健康与遗传心理学研究室知识库

在中国，约有7.4%的夫妇被诊断为不孕不育。对大多数人来说，怀孕和生育是结婚后预期的重要事件，不能正常怀孕不仅意味着他们需要接受医疗服务及生理上的痛苦，也意味着他们会承受心理上的打击。生育往往与社会角色的失败有关，但之前的研究很少从社会文化的角度来看待不孕问题。本研究试图探究患者的性别角色信念与他们的生育压力的关系，并考虑不孕原因在其中的调节作用。

研究一:研究目的:从个体层面探讨女性的性别角色信念与生育压力的关系:是否自己原因的调节作用。研究方法:研究对象:北京某三甲医院就诊的不孕女性患者284人。研究工具:一般人口学问卷、性别角色信念量表(GRBS)和生育问题量表(FP工)。统计方法:有调节的中介模型分析。研究结果:(1>女性的性别角色信念(得分越高越传统)能正向预测其生育压力。(2>母亲身份重要性在女性的性别角色信念与不孕对生活影响的关系中起到了中介作用。(3)是否女性原因调节了性别角色信念对生育压力的影响。具体来说，对于仅自身原因导致不孕的女性，性别角色信念直接影响不孕对生活的影响;对于其它原因不孕的女性，性别角色信念通过母亲身份重要性，间接作用于不孕对生活的影响。

研究二:研究目的:从夫妻层面探讨性别角色信念与自己及配偶的生育压力的关系，以及不孕原因在其中的调节作用。研究方法:研究对象:北京某三甲医院就诊的不孕夫妇165对。研究工具:同研究一。统计方法:行动者一对象互倚模型。研究结果:(1)行动者效应:男女方的性别角色信念都能正向预测不孕对自己生活的影响;(2)对象效应:丈夫的性别角色信念通过妻子的母亲身份重要性间接影响不孕对妻子生活的影响，但妻子的性别角色信念并不能显著预测丈夫的生育压力; (3有调节的中介模型:不孕原因的一个哑变量(即女性特异性不孕相对于共同/未知原因不孕)在“丈夫的性别角色信念一妻子的母亲身份重要J陛一不孕对妻子生活的影响”这一中介路径中起到调节作用。具体来说，对于女性特异性原因不孕的夫妇，丈夫的性别角色信念直接作用于不孕对妻子生活的影响;对于共同/未知原因不孕的夫妇，妻子的母亲身份重要性中介了丈夫性别角色信念与妻子不孕对生活影响的关系。

讨论:(1) 无论男性还是女性，社会文化对性别角色的规范都能通过个体内化的信念，影响他们在不孕时感受到的生育压力。不孕不育不应被看作普通的生理疾病，而应被看作社会文化影响下的一种复杂的社会问题;(2>不孕夫妻内部的相互影响是不对称的，只有丈夫的性别角色信念能显著预测妻子的生育压力，可能与中国传统男权思想影响下男性更强大的话语权与对子嗣的看重有关;(3)女性特异性不孕的夫妇中，女性的母亲身份重要性并没有因为自己及丈夫的传统性别角色而加强，这可能反映了这些女性在“自己不能生育”与“应该有孩子”的认知失调下的态度改变。

In China, up to 7.4 percent of couples are diagnosed with infertility. For most couples and individuals, childbearing is expected to be an inevitable event after marriage. Therefore, infertility, as a stressor, could threaten the controllability of the marriage. Fertility is associated with failure of social roles, but few studies has investigated the infertility stress from a socio-cultural perspective. The present study attempted to explore the relationship between infertile couples' gender role beliefs and their infertility stress, as well as the moderation effect of infertility reason.

Study 1: Objectives: to explore the relationship between females' gender role beliefs and their infertility stress as well as the moderation effect of infertility reason at an individual level. Methods: participants: 284 infertile female patients in a hospital in Beijing. Measures: a demographic questionnaire, Gender Role Belief Scale (GRBS), and Fertility Problem Inventory (FPI) were used. Statistics: moderated mediation model analysis was adopted. Results: (1) Infertile females' gender role beliefs (higher score means more traditional gender role beliefs) positively significantly predicted their infertility stress. (2) Representations about the importance of parenthood mediated the association between gender role beliefs and the impact of infertility on life domain. (3) Moderation analysis indicated that, for women with nonfemale-specific-factor infertility (i.e. the male factor, both factor or unknown factor infertility), the relationship between gender role beliefs and representations about the importance of parenthood was significant; in contrast, this relationship did not exist among women with female-specific infertility.

Study 2: Objective: to investigate the effect of gender role beliefs on one's and his/her spouse's infertility stress, as well as the moderation effect of infertility reason at a dyad level. Methods: participants: one hundred and sixty-five infertile couples in a hospital in Beijing. Measures: as same as study 1.Statistics: Actor-Partner Independence Model were adopted. Results: (1) Actor effect: both male's and female's gender role beliefs positively predicted the impact of infertility on their own life domain; Partner effect: husbands' gender role beliefs made effect on the impact of infertility wives' life domain through wives' importance of motherhood. In contrast, In contrast wives' gender role beliefs did not predict significantly the husbands' infertility stress; (3) Moderated mediation model: one of the dummy variable of infertility reason (i.e., female-specific reason versus common/unknown reason) played a moderating role in the mediation path of "husbands' gender role beliefs, wives' importance of motherhood, and the impact of infertility on wives' life domain". Specifically, for couples with female specific infertility, the husbands' gender role beliefs made direct effect on the impact of infertility on wives' life domain. For couples with common/unknown infertility, wife's importance of motherhood mediated the relationship between the husbands' gender role beliefs and the impact of infertility on wives' life domain.

Discussion: (1) For both men and women, sociocultural norms of gender roles

could make effect on patients' infertility stress, by means of their internalized gender role beliefs. Infertility should not be regarded as an ordinary physical disease, but as a complex social problem under the influence of social culture; (2) The interaction between husbands and wives within the dyads is asymmetrical. Only husbands' gender role beliefs could predict wives' infertility stress, which may be due to men's stronger decision-making power and higher emphasis on heirs, in the background of traditional Chinese patriarchal thoughts; (3) For couples with female-specific infertility, females' importance of motherhood was not enhanced by traditional gender role beliefs of themselves and their husbands. The reason may be the attitude change under the cognitive dissonance as they have to face two conflicting thoughts: "I am infertile" and "I should have children".