The main objective of the proposed project is to determine the efficacy of a group cognitive-behavioral treatment intervention in: 1) reducing negative psychological symptoms including depression, anxiety, and marital distress, 2)increasing positive psychological symptoms including self- esteem and health-promoting lifestyle behaviors, and 3)increasing conception rates. Recent research indicates that infertile women report equivalent depression scores to individuals with other serious chronic medical conditions including cancer and heart disease. Previous research has demonstrated that infertile women report the highest levels of depressive symptoms between the second and third year of infertility. Data from an uncontrolled non-randomized study revealed that women who attended a ten session group behavioral treatment program had significant decreases in depressive symptoms as well as a higher than anticipated conception rate. It is proposed in this preventive intervention study that 360 women who have infertility durations of 12 to 24 months be randomized into one of three groups: a cognitive-behavioral intervention group, a standard support group, and a control group. Each intervention group will meet for ten sessions. Conception rate data will be collected. Subjects will be tested every six months until their infertility durations reach four years, or until they conceive on the following variables: depression, anxiety, marital distress, self-esteem, and health-promoting lifestyle behaviors. It is hypothesized that women who. attend the cognitive-behavioral intervention group will have significantly fewer negative and more positive psychological symptoms and higher conception rates than women who attend the support group or the control subjects. It is also hypothesized that women who attend the support group will have fewer negative and more positive psychological symptoms and higher conception rates than the control subjects.
