Anxiety and depression among infertile women: a cross-sectional survey from Hungary

BACKGROUND: Infertility is often associated with a chronic state of stress which may manifest itself in anxiety-related and depressive symptoms. The aim of our study is to assess the psychological state of women with and without fertility problems, and to investigate the background factors of anxiety-related and depressive symptoms in women struggling with infertility. METHODS: Our study was conducted with the participation of 225 (134 primary infertile and 91 fertile) women, recruited in a clinical setting and online. We used the following questionnaires: Spielberger Trait Anxiety Inventory (STAI-T), Shortened Beck Depression Inventory (BDI) and Fertility Problem Inventory (FPI). We also interviewed our subjects on the presence of other sources of stress (the quality of the relationship with their mother, financial and illness-related stress), and we described sociodemographic and fertility-specific characteristics. We tested our hypotheses using independent-samples t-tests (M +/- SD) and multiple linear regression modelling (ss). RESULTS: Infertile women were younger (33.30 +/- 4.85 vs. 35.74 +/- 5.73, p = .001), but had significantly worse psychological well-being (BDI = 14.94 +/- 12.90 vs. 8.95 +/- 10.49, p < .0001; STAI-T = 48.76 +/- 10.96 vs. 41.18 +/- 11.26, p < .0001) than fertile subjects. Depressive symptoms and anxiety in infertile women were associated with age, social concern, sexual concern and maternal relationship stress. Trait anxiety was also associated with financial stress. Our model was able to account for 58% of the variance of depressive symptoms and 62% of the variance of trait anxiety. CONCLUSIONS: Depressive and anxiety-related symptoms of infertile women are more prominent than those of fertile females. The measurement of these indicators and the mitigation of underlying distress by adequate psychosocial interventions should be encouraged

Termination of the leprosy isolation policy in the US and Japan : Science, policy changes, and the garbage can model

BACKGROUND: In both the US and Japan, the patient isolation policy for leprosy /Hansen's disease (HD) was preserved along with the isolation facilities, long after it had been proven to be scientifically unnecessary. This delayed policy termination caused a deprivation of civil liberties of the involuntarily confined patients, the fostering of social stigmas attached to the disease, and an inefficient use of health resources. This article seeks to elucidate the political process which hindered timely policy changes congruent with scientific advances. METHODS: Examination of historical materials, supplemented by personal interviews. The role that science played in the process of policy making was scrutinized with particular reference to the Garbage Can model. RESULTS: From the vantage of history, science remained instrumental in all period in the sense that it was not the primary objective for which policy change was discussed or intended, nor was it the principal driving force for policy change. When the argument arose, scientific arguments were employed to justify the patient isolation policy. However, in the early post-WWII period, issues were foregrounded and agendas were set as the inadvertent result of administrative reforms. Subsequently, scientific developments were more or less ignored due to concern about adverse policy outcomes. Finally, in the 1980s and 1990s, scientific arguments were used instrumentally to argue against isolation and for the termination of residential care. CONCLUSION: Contrary to public expectations, health policy is not always rational and scientifically justified. In the process of policy making, the role of science can be limited and instrumental. Policy change may require the opening of policy windows, as a result of convergence of the problem, policy, and political streams, by effective exercise of leadership. Scientists and policymakers should be attentive enough to the political context of policies

Longitudinal analyses of the relationship between unsupportive social interactions and psychological adjustment among women with fertility problems

This study examined the association of unsupportive social interactions and psychological adjustment among 123 women with fertility problems, and tested whether threat appraisals and avoidance coping mediate this association. Cross-sectional analyses suggested that infertility-specific unsupportive responses received from other people were associated positively with adjustment problems. Avoidance coping and threat appraisals mediated this association between unsupportive social interactions and adjustment. Longitudinal analyses with 67 of these women revealed that after controlling for Time 1 adjustment, Time 1 unsupportive social interactions were associated positively with depressive symptoms and overall psychological distress only for women who remained infertile at Time 2, compared with women who were pregnant or had given birth. Associations between Time 1 unsupportive social interactions and self-esteem at Time 2 were similar for both groups of women.Unsupportive social interactions Avoidance coping Psychological adjustment Infertility Women's health USA

Can Couples Assessment and Feedback Improve Relationships? Assessment as a Brief Relationship Enrichment Procedure

Many counseling psychologists provide marital assistance to couples who have relationship problems and those who seek to enrich their relationships. The authors investigated the effects of individualized relationship assessment and feedback in relation to merely completing written questionnaires about the relationships on couples' satisfaction and commitment. Student couples ( N = 48; 26 married, 15 cohabiting, 7 engaged) participated either in (a) 3 sessions of assessment feedback ( n = 28) or (b) written assessment only ( n = 20). Assessment-feedback couples improved more over time than did written-assessment-only couples. The authors concluded that assessment and feedback produce small positive changes in already well-functioning relationships. Those changes may account for a substantial proportion of the changes produced by relationship enrichment programs