Adjustment toward infertility mediates the relationship between coping, depression and anxiety in men: A confirmatory analysis

Abstract

Objective: The aim of the present study was to develop a theoretical framework for the relationships between coping, adjustment toward infertility, depression and anxiety and to present a confirmatory analysis of the developed theoretical framework in men who, together with their spouses, were candidates for assisted reproductive technology (ART) treatment. Study design: This cross-sectional study was conducted on 212 men selected from the couples who were candidate for ART. Depression and anxiety, adjustment toward infertility, and coping strategies were assessed using self-report questionnaire. Statistical analysis was performed using the plug-in application PROCESS macro and AMOS software. Results: The results showed that higher depression and anxiety scores were related to lower adjustment to infertility. Higher adjustment score was associated with lower self-blame, self-focused rumination, active confronting and avoidance coping strategies scores significantly. In the depression and anxiety pathway models, the positive relationship between active confronting and elf-focused rumination coping strategies were mediated by adjustment. However, the effect of active confronting on depression and anxiety was significant only with mediating role of adjustment. The direct and indirect relationship of self-focused rumination and the indirect relationship of active confronting with depression and anxiety had a good fitness (CMIN/ DF = .419). Conclusion: The self-focused rumination and active confronting coping strategies, having negative association with adjustment to infertility, and may increase depression and anxiety in men undergoing ART; however, higher adjustment is associated with decreased depression and anxiety. Therefore, mental health programs for men undergoing ART may need to focus on improving the skills of adaptive coping strategies. (C) 2021 Elsevier B.V. All rights reserved.