Dispositional optimism and psychological adjustment to fertility treatment

Abstract

Evidence suggests that women who undergo fertility treatment experience symptoms of anxiety and depression. Psychological adjustment to treatment may in part be explained by predisposing personality factors such as one's dispositional tendency to expect positive compared to negative outcomes. Here, we assessed whether individual differences in optimism predicted symptoms of anxiety and depression among women undergoing fertility treatment and whether this association (if present) varied by treatment outcome (success vs. failure). Women undergoing fertility treatment were followed prospectively over 4 time points: baseline, 4-month follow-up (T1), 10-month follow-up (T2), and 18-month follow-up (T3). Optimism (measured at baseline) was assessed by the Life Orientation Test (LOT) and anxiety and depression (measured at T1, T2, and T3) were assessed by the state anxiety subscale of the State-Trait Anxiety Inventory (STAI) and the Center for Epidemiological Studies Depression Scale (CES-D), respectively. Participants were 337 women (ages 21–46; 75% Caucasian). Of these, 187 were classified as treatment successes defined as having delivered a baby or achieved pregnancy by the 18-month follow-up and 150 were classified as treatment failures. Multiple regression analyses showed that independent of covariates (age, socioeconomic status, parity) greater optimism predicted fewer anxiety symptoms at each time point (P's < .001), accounting for 11.7%, 6.8%, and 9.2% of the variance in anxiety symptoms at T1, T2, and T3, respectively. To determine whether the relation between optimism and anxiety symptoms varied according to treatment outcome (success vs. failure), interactions between optimism and treatment outcome were tested. Results showed interactions were non-significant (P's > .05). With respect to depressive symptoms, multiple regression analyses showed that independent of covariates optimism predicted depressive symptoms at T1 (r = −.114, P=.043) but not at T2 or T3 (P's > .05). Women presenting for fertility treatment may possess personality characteristics that make them more or less vulnerable to experiencing negative emotions during treatment. Here, we conclude that women with greater optimism may be protected from experiencing anxiety symptoms even when they experience treatment failure; optimism does not appear to afford the same protection from depressive symptoms, however.