Positive affect mediates the relationships between resilience, social support and posttraumatic growth of women with infertility

Relationships between work-family conflict, infertility-related stress, resilience and social support in patients undergoing infertility treatment

Fertility treatments can be physically and psychologically exhausting for those who do it due to high expectations and possible frustration with the negative results. Moreover, it demands time and high financial investment, which are sometimes stressful factors for the working patient. Two aspects that can ease this context are resilience and social support. The present article aims to investigate the levels of work-family conflict in individuals undergoing infertility treatment and their associations with stress, resilience, and social support. The survey of 242 patients addressed sociodemographic data, Infertility-Related Stress Scale-Brazil (IRSS-BP), Connor-Davidson Resilience Scale 10 (CD-RISC 10), Perceived Social Support Scale (PSSS), and Work-Family Conflict Scale. Data were analyzed using R (4.3.2). Findings suggest that the level of Work-Family Conflict is higher in men (p = 0.020). The scale is also positively associated with Infertility Stress and negatively correlated with Resilience and Social Support.

The roles of parenting, resilience, and interpersonal relationships on adolescents' mental health and stress-related growth during COVID-19

BACKGROUND

The present longitudinal study investigated parenting style as a precursor for Chinese adolescents' stress-related growth and mental health difficulties during the COVID-19 pandemic, as well as the mediating roles of intrapersonal resilience and interpersonal relationships (i.e., peer and parent-adolescent).

METHODS

Chinese adolescents in a middle school (7th grade) and their parents in Beijing, China, were invited to complete a survey at two time points (T1: September 2020, T2: June 2021). A total of 206 adolescents (52.9% boys; Mage  = 12.90 years, SDage  = 0.33) and parents (17.5% fathers, 82.4% mothers; Mage  = 43.50 years, SDage  = 4.76 years) were included in this study.

RESULTS

Results showed that Chinese parents' authoritarian, not authoritative parenting, predicted adolescents' mental health difficulties nine months later. In addition, parent-adolescent relationships, but not peer relationships nor resilience, mediated the relations between parenting style and stress-related growth. Adolescents' resilience predicted fewer mental health difficulties.

CONCLUSION

It is important to target multiple ecologies (e.g., family) of adolescents for promoting positive adjustment.

Resilience among involuntarily childless couples and individuals undergoing infertility treatment: a systematic review

Infertility is regarded as a highly stressful and challenging experience. However, the response to this unexpected moment varies from one individual to the other. The review explores research that studies resilience in the context of infertility and its treatment. The purpose was to study the protective and risk factors associated with resilience and to identify psychosocial factors that could play a crucial role in resilience among infertile couples and individuals who are seeking infertility treatment. Four major databases (PubMed, Scopus, ScienceDirect, and Wiley Online Library) were searched with appropriate keywords. A total of 4101 articles were retrieved from the databases and after following various levels of screening 18 articles were finalized. These articles explored resilience and other psychosocial factors in couples/individuals seeking infertility treatment. The protective factors associated with resilience were quality of life, coping, social support, and posttraumatic growth. The risk factors associated with resilience were infertility-related stress, anxiety and depression. The unexpected diagnosis of infertility might be disturbing for many, still, it may not be extremely agonizing for some. Individuals who are encouraged to utilize their own resources and seek support are able to deal with stressors associated with infertility.

Interrelations of resilience factors and their incremental impact for mental health: insights from network modeling using a prospective study across seven timepoints

Resilience can be viewed as trajectory of stable good mental health or the quick recovery of mental health during or after stressor exposure. Resilience factors (RFs) are psychological resources that buffer the potentially negative effects of stress on mental health. A problem of resilience research is the large number of conceptually overlapping RFs complicating their understanding. The current study sheds light on the interrelations of RFs in the face of the COVID-19 pandemic as a use case for major disruptions. The non-preregistered prospective study assessed a sample of 1275 German-speaking people from February 2020 to March 2021 at seven timepoints. We measured coping, hardiness, control beliefs, optimism, self-efficacy, sense of coherence (SOC), sense of mastery, social support and dispositional resilience as RFs in February 2020, and mental health (i.e., psychopathological symptoms, COVID-19-related rumination, stress-related growth) at all timepoints. Analyses used partial correlation network models and latent growth mixture modeling (LGMM). Pre-pandemic RFs were strongly interrelated, with SOC being the most central node. The strongest associations emerged between coping using emotional support and social support, SOC and sense of mastery, and dispositional resilience and self-efficacy. SOC and active coping were negatively linked. When we examined RFs as predictors of mental health trajectories, SOC was the strongest predictor of psychopathological symptoms and rumination, while trajectories of stress-related growth were predicted by optimism. Subsequent network analyses, including individual intercepts and slopes from LGMM, showed that RFs had small to moderate associations with intercepts but were unrelated to slopes. Our findings provide evidence for SOC playing an important role in mental distress and suggest further examining SOC's incremental validity. However, our results also propose that RFs might be more important for stable levels of mental health than for adaptation processes over time. The differential associations for negative and positive outcomes support the use of multidimensional outcomes in resilience research.

A Bifactor-ESEM Representation of the Multidimensional Scale of Perceived Social Support

The aim of this study is to examine the factor structure of Turkish version of the Multidimensional Scale of Perceived Social Support (MSPSS) and to analyze its psychometric properties through the bifactor-ESEM framework. Using a convenience sample of 1124 Turkish adults, seven different models were tested. The results supported the superiority of a bifactor-ESEM solution that included three specific factors (family, friends, and significant others) and a general factor. In addition, bifactor indices showed that the general factor of MSPSS is not strong enough and its multidimensional structure is supported. For the bifactor-ESEM model, strict measurement invariance was achieved according to the gender variable. Our results supported convergent validity for the general and specific factors of the MSPSS, which were found to be associated with measures of distress, loneliness, and resilience. As a result, MSPSS is a valid and reliable measurement tool with its bifactor-ESEM model.

Identifying modifiable factors associated with psychological health in women experiencing infertility

This study assessed the relationship between modifiable psychological variables and depression, anxiety, and posttraumatic growth in women experiencing infertility. U.S. women (N = 457) who identified as experiencing infertility completed standardized self-report measures of mindfulness, self-compassion, positive affect, intolerance of uncertainty, relationship satisfaction, experiential avoidance, depression, anxiety, and posttraumatic growth. Clinical and demographic characteristics (age, duration trying to conceive, miscarriage, and childlessness) did not predict depression or anxiety. Lower positive affect and higher experiential avoidance were associated with depression and anxiety. Lower self-compassion was associated with depression; higher intolerance of uncertainty was associated with anxiety. There were indirect effects of mindfulness on anxiety and depression via these variables. Future research should explore whether intervening on these factors reduces depressive and anxiety symptoms. Promoting mindfulness may have beneficial effects on symptoms via its downstream effects on multiple coping variables. Counterintuitively, posttraumatic growth was associated with higher intolerance of uncertainty and experiential avoidance.

Contribution of personal and community resources to personal growth of mothers from Israel and Turkey

AIMS

The transition to parenthood is considered one of the most important milestones in a person's life, bringing with it various changes and challenges. One possible outcome of such a life-altering and stressful event is the experience of personal growth (PG). This study examines the contribution of a mother's personal resources (emotion regulation strategies, resilience) and environmental resources (sense of community) to her PG following the transition to motherhood, taking into account the role played by ethnicity.

METHODS

Data was collected from 402 Israeli Arab, Israeli Jewish, and Turkish first-time mothers of babies up to twenty-four months old.

RESULTS

It was found that Israeli Arab mothers reported significantly higher expressive suppression and PG than the other two groups. In addition, Israeli Arab mothers scored significantly higher on resilience, and Israeli Jewish mothers scored significantly higher on sense of community, than Turkish mothers. After controlling for mother and baby background variables, cognitive reappraisal and sense of community were found to predict PG. Two interactions emerged: higher sense of community was related to greater PG only among Israeli Arab mothers; and a positive association between resilience and growth was found only among Israeli Jewish mothers. The results are discussed in relation to the literature.

CONCLUSION

Personal and environmental resources contribute differently to growth of first-time mothers in different cultures. Thus, rather than implementing the same type of intervention in all cultures, appropriate interventions should be tailored for each culture in accordance with its unique characteristics.

[A Structural Equation Model for Posttraumatic Growth among Cured Patients with COVID-19]

PURPOSE

This study aimed to develop and test a model for posttraumatic growth among cured patients with COVID-19. This model was based on Calhoun and Tedeschi's Posttraumatic Growth model and a literature review.

METHODS

The participants comprised 223 patients cured from COVID-19 who were ≥ 19 years of age. The data were collected through an online questionnaire from March 21 to 24, 2022. The assessment tools included the Impact of Event Scale: Revised Korean version, the Connor-Davidson Resilience Scale, the Distress Disclosure Index, the Multidimensional Scale of Perceived Social Support, the Korean version of the Event-related Rumination Inventory, and the Korean version of the Post-traumatic Growth Inventory. Data were analyzed using the IBM SPSS version 24.0 and IBM AMOS 26.0.

RESULTS

The modified model showed appropriate goodness of fit (χ² = 369.90, χ²/degree of freedom = 2.09, SRMR = .09, RMESA = .07, CFI = .94, TLI = .93). The post-traumatic growth of cured patients with COVID-19 was explained through distress perception, self-disclosure, and deliberate rumination, with the explanatory power being 70.0%.

CONCLUSION

This study suggests preparing a disaster psychology program involving experts who can activate deliberate rumination is necessary. Further, this study may serve as basic data for developing a program to enhance the post-traumatic growth of patients cured from COVID-19.

The prevalence of adjustment disorder and predisposing factors in infertile women

BACKGROUND

Infertility is a stressful life event that increases the risk of developing mental disorders, particularly adjustment disorder (AD). Given the paucity of data on the prevalence of AD symptoms in infertility, the purpose of this study was to ascertain the prevalence, clinical presentation, and risk factors for AD symptoms in infertile women.

METHOD

In a cross-sectional study, 386 infertile women completed questionnaires including the Adjustment Disorder New Module-20 (ADNM), the Fertility Problem Inventory (FPI), the Coronavirus Anxiety Scale (CAS), and the Primary Care Posttraumatic Stress Disorder (PC-PTSD-5) at an infertility center between September 2020 and January 2022.

RESULT

The results indicated that 60.1% of infertile women exhibited AD symptoms (based on ADNM > 47.5). In terms of clinical presentation, impulsive behavior was more common. No significant relationship was observed between prevalence and women's age or duration of infertility. Infertility stress (β = 0.27, p < 0.001), coronavirus anxiety (β = 0.59, p = 0.13), and a history of unsuccessful assisted reproductive therapies (β = 2.72, p = 0.008) were several predisposing factors for AD symptoms in infertile women.

CONCLUSIONS

The findings suggest that all infertile women be screened from the start of infertility treatment. Additionally, the study suggests that infertility specialists should focus on combining medical and psychological treatments for individuals predisposed to AD, particularly infertile women who exhibit impulsive behaviors.

Network analysis of affect, emotion regulation, psychological capital, and resilience among Chinese males during the late stage of the COVID-19 pandemic

Background

Previous studies have confirmed that both affect and emotion regulation strategies are closely associated with psychological capital (PsyCap) and resilience. These factors are assumed to buffer the effect of the COVID-19 pandemic on mental health, especially among males. However, these interactions have not been closely examined to date. To fill this gap, this paper explores the dimension-level relationships of these psychological constructs among Chinese males during the late stage of the COVID-19 pandemic and identified critical bridge dimensions using network analysis.

Methods

A total of 1,490 Chinese males aged 21–51 years completed self-report scales assessing emotion regulation strategies, affect, PsyCap, and psychological resilience. Two regularized partial correlation networks, namely the affect and emotion regulation-PsyCap network and the affect and emotion regulation-psychological resilience network, were then constructed to examine links between the dimensions of these constructs. The bridge expected influence (BEI) index was also calculated for each node to identify important bridge nodes.

Results

Positive affect, negative affect, cognitive reappraisal, and expressive suppression showed distinct and complex links to various dimensions of PsyCap or psychological resilience. In both networks, positive affect, cognitive reappraisal, and negative affect were identified as critical bridge nodes, with the first two having positive BEI values and the third having a negative value.

Conclusion

The findings elucidate the specific role of the dimensions of emotion regulation or affect in relation to PsyCap and psychological resilience, which facilitates further understanding of the mechanisms underlying these interrelationships. These findings also provide implications for developing effective intervention strategies to increase PsyCap and psychological resilience.

Predictors of Post-Traumatic Growth in a Sample of United Kingdom Mental and Community Healthcare Workers during the COVID-19 Pandemic

Experiences of adversity can generate positive psychological effects alongside negative impacts. Little research to date has evaluated predictors of post-traumatic growth in mental or community healthcare workers during the COVID-19 pandemic. Following a survey of 854 community and mental healthcare staff in the United Kingdom in July to September 2020, multiple linear regression was used to determine the association between hypothesised risk and protective factors (personal, organisational and environmental variables) and total scores on the Post-traumatic Growth Inventory-Short Version. Positive self-reflection activities, black and minority ethnic status, developing new healthcare knowledge and skills, connecting with friends and family, feeling supported by senior management, feeling supported by the UK people, and anxiety about the personal and work-related consequences of COVID-19 each significantly independently predicted greater post-traumatic growth. Working in a clinical role and in mental healthcare or community physical healthcare predicted lower post-traumatic growth. Our research supports the value of taking an organisational growth-focused approach to occupational health during times of adversity, by supporting staff to embrace opportunities for personal growth. Valuing staff's cultural and religious identity and encouraging self-reflective activities, such as mindfulness and meditation, may help to promote post-traumatic growth.

Personal Growth and Life Satisfaction during Fertility Treatment-A Comparison between Arab and Jewish Women

Coping with difficulty conceiving and the ensuing fertility treatments is a stressful experience that impacts many aspects of women's lives. On the basis of Lazarus and Folkman's model of stress and coping and Schaefer and Moos's model of personal growth, and in view of the sparse literature on cultural aspects of infertility and personal growth, this study examined the relationship between stress on the one hand and personal growth and life satisfaction on the other among Arab and Jewish Israeli women. Furthermore, it investigated the moderating role played by perceived stigma, coping flexibility, cultural orientation (individualism and collectivism), and ethnicity. Two hundred five Arab and Jewish Israeli women undergoing fertility treatment completed self-report questionnaires. The results show that Arab women reported higher levels of personal growth and individualism than Jewish women. In the whole sample, a linear negative relationship was found between stress and life satisfaction, and a curvilinear relationship was found between stress and personal growth. In addition, perceived stigma, collectivism, individualism, and coping flexibility were found to moderate the association between perceived stress and personal growth. The findings provide further understanding of personal growth in the context of infertility, showing that personal resources and perceptions are more important than cultural differences in this regard.

Social support and posttraumatic growth: A meta-analysis

BACKGROUND

The beneficial role of social support on posttraumatic growth (PTG) has been assumed by theoretical models and established in some studies. However, there are inconsistent findings and little knowledge on moderators. The present study aims to investigate the overall effect size of the relationship and identify factors affecting the association.

METHODS

Six electronic databases were searched. Newcastle-Ottawa Quality Assessment Scale (NOS) were used to evaluate the quality of studies. Study quality, study design, trauma type, PTG measure, social support measure, continent, publishing language, sample size, gender, religion, and age were analyzed as moderators. Meta-regression was conducted with the significant differential predictors in moderator analysis.

RESULTS

The meta-analysis included 217 samples and a total of 47,940 participants from both longitudinal and cross-sectional studies. There was a medium positive effect size between social support and PTG in random effect model, r = 0.418, p < .001. The meta-regression analysis indicated that the association between social support and PTG was stronger among caregivers (vs. other traumatized samples), Chinese, older individuals and studies with smaller sample size.

LIMITATIONS

Only survey results were included in the analysis. The retrospective self-report may limit a more objective assessment of the relations. In addition, 87 % of the studies were cross-sectional, which may influence the estimation of a valid effect size.

CONCLUSIONS

Regarding the medium positive association between social support and PTG, it is important to enhance social support for trauma survivors. It will be especially effective for caregivers, Chinese, and older people.

Does infertility develop posttraumatic growth or anxiety/depressive symptoms? Roles of personality traits, resilience, and social support

PURPOSE

This study aimed to explore levels of posttraumatic growth (PTG) and anxiety/depressive symptoms and the role of personality traits, resilience, and social support as predictors of PTG in infertile men/women.

DESIGN AND METHODS

In our cross-sectional study, 162 infertile individuals (40 men and 122 women) completed the research questionnaires, including PTG, State-Trait Anxiety Inventory, Fertility Problem Inventory, NEO Five-Factor Inventory, Perceived Social Support, Kobasa hardiness short 20-item, and Beck Inventory Depression (BDI-II).

RESULTS

The prevalence of PTG was higher than that of anxiety/depressive symptoms (55.6% vs. 45.7%/40.7%). Neuroticism (β = 0.54 ± 0.25, p < 0.03), extroversion (β = 0.69 ± 0.26, p < 0.01), and resilience (β = 0.33 ± 0.12, p < 0.008) were positive predictors of PTG.

PRACTICE IMPLICATIONS

Infertile men/women with high level of resilience, extroversion, and neuroticism may have more tendency toward personal growth rather than distress. Practitioners ought to direct counseling to promote factors of personal growth.

Ambivalence experienced by infertile couples undergoing IVF: a qualitative study

The emotional consequences of infertility are well documented. However, relatively few studies have emphasized the dyadic emotional interaction within couples, despite infertility being a shared life event. This study adopted a dyadic (between two people) approach to explore the emotional complexity that infertile couples face. A descriptive qualitative study was conducted with 24 participants, including eight infertile couples and eight wives undergoing infertility treatments. Conjoint and individual interviews were conducted through purposive sampling in a large fertility centre in Tianjin, China, between June and August 2015. Thematic analysis identified two main themes: (i) 'decisional ambivalence', with subthemes of 'ambivalent attitudes towards treatment', 'uncertainty about treatment outcomes', and 'treatment-related lifestyle changes'; and (ii) 'relational ambivalence' which included subthemes of 'intergenerational ambivalence' and 'partner ambivalence'. Complex emotions of ambivalence among infertile couples were common as infertility clearly shattered their assumptive world on family formation. With complex entanglement of mixed emotions, ambivalence was intimately associated with cultural norms, social expectations, and active or over engagement of family members in Chinese societies. Since ambivalence could threaten mental and physical health during pregnancy, healthcare professionals should be prepared to assist infertile couples with identifying, articulating, and normalizing decisional and relational ambivalence during the treatment process.

Post-Traumatic Growth in Women with Breast Cancer: Intensity and Predictors

Experiencing a traumatic situation such as breast cancer can, beside negative consequences, have a positive impact, described as post-traumatic growth (PTG). A factor that facilitates psychological recovery when coping with stressful events is psychological resilience. The aim of the present study was to assess whether PTG occurs in a group of women with breast cancer and whether resilience is a personal trait contributing to its occurrence. The study group comprised 100 women with breast cancer, aged 31-80 years, almost half of whom were aged 61-70 years (n = 46, 46%). The Post-Traumatic Growth Inventory, the Impact of Event Scale, and the Resilience Assessment Questionnaire (KOP) were used for the study. All women manifested PTG, with a mean intensity of 76.61 ± 13.45 points. The greatest changes were observed in the subjects' appreciation of life, and the smallest in their relations with others, self-perception, and spiritual changes. The KOP scale measured a mean resilience of 103.80 ± 16.57. The results obtained confirm the co-occurrence of psychological resilience and PTG, especially personal resilience and social competences. Additionally, women subjected to additional traumatic events other than cancer manifested a higher level of PTG.

An Approach to the Unified Conceptualization, Definition, and Characterization of Social Resilience

The purpose of this article is to offer a synthesis of the characteristics of social resilience, integrating the different approaches received from the social sciences. We propose to focus this conceptual framework as a previous and necessary step for the later study of the possible ways of promotion of this social resilience, that will help to strengthen the welfare and public health systems. The paper explores the difficulties in defining these characteristics, identifying their constituent elements. After this, the paper study the challenges to the future development of resilience models, showing the ways that offer some advances. Finally, we conclude that the social resilience must be conceived as a dynamic, multi-level, and evolutionary process if we are to help societies not only cope with adversity but also to adapt and transform themselves.

Posttraumatic Growth in Women With a Long-Standing Experience of Involuntary Childlessness in the Czech Republic

This qualitative research study aimed to examine aspects of posttraumatic growth (PTG) in women with a long-standing experience of involuntary childlessness. In-depth semi-structured interviews, lasting an average of 53 min, were conducted in the Czech Republic. Twenty-four women, averaging 38.8 years old with an average of 6.2 years of infertility experience, participated. They were asked how involuntary childlessness affected/changed their partnerships, sexual life, job, future plans, attitude to children/values/faith, and leisure time. Participants shared both positive and negative aspects of the infertility experience. Data were analyzed using thematic analysis. Five main themes of PTG were identified: strengthening of partnership, greater humility, deeper self-appreciation, reassessment of relationships, and changes in the philosophy of life. These findings could be useful to mental health providers to facilitate the PTG process in patients.

Psychosocial correlates of fertility-related quality of life among infertile women with repeated implantation failure: The mediating role of resilience

OBJECTIVE

This study aimed to examine associations between psychosocial factors and fertility-related quality of life (FertiQoL) among infertile women with repeated implantation failure (RIF), and to identify the possible role of resilience in mediating the effect of social support on FertiQoL.

MATERIALS AND METHODS

A cross-sectional study was conducted with 234 infertile women with RIF in total. Fertility quality of life scale (FertiQoL), perceived social support scale (PSSS), and Connor-Davidson Resilience Scale (CD-RISC) were used to evaluate the patients. Data were described by univariate and multivariate analyses. Stepwise regression method was performed to analyse the mediating effect of resilience.

RESULTS

Social support had a positive predictive effect on FertiQoL (β = 0.757, P < 0.001), also positive on resilience (β = 0.847, P < 0.001). After both variables were added to the regression equation, resilience was found to have a significant positive predictive effect on FertiQoL (β = 0.798, P < 0.001), while the predictive effect of social support on FertiQoL was no longer significant (β = 0.081, P > 0.05). The results indicated that resilience played a complete mediating role between social support and FertiQoL.

CONCLUSION

This study preliminarily verified the mediating role of resilience between social support and FertiQoL among infertile women with RIF. Interventions that consider enhancing resilience and building social support will likely improve their FertiQoL.

Posttraumatic Growth after the Fukushima Nuclear Disaster: Examination of Free Descriptions among Fukushima Residents Who Lived in the Evacuation Area

We examined the differences in the posttraumatic growth (PTG) free descriptions from clusters of Fukushima residents (evacuation and non-evacuation zones) who experienced the Great East Japan Earthquake, and the relationship between "recovery from radiation anxiety" and the PTG-free description classification in these regions. A mail survey was conducted in August 2016 among Fukushima residents aged 20-79 years for free descriptions of their PTG. Participants were then divided into the "no anxiety," "recovered from anxiety," and "unrecovered from anxiety" groups based on their "recovery from radiation anxiety." Data from 786 responses were analyzed. The PTG-free descriptions were classified into eight categories. Among those who lived in the evacuation zone versus those in the non-evacuation zone, "relating to others" (non-evacuation zone: 11.9% vs. evacuation zone: 18.4%) and "appreciation of life" (non-evacuation zone: 2.7% vs. evacuation zone: 9.8%) were significantly higher, and "increased awareness of disaster prevention" (non-evacuation zone: 20.4% vs. evacuation zone: 8.0%) was significantly lower. In the evacuation zone, "renewed recognition of nuclear issues" was significantly lower than the expected value in the no anxiety group (3.1%) and significantly higher than the expected value in the recovered group (22.9%). Further studies are needed to build support measures and potentially aid in preparing for future disasters.

Dyadic Effects of Fluid Mindset on Psychological Growth in Immigrant Mothers and Their Children: Indirect Effect of Resilience

Immigration research has recently investigated positive adaptation outcomes such as psychological growth. This study tested actor and partner effects between fluid mindset and psychological growth, mediated by resilience, in 200 migrant mother-child dyads from Mainland China to Hong Kong. Mothers' fluid mindset had significant actor and partner effects on their own and their children's psychological growth, whereas children's fluid mindset showed an actor effect. For mothers and children, fluid mindset had significant actor indirect effects on psychological growth via resilience. Mothers' fluid mindset had a significant partner indirect effect on children's psychological growth via children's resilience. The findings have implications for enhancing immigrants' psychological growth by strengthening fluid mindset and considering mothers and children as the intervention unit in resilience programs.

The Joyful Life: An Existential-Humanistic Approach to Positive Psychology in the Time of a Pandemic

In the midst of a global pandemic, psychology has a duty to identify dispositional or character traits that can be cultivated in citizens in order to create resiliency in the face of profound losses, suffering and distress. Dispositional joy holds some promise as such a trait that could be especially important for well-being during the current pandemic and its consequences. The concept of the Joyful Life may operate as bridge between positive psychology and humanistic, existential, and spiritual views of the good life, by integrating hedonic, prudential, eudaimonic and chaironic visions of the good life. Previous phenomenological research on state joy suggests that momentary states of joy may have features that overlap with happiness but go beyond mere hedonic interests, and point to the experience of a life oriented toward virtue and a sense of the transcendent or the sacred. However, qualitative research on the Joyful Life, or dispositional joy, is sorely lacking. This study utilized a dialogical phenomenological analysis to conduct a group-based analysis of 17 volunteer students, who produced 51 autobiographical narrative descriptions of the joyful life. The dialogical analyses were assisted by integration of the Imagery in Movement Method, which incorporated expressive drawing and psychodrama as an aid to explicate implicit themes in the experiences of the participants. The analyses yielded ten invariant themes found across the autobiographical narrative descriptions: Being broken, being grounded, being centered, breaking open, being uplifted, being supertemporal, being open to the mystery, being grateful, opening up and out, and being together. The descriptions of a Joyful Life were consistent with a meaning orientation to happiness, due to their emphasis on the cultivation of virtue in the service of a higher calling, the realization of which was felt to be a gift or blessing. The discussion examines implications for future research, including the current relevance of a joyful disposition during a global pandemic. Due to the joyful disposition's tendency to transform suffering and tragedy into meaning, and its theme of an orientation to prosocial motivations, the Joyful Life may occupy a central place in the study of resiliency and personal growth in response to personal and collective trauma such as COVID-19.

Relationship between infertility-related stress and resilience with posttraumatic growth in infertile couples: gender differences and dyadic interaction

STUDY QUESTION

Are there any gender differences and dyadic interactions in the associations between infertility-related stress and resilience and posttraumatic growth in infertile couples?

SUMMARY ANSWER

Husbands' posttraumatic growth was only impacted by their own infertility-related stress and resilience, whereas wives' posttraumatic growth was influenced by their own resilience and their spouses' resilience.

WHAT IS KNOWN ALREADY

Posttraumatic growth may play a significant role in protecting the infertile couples' psychological well-being and contribute to positive pregnancy outcomes. The reciprocal influence on each other within the infertile couple in terms of relationships between infertility-related stress and resilience and posttraumatic growth has been largely overlooked.

STUDY DESIGN, SIZE, DURATION

This cross-sectional study included 170 couples who were recruited from the First Affiliated Hospital of Soochow University between September 2019 and January 2020.

PARTICIPANTS/MATERIALS, SETTING, METHODS

The Fertility Problem Inventory, Connor-Davidson Resilience Scale-10, and Post-traumatic Growth Inventory were used to measure infertility-related stress, resilience, and posttraumatic growth. The Actor-Partner Interdependence Model was used to analyze the effects of infertility-related stress and resilience on the couple's own posttraumatic growth (actor effect) as well as on their partner's posttraumatic growth (partner effect).

MAIN RESULTS AND THE ROLE OF CHANCE

Husbands had higher levels of resilience than wives, while no significant gender differences were found in the levels of infertility-related stress and posttraumatic growth. Posttraumatic growth correlated with each other among infertile couples. Husbands' infertility-related stress had actor effects on their own posttraumatic growth, while wives' infertility-related stress had no effect on their own or their spouses' posttraumatic growth. Husbands' resilience had actor and partner effects on their own and their wives' posttraumatic growth, while wives' resilience only had an actor effect on their own posttraumatic growth.

LIMITATIONS, REASONS FOR CAUTION

First, our sample was limited to infertile Chinese couples seeking clinical treatment. Second, sociodemographic and psychological measures were self-reported. Third, as the current study is a cross-sectional study, the dynamic process of posttraumatic growth is unknown.

WIDER IMPLICATIONS OF THE FINDINGS

Infertile couples should be considered as a whole in studies on infertility. Couple-based psychological interventions are critical and more effective in improving mental health among individuals with infertility. Elevating the level of resilience may contribute to improving posttraumatic growth for both husbands and wives. Moreover, enhancing the ability to cope with infertility-related stress might be useful for husbands and indirectly contribute to wives' posttraumatic growth.

STUDY FUNDING/COMPETING INTEREST(S)

This research was supported by the National Natural Science Foundation of China (Grant No. 31900783) and the College Natural Science Research Project of Jiangsu Province (Grant No.19KJD320004). The authors declare no conflict of interest.

TRIAL REGISTRATION NUMBER

N/A.

Family resilience is a protective buffer in the relationship between infertility-related stress and psychological distress among females preparing for their first in vitro fertilization-embryo transfer

The present study aimed to evaluate psychological distress and scrutinized whether family resilience plays a moderating role in the association between infertility-related stress and psychological distress among infertile females preparing for their first IVF-ET. A total of 492 infertile females completed self-reported measures including the Kessler 10 Psychological Distress Scale (K10), the fertility problem inventory (FPI), and the Family Resilience Assessment Scale (FRAS). The results showed 21 (65.2%) participants reported moderate or higher levels of psychological distress. While controlling for economic status, we found psychological distress to be positively linked to infertility-related stress (β=0.483, P<0.001), and negatively related to family resilience (β=-0.145, P=0.001). The simple slopes analysis showed that infertility-related stress had a weaker positive association with psychological distress for individuals at 1 SD (β = 0.443, P < 0.001) above the mean on family resilience compared to those at 1 SD (β = 0.537, P < 0.001) below the mean. Thus, it suggests that clinical practice should conduct family resilience-oriented interventions to facilitate family resilience among infertile females preparing for their first IVF-ET, with the goal to reduce psychological distress.

Psychological experience and coping strategies of patients in the Northeast US delaying care for infertility during the COVID-19 pandemic

BACKGROUND

On March 17, 2020 an expert ASRM task force recommended the temporary suspension of new, non-urgent fertility treatments during an ongoing world-wide pandemic of Covid-19. We surveyed at the time of resumption of fertility care the psychological experience and coping strategies of patients pausing their care due to Covid-19 and examined which factors were associated and predictive of resilience, anxiety, stress and hopefulness.

METHODS

Cross sectional cohort patient survey using an anonymous, self-reported, single time, web-based, HIPPA compliant platform (REDCap). Survey sampled two Northeast academic fertility practices (Yale Medicine Fertility Center in CT and Montefiore's Institute for Reproductive Medicine and Health in NY). Data from multiple choice and open response questions collected demographic, reproductive history, experience and attitudes about Covid-19, prior infertility treatment, sense of hopefulness and stress, coping strategies for mitigating stress and two validated psychological surveys to assess anxiety (six-item short-form State Trait Anxiety Inventory (STAl-6)) and resilience (10-item Connor-Davidson Resilience Scale, (CD-RISC-10).

RESULTS

Seven hundred thirty-four patients were sent invitations to participate. Two hundred fourteen of 734 (29.2%) completed the survey. Patients reported their fertility journey had been delayed a mean of 10 weeks while 60% had been actively trying to conceive > 1.5 years. The top 5 ranked coping skills from a choice of 19 were establishing a daily routine, going outside regularly, exercising, maintaining social connection via phone, social media or Zoom and continuing to work. Having a history of anxiety (p < 0.0001) and having received oral medication as prior infertility treatment (p < 0.0001) were associated with lower resilience. Increased hopefulness about having a child at the time of completing the survey (p < 0.0001) and higher resilience scores (p < 0.0001) were associated with decreased anxiety. Higher reported stress scores (p < 0.0001) were associated with increased anxiety. Multiple multivariate regression showed being non-Hispanic black (p = 0.035) to be predictive of more resilience while variables predictive of less resilience were being a full-time homemaker (p = 0.03), having received oral medication as prior infertility treatment (p = 0.003) and having higher scores on the STAI-6 (< 0.0001).

CONCLUSIONS

Prior to and in anticipation of further pauses in treatment the clinical staff should consider pretreatment screening for psychological distress and provide referral sources. In addition, utilization of a patient centered approach to care should be employed.

Positive affect and mindfulness as predictors of resilience amongst women leaders in higher education institutions

Orientation: Psychological resources are the factors that appear to have a significant impact on how leaders adapt to adversity and remain resilient. Positive affect and mindfulness are the psychological resources that positively relate to the levels of resilience of women leaders in higher education institutions.Research purpose: The purpose of this study was to investigate the effect of positive affect and mindfulness on the levels of resilience of women leaders in higher education institutions in South Africa.Motivation for the study: Identifying the internal resources women leaders use to facilitate resilience will allow higher education institutions to prioritise these resources in leadership support programmes to assist these women leaders.Research approach/design and method: A cross-sectional survey design was used to collect data in a purposive sample of n = 255 women leaders in four South African higher education institutions. Pearson’s correlation analyses, multiple regression analyses and mediation analysis were used to analyse the data.Main findings: Findings indicated that positive affect and mindfulness were found to be significant predictors of resilience. Additionally, mindfulness was found to be a partial mediator in the relationship between positive affect and resilience.Practical/managerial implications: Higher education institutions can assist women leaders by investing in psychological resources such as mindfulness and positive affect to enhance the levels of resilience.Contribution/value-add: This study contributes to the limited research on the role of internal resources to enhance resilience in a workplace setting and more specifically amongst women leaders.

Social Support and Loneliness Among Chinese Caregivers of Children With Chronic Kidney Disease During the COVID-19 Pandemic: A Propensity Score Matching Analysis

To evaluate social support and loneliness as well as their association among caregivers of children with chronic kidney disease (CKD) from China during the coronavirus disease 2019 (COVID-19) pandemic. We collected data for caregivers of children with CKD and caregivers of healthy children and matched the two groups using propensity score matching (PSM). We compared the differences in social support and loneliness between the two groups after matching and analyzed the relationship between social support and loneliness in the observation group. Before PSM, we analyzed the data for 247 caregivers of children with CKD and 315 caregivers of healthy children from 13 provinces. After PSM, the two groups each included 202 caregivers. The social support score of caregivers of children with CKD was lower than that of caregivers of healthy children (P < 0.002), while the loneliness score was higher for caregivers of children with CKD than for caregivers of healthy children (P < 0.008). The social support score was negatively correlated with the loneliness score (r = -0.598, P < 0.001). Caregivers of children with CKD experienced less social support and greater loneliness than caregivers of healthy children during the COVID-19 pandemic. Therefore, greater attention should be paid to providing social support for caregivers of CKD children and to improving the ability of these caregivers to cope with loneliness.