Psychological Interventions for Infertile Couples: Does Gender Matter?

Purpose: Gender-specific differences exist between male and female infertility patients' mental health, the meaning of infertility in their lives, and the coping strategies used. This systematic review examines whether gender-specific aspects are addressed in psychological intervention studies for infertility and whether infertile women and men benefit equally from such interventions. Methods: Databases were searched to identify relevant articles published between 1978 and 2007 (384 articles). The review included both controlled and uncontrolled psychological intervention studies examining results for infertile women and men separately. Outcome measures (depressive symptoms, anxiety, and mental distress) and gender-specific baseline characteristics (mental distress at pre-assessment, cause of infertility, and medical treatment) were collected. A total of twelve studies were finally included. Results: In 10 of 12 studies, women exhibited higher levels of mental distress than men. Gender-specific aspects were not addressed in the psychological interventions. Examining the efficacy of psychological interventions revealed that women exhibited stronger positive mental health effects in 2 of the 12 studies. Conclusion: Psychological distress before psychological treatment seems more pronounced in women than in men. Therefore psychological interventions for infertile couples should take gender-specific aspects into account. More research is needed to address the gender-specific aspects regarding psychological interventions for infertility.

A Longitudinal Analysis of the Relations Among Stress, Depressive Symptoms, Leisure Satisfaction, and Endothelial Function in Caregivers

Stress and depressive symptoms have been associated with impaired endothelial function as measured by brachial artery flow-mediated dilation (FMD), possibly through repeated and heightened activation of the sympathetic nervous system. Behavioral correlates of depression, such as satisfaction with leisure activities (i.e., leisure satisfaction), may also be associated with endothelial function via their association with depressive symptoms. This study examined the longitudinal associations between stress, depressive symptoms, leisure satisfaction, and endothelial function as measured by FMD.

Psychological Real Estate: Fractured Female Identity in the Victorian Novel

"Psychological Real Estate: Fractured Female Identity in the Victorian Novel" examines the use of domestic space in three Victorian novels, Charlotte Bronte's Jane Eyre (1847), Mary Elizabeth Braddon's Lady Audley's Secret (1862), and George Eliot's Middlemarch (1871-2). Because Victorian gender identity was conceived of in spatial terms, this thesis explores how the three female authors use complicated domestic environments to engage the problem of conventional Victorian femininity. In the Victorian mindset, a woman's place is confined to the home, or private sphere; however, even the private sphere is intruded upon by public spaces. Expected to conform to the Victorian formulation of femininity in public spaces within the home, women had only their private spaces to cultivate the unique, individualistic aspects of their selves. This thesis explores the ways in which the female protagonists negotiate these gender encoded spaces to argue that because Victorian women had to maintain separate and often disparate identities within domestic space, their identities became problematically fractured. Additionally, in each of these texts, the authors use the failure or loss of the estate, the structure which rigidly upholds the gendered binaries, to expose the harm such fracturing identity formulation caused for Victorian society as a whole. This thesis concludes by examining the final residences of the female characters and arguing that the authors use these final private spaces to assert more feminist re-envisionings of their society's construction of femininity.

Child Aggression in a Post-Communist Country: Race and Gender Aspects in a Cross-Cultural Comparison

Gypsies represent approximately 2.5% of the Czech population, but are considerably over-represented among the unemployed, prisoners, schooldropouts, neglected children, etc. Together with racist attitudes on the part of the majority, this causes strong inter-ethnic tension and obviouseconomic, moral and political problems. This research studied the way in which this situation is reflected in peer relations between Gypsy andmajority children in schools. Six samples of children (totalling 2974 children aged 7-15, of whom 15% were Gypsies) were studied through peernomination, teacher assessment and self-reporting. Gypsy/non-Gypsy and gender dichotomies were correlated with measures of aggression,victimisation and acceptance/rejection. The results showed that Gypsy children, both boys and girls, were more likely to nominate their Gypsy peers as aggressors than they nominatemajority children, implying that they tend to direct their rejection toward their own kind. The number of Gypsy children in a class was also animportant factor with Gypsies being more likely to be accepted and less likely to appear aggressive when they were only one or two in a class, thanin a class where there was a greater number of Gypsy pupils. When whole classes were taken as the unit of analysis, Gypsy children were seen asmore likely to behave aggressively in class by their Gypsy and non-Gypsy counterparts as well as by their teachers. At the same time they aremuch less likely to become victims of aggression than are non-Gypsy children, both boys and girls. Mr. Rican also found that the acceptance/rejection patterns of Gypsy children betray their unsatisfactory socialisation. Among their peers, Gypsyor non-Gypsy, they tend to prefer aggressors or children who teachers describe as showing little discipline or effort to succeed at school. Partialcorrelation to assess the influence of seniority on aggressiveness provided a warning that the recent lengthening of compulsory school attendance islikely to bring an increase in aggressiveness. He believes that Gypsy ethnic identity has lost many of its important positive aspects, making itsnegative aspects more prominent and more dangerous. He does however find some possible ways for teachers to reinforce the positive aspects ofGypsy children's identities in order to support their socialisation at schools.

Towards a Variety of Family Models: Economic Contributions of Spouses and Family Power

In Western societies the increase in female employment (especially among married women) is seen as having brought about the crisis of the traditional model of the family, reinforcing the position of the "modern" model - the egalitarian family with two working spouses and a "dual-career" family. In contrast, the transitional situation in the post-communist countries during the 1990s is producing a crisis of the family with two working spouses (the basic type of the communist period) and leading to new power relations within the family. While the growth of dual-earner households in this century has implied modification of family models towards greater symmetry of responsibility for breadwinning and homemaking, there is considerable evidence that women's increased employment does not necessarily lead to a more egalitarian approach to gender roles within the family. The group set out to investigate the economic situation of families and economic power within the fame as a crucial factor in the transformation of families with two working spouses in order to reveal the specific patterns of gender contracts and power relations within the family that are emerging in response to the current political and economic transformation. They opted for a comparative approach, selecting the Czech Republic as a country where the very similar tendencies of a few years ago (almost 100% of women employed and the family as a realm of considerable private freedom where both women's and men's gender identities and the traditional distribution of family responsibilities were largely preserved) are combined with a very different experience in terms of economic inequalities during the 1990s to that of Russia. In the first stage of the study they surveyed 300 married couples (150 in each country) on the question of breadwinning. They then carried out in-depth interviews with 10 couples from each country (selected from among the educated layers of the population), focusing on the process of the social construction of gender, using breadwinning and homemaking as gender boundaries which distinguish men from women. By analysing changes in social position and the type of interpersonal interaction of spouses they distinguished two main types of family contracts: the neo-traditional "communal sharing" (with male breadwinner, traditional distribution of family chores and negotiated family power) and the modern one based on negotiated agreement. The most important pre-conditions of husband-wife agreement about breadwinning seemed to imply their overall gender ideology rather than the economic and/or family circumstances. In general, wives were more likely to express egalitarian views, supporting the blurring or even elimination of many gender boundaries. Husbands, on the other hand, more often gave responses calling for the continued maintenance of gender boundaries. The analysis showed that breadwinning is still an important gender boundary in these cultures, one that is assumed unless it is explicitly questioned and that is seen as part of what makes a man a "real man". The majority of respondents seemed to be committed to egalitarian ideology on gender roles and the distribution of family tasks, including decision making, but this is contradicted by the persistent idea of the husband as the breadwinner. This contradiction is more characteristic of the Russian situation than of the Czech. The quantitative study showed a difference in prevailing family models between the two countries, with a clearer shift towards the traditional family contract in the Russian case. The Czechs were more likely to consider their partnerships as based on negotiated agreement, while the Russians saw theirs as based on egalitarian contract, in both cases seeing this as the norm. The majority of couples said they felt satisfied with their marriage, although in both countries wives seemed to be less satisfied. There was however a difference in the issues that aroused dissatisfaction, with Czech women being more sensitive to issues such as self-realisation, personal independence, understanding and recognition in the family, and Russians to issues of love, understanding and recognition. The most disputed area for the majority of families was chores in the home, presumably because in many families both husband and wife were working hard outside the home and because a number of partners had differing views as to the ideal distribution of chores within the family. The distribution of power in the family seems to be linked to the level of well being. The analysis showed that in the dominant democratic model there is still an inverse connection between family leadership and well being: the more prominent the wife's position as head of the family is, the lower the level of family income. This may reflect both the husband's refusal to play the leading role in the family and even his rejection of any involvement in family issues in such a family. The qualitative research revealed that both men and women see the breadwinning role to be an essential part of masculine identity, a role which the female partner would take on temporarily to assist the male but not permanently since this would threaten the gender boundaries and the man's identity. At the same time, few breadwinners expressed a sense of job satisfaction and all considered their choice as imposed on them by the circumstances (i.e. having a family in difficult times). The group feel that family orientation and some loss of personal involvement in their profession is partly reflected in the fact that many of the men felt more comfortable and self-confident at home than at work. Women's work, on the other hand, was largely seen as a source of personal and self-realisation and social life. Eight out of ten of the Russian women interviewed were employed, although only two on a full-time basis, but none saw their jobs as adding substantially to the family budget. Both partners see the most important factor as the wife's wish to work or stay at home, and do not think it wise for the wife to work at the expense of her part of the "family contract", although husbands from the "egalitarian" relationships expressed more willingness to compromise. The analysis showed clearly that wives and husbands did not construct gender boundaries in isolation, with the interviews providing clear evidence of negotiation. At the same time, husbands' interpretations of their wives' employment were less susceptible to the influence of negotiation than were their gender attitudes and norms about breadwinning. One of the most interesting aspects of the spouses' negotiations was the extent to which they disagreed about what they seemed to have agreed upon. Most disagreements about the breadwinning boundaries, however, were over norms and were settled by changes in norms rather than in behavioural interpretation. Changes in norms were often a form of peace offering or were in response in changes in circumstances. The study did show, however, that many of the efforts at cooperation and compensation were more symbolic than real and the group found the plasticity of expressed gender ideology to be one of the most striking findings of their work. They conclude that the shift towards more traditional gednder distributions of incomes and domestic chores does not automatically mean the reestablishment of a patriarchal model of family power. On the contrary, it seems to be a compromise formation, relatively unstable, temporary and containing self-defeating forces as the split between the personal and professional value of work and its social value expressed in a money equivalent cannot be maintained for generations.

The moderating effect of personal mastery and the relations between stress and Plasminogen Activator Inhibitor-1 (PAI-1) antigen

OBJECTIVE: This study tested whether feelings of personal control over one's life circumstances (i.e., personal mastery) would attenuate the relations between stress (i.e., negative life events and caregiving distress) and Plasminogen Activator Inhibitor (PAI)-1 antigen, an inhibitor of fibrinolysis implicated in the development of cardiovascular disease. DESIGN: Seventy-one spousal dementia caregivers were assessed for plasma levels of PAI-1 antigen, negative life events, caregiver distress, and feelings of personal mastery. Regression analysis was used to determine if personal mastery moderated the relations between stress (i.e., life stress and caregiving distress) and PAI-1 antigen levels. MAIN OUTCOME MEASURE: Plasminogen activator inhibitor (PAI)-1 antigen in plasma. RESULTS: After controlling for other factors associated with PAI-1 antigen levels, negative life events were positively associated with plasma PAI-1 antigen concentrations in participants low in personal mastery (beta = .31; p = .050) but not in individuals high in personal mastery (beta = .22; p = .184). The moderating effect of mastery on the relations between caregiving distress and PAI-1 antigen did not reach statistical significance (p = .091). CONCLUSIONS: These data suggest that mastery may protect individuals from some of the alterations in hemostatic factors that have been linked to cardiovascular risk.

Longitudinal platelet reactivity to acute psychological stress among older men and women

Platelet reactivity to acute stress is associated with increased cardiovascular disease risk; however, little research exists to provide systematic methodological foundations needed to generate strong longitudinal research designs. Study objectives were: 1) to evaluate whether markers of platelet function increase in response to an acute psychological stress test among older adults, 2) to establish whether reactivity remains robust upon repeated administration (i.e. three occasions approximately 1 year apart), and 3) to evaluate whether two different acute speech stress tasks elicit similar platelet responses. The 149 subjects (mean age 71 years) gave a brief impromptu speech on one of two randomly assigned topics involving interpersonal conflict. Blood samples drawn at baseline and post-speech were assayed using flow cytometry for platelet responses on three outcomes (% aggregates, % P-selectin expression, and % fibrinogen receptor expression). Three-level hierarchical linear modeling analyses revealed significant stress-induced increases in platelet activation on all outcomes (p < 0.001). No significant habituation on any measure was found. Additional reactivity differences were associated with male gender, history of myocardial infarction, and use of aspirin, statins, and antidepressants. The results demonstrate that laboratory acute stress tests continued to produce robust platelet reactivity on three activation markers among older adults over 3 years.

The prevalence of burnout among psychologists and psychological associates in the state of Texas

This study investigates the prevalence of burnout among a sample of Texas psychologists and psychological associates as well as differences between the three categories of practitioners within that group (Licensed Psychology Health Care Providers (LPHCP), Licensed Psychologists - Certified Psychologists (LP-CP), Psychological Associates (PA)).^ The Maslach Burnout Inventory and a questionnaire seeking demographic information was used in this cross-sectional survey. Sample size was 654. A stratified proportionate random sample of Texas Psychologists was drawn. The response rate based on usable returns was 55% (n = 359). General demographic characteristics were determined mainly by frequency distributions. For comparing means of samples, t and multiple range tests were used. A series of one-way and two-way analysis of variance procedures were used to compare subgroup differences in burnout.^ The universe was representative for the sample and for the three categories of psychologists. Urban subjects were more likely to respond, as were male PAs. Practitioners were as likely male as female, working in an urban area, in their present job eight years, and in the occupation for fifteen. The LPHCP group were older, had been in psychology and at their present job longer, and were more likely to belong to both state and local professional organizations than the other two groups. Males outnumbered females in this group and in LP-CPs. This gender trend was reversed for PAs. Of the total sample, 76% reported high job satisfaction and 77% had high levels of perceived job autonomy. There was no significant difference between the study sample and the mental health norms in emotional exhaustion (EE). Our sample had significantly less feelings of depersonalization (DP) and higher feelings of personal accomplishment (PA). Psychological Associates felt significantly less personal accomplishment than the other groups. Predictors for the total sample indicated younger practitioners and those with low job satisfaction had significantly higher burnout, as did males when compared to their female cohorts. Some types of jobs were more likely to contribute to burnout than others. Membership in their local area professional organization lessened the chances for burnout significantly. Predictors for categories of psychologists indicated that males in the LPHCP and LP-CP groups were at higher risk than females. Further, for LP-CPs low job satisfaction and job autonomy, as well as job sites, were significant. Those in this group who worked as school psychologists were at the highest risk for burnout. Job dissatisfaction was the major predictor of burnout for psychological associates. Practitioners working in state or government agencies, school systems and administrative jobs generally had higher burnout than those on a university faculty or in private practice. (Abstract shortened by UMI.) ^

Psychosocial aspects on the treatment of HIV-infection

Psychological and social factors have a deep impact on the treatment of HIV-infection, from the readiness to start antiretroviral therapy to treatment adherence over time. Among psychological factors, anxiety may affect HIV-infected persons in all stages of disease, from the disclosure of HIV diagnosis to the decision to start and maintain treatment. This is a lifelong challenge for both patients and doctors. Psychiatric comorbidities (depression, addiction) may enhance negative psychological effects of HIV. Among social factors, stigma and discrimination may occur in families and at work, leading to a loss of social support resulting in isolation and poverty. This may prevent HIV-positive individuals from seeking medical care. These aspects are particularly important in some groups of patients as injecting drug users and migrants. Acknowledgment and consideration of psychosocial factors are therefore essential for the long term success of antiretroviral therapy.

Individual group efficacy beliefs and performance motivation: A mediational approach

Introduction: According to the theoretical model of Cranach, Ochsenbein, and Valach (1986) understanding group actions needs consideration of aspects at both the group level and the level of individual members. For example individual action units constituting group actions are motivated at the individual level while potentially being affected by characteristics of the group. Theoretically, group efficacy beliefs could be a part of this motivational process as they are an individual’s cognitive contents about group-level abilities to perform well in a specific task. Positive relations between group level efficacy-beliefs and group performance have been reported and Bandura and Locke (2003) argue that this relationship is being mediated by motivational processes and goal setting. The aims of this study were a) to examine the effects of group characteristics on individual performance motivation and b) to test if those are mediated by individual group efficacy beliefs. Methods: Forty-seven students (M=22.83 years, SD=2.83, 34% women) of the university of Berne participated in this scenario based experiment. Data were collected on two collection points. Subjects were provided information about fictive team members with whom they had to perform a group triathlon. Three values (low, medium, high) of the other team members’ abilities to perform in their parts of the triathlon (swimming and biking respectively) were combined in a 3x3 full factorial design (Anderson, 1982) yielding nine groups. Subjects were asked how confident they were that the teams would perform well in the task (individual group efficacy beliefs), and to provide information about their motivation to perform at their best in the respective group contexts (performance motivation). Multilevel modeling (Mplus) was used to estimate the effects of the factors swim and bike, and the context-varying covariate individual group efficacy beliefs on performance motivation. Further analyses were undertaken to test if the effects of group contexts on performance motivation are mediated by individual group efficacy beliefs. Results: Significant effects were reported for both the group characteristics (βswim = 7.86; βbike = 8.57; both p < .001) and the individual group efficacy beliefs (βigeb; .40, p < .001) on performance motivation. The subsequent mediation model indicated that the effects of group characteristics on performance motivation were partly mediated by the individual group efficacy beliefs of the subjects with significant mediation effects for both factors swim and bike. Discussion/Conclusion: The results of the study provide further support for the motivational character of efficacy beliefs and point out a mechanism by which team characteristics influence performance relevant factors at the level of individual team members. The study indicates that high team abilities lead to augmented performance motivation, adding a psychological advantage to teams already high on task relevant abilities. Future investigations will be aiming at possibilities to keep individual performance motivation high in groups with low task relevant abilities. One possibility could be the formulation of individual task goals. References: Anderson, N. H. (1982). Methods of information integration theory. New York: Academic Press. Bandura, A. & Locke, E. A. (2003). Negative self-efficacy and goal effects revisited. Journal of Applied Psychology, 88, 87-99. Cranach, M. von, Ochsenbein, G. & Valach, L. (1986). The group as a self-active system: Outline of a theory of group action. European Journal of Social Psychology, 16, 193-229.

Psychological Data from an Exploration of the Rapport / Synchrony Interplay Using Motion Energy Analysis

These data result from an investigation examining the interplay between dyadic rapport and consequential behavior-mirroring. Participants responded to a variety of interpersonally-focused pretest measures prior to their engagement in videotaped interdependent tasks (coded for interactional synchrony using Motion Energy Analysis [17,18]). A post-task evaluation of rapport and other related constructs followed each exchange. Four studies shared these same dependent measures, but asked distinct questions: Study 1 (Ndyad = 38) explored the influence of perceived responsibility and gender-specificity of the task; Study 2 (Ndyad = 51) focused on dyad sex-makeup; Studies 3 (Ndyad = 41) and 4 (Ndyad = 63) examined cognitive load impacts on the interactions. Versions of the data are structured with both individual and dyad as the unit of analysis. Our data possess strong reuse potential for theorists interested in dyadic processes and are especially pertinent to questions about dyad agreement and interpersonal perception / behavior association relationships.

Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.