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Published in: Journal of Clinical Psychology in Medical Settings 2/2017

01-06-2017

The Role of Attachment Anxiety and Attachment Avoidance on the Psychosocial Well-being of Infertile Couples

Authors: M. Moura-Ramos, T. Almeida Santos, M. C. Canavarro

Published in: Journal of Clinical Psychology in Medical Settings | Issue 2/2017

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Abstract

This study’s objective was to explore the mediating role of attachment orientation in infertile women and their partners as a mediator of the relationship between need for parenthood and psychosocial well-being. Ninety participants (45 couples) undergoing in vitro fertilization completed self-report questionnaires that assessed representations of the importance of parenthood, attachment orientations, and psychosocial well-being. Path analysis was used to examine the direct and indirect effects. The results indicated that women’s attachment anxiety mediated the effect of need for parenthood on the psychological well-being of themselves and their partner. Although causality cannot be assumed, this study highlights the importance of considering attachment orientations and related strategies of emotion regulation in clinical settings and the need to address the meaning of parenthood for promoting couples’ well-being.
Literature
go back to reference Bayley, T. M., Slade, P., & Lashen, H. (2009). Relationships between attachment, appraisal, coping and adjustment in men and women experiencing infertility concerns. Human Reproduction, 24, 2827–2837. doi:10.1093/humrep/dep235.CrossRefPubMed Bayley, T. M., Slade, P., & Lashen, H. (2009). Relationships between attachment, appraisal, coping and adjustment in men and women experiencing infertility concerns. Human Reproduction, 24, 2827–2837. doi:10.​1093/​humrep/​dep235.CrossRefPubMed
go back to reference Benyamini, Y., Gozlan, M., & Kokia, E. (2009). Women’s and men’s perceptions of infertility and their associations with psychological adjustment: A dyadic approach. British Journal of Health Psychology, 14, 1–16. doi:10.1348/135910708X279288.CrossRefPubMed Benyamini, Y., Gozlan, M., & Kokia, E. (2009). Women’s and men’s perceptions of infertility and their associations with psychological adjustment: A dyadic approach. British Journal of Health Psychology, 14, 1–16. doi:10.​1348/​135910708X279288​.CrossRefPubMed
go back to reference Bowlby, J. (1982). Attachment and loss. Vol. I. Attachment, (2nd ed.). New York: Basic Books. Bowlby, J. (1982). Attachment and loss. Vol. I. Attachment, (2nd ed.). New York: Basic Books.
go back to reference Brennan, K. A., Clark, C. L., & Shaver, P. R. (1988). Self-report measurement of adult attachment: An integrative overview, In A. J. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 46–76). New York: Guilford. Brennan, K. A., Clark, C. L., & Shaver, P. R. (1988). Self-report measurement of adult attachment: An integrative overview, In A. J. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 46–76). New York: Guilford.
go back to reference Canavarro, M. C., Dias, P., & Lima, V. (2006). A avaliação da vinculação do adulto: Uma revisão crítica a propósito da aplicação da Adult Attachment Scale-R (AAS-R) na população portuguesa [Assessment of adult attachment: A critical revision about the application of the Adult Attachment Scale-R (AAS-R) to the Portuguese population]. Psicologia, 20, 155–187. Canavarro, M. C., Dias, P., & Lima, V. (2006). A avaliação da vinculação do adulto: Uma revisão crítica a propósito da aplicação da Adult Attachment Scale-R (AAS-R) na população portuguesa [Assessment of adult attachment: A critical revision about the application of the Adult Attachment Scale-R (AAS-R) to the Portuguese population]. Psicologia, 20, 155–187.
go back to reference Donarelli, Z., Kivlighan, D. M., Allegra, A., & Lo Coco, G. (2016). How do individual attachment patterns of both members of couples affect their perceived infertility stress? An actor–partner interdependence analysis. Personality and Individual Differences, 92, 63–68. doi:10.1016/j.paid.2015.12.023.CrossRef Donarelli, Z., Kivlighan, D. M., Allegra, A., & Lo Coco, G. (2016). How do individual attachment patterns of both members of couples affect their perceived infertility stress? An actor–partner interdependence analysis. Personality and Individual Differences, 92, 63–68. doi:10.​1016/​j.​paid.​2015.​12.​023.CrossRef
go back to reference Donarelli, Z., Lo Coco, G., Gullo, S., Marino, A., Volpes, A., & Allegra, A. (2012). Are attachment dimensions associated with infertility-related stress in couples undergoing their first IVF treatment? A study on the individual and cross-partner effect. Human Reproduction, 27, 3215–3225. doi:10.1093/humrep/des307.CrossRefPubMed Donarelli, Z., Lo Coco, G., Gullo, S., Marino, A., Volpes, A., & Allegra, A. (2012). Are attachment dimensions associated with infertility-related stress in couples undergoing their first IVF treatment? A study on the individual and cross-partner effect. Human Reproduction, 27, 3215–3225. doi:10.​1093/​humrep/​des307.CrossRefPubMed
go back to reference Ein-Dor, T., Mikulincer, M., & Shaver, P. R. (2011). Attachment insecurities and the processing of threat-related information: Studying the schemas involved in insecure people’s coping strategies. Journal of Personality and Social Psychology, 101, 78–93. doi:10.1037/a0022503.CrossRefPubMed Ein-Dor, T., Mikulincer, M., & Shaver, P. R. (2011). Attachment insecurities and the processing of threat-related information: Studying the schemas involved in insecure people’s coping strategies. Journal of Personality and Social Psychology, 101, 78–93. doi:10.​1037/​a0022503.CrossRefPubMed
go back to reference Fekkes, M., Buitendijk, S. E., Verrips, G. H. W., Braat, D. D. M., Brewaeys, A. M. A., Dolfing, J. G., & Macklon, N. S. (2003). Health-related quality of life in relation to gender and age in couples planning IVF treatment. Human Reproduction, 18, 1536–1543. doi:10.1093/humrep/deg276.CrossRefPubMed Fekkes, M., Buitendijk, S. E., Verrips, G. H. W., Braat, D. D. M., Brewaeys, A. M. A., Dolfing, J. G., & Macklon, N. S. (2003). Health-related quality of life in relation to gender and age in couples planning IVF treatment. Human Reproduction, 18, 1536–1543. doi:10.​1093/​humrep/​deg276.CrossRefPubMed
go back to reference Fraley, R. C., Heffernan, M. E., Vicary, A. M., & Brumbaugh, C. C. (2011). The experiences in close relationships-relationship structures questionnaire: A method for assessing attachment orientations across relationships. Psychological Assessment, 23, 615–625. doi:10.1037/a0022898.CrossRefPubMed Fraley, R. C., Heffernan, M. E., Vicary, A. M., & Brumbaugh, C. C. (2011). The experiences in close relationships-relationship structures questionnaire: A method for assessing attachment orientations across relationships. Psychological Assessment, 23, 615–625. doi:10.​1037/​a0022898.CrossRefPubMed
go back to reference Kenny, D. A., Kashy, D. A., & Cook, W. L. (2006). Dyadic data analysis. New York: The Guilford Press. Kenny, D. A., Kashy, D. A., & Cook, W. L. (2006). Dyadic data analysis. New York: The Guilford Press.
go back to reference Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.). New York: Guilford Press. Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.). New York: Guilford Press.
go back to reference Mahajan, N. N., Turnbull, D. A., Davies, M. J., Jindal, U. N., Briggs, N. E., & Taplin, J. E. (2009). Adjustment to infertility: The role of intrapersonal and interpersonal resources/vulnerabilities. Human Reproduction, 24, 906–912. doi:10.1093/humrep/den462.CrossRefPubMed Mahajan, N. N., Turnbull, D. A., Davies, M. J., Jindal, U. N., Briggs, N. E., & Taplin, J. E. (2009). Adjustment to infertility: The role of intrapersonal and interpersonal resources/vulnerabilities. Human Reproduction, 24, 906–912. doi:10.​1093/​humrep/​den462.CrossRefPubMed
go back to reference Martins, M. V., Peterson, B. D., Almeida, V., Mesquita-Guimaraes, J., & Costa, M. E. (2014). Dyadic dynamics of perceived social support in couples facing infertility. Human Reproduction, 29, 83–89. doi:10.1093/humrep/det403.CrossRefPubMed Martins, M. V., Peterson, B. D., Almeida, V., Mesquita-Guimaraes, J., & Costa, M. E. (2014). Dyadic dynamics of perceived social support in couples facing infertility. Human Reproduction, 29, 83–89. doi:10.​1093/​humrep/​det403.CrossRefPubMed
go back to reference Mikulincer, M., & Florian, V. (1995). Appraisal and coping with a real-life stressful situation: The contribution of attachment styles. Personality and Social Psychology Bulletin, 21, 406–414. doi:10.1177/0146167295214011.CrossRef Mikulincer, M., & Florian, V. (1995). Appraisal and coping with a real-life stressful situation: The contribution of attachment styles. Personality and Social Psychology Bulletin, 21, 406–414. doi:10.​1177/​0146167295214011​.CrossRef
go back to reference Mikulincer, M., Shaver, P., & Pereg, D. (2003). Attachment theory and affect regulation: The dynamics, development, and cognitive consequences of attachment-related strategies. Motivation and Emotion, 27, 77–102. doi:10.1023/A:1024515519160.CrossRef Mikulincer, M., Shaver, P., & Pereg, D. (2003). Attachment theory and affect regulation: The dynamics, development, and cognitive consequences of attachment-related strategies. Motivation and Emotion, 27, 77–102. doi:10.​1023/​A:​1024515519160.CrossRef
go back to reference Mikulincer, M., & Shaver, P. R. (2003). The attachment behavioral system in adulthood: Activation, psychodynamics, and interpersonal processes. In M. P. Zanna (Ed.), Advances in experimental social psychology (pp. 53–152). New York: Academic Press. Mikulincer, M., & Shaver, P. R. (2003). The attachment behavioral system in adulthood: Activation, psychodynamics, and interpersonal processes. In M. P. Zanna (Ed.), Advances in experimental social psychology (pp. 53–152). New York: Academic Press.
go back to reference Mikulincer, M., & Shaver, P. R. (2011). An attachment perspective on interpersonal and intergroup conflict. In J. P. Forgas, A. Kruglanski & K. D. Williams (Eds.), The psychology of social conflict and aggression. New York, NY: Psychology Press. Mikulincer, M., & Shaver, P. R. (2011). An attachment perspective on interpersonal and intergroup conflict. In J. P. Forgas, A. Kruglanski & K. D. Williams (Eds.), The psychology of social conflict and aggression. New York, NY: Psychology Press.
go back to reference Miller, W. B. (1994). Childbearing motivations, desires, and intentions: A theoretical framework. Genetic, Social and General Psychology Monographs, 120, 223–258. Miller, W. B. (1994). Childbearing motivations, desires, and intentions: A theoretical framework. Genetic, Social and General Psychology Monographs, 120, 223–258.
go back to reference Moreira, H., Martins, T., Gouveia, M. J., & Canavarro, M. C. (2015). Assessing adult attachment across different contexts: Validation of the Portuguese version of the experiences in close relationships–relationship structures questionnaire. Journal of Personality Assessment, 97, 22–30. doi:10.1080/00223891.2014.950377.CrossRefPubMed Moreira, H., Martins, T., Gouveia, M. J., & Canavarro, M. C. (2015). Assessing adult attachment across different contexts: Validation of the Portuguese version of the experiences in close relationships–relationship structures questionnaire. Journal of Personality Assessment, 97, 22–30. doi:10.​1080/​00223891.​2014.​950377.CrossRefPubMed
go back to reference Moura-Ramos, M., Gameiro, S., Canavarro, M. C., & Soares, I. (2012). Assessing infertility stress: Re-examining the factor structure of the fertility problem inventory. Human Reproduction, 27, 496–505. doi:10.1093/humrep/der388.CrossRefPubMed Moura-Ramos, M., Gameiro, S., Canavarro, M. C., & Soares, I. (2012). Assessing infertility stress: Re-examining the factor structure of the fertility problem inventory. Human Reproduction, 27, 496–505. doi:10.​1093/​humrep/​der388.CrossRefPubMed
go back to reference Moura-Ramos, M., Gameiro, S., Canavarro, M. C., Soares, I., & Almeida-Santos, T. (2016). Does infertility history affect the emotional adjustment of couples undergoing assisted reproduction? The mediating role of the importance of parenthood. British Journal of Health Psychology, 21, 302–317. doi:10.1111/bjhp.12169.CrossRefPubMed Moura-Ramos, M., Gameiro, S., Canavarro, M. C., Soares, I., & Almeida-Santos, T. (2016). Does infertility history affect the emotional adjustment of couples undergoing assisted reproduction? The mediating role of the importance of parenthood. British Journal of Health Psychology, 21, 302–317. doi:10.​1111/​bjhp.​12169.CrossRefPubMed
go back to reference Moura-Ramos, M., Gameiro, S., Soares, I., Santos, T. A., & Canavarro, M. C. (2010). Psychosocial adjustment in infertility: A comparison study of infertile couples, couples undergoing assisted reproductive technologies and presumed fertile couples. Psicologia, Saúde & Doenças, 11, 297–318.CrossRef Moura-Ramos, M., Gameiro, S., Soares, I., Santos, T. A., & Canavarro, M. C. (2010). Psychosocial adjustment in infertility: A comparison study of infertile couples, couples undergoing assisted reproductive technologies and presumed fertile couples. Psicologia, Saúde & Doenças, 11, 297–318.CrossRef
go back to reference Moura-Ramos, M., Moreira, H., Pereira, M., Fonseca, A., & Canavarro, M. C. (2016). Adult Attachment Scale: A comparison between the two and the three factor model solution of the Portuguese version of the AAS. Manuscript in preparation. Moura-Ramos, M., Moreira, H., Pereira, M., Fonseca, A., & Canavarro, M. C. (2016). Adult Attachment Scale: A comparison between the two and the three factor model solution of the Portuguese version of the AAS. Manuscript in preparation.
go back to reference Peterson, B. D. (2015). Fertility counseling for couples. In S. N. Covington (Ed.), Fertility counseling: Clinical guide and case studies (pp. 60–73). Cambridge: Cambridge University Press.CrossRef Peterson, B. D. (2015). Fertility counseling for couples. In S. N. Covington (Ed.), Fertility counseling: Clinical guide and case studies (pp. 60–73). Cambridge: Cambridge University Press.CrossRef
go back to reference Peterson, B. D., Sejbaek, C. S., Pirritano, M., & Schmidt, L. (2014). Are severe depressive symptoms associated with infertility-related distress in individuals and their partners? Human Reproduction, 29, 76–82. doi:10.1093/humrep/det412.CrossRefPubMed Peterson, B. D., Sejbaek, C. S., Pirritano, M., & Schmidt, L. (2014). Are severe depressive symptoms associated with infertility-related distress in individuals and their partners? Human Reproduction, 29, 76–82. doi:10.​1093/​humrep/​det412.CrossRefPubMed
go back to reference Schmidt, L. (2006). Infertility and assisted reproduction in Denmark: Epidemiology and psychosocial consequences. Danish Medical Bulletin, 53, 390–417.PubMed Schmidt, L. (2006). Infertility and assisted reproduction in Denmark: Epidemiology and psychosocial consequences. Danish Medical Bulletin, 53, 390–417.PubMed
go back to reference Shaver, P. R., & Mikulincer, M. (2007). Adult attachment strategies and the regulation of emotion. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 446–465). New York: Guilford Press. Shaver, P. R., & Mikulincer, M. (2007). Adult attachment strategies and the regulation of emotion. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 446–465). New York: Guilford Press.
go back to reference Van den Broeck, U., D’Hooghe, T., Enzlin, P., & Demyttenaere, K. (2010). Predictors of psychological distress in patients starting IVF treatment: Infertility-specific versus general psychological characteristics. Human Reproduction, 25, 1471–1480. doi:10.1093/humrep/deq030.CrossRefPubMed Van den Broeck, U., D’Hooghe, T., Enzlin, P., & Demyttenaere, K. (2010). Predictors of psychological distress in patients starting IVF treatment: Infertility-specific versus general psychological characteristics. Human Reproduction, 25, 1471–1480. doi:10.​1093/​humrep/​deq030.CrossRefPubMed
go back to reference Vaz Serra, A., Canavarro, M. C., Simões, M. R., Pereira, M., Gameiro, S., Quartilho, M. J., & Paredes, T. (2006). Estudos psicométricos do instrumento de avaliação da qualidade de vida da Organização Mundial de Saúde (WHOQOL-Bref) para Português de Portugal [Psychometric studies of the quality of life assessment tool of the World Health Organization for European portuguese]. Psiquiatria Clínica, 27, 41–49. Vaz Serra, A., Canavarro, M. C., Simões, M. R., Pereira, M., Gameiro, S., Quartilho, M. J., & Paredes, T. (2006). Estudos psicométricos do instrumento de avaliação da qualidade de vida da Organização Mundial de Saúde (WHOQOL-Bref) para Português de Portugal [Psychometric studies of the quality of life assessment tool of the World Health Organization for European portuguese]. Psiquiatria Clínica, 27, 41–49.
go back to reference Verhaak, C. M., Smeenk, J. M., Evers, A. W., Kremer, J. A., Kraaimaat, F. W., & Braat, D. D. (2007). Women’s emotional adjustment to IVF: A systematic review of 25 years of research. Human Reproduction Update, 13, 27–36. doi:10.1093/humupd/dml040.CrossRefPubMed Verhaak, C. M., Smeenk, J. M., Evers, A. W., Kremer, J. A., Kraaimaat, F. W., & Braat, D. D. (2007). Women’s emotional adjustment to IVF: A systematic review of 25 years of research. Human Reproduction Update, 13, 27–36. doi:10.​1093/​humupd/​dml040.CrossRefPubMed
go back to reference Verhaak, C. M., Smeenk, J. M., Evers, A. W., van Minnen, A., Kremer, J. A., & Kraaimaat, F. W. (2005). Predicting emotional response to unsuccessful fertility treatment: A prospective study. Journal of Behavioural Medicine, 28, 181–190. doi:10.1007/s10865-005-3667-0.CrossRef Verhaak, C. M., Smeenk, J. M., Evers, A. W., van Minnen, A., Kremer, J. A., & Kraaimaat, F. W. (2005). Predicting emotional response to unsuccessful fertility treatment: A prospective study. Journal of Behavioural Medicine, 28, 181–190. doi:10.​1007/​s10865-005-3667-0.CrossRef
go back to reference Wei, M., Heppner, P. P., & Mallinckrodt, B. (2007). Perceived coping as a mediator between attachment and psychological distress: A structural equation modeling approach. Journal of Counseling Psychology, 50, 438–447. doi:10.1037/0022-0167.50.4.438.CrossRef Wei, M., Heppner, P. P., & Mallinckrodt, B. (2007). Perceived coping as a mediator between attachment and psychological distress: A structural equation modeling approach. Journal of Counseling Psychology, 50, 438–447. doi:10.​1037/​0022-0167.​50.​4.​438.CrossRef
go back to reference WHOQoL GROUP. (1995). The World Health Organization Quality of Life Assessment (WHOQOL): Position paper from the World Health Organization. Social Science & Medicine, 41, 1403–1409.CrossRef WHOQoL GROUP. (1995). The World Health Organization Quality of Life Assessment (WHOQOL): Position paper from the World Health Organization. Social Science & Medicine, 41, 1403–1409.CrossRef
go back to reference Wischmann, T., Stammer, H., Herhard, H., & Verres, R. (2001). Psychosocial characteristics of infertile couples: A study by the ‘Heidelberg Fertility Consultation Service’. Human Reproduction, 16, 1753–1761.CrossRefPubMed Wischmann, T., Stammer, H., Herhard, H., & Verres, R. (2001). Psychosocial characteristics of infertile couples: A study by the ‘Heidelberg Fertility Consultation Service’. Human Reproduction, 16, 1753–1761.CrossRefPubMed
Metadata
Title
The Role of Attachment Anxiety and Attachment Avoidance on the Psychosocial Well-being of Infertile Couples
Authors
M. Moura-Ramos
T. Almeida Santos
M. C. Canavarro
Publication date
01-06-2017
Publisher
Springer US
Published in
Journal of Clinical Psychology in Medical Settings / Issue 2/2017
Print ISSN: 1068-9583
Electronic ISSN: 1573-3572
DOI
https://doi.org/10.1007/s10880-017-9496-9

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