The role of dispositional and situated optimism in psychological adjustment to high-risk pregnancy

Abstract

Background: The uncertainty and lack of control involved in high-risk pregnancy (HRP) expose women to stressors beyond those experienced in low-risk pregnancies. Hence, their psychological adjustment is expected to be lower compared to low-risk pregnancies. Dispositional optimism is known to be related to better outcomes in health risk settings. According to Carver and Scheier's theory of self-regulation, this association should be partially mediated by situated optimism, yet existing research is equivocal. Methods: Pregnant women were recruited at women's health centers and pre-natal classes (high-risk n=228; low-risk n=160). All participants filled in measures of distress and well-being; HRP also rated optimism, maternal-fetal attachment, perceived uncertainty, treatment control and personal controllability. Findings: Psychological adjustment was lower among women in HRP (ts>2, ps<.05). Dispositional optimism, lower perceived uncertainty regarding the pregnancy, treatment and personal control were related to better psychological adjustment to HRP. Regression models using PROCESS showed that situated optimism (=perceived uncertainty) mediated the associations between dispositional optimism and wellbeing/distress, controlling for control perceptions and already having children (e.g., for distress Rsquare=.21, direct effect=-.18, p=.03, indirect effect=-.16, p<.001). Attachment was related only to treatment and personal control. Discussion: The findings support the assertion that dispositional optimism may operate via situated optimism. When possible, and especially for women low in dispositional optimism, it is important to promote situated optimism by relieving unnecessary uncertainty and providing confidence in the treatment; when impossible, women with HRP may need more psychosocial support to facilitate adjustment. Perceived lack of control can impede the normal attachment process.