PREDICTING PSYCHOLOGICAL ADJUSTMENT TO ABORTION

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The identification of factors that place women "at risk" for the experience of post-abortion psychological distress and that promote long-term adjustment to abortion are important mental health issues. The primary aim of this research is to propose and test a theoretical model of adjustment to abortion within a stress and coping framework. We hypothesize that level of distress immediately following abortion is a function of two proximal cognitive appraisals: the extent to which the abortion is appraised as threatening to important aspects of self, and perceived self-efficacy for coping with the abortion. The extent to which the abortion is appraised as threatening is hypothesized to be a function of the extent to which it conflicts with important personal goals, attitudes or self-views, and/or important social relationships. Self-efficacy for coping with the abortion is hypothesized to be a function of perceived personal resources (e.g., self-esteem, optimism) and social resources (e.g., social support). We hypothesize that the intensity of distress experienced immediately subsequent to the abortion, as well as pre-abortion appraisals of threat and self-efficacy for coping, will independently predict the specific coping efforts that women employ to deal with their longer-term emotional reactions to the abortion. In addition, we hypothesize that prior levels of distress, the types of coping efforts that are employed to manage this distress, and intervening events that occur after the abortion (e.g., physical complications, difficulty in conceiving when desired) will determine long-term adjustment to abortion. Secondary aims of this research are: (1) to explore the role of the male partner in the abortion experience, (2) to explore the impact of anti-abortion picketing at the clinic on women's adjustment to abortion, and (3) to examine the extent to which perceived personal and social conflicts about pregnancy and parenthood, and the appraised threat of pregnancy and parent- hood, are independent predictors of post-abortion adjustment. A longitudinal study of 600 women undergoing first-trimester abortion and 240 male partners who accompany them is proposed. Within one hour prior to having an abortion, measures of personal/social resources, personal/social conflict, appraisals of threat, and judgments of self-efficacy for coping with the abortion will be obtained. Distress will be measured at three time points: approximately 30-60 min post-abortion, at a three-week follow-up visit, and at two years post-abortion. At the latter two time periods the following will also be assessed: positive well-being, specific coping efforts that have been employed to deal with emotional reactions to the abortion, the perceived effectiveness of those efforts, and intervening events. Responses of male partners, and objective ratings of picketing, will be obtained at the clinic on the day of the abortion.