbey
,
A.
,
Andrews
,
L. J.
and
Halman
,
F. M.
1991
.
Gender's role in responses to infertility.
.
Psychology of Women Quarterly
,
15
:
295
–
316
.
Adams
,
E. J.
2002
.
Adjustment to infertility: The role of coping strategies, time in treatment, and infertility category (Doctoral dissertation, New School for Social Research, 2002).
.
Dissertation Abstracts International
,
62
(9‐B)
:
4207
Anderson
,
K. M.
,
Sharpe
,
M.
,
Rattray
,
A.
and
Irvine
,
D. S.
2003
.
Distress and concerns in couples referred to a specialist infertility clinic.
.
Journal of Psychosomatic Research
,
54
:
353
–
355
.
Andrews
,
L. J.
,
Abbey
,
A.
and
Halman
,
F. M.
1991
.
Gender's role in responses to infertility.
.
Psychology of Women Quarterly
,
15
:
295
–
316
.
Beaurepaire
,
J.
,
Jones
,
M.
,
Thiering
,
P.
,
Saunders
,
D.
and
Tennant
,
C.
1994
.
Psychological adjustment to infertility and its treatment: Male and female responses at different stages of IVF/ET treatment.
.
Journal of Psychosomatic Research
,
38
:
229
–
240
.
Benazon
,
N.
,
Wright
,
J.
and
Sabourin
,
S.
1992
.
Stress, sexual satisfaction, and marital adjustment in infertile couples.
.
Journal of Sex and Marital Therapy
,
18
:
273
–
284
.
Berg
,
B. J.
and
Wilson
,
J. F.
1991
.
Psychological functioning across stages of treatment for infertility.
.
Journal of Behavioral Medicine
,
14
:
11
–
26
.
Berg
,
B. J.
,
Wilson
,
J. F.
and
Weingartner
,
P. J.
1992
.
Psychological sequelae of infertility treatment: The role of gender and sex‐role identification.
.
Social Science and Medicine
,
33
:
1071
–
1080
.
Cook
,
R.
,
Parsons
,
J.
,
Mason
,
B.
and
Golombok
,
S.
1989
.
Emotional, marital and sexual functioning in patients embarking upon IVF and AID treatment for infertility.
.
Journal of Reproductive and Infant Psychology
,
7
:
87
–
93
.
Daniluk
,
J. C.
1988
.
Infertility: Intrapersonal and interpersonal impact.
.
Fertility and Sterility
,
49
:
982
–
990
.
Daniluk
,
J. C.
,
Leader
,
A.
and
Taylor
,
P. J.
1987
.
Psychological and relationship changes in couples undergoing infertility investigation: Some implications for counselors.
.
British Journal of Guidance and Counselling
,
15
:
29
–
36
.
Demyttenaere
,
K.
,
Nijs
,
P.
,
Evers‐Kiebooms
,
G.
and
Koninckx
,
P. R.
1991
.
Coping, ineffectiveness of coping and the psychoendocrinological stress responses during in‐vitro fertilization.
.
Journal of Psychosomatic Research
,
35
:
231
–
243
.
Domar
,
A. D.
,
Broome
,
A.
,
Zuttermeister
,
P. C.
,
Seibel
,
M. M.
and
Friedman
,
R.
1992
.
The prevalence and predictability of depression in infertile women.
.
Fertility and Sterility
,
58
:
1158
–
1161
.
Domar
,
A. D.
,
Zuttermeister
,
P. C.
and
Friedman
,
R.
1993
.
The psychological impact of infertility: comparison with patients with other medical conditions.
.
Journal of Psychosomatic and Obstetrics and Gynecology
,
14
:
45
–
52
.
Greil
,
A. L.
,
Leitko
,
T. A.
and
Porter
,
K. P.
1986
.
Infertility: His and hers.
.
Gender and Society
,
2
:
172
–
199
.
Harrison
,
R. F.
,
O'Moore
,
R. R.
and
O'Moore
,
A. M.
1984
.
Stress and fertility: Some modalities of investigation and treatment in couples with unexplained infertility in Dublin.
.
International Journal of Fertility
,
31
:
153
–
159
.
Hynes
,
G. J.
,
Callan
,
V. J.
,
Terry
,
D. J.
and
Gallois
,
C.
1992
.
The psychological well‐being of infertile women after a failed IVF attempt: The effects of coping.
.
British Journal of Medical Psychology
,
65
:
269
–
278
.
La Joie
,
M.
2003
.
Psychological adjustment of women experiencing secondary infertility (Doctoral dissertation, New York University School of Social Work, 2003).
.
Dissertation Abstracts International
,
64
:
662
Lalos
,
A.
,
Lalos
,
O.
,
Jacobson
,
L.
and
Von Schoultz
,
B.
1986
.
Depression, guilt, and isolation among infertile women and their partners.
.
Journal of Psychosomatic Obstetrics and Gynaecology
,
5
:
197
–
206
.
Leiblum
,
S. R.
,
Kemmann
,
E.
and
Lane
,
M. K.
1987
.
The psychological concomitants of in vitro fertilization.
.
Journal of Psychosomatic Obstetrics and Gynaecology
,
6
:
233
–
237
.
McEwan
,
K. L.
,
Costello
,
C. G.
and
Taylor
,
P. J.
1987
.
Adjustment to infertility.
.
Journal of Abnormal Psychology
,
96
:
108
–
116
.
Morrow
,
K. A.
,
Thoreson
,
R. W.
and
Penny
,
L. L.
1995
.
Predictors of psychological distress among infertility clinic patients.
.
Journal of Consulting and Clinical Psychology
,
63
:
163
–
167
.
Murphy
,
D. J.
2001
.
Adjustment to infertility: The contribution of attachment style and marital satisfaction.
.
(Doctoral dissertation, Adelphi University, 2001.) Dissertation Abstracts International
,
61
:
6142
Raval
,
H.
,
Slade
,
P.
,
Buck
,
P.
and
Lieberman
,
B. E.
1987
.
The impact of infertility on emotions and the marital and sexual relationship.
.
Journal of Reproductive and Infant Psychology
,
5
:
221
–
234
.
Schroder
,
M.
1996
.
Time in treatment, cognitive appraisal, dispositional optimism, and age as predictors of distress in women experiencing infertility.
.
(Doctoral Dissertation, Fordham University, 1996.) Dissertation Abstracts International
,
58
:
1540
Stanton
,
A. L.
,
Tennon
,
H.
,
Affleck
,
G.
and
Mendola
,
R.
1991
.
Cognitive appraisal and adjustment to infertility.
.
Women and Health
,
17
:
1
–
15
.
Stanton
,
A. L.
,
Tennon
,
H.
,
Affleck
,
G.
and
Mendola
,
R.
1992
.
Coping and adjustment to infertility.
.
Journal of Social and Clinical Psychology
,
11
:
1
–
13
.
Wright
,
J.
,
Bissonnette
,
F.
,
Duchesne
,
C.
,
Benoit
,
J.
,
Sabourin
,
S.
and
Girard
,
Y.
1991
.
Psychological distress and infertility: Men and women respond differently.
.
Fertility and Sterility
,
55
:
100
–
108
.