Fotopoulos, C.; (2004) An exploration of psychological, dyadic and sexual functioning amongst couples following recurrent miscarriage, with an examination of the potential function of role and goal investment and social support. Doctoral thesis , University of London.

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Abstract

Recurrent miscarriage is the loss of three or more consecutive pregnancies before 24 weeks gestation and affects up to 1% of women. Until recently there has been a paucity of research into the psychological impact of this experience, and the available research has tended to almost exclusively focus on the incidence and nature of maternal distress and wellbeing. Yet the research on the psychological impact of a single miscarriage suggests that the experience of recurrent miscarriage is likely to affect both partners as individuals and as a couple. The aim of the current study was to address the gap in the literature by carrying out a quantitative cross-sectional examination of the psychological, dyadic and sexual functioning in a sample of 80 couples attending the Recurrent Miscarriage Clinic (RMC) for their first appointment. Measures administered included an assessment of distress using the HADS, an assessment of coping strategies using the COPE, an assessment of couple adjustment using the DAS, and an assessment of sexual functioning using the GRISS. In addition, social support was assessed using the SOS, and the couple's investment in the roles and goals in their life, including becoming a parent, was assessed utilising the RAG. Following the social cognitive and family life cycle models, it was proposed that partners who had relatively over-invested in becoming parents, in comparison with other roles and goals, would be most vulnerable to emotional distress and dyadic/sexual dysfunction, and would be most likely to use inadequate coping. These hypotheses were not supported by the data. However as predicted, dyadic adjustment and avoidance coping were found to be significantly related to emotional distress in both men and women. Furthermore, female emotion- focused coping was significantly related to female anxiety. After controlling for dyadic adjustment, the only type of coping independently associated with emotional distress was female emotion-focused coping in relation to female anxiety. After controlling for coping, dyadic adjustment continued to be a predictor of male anxiety and depression and female anxiety, but not depression. Contrary to predictions sexual functioning was not associated with emotional distress and although social support was found to have a significant independent relationship with female depression, this relationship was no longer significant once other variables were controlled for. The results are discussed in light of clinical implications and with consideration of qualitative feedback also collected from participants.

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