Illness representations, coping and psychological morbidity in infertility

This study uses a cross sectional survey design to explore the illness representations, coping strategies and levels of psychological morbidity of patients planning IVF treatments. The aim was to develop a theoretical understanding, within the framework of the self-regulation model, of the factors which predict anxiety and depression in this group. Fifty patients completed a demographic questionnaire, the Illness Perception Questionnaire, the COPE and the Hospital Anxiety and Depression Scale. Chance, stress and age were the most commonly endorsed causal factors. Those without a diagnosis were more likely than those with one to think that chance had caused their infertility, but there was no difference between groups in belief in psychological causes. The coping style of this group of patients was characterised by planning and active coping within the ethos of acceptance. Overall, they used adaptive strategies significantly more than maladaptive, and this pattern did not differ between men and women. As a group, these patients' anxiety and depression scores did not fall into the clinically significant range and there were no significant differences in distress scores between groups. The relationships between illness perceptions, coping and distress were examined. Stepwise multiple regressions revealed that both illness perceptions and coping strategies predicted anxiety and depression. An adapted version of the self regulation model shows that belief in psychological cause for infertility, lack of coherence, and high levels of emotionalism and emotional lability were associated with use of maladaptive coping strategies; and increased anxiety and depression. Theoretical and clinical implications of the research are presented, along with a critique of the research; and ideas for future research are discussed.