Robert J. Edelmann

The impact of infertility on psychological functioning

To explore the impact of infertility on psychological functioning 130 couples presenting with primary infertility were assessed at their initial visit to an infertility clinic. Of these, 116 couples were assessed on a second occasion some 7-9 months later when in most cases the medical tests were complete. Measures of personality, psychopathology, perceived social support, sex role identity and marital state were obtained from both partners. The set was subsequently divided into five subgroups on the basis of the diagnosis made or the outcome (female cause, male cause, female and male cause, unexplained and pregnant). The results show little evidence of psychopathology in the sample, depression scores remained low throughout the period of investigation. The results also indicated stable marital relationships. Scores on tests of anxiety and psychiatric morbidity declined between the first and second assessment except in the case of men who were diagnosed with a fertility problem. The implications of these findings are discussed in the increased use of donor insemination which circumvents rather than treats the problem of male infertility.

Self‐reported and actual physiological responses in social phobia

OBJECTIVES The aim of the current study was to compare physiological reactions and self-reports of bodily sensations for social phobics, clinically anxious and non-anxious controls across four tasks. DESIGN A within-group design was used in which each participant took part in four tasks. Two were designed to be demanding, either physically (riding an exercise bicycle) or mentally (mental arithmetic task), while two, a mental imagery task (personally relevant situation) and a social conversation, were designed specifically to be anxiety provoking. METHODS Of the 54 participants, 18 were generalized social phobics, 18 were clinically anxious but not socially phobic (8 with panic disorder, 6 with generalized anxiety disorder and 4 simple phobics), and 18 were non-anxious. Heart rate, skin conductance, and facial and neck temperatures were recorded continuously during four different tasks and rest periods with corresponding self-report ratings of bodily sensations taken to reflect 13 sampling points. RESULTS There were no group differences on any of the physiological measures during any of the four tasks. However, there were a number of between-group differences with regard to ratings of bodily sensations. Both clinical groups had higher ratings of racing heart than the non-anxious control group during the imagery task. In addition, social phobics had significantly higher ratings of racing heart during the social conversation in relation to both comparison groups. With regard to ratings of body heat, the anxious group had greater ratings than the non-anxious controls during the imagery task. Finally with regard to ratings of sweaty hands, both clinical groups had higher ratings than the non-anxious controls during the social conversation. All three groups were generally inaccurate in their ratings of bodily sensations.

Coping strategies and psychological adjustment of couples presenting for IVF

The study was designed to examine the extent to which the psychological profiles of couples entering an IVF programme were influenced by evidence of previous fertility, the history of fertility investigations, the diagnosis made, and the coping strategies adopted. A sample of 152 couples was administered a number of standardized psychological instruments and a coping strategies questionnaire. They showed little variation from the normative range on the standardized measures. There was little evidence of differences between couples referred for primary or secondary infertility, between those with some evidence of fertility and those with none, or between different diagnostic groups. In relation to coping strategy, for women at least, taking direct action appears to be effective if it is associated with some degree of acceptance of ones position. For males, the picture is less clear, though direct action and acceptance again appear to be effective coping strategies.

Behavioural inhibition and symptoms of anxiety and depression: Is there a specific relationship with social phobia?

OBJECTIVES The aim of the study was to examine the relationships between tendencies towards different mental health problems assessed via questionnaires (social phobia, agoraphobia, general anxiety/panic, depression), the two latent dimensions of behavioural inhibition (childhood social/school fears, non-social fears/ illness), and sensory-processing sensitivity. DESIGN A cross-sectional design was employed. METHOD Volunteer participants (N = 234) from anxiety and depression self-help organizations completed five mailed questionnaires. These were the Social Phobia and Anxiety Inventory, Beck Depression Inventory II and Beck Anxiety Inventory; the Highly Sensitive Person Scale, a measure of trait sensitivity to environmental stimuli; and the Retrospective Self-Report of Inhibition. RESULTS Higher levels of anxiety, but not depression, were associated with increased self-reported sensitivity to environmental stimuli. Recalled childhood social/school fears were related to elevated scores on measures of social phobia and depression, while recalled non-social fears/illness were not associated with any index of psychopathology. CONCLUSION These results extend those of previous research by suggesting specific patterns of relationships of both sensitivity to environmental stimuli and behavioural inhibition with symptoms of anxiety and depression. It is suggested that in investigating long-term outcome, prospective behavioural inhibition studies would benefit from examining the temporal corollaries of the underlying social and non-social dimensions. Sample and design limitations are discussed.

The etiology of social phobia: toward a developmental profile.

Social phobia is an extremely disruptive and distressing anxiety disorder that can impact on many areas of an individuals life. Yet, despite the fact that lifetime prevalence rates are relatively high, its etiology is still poorly understood. The aim of this review is to draw together findings from the broad base of nonclinical literature associated with behavioral inhibition (BI), shyness, social anxiety, and passive-anxious withdrawal and to compare these findings with those from the limited number of clinical studies with social phobics. Such comparison is not unproblematic due to conceptual differences between terms used and methodological divergence; these issues are discussed in some detail. The consonance of findings, however, suggests a viable profile for the developmental course of social phobia. This profile incorporates temperament variables, behavioral motivational, parenting styles, peer relationships, and internalization problems. Finally, specific suggestions for future research are offered.

Distress and marital problems associated with infertility

Abstract Problems of emotional adjustment and marital difficulties experienced by a large sample of patients (843 couples) attending an infertility clinic between 1975 and 1985 were investigated by means of a postal questionnaire. An emotional distress score and a marital problems score were computed for each individual and these were related to four principal variables: (1) how long the couples had known of their infertility, (2) whether the cause had been diagnosed, (3) the period of time undergoing investigations, and (4) whether the male or female was responsible. The emotional wellbeing of couples was affected by prolonged periods of clinical investigation and greater emotional and marital difficulties were reported by both men and women when the cause of the infertility lay with the man. The implications for the development of services and for further research are discussed.

A psychological profile of endometriosis patients in comparison to patients with pelvic pain of other origins

In order to investigate the possibility of a specific psychological profile associated with endometriosis, 81 women with pelvic pain were studied, of whom 40 were diagnosed as having endometriosis and 41 other gynaecological problems. Each patient completed six standardized psychometric tests to assess personality, psychopathology, marital state and pain. Endometriosis patients obtained higher psychoticism, introversion and anxiety scores in comparison to the other pain patients, although the two groups did not differ on pain ratings. Both groups obtained neuroticism, anxiety and psychiatric morbidity scores which were elevated relative to normative data. The possibility that there are certain psychological characteristics which make some women vulnerable to endometriosis is discussed.

Self-esteem, irrational beliefs and coping strategies in relation to eating problems in a non-clinical population

Abstract In order to evaluate the relationship between three factors commonly associated with eating disorders, Rosenbergs Self-Esteem Scale (SES), the Irrational Beliefs Scale (IBS), Coping Index (CI) and Eating Disorders Inventory (EDI) were administered to 49 undergraduate Ss . Higher EDI scores were related to lower self-estreem, increased irrational beliefs, less frequent use of cognitive and behavioural coping strategies and increased use of avoidance coping. The implications of the results for future research are discussed.

Social Embarrassment: An Analysis of the Process

In recent years the phenomenon of embarrassment has attracted an increasing research interest. As a result, there have been a number of attempts to conceptualize the underlying process. Although these tend to emphasize similar aspects of the phenomenon (social transgressions, negative public image, heightened self-attention), there are a number of gaps in our knowledge of the process involved. This paper reviews previous models of embarrassment and presents an adapted and extended account of the underlying process. The five central aspects are: knowledge of social rules, protective self-presentation, self-awareness, labelling, and dealing with embarrassment. These are described and discussed, and implications of the model for future research are considered.

Psychological aspects of in vitro fertilization: a gender comparison.

This paper reports findings from a study investigating gender differences on the General Health Questionnaire (GHQ) and questionnaire ratings of the impact of in vitro fertilization (IVF), stressful aspects of treatment and reaction to a failed IVF attempt. The participants were 101 men and 117 women who were consecutive referrals to an IVF clinic. In line with previous research, women in comparison to men, rated IVF as having more impact upon emotional state. Scores on the GHQ were also consistent with greater emotional distress for women than men in relation to infertility diagnosis and treatment. With regard to the impact of IVF on the couples sexual and marital relationship there were few gender differences, although both men and women felt that there was a greater likelihood that IVF had decreased the female partners desire for sex. Both men and women agreed that a negative outcome and waiting for results were the most stressful aspects of IVF and, although the mean differences were again small, women reported experiencing more stress than men at a number of stages of treatment. Women were also more likely than men to endorse negative reactions in relation to IVF failure. The results are discussed in relation to counselling issues.