Journal of Behavioral Medicine

, Volume 15, Issue 2, pp 171–187 | Cite as

Coping and Cognitive factors in adaptation toin vitro fertilization failure

  • Mark D. Litt
  • Howard Tennen
  • Glenn Affleck
  • Susan Klock


Characteristics were identified that predict adaptation following an unsuccessful attempt at in vitrofertilization (IVF). Forty-one women and their husbands were interviewed and administered questionnaires prior to IVF and 2 weeks after notice of a positive or negative pregnancy test. Of the 36 couples who failed to conceive as a result of IVF, 6 of the women studied developed clinical depressive symptoms. Those women who reported poorest adaptation to IVF failure were more likely to have reported depressive symptoms prior to IVF, were more likely to have reported feeling a general loss of control over their lives as a result of infertility, tended to use escape as a coping strategy, and reported having felt some responsibility for their IVF failure. Dispositional optimism, as well as a sense of being partially responsible for the infertility, was protective of distress following IVF failure.

Key words

appraisal coping psychological adaptation in vitro fertilization 


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  1. Affleck, G., Tennen, H., Croog, S., and Levine, S. (1987). Causal attribution, perceived benefits, and morbidity after a heart attack: An eight year study.J. Consult. Clin. Psychol. 55: 29–35.PubMedGoogle Scholar
  2. Aidwin, C. A., and Revenson, T. A. (1987). Does coping help? A reexamination of the relation between coping and mental health.J. Personal. Soc. Psychol. 53: 337–348.Google Scholar
  3. Baram, D., Tourtelot, E., Eberhard, M., and Huang, K. E. (1988). Psychosocial adjustment following unsuccessfulin vitro fertilization.J. Psychosom. Obstet. Gynecol. 9: 181–190.Google Scholar
  4. Berg, B. J., and Wilson, J. F. (1990). Psychiatric morbidity in the infertile population: A reconceptuaiization.Fertil Steril. 53: 654–661.PubMedGoogle Scholar
  5. Berkowitz, G. S. (1986). Epidemiology of infertility and early pregnancy wastage. In A. H. DeCherney (ed.),Reproductive Failure, Churchill-Livingstone, New York.Google Scholar
  6. Cohen, J., and Cohen, P. (1975).Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences, Erlbaum, Hillsdale, NJ.Google Scholar
  7. Dennerstein, L., and Morse, C. (1985). Psychological issues in 1VF.Clin. Obstet. Gynecol. 12: 835–846.Google Scholar
  8. Derogatis, L. R. (1975).Brief Symptom Inventory, Clinical Psychometric Research, Baltimore.Google Scholar
  9. Felton, B., and Revenson, T. (1984). Coping with chronic illness: A study of illness controllability and the influence of coping strategies on psychological adjustment.J. Consult. Clin. Psychol. 52: 343–353.PubMedGoogle Scholar
  10. Folkman, S., and Lazarus, R. S. (1980). An analysis of coping in a middle-aged community sample.J. Health Soc. Behav. 21: 219–239.PubMedGoogle Scholar
  11. Forsythe, C., and Compas, B. (1987). Interaction of cognitive appraisals of stressful events and coping. Testing the goodness of fit hypothesis.Cog. Ther. Res. 11: 473–485.Google Scholar
  12. Freeman, E. W., Boxer, A. S., Rickels, K., Tureck, R., and Mastroianni, L. (1985). Psychological evaluation and support in a program ofin vitro fertilization and embryo transfer.Fertil. Steril. 43: 48–53.PubMedGoogle Scholar
  13. Garner, C. H. (19).In vitro fertilization and embryo transfer.JOGN Nurs. 12: 75–78.Google Scholar
  14. Greenfeld, D., Mazure, C., Haseltine, F. P., and DeCherney, A. H. (1983). The role of the social worker in thein-vitro fertilization program.Soc. Work Health Care 10: 71–79.Google Scholar
  15. Langer, E. J. (1983).The Psychology of Control, Sage, Beverly Hills, CA.Google Scholar
  16. Lazarus, R. S., and Folkman, S. (1984).Stress, Appraisal, and Coping, Springer, New York.Google Scholar
  17. Lefcourt, H. M. (1976).Locus of Control: Current Trends in Theory and Research, Halstead, New York.Google Scholar
  18. Leiblum, S. R., Kemmann, E., and Lane, M. K. (1987). The psychological concomitants ofin vitro fertilization.J. Psychosom. Obstet. Gynecol. 6: 165–178.Google Scholar
  19. Levenson, H. (1972). Distinctions within the construct of internal-external control: Development of a new scale. Proceedings of the 80th Annual Convention of the American Psychological Association, p. 261.Google Scholar
  20. Litt, M. D. (1988). Cognitive mediators of stressful experience: Self-efficacy and perceived control.Cog. Ther. Res. 12: 241–260.Google Scholar
  21. Lubin, B. (1965). Adjective check list for the measurement of depression.Arch. Gen. Psychiat. 12: 57–62.PubMedGoogle Scholar
  22. Mahlstedt, P. P., Macduff, S., and Bernstein, J. (1987). Emotional factors and thein vitro fertilization and embryo transfer process.J. Vitro Pert. Embryo Trans. 4: 232–236.Google Scholar
  23. Major, B., Mueller, P., and Hildebrandt, K. (1985). Attributions, expectations, and coping with abortion.J. Personal. Soc. Psychol. 48: 585–599.Google Scholar
  24. Manne, S., and Zautra, A. (1989). Spouse criticism and support: Their association with coping and psychological adjustment among women with rheumatoid arthritis.J. Personal. Soc. Psychol. 56: 608–617.Google Scholar
  25. Mazure, C. M., and Greenfeld, D. A. (1989). Psychological studies ofin vitro fertilization/embryo transfer participants.J. Vitro Fert. Embryo Trans. 6: 242–256.Google Scholar
  26. Mendola, R. A., Tennen, H., Affleck, G., McCann, L., and Fitzgerald, T. (1990). Appraisal and adaptation among women with impaired fertility.Cog. Ther. Res. 14: 79–92.Google Scholar
  27. Metalsky, G. I., Halberstadt, L. J., and Abramson, L. Y. (1987). Vulnerability to depressive mood reactions: Toward a more powerful test of the diathesis-stress and causal mediation components of the reformulated theory of depression.J. Personal. Soc. Psychol. 52: 386–393.Google Scholar
  28. Newton, C. R., Hearn, M. T., and Yuzpe, A. A. (1990). Psychological assessment and follow-up afterin-vitro fertilization: Assessing the impact of failure.Fertil. Steril. 54: 879–886.PubMedGoogle Scholar
  29. Parker, J., McCrae, C., Snarr, K., Beck, N., Frank, R., Anderson, S., and Walker, S. (1988). Coping strategies in rheumatoid arthritis.J. Rheum. 15: 1376–1383.PubMedGoogle Scholar
  30. Rothbaum, F., Weisz, J. R., and Snyder, S. S. (1982). Changing the world and changing the self: A two-process model of perceived control.J. Personal. Soc. Psychol. 42: 5–37.Google Scholar
  31. Scheier, M. F., and Carver, C. S. (1985). Optimism, coping and health: Assessment and implications of generalized outcome expectancies.Health Psychol. 4: 219–247.PubMedGoogle Scholar
  32. Scheier, M. F., and Carver, C. S. (1987). Dispositional optimism and physical well-being: The influence of generalized outcome expectancies on health.J. Personal. 55: 169–210.Google Scholar
  33. Scheier, M. F., Weintraub, J. K., and Carver, C. S. (1986). Coping with stress: Divergent strategies of optimists and pessimists.J. Personal. Soc. Psychol. 51: 1257–1264.Google Scholar
  34. Scheier, M. F., Matthews, K. A., Owens, J. F., Magovern, S. R., Lefebvre, R. C., Abbott, R. A., and Carver, C. S. (1989). Dispositional optimism and recovery from coronary artery bypass surgery: The beneficial effects on physical and psychological well-being.J. Personal. Soc. Psychol. 57: 1024–1040.Google Scholar
  35. Seibel, M. M., and Levin, S. (1987). A new era in reproduction technologies: The emotional stages ofin-vitro fertilization.J. Vitro Pert. Embryo Trans. 4: 135–140.Google Scholar
  36. Seligman, M. E. P. (1975).Helplessness, W. H. Freeman, San Francisco.Google Scholar
  37. Spanier, G. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads.J. Man. Family 38 (Feb): 15–28.Google Scholar
  38. Stanton, A., Tennen, H., Affleck, G., and Mendola, R. A. (1992). Cognitive appraisal, coping processes, and adjustment to infertility.J. Soc. Clin. Psychol. (in press).Google Scholar
  39. Taylor, S. E. (1983). Adjustment to threatening events: A theory of cognitive adaptation.Am. Psychologist 38: 1161–1173.Google Scholar
  40. Taylor, S. E., and Brown, J. (1988). Illusion and well-being A social-psychological perspective on mental health.Psychol. Bull. 103: 193–210.PubMedGoogle Scholar
  41. Tennen, H., and Affleck, G. (1987). The benefits and cost of optimistic explanations and dispositional optimism.J. Personal. 55: 377–393.Google Scholar
  42. Tennen, H., and Affleck, G. (1990). Blaming others for threatening events.Psychol. Bull. 108: 209–232.Google Scholar
  43. Tennen, H., Affleck, G., and Gershman, K. (1986). Self-blame among parents of infants with perinatal complications: The role of self-protective motives.J. Personal Soc. Psychol. 50: 690–696.Google Scholar
  44. Timko, C., and Janoff-Bulman, R. (1982). Attributions, vulnerability, and psychological adjustment: The case of breast cancer.Health Psychol. 4: 521–544.Google Scholar
  45. Vieyra, M. A., Tennen, H., Affleck, G., Allen, G., and McCann, L. (1990). The effects of gender and measurement strategy on causal attributions for infertility.Basic Appl. Soc. Psychol. 11: 219–232.Google Scholar

Copyright information

© Plenum Publishing Corporation 1992

Authors and Affiliations

  • Mark D. Litt
    • 1
  • Howard Tennen
    • 2
  • Glenn Affleck
    • 2
  • Susan Klock
    • 3
  1. 1.Department of Behavioral Sciences and Community HealthUniversity of Connecticut Health CenterFarmington
  2. 2.Department of PsychiatryUniversity of Connecticut Health CenterUSA
  3. 3.Department of PsychiatryBrigham and Women's HospitalUSA

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