title: The psychosocial transition associated with spontaneous 46,XX primary ovarian insufficiency: illness uncertainty, stigma, goal flexibility, and purpose in life as factors in emotional health.
abstract: OBJECTIVE
  To examine factors associated with emotional well-being in women with spontaneous primary ovarian insufficiency.
  
  
  METHODS
  Cross-sectional and case-control study.
  
  
  METHODS
  Clinical research center, national U.S. health research facility.
  
  
  METHODS
  Women diagnosed with spontaneous 46,XX primary ovarian insufficiency (n = 100) at a mean age of 32.4 years and healthy control women of similar age (n = 60).
  
  
  METHODS
  Administration of validated self-reporting instruments.
  
  
  METHODS
  Illness uncertainty, stigma, goal disengagement/re-engagement, purpose in life, Positive and Negative Affect Schedule, Center of Epidemiologic Studies Depression Scale, State-Trait Anxiety Inventory.
  
  
  RESULTS
  Compared with controls, women with spontaneous primary ovarian insufficiency scored adversely on all measures of affect. Illness uncertainty and purpose in life were significant independent factors associated with anxiety (R(2) = 0.47), stigma and purpose in life were the significant independent factors associated with depression (R(2) = 0.51), and goal re-engagement and purpose in life were significantly and independently associated with positive affect (R(2) = 0.43).
  
  
  CONCLUSIONS
  This evidence supports the need for prospective studies. Our findings are consistent with the hypothesis that clinicians could improve the emotional well-being of their patients with primary ovarian insufficiency by [1] informing them better about their condition, [2] helping them to feel less stigmatized by the disorder, and [3] assisting them in developing alternative goals with regard to family planning as well as other goals.
authors.affiliation: Department of Psychology, Arizona State University, Tempe, Arizona, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Davis
authors.forename: June L
authors.initials: JL
authors.lastname: Ventura
authors.forename: Mary
authors.initials: M
authors.lastname: Wieners
authors.forename: Sharon N
authors.initials: SN
authors.lastname: Covington
authors.forename: Vien H
authors.initials: VH
authors.lastname: Vanderhoof
authors.forename: Mary E
authors.initials: ME
authors.lastname: Ryan
authors.forename: Deloris E
authors.initials: DE
authors.lastname: Koziol
authors.forename: Vaishali B
authors.initials: VB
authors.lastname: Popat
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Nelson
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D016022:Case-Control Studies; D041321:Chromosomes, Human, X; D017281:Cost of Illness; D004644:Emotions; D005260:Female; D006040:Goals; D006801:Humans; D008019:Life Style; D008603:Mental Health; D010555:Personality Inventory; D011287:Prejudice; D016649:Primary Ovarian Insufficiency / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D011788:Quality of Life; D012307:Risk Factors; D012649:Self Concept; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology; D035501:Uncertainty