Relationships between attachment, appraisal, coping and adjustment in men and women experiencing infertility concerns.

BACKGROUND Attachment style may influence distress and relationship satisfaction in infertile couples. Appraisal and coping have also been linked to adjustment to infertility and may be related to attachment patterns. The study examined these associations in men and women around the time of attending initial appointments at fertility clinics. METHODS Attachment, appraisal, coping, general well-being, infertility-related stress and relationship satisfaction questionnaires were completed by 98 women and 64 men. Data were analysed by gender comparisons, correlations and path analysis. RESULTS Attachment anxiety was associated with well-being in women via appraisal of infertility as a loss and use of self-blame and avoidance (SBA) coping. Attachment anxiety was also linked with infertility-related stress through SBA. In men, attachment anxiety was associated with well-being and infertility-related stress again via SBA coping. Attachment anxiety and avoidance were related to lower relationship satisfaction in women, whereas only the former was important for men. CONCLUSIONS Attachment patterns link to couples' relationship satisfaction and are associated with adjustment via appraisal and coping. Identification of such patterns may assist in identifying need and tailoring cognitive interventions to individuals. Participants were mainly white and well-educated, and wider generalization cannot automatically be assumed.