Adaptive and maladaptive grief responses following TOPFA: actor and partner effects of coping strategies

Abstract

Objective: This study aimed to (1) compare women and men regarding absolute and relative coping following a termination of pregnancy for foetal abnormality and (2) assess the influence of relative coping on each partner’s adaptive and maladaptive grief responses. Background: Although differences in coping have been cited to explain gender differences on grief symptomatology after a spontaneous pregnancy loss, no study yet has compared women and men regarding use of coping strategies after termination of pregnancy for foetal abnormality. Furthermore, considering the relatively high prevalence of clinically relevant grief symptomatology among women following this event, the coping strategies of both women and their partners should be explored as predictors. Methods: 41 couples completed the Perinatal Grief Scale and the Brief COPE, 1–6 months after termination of pregnancy for foetal abnormality. Results: Women used Religion more frequently than men. Women’s absolute and relative scores on Emotional Support, Instrumental Support and Venting were higher than men’s. Men presented higher scores on relative use of Acceptance, Humour and Denial. Acceptance positively predicted adaptive grief responses. Self-Blame, Denial, Active Coping and Instrumental Support were positive predictors of maladaptive grief responses. Humour was negatively associated with both types of grief responses. Partner effects were found for Self-Blame and Active Coping. Conclusion: As gender differences regarding coping are normative, psychoeducation may be used to foster intracouple acceptance. Due to their interdependence, both partners should be assessed. Coping strategies like self-blame, associated with maladaptive responses, should be prevented while fostering the use of helpful strategies involving acceptance.

Keywords:

• Actor–Partner Interdependence Model
• adaptive and maladaptive grief responses
• couple
• relative coping
• termination of pregnancy for foetal abnormality

Acknowledgements

This study is part of the ‘Reproductive decisions and transition to parenthood following a pre- or postnatal diagnosis of foetal abnormality’ research project, integrated in the Relationships, Development & Health Research Group of the R&D Unit Institute of Cognitive Psychology, Vocational and Social Development of the University of Coimbra (Pest-OE/PSI/UI0192/2011). Bárbara Nazaré and Ana Fonseca are supported by PhD Scholarships from the Portuguese Foundation for Science and Technology (SFRH/BD/43204/2008, SFRH/BD/47053/2008, respectively).