title: Psychosocial Vulnerability, Resilience Resources, and Coping with Infertility: A Longitudinal Model of Adjustment to Primary Ovarian Insufficiency.
abstract: BACKGROUND
  The infertility associated with primary ovarian insufficiency (POI) presents significant emotional challenges requiring psychosocial adjustment. Few investigations have explored the longitudinal process of adaptation to POI.
  
  
  OBJECTIVE
  This longitudinal investigation tests a model of adjustment to POI that includes separate psychosocial vulnerability and resilience resource factors.
  
  
  METHODS
  Among 102 women with POI, personal attributes reflective of vulnerability and resilience were assessed at baseline. Coping strategies were assessed 4 months later and measures of distress and well-being 12 months later.
  
  
  RESULTS
  As hypothesized, confirmatory factor analysis yielded separate, inversely correlated vulnerability and resilience resource factors at baseline, and distress and well-being factors at 12 months. Contrary to predictions, maladaptive and adaptive coping strategies were not bi-factorial. Moreover, a single stand-alone strategy, avoidance (i.e., refusing to acknowledge stress), mediated the association between baseline vulnerability and 12-month distress.
  
  
  CONCLUSIONS
  For women with POI, interventional studies targeted to reduce avoidance are indicated.
authors.affiliation: VA Connecticut Healthcare System, 950 Campbell Ave., Mail Code 11ACSL-G, West Haven, CT, 06516, USA. mary.driscoll3@va.gov.|Yale School of Medicine, New Haven, CT, USA. mary.driscoll3@va.gov.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Driscoll
authors.affiliation: Arizona State University, Tempe, AZ, USA.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Davis
authors.affiliation: Arizona State University, Tempe, AZ, USA.
authors.forename: Leona S
authors.initials: LS
authors.lastname: Aiken
authors.affiliation: Arizona State University, Tempe, AZ, USA.
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Yeung
authors.affiliation: Rachel's Well, Inc., McLean, VA, USA.
authors.forename: Evelina Weidman
authors.initials: EW
authors.lastname: Sterling
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Vien
authors.initials: V
authors.lastname: Vanderhoof
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Karim Anton
authors.initials: KA
authors.lastname: Calis
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Vaishali
authors.initials: V
authors.lastname: Popat
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Sharon N
authors.initials: SN
authors.lastname: Covington
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Nelson
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000523:psychology*; D008137:Longitudinal Studies; D016649:Primary Ovarian Insufficiency / Q000523:psychology*; D055500:Resilience, Psychological; D013315:Stress, Psychological / Q000523:psychology*; D055815:Young Adult
keywords: Adaptation; Coping; Infertility; POI; Premature menopause; Premature ovarian failure; Resilience; Risk