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Open Access 01-08-2011

Moving forward during major goal blockage: situational goal adjustment in women facing infertility

Authors: Elizabeth H. Thompson, Julia T. Woodward, Annette L. Stanton

Published in: Journal of Behavioral Medicine | Issue 4/2011

Abstract

Individuals confronting chronic medical conditions often face profound challenges to cherished life goals. The primary aim of this study was to examine the associations of goal adjustment with psychological adjustment in the context of infertility. At study entry (T1; n = 97) and 6 months later (T2; n = 47), women in fertility treatment completed measures of goal blockage, goal adjustment ability, and psychological adjustment. At T1, greater perceived and actual goal blockage were related to negative psychological adjustment. Ability to disengage from the goal of biological parenthood was associated with less infertility-specific thought intrusion, whereas engagement with other goals was related to fewer depressive symptoms and greater positive states of mind. Greater general goal engagement was protective against the negative relationships between low goal disengagement and the dependent variables. Promoting letting go of the unattainable and investing in the possible may be a useful intervention to foster well-being among individuals experiencing profound goal blockage.

In response to reviewers’ recommendations, additional analyses were conducted to assess for group difference between women with children (N = 35) and women without children (N = 62). On average, women with children had been married for a longer time than women without children (t[80] = −2.88, P < .01), but no other differences on demographics or infertility-specific variables emerged. Controlling for differences in number of years married, ANCOVAs indicated no significant group differences on psychological adjustment indices, goal blockage variables, or goal engagement in direct response to infertility at T1. Women with children reported significantly higher goal disengagement (T1, T2) and general goal engagement (T1) than women without children. Findings from analyses examining the hypothesized association between psychological adjustment variables and interactions between goal disengagement and general goal engagement were not affected significantly by whether women did or did not have children (controlling for years married). Analyses examining the hypothesized relationship between goal appraisals and psychological adjustment revealed that number of treatment attempts (actual goal blockage) was associated with poorer psychological adjustment for women with children but was not significantly associated with psychological adjustment for women without children. This finding may be explained by the greater variation in actual goal blockage for women with children (range 0–44, SD = 7.88) than women without children (range 0–16, SD = 4.74). Longitudinal analyses were conducted to assess whether baseline goal adjustment measures predicted a change in psychological adjustment measures for both groups. A significant interaction between group and general goal engagement emerged as a predictor of change in depressive symptoms. In subgroup analyses, general goal engagement was negatively associated with depressive symptoms for women without children and positively associated with depressive symptoms for women with children, although neither relationship was significant (P < .10).

Longitudinal analyses were conducted to assess whether baseline psychological measures predicted a change in goal adjustment measures for both women with children and women without children. T1 psychological functioning significantly predicted change in goal disengagement for women with children but did not predict significant change in goal disengagement for women without children. These relationships may be due to differences in variance in T2 goal disengagement for women with children (range 9–53, SD = 12.32) and women without children (range 9–44, SD = 8.69). Interactions were not significant in predicting changes in general goal engagement or goal engagement in direct response to infertility.

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Title: Moving forward during major goal blockage: situational goal adjustment in women facing infertility
Authors: Elizabeth H. Thompson
Julia T. Woodward
Annette L. Stanton
Publication date: 01-08-2011
Publisher: Springer US
Published in: Journal of Behavioral Medicine / Issue 4/2011
Print ISSN: 0160-7715
Electronic ISSN: 1573-3521
DOI: https://doi.org/10.1007/s10865-010-9309-1

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