Re-examining the Role of Coping Strategies in the Associations Between Infertility-Related Stress Dimensions and State-Anxiety: Implications for Clinical Interventions With Infertile Couples

Abstract

Research has shown a direct relationship between infertility-related stress and anxiety in infertile patients. The present study goes into this relationship in depth, testing the moderating role of coping strategies (Seeking Social Support, Avoidant, Positive Attitude, Problem-Solving, Turning to Religion) in the associations between specific infertility-related stress dimensions (Social Concern, Need for Parenthood, Rejection of Childfree Lifestyle, Couple’s Relationship Concern) and State-Anxiety among male and female partners of infertile couples. Gender differences were also explored. Both members of 254 infertile couples completed a questionnaire consisting of Socio-demographics, Fertility Problem Inventory–Short Form (FPI-SF), Coping Orientation to Problem Experienced–New Italian Version (COPE-NIV), and State-Trait Anxiety Inventory-Y (STAI-Y). The results revealed that Social Concern and Couple’s Relationship Concern, in both partners, and Need for Parenthood, in female partners, had positive correlations with State-Anxiety. Seeking Social Support and Avoidant coping were related to increasing levels of State-Anxiety in both partners, whereas Positive Attitude coping strategies were related to lower levels of State-Anxiety in female partners. Problem-Solving and Avoidant coping played moderating roles between specific infertility-related stress dimensions and State-Anxiety in unexpected directions. Problem-Solving exacerbated the negative effects of Social Concern, whereas Avoidant coping buffered the negative effects of several infertility-related stress dimensions in both partners. Interventions to improve stress management and psychological health in infertile couples should consider that the adequacy of coping strategies is inherently situation specific. It therefore follows that patient-centered clinical interventions should consider the potential inadequacy of promoting Problem-Solving strategies, and that even Avoidance can be an efficient strategy for dealing with specific infertility-related stress dimensions.

Perceived Past and Current COVID-19-Stressors, Coping Strategies and Psychological Health among University Students: A Mediated-Moderated Model

“…Following this approach, among the wide range of individual characteristics featuring stress processes [ 27 ], coping strategies play an essential role in influencing an individual’s adjustment to situations and, thus, in determining the development of stress-related health outcomes [ 28 , 29 , 30 ]. In line with this, while most research conducted during the COVID-19 pandemic has paid great attention to the sources of stress characterizing university students ‘experiences [ 22 , 23 , 24 , 25 ], some studies have also explored the strategies they have adopted to deal with the new-unprecedented-reality [ 21 , 31 , 32 , 33 , 34 ].…”

“…However, considering the still open debate on stress process and adaptive/maladaptive coping strategies in the literature beyond the COVID-19 emergency [ 27 , 30 ], as well as taking into account the limited evidence on the effectiveness of coping strategies among university students during the pandemic, further research providing evidence-based and updated contributions is needed to promote students’ adjustment in the current period, namely in the crucial aftermath of the COVID-19 pandemic.…”

The effect of depression and the reframing strategy on the level of satisfaction with family life in infertile and post-miscarriage couples: dyadic analyzes

“…Research shows that people are prone to experience positive changes in the psychological sphere if they can give meaning to a difficult experience (Neimeyer, Baldwin, & Gillies, 2006). It turns out that even in the situation of significantly higher results on the depressiveness scale in women, the use of a positive reframing of the experienced problem by both women and their husbands is so effective that it reduces the impact of depressiveness, leads to stress reduction and greater life satisfaction in., 2021, Zurlo, Della Volta &Vallone, 2020).…”

“…The selection of strategies for coping with the problem of infertility, in addition to gender, turns out to be related to the level of perceived stress and the perception of infertility as a loss or as a challenge. Women struggling with the problem of infertility experience high anxiety, uncertainty and lack of control (Dana, Narimani, Mikaeili, 2013;Yazdani, Kazemi, Fooladi, & Samani, 2016), which is associated with more frequent use of avoidance strategies, self-blame, denial and distraction (Gourounti et al, 2012, Iordăchescu et al, 2021, Zurlo, Della Volta, Vallone, 2020 and perceiving the problem of infertility as a loss (Kalus, 2014). Also, infertile men with higher levels of stress most often adopted blame and avoidance strategies (Babore, Stuppia, Trumello, Candelori, Antonucci, 2017, Nagórska, Obrzut, Ulman & Darmochwał-Kolarz, 2021.…”

Association of Anxiety With Sperm Quality: a Multicentre Cross-sectional Study in China During the COVID-19 Outbreak

“…Research ndings based on infertile men found that anxiety may be associated with decreased semen quality [22][23][24] . A controlled study of 94 patients undergoing in vitro fertilization (IVF) and 85 normal subjects showed that increased levels of state and trait anxiety were associated with decreased semen volume, sperm concentration, total sperm count, and decreased sperm motility [14] .…”