Adaptive and maladaptive grief responses following TOPFA: Actor and partner effects of coping strategies.

Abstract

Objective: This study aimed to 1) compare women and men regarding absolute and relative coping following a termination of pregnancy for fetal abnormality and 2) assess the influence of relative coping on each partner’s adaptive and maladaptive grief responses. Background: Although differences in coping have been cited to explain gender differences on grief symptomatology after a spontaneous pregnancy loss, no study yet has compared women and men regarding use of coping strategies after termination of pregnancy for fetal abnormality. Furthermore, considering the relatively high prevalence of clinically relevant grief symptomatology among women following this event, both one’s and the partner’s coping responses should be explored as predictors. Methods: 41 couples answered the Perinatal Grief Scale and the Brief COPE, one to six months after termination of pregnancy for fetal abnormality. Results: Women used Religion more frequently than men. Women’s absolute and relative scores on Emotional Support, Instrumental Support, and Venting were higher than men’s. Men presented higher scores on relative use of Acceptance, Humour, and Denial. Acceptance positively predicted adaptive grief responses. Self-Blame, Denial, Active Coping, and Instrumental Support were positive predictors of maladaptive grief responses. Humour was negatively associated with both types of grief responses. Partner effects were found for Self-Blame and Active Coping. Conclusion: As gender differences regarding coping are normative, psychoeducation may be used to foster intracouple acceptance. Due to their interdependence, both partners’ should be assessed. Coping strategies (i.e. self-blame) associated with maladaptive responses should be prevented, while fostering the use of helpful strategies (i.e. acceptance). Keywords: Actor-Partner Interdependence Model; adaptive and maladaptive grief responses; couple; relative coping; termination of pregnancy for fetal abnormality.