SUBJECTS

1. METHOD • SUBJECTS • The sample included 320 subjects: 120 normal control subjects (60 couples) without known fertility problems (NC); 120 subjects (60 couples) with an infertility diagnosis pursuing medical treatment (IG) and 80 subjects (40 couples) with an infertility diagnosis who are adoption candidates (AG). • Table 1 presents sample characteristics in terms of age, years of education, and socioeconomic level. Significant differences between the groups were found in age (F= 8.32; p=.000) and in years of education (F=20.55; p=.000). • INSTRUMENTS • Beck Depression Inventory - BDI; Beck, A., Ward, C., Mendelson, M., Mock, J., & Erbaugh, J., 1961); Coping Styles Questionnaire (CSQ (3); Rogers, D., 1996); Others As Shamer (OAS; Goss, K., Gilbert, P., & Allan, S., 1994,); Experience of Shame Scale (ESS; Andrews, B., Qian, M., & Valentine, J., 2002); Acceptance and Action Questionnaire (AAQ II; Hayes, S.C. et al., 2004,); Self-Compassion Scale (SELFCS; Neff, K.D., 2003; Intimacy Dimensions Scale(IDS; Crespo, Narciso, Ribeiro, & Costa, 2006); Female Sexual Function Index (FSFI; Rosen et al., 2000); International Index of Erectile Function (IIEF; Rosen et al., 1997); Dyadic Adjustment Scale (DAS; Spanier, 1976). • PROCEDURE • Participants filled in the questionnaires voluntarily, at their home and sent them by mail. Informed consent to participate in this study was previously asked. Normal controls were people from general population, infertility subjects were recruited in specialized clinics (public and private) and adoption candidates were recruited by adoption public agencies. REFERENCES • Boivin, J. (2003). A review of psychological interventions in infertility. Social Science & Medicine, 57, 2325-2341. • Chen, T-H, Chang, S-P, Tsai, C-F, & Juang, K-D (2004). Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic. Human Reproduction. 19, 10, 2313-2318. • Cousineau, T. M., & Domar, A. D. (2007). Psychological impact of infertility. Best Practice & Research Clinical Obstetrics and Gynaecology, 21, 2, 293-308. • Crespo, C., Narciso, I., Ribeiro, M. T., & Costa, M. E. (2006). Desenvolvimento da Escala de Dimensões da Intimidade: primeiro estudo empírico. Psychologica, 41, 45-63. • Goss, K., Gilbert, P., & Allan, S. (1994). An exploration of shame measure: The “others as shamer scale”. Personality and Individual Differences, 17, 713-717. • Neff, K. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2, 223-250. • Roger, D., Jarvis, G., & Najarian, B. (1993). Detachment and coping: The construction and validation of a new scale for measuring coping strategies. Personality and Individual Differences, 15, 6, 619-626. • Rosen, R. C., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsig, R. et al. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-reposrt instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy, 26, 191-208. • Rosen, R. C., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrck, J., & Mishra, A. (1997). The International Index of Erectile Function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49, 822-830. • Spanier, G. B., (1976). Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. Journal of Marriage and Family, 38, 15-28. • Vaz Serra, A., S., & Pio Abreu, J. L. (1973). Aferição dos quadros clínicos depressivos – estudo preliminar de novos agrupamentos sintomatológicos para complemento do “Inventário Depressivo de Beck”. Coimbra Médica, XX, 713-736. • Wischmann, T., Stammer, H., Scherg, H., Gerhard, I., & Verres, R. (2001). Psychological characteristics of infertile couples: a study by the Heidelberg Fertility Consultation Service. Human Reproduction, 16, 8, 1753-1761. Infertility in Portugal: Psychological Aspects Ana Galhardo, Marina Cunha, José Pinto-Gouveia (anagalhardo@ismt.pt) (marina_cunha@ismt.pt) (jpgouveia@fpce.uc) Faculty of Psychology and Educational Sciences – CINEICC University of Coimbra, PORTUGAL INTRODUCTION Investigation shows a high prevalence of psychiatric disorders in women receiving medical treatment for infertility. Chen, Chang, Tsai and Juang (2004) refer that 40.2% presented a psychiatric disorder, with generalized anxiety disorder being the most frequent diagnosis (23.2%), followed by major depression (17.0%) and distimia disorder (9.8%). Noteworthy is the fact that anxiety and depression levels in infertile women are equivalent to the ones found in women with heart disease, cancer and HIV positive (Domar, Zuttermeister, & Friedman, 1993 cit. in Cousineau, & Domar, 2007). Infertility is doubtless a crisis and an event that causes psychological stress (Leiblum & Greenfield, 1997; Brovich & Fisher, 1998; Burns & Covington, 1999 cit. in Wishmann, Stammer, Scherg, & Verres, 2001). Its consequences can be seen at various levels being noteworthy the personal suffering and social repercussions. GOALS This study is intended to proceed to the characterization of subjects with a diagnosis of infertility in terms of individual psychological functioning, measuring variables such as anxiety, depression, shame, self-compassion, acceptance, positive and negative affection, and coping styles. Due to the fact that infertility can also interfere with couple´s relational dynamics, it is intended to characterize some aspects of conjugal relationship, such as intimacy, sexual functioning and marital adjustment. The establishment of comparisons between these couples and couples of the general population, in fertile age, with at least a child and without known fertility problems, in what concerns the variables in study, as well as with couples with infertility problems that are candidates for adoption is also intention of this investigation. RESULTS As shown in Table 2, subjects from the infertility group scored higher than normal control s and than subjects from the adoption group in measures of depression, detached/emotional and avoidant coping styles, internal shame and external shame. No significant differences were found between normal controls and candidates for adoption in these variables. In what concerns acceptance, the infertility group presents the lower score and normal controls and the adoption group have no significant differences between them. Infertility subjects also tend to be more self-compassionate than adoption candidates, but there were no differences between the groups for optimism. In what concerns couples’ intimacy, infertility subjects show the higher value, distinguishing themselves from normal controls but not from adoption candidates. No differences between the groups were found in terms of sexual functioning, neither for men or women. Dyadic adjustment seems to be higher for couples who want to adopt a child. These couples scored higher than normal controls but no differences were found between them and infertility subjects. Table 1. Sample characteristics Table 2. Mean comparisons by using ANOVAS CONCLUSIONS • Subjects with an infertility diagnosis who are receiving medical treatment show significant higher scores in psychopathological measures and significant lower scores in measures that assess a more positive/protective psychological functioning. • Contrary to what is mentioned in literature, there were no significant differences in sexual functioning between infertile couples, normal controls and candidates for adoption. • Infertility subjects present higher scores than normal controls in intimacy which suggest that infertility may function as a couples’ cohesion factor (e.g. during medical treatment). • Results suggest that the assessment of these variables may contribute to a better psychological intervention plan during medical treatment.