'H-“‘\" unmv This is to certify that the dissertation entitled A COMPARATIVE ANALYSIS OF EXPECTANT FATHERS 0N COUVADE SYMPTOMATOLOGY AND ASSOCIATED PERSONALITY TRAITS presented by Normand Adrien Gilbert has been accepted towards fulfillment of the requirements for __Eh_.JL_degree in heantLEdusation, Counseling Psychology, and Human Performance Major sor Date May 6, 1987 Mr!).'.,... Arr .- A v :-1 ”L v , . . 0‘1 1 MSU RETURNING MATERIALS: Place in book drop to LJBRARJES remove this checkout from —_ your record. FINE_S_ will be charged if book is returned after the date stamped below; Mic . ' x00 02; W" was T.n‘; 0 3 ":“"3 \II ‘u. ' “.V‘ ‘i- '0’“; V“ A (DWARATIVE ANALYSIS OF EWECTANT FATHERS (N (DUVAII SYMPTOMATQmY IND ASSOCIATED PERSGIMITY TRAITS By Normand Adrien Gilbert A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirenents for the degree of IDCTOR OF H‘I ILOSOH'IY Department of Health Education. Counseling Psychology. and Hunan Performance 1987 Copyright by NORMAND ADRIEN GILBERT I987 ABSTRACT A mMPPRATIVE ANALYSIS OF EXPECTANT FATHERS m COUVAII SYMPTOMATOLGSY AND ASSOCIATED PERSONALITY TRAITS By Normand Adrien Gilbert This study examined psychophysiological symptans of expectant fathers. Anecdotal and empirical reports in the literature have suggested the presence of a specialized group of functional symptans some expectant fathers experience. The purpose of this study was to clarify whether noted symptans (toothaches. indigestion/heartburn. nausea. stanach aches. vaniting. diarrhea. constipation. leg aches. stanach swelling. weight gain or weight loss [unplanned]. sties on the eyelid. excessive fatigue. and loss of appetite/increased appetite) constitute a syndrane or merely are related to other symptans asso- ciated with general anxiety. The association of personality traits and acute couvade symptomatology of expectant fathers was assessed. The relationship of expectant fathers' partners' functioning with couvade symptanatology was also considered. Fifty-two cohabiting expectant parents in their third trimester of pregnancy volunteered to participate in this study. Subjects were asked to oompl ete two questionnaires. The General Information Ques- tionnaire sought pertinent danographic and historical information and Normand Adrien Gilbert included a checklist of symptans (couvade and anxiety symptoms) on whose frequency and severity respondents reported. A distinction was made between chronic and acute symptanatol ogy. with interest in con- si dering only those symptans associated in a timely fashion with the period of the pregnancy. The Personality Research Form--Form E devised by Jackson (l984) was used to assess functioning along eigit personality traits (affiliation. nurturance. exhibition. social recog- nition. aggression. defendence. autonomy. and succorance). Two groups were fanned. based on the degree of acute couvade symptomatology reported by expectant fathers. A highly acute- symptanatic group was canpared to a group of nonsymptanatic expectant fathers. Sample means were compared on the variables under consideration. using a .t-test. Significance was set at the .05 level. Highly acute- symptomatic expectant fathers exhibited sigtificantly more chronic couvade symptans. as well as chronic anxiety symptans. than did nonsymptanatic expectant fathers. The highly acute-symptanatic group also exhibited a significantly higher degree of nurturance than did the nonsymptanatic expectant fathers. Partners of higily acute- symptanatic expectant fathers exhibited a significantly less degree of nurturance than did partners of nonsymptomatic expectant fathers. Additional correlational analyses canparing all expectant fathers on the variables under consideration supported the group differences noted in the canparative analyses. This dissertation is dedicated to Edouard and Jeanne. my parents. whose thwarted aspirations for education were to be overshadowed by their support of and pleasure in their chil dren's academic achievements. ACKNCMLEIISILENTS The canpletion of this study was accanplished with the support and guidance of many individuals. I wish to thank the menbers of my dissertation camnittee. Dr. Richard Johnson. who served as director and chairman along with Dr. Killian Hinds; Dr. Gilbert DeRath; and Dr. Christine Shafer. Their personal interest. availability. and support were appreciated. This committee's broad range of expertise provided the guidance fran the inception of this study to accanplish a unique and worthwhile research investigation. In addition. acknowledgnents are extended to the following individuals: Lynn Snellman. for her availability in providing me valuable consultations regarding the retrieval and analysis of data for this study; Susan Cooley. for her efficient work in typing and exper- tise in editing this dissertation; Annette Whiting. for her availabil- ity and thoroughness in data preparation and coding of questionnaires; . the staff and physicians of area hospitals. clinics. and offices pro- viding services to expectant parents. for their help in securing sub- Jects for this investigation; and Richard Hechtl. Professor of Psychology at St. Anselm College. for his challenging support that encouraged me to pursue graduate studies in psychology. vi TABLE OF (DNTENTS Page LIST OF TELES O O O O O O O O O O O O O O O O O O O O O O O O 0 ix Chapter I. II. III. IV. RATIONN-E FOR ME stY O O O I O O O O O O O O O O O O 1 Introduction and Statanent of the Problem . . . . . . 1 Purpose 0 C O O O O C O O O O O O O O O O O O O O O O 2 Limitations and General izability of the Study . . . . 5 Overview of the Remainder of the Dissertation . . . . 6 REVIEWOFTHELITERATURE................ 7 Historical Roots of Couvade Syndrane . . . . . . . . . 7 The wwade R1tua1 O O O O O O O O O O O O O O O O O 7 “ma“ syndrane O I I O O C O O I O I O O O O O O O O 1] Prevalence of Couvade Syndrane . . . . . . . . . . . l2 Theoretical Foundations of Couvade Syndrane . . . . 16 smary O O O O O O O O O O O I O O O O O O O O O O O 26 EmomLmY O O O O O O O O O O O O O O O O O O O O O O 27 IntrOdUCt1 on O O O O O O O O O O O O O O O O O O O I O 27 SUbJeCtS O O O O O O O O O O O O I O O O O O O O O O O 27 Instrunentation................... 28 The General Information Questionnaire . . . . . . . 28 Personality RGSGBT'CI'I Pom-Form E o o o o o o o o o 30 Data-MEIYS‘IS PT‘OGdUI‘BS o o o o o o o o o o o o o o o 33 HyPOtheses O O O O O O O O O O O O O O O O O O O O O O 33 RESULB O O O O O O O O O O O O O O O I O O O O O O O O 34 Descriptive Information on the Sample . . . . . . . . 35 Results of Hypothesis Testing . . . . . . . . . . . . 4T Results of Supplementary Canparative Analyses . . . . 47 Results of Correlational Analyses . . . . . . . . . . 50 Smary 53 vii. V. SJIMARY. LIMITATIWS. COIQUSIWS. Sunmary . Limitations .......... Conclusions.......... Couvade and Anxiety Factors . Personality Factors--Expectant AND RECOMMENDATIGIS Fa thers Personality Factors--Personality Traits of Partners of Highly Acute-Symptanatic Expectant Fathers 0 O O O O O O O O O O O O O I O O O 0 Recommendations ........... APPEN DI x O O O O O O O O O O O O O O O O O O O O O O O O O O REFERENGS O O O O O I O O O O O I I O O O O O O O O O O O 0 viii Ta bl e 3.1 3.2 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 LIST OF TABLES Reliability Scores of Two Samples on Eight Pertinent Scales of the Personality Research Form--Form E . . Convergent Validity Scores of a College Sample on Eight Pertinent Scales of the Personality Research Fom--Fom E O O O O O O O I O I O O 0 O O O O O O 0 Identifying Data on Expectant Parents . . . . . . . . . Frequency Distribution on Nunber of Years Married for Married Expectant Parents . . . . . . . . . . . . . Racial or Ethnic Origins of Expectant Parents . . . . . Religious Affiliation of Expectant Parents . . . . . . Occupation of Expectant Parents . . . . . . . . . . . . Frequency Distribution of Couvade I and Couvade II . . Reliability Scores for Personality Traits of Expectant Fathers 0 O O I I O O 0 O O O O O I O O O O O O O 0 Reliability Scores for Couvade I and II. Anxiety I and II. and Personality Traits of Partners of Expectant Fathers 0 O I O O I O O O O O O O O O O O O O O O 0 Descriptive Data on Asymptomatic and Symptanatic CouvadeSyptanatolog ............... Results of t-Test for Hypothesisl . . . . . . . . . . Results of .t-Test for Hypothesis 2 . . . . . . . . . . Results of .t-Test for Hypothesis 3 . . . . . . . . . . Results of I-Test for Hypothesis 4 . . . . . . . . . . Results of .t-Test for Hypothesis 5 . . . . . . . . . . RBSUItS Of I-TGSt fOI‘ HypOthGS‘IS 6 o o o o o o o o o o Page 31 32 36 36 36 37 37 39 41 41 42 44 44 45 45 46 46 4.16 4.17 4.18 4.19 4.20 4.21 4.22 Results of x-Test for Hypothesis 7 . . . . . . . . . ReSlntS 0f I-TeSt for Hymthes1s 8 o o o o o o o o 0 Results of .t-Test for Chronic Couvade Symptcmatol ogy (cal-Iva“ I) O O O O O O O O O O O O O O O O O O 0 Results of .t-Test for Chronic Anxiety Symptans (Anfiety I) O O O I O O O O O O O O O O I O O O 0 Results of .t-Test for Partner's Anxiety I . . . . . . Results of .t-Test for Partner's Nurturance . . . . . Pearson Correlation Coefficients (L) for Dependent Variables: All Expectant Fathers . . . . . . . . Pa ge 47 47 48 48 49 49 51 CHAPTER I RATICNALE FOR THE STUDY Intmducflmanmmembflmbhm Most research on expectant parenthood has focused on expectant mothers. Accordingly. expectant fathers have lacked a group identity and have been relatively ignored (Zal R. 1980). Underlying this situation is the stereotypical view and expectation that the male's role is merely to impregnate. and once this has occurred. his role is secondary or supportive (Jessner. Weigert. & Foy. 1970). Enhancing such beliefs have been traditional psychoanalytic conceptual izations that have accorded little importance to the father's role during the preoedipal stages of his child's development (Burlingham. 1973). Recent developments have aroused interest in research on expect- ant fathers. Jessner et al. H970) noted changes in thought. enhanc- ing the importance of fathers in child devel opnent. The authors suggested that the presence of sociological shifts. particularly those occurring in the urban family. along with cultural redefinitions of masculinity. have contributed to an understanding of the role of fathers in this developnental process. Shifts in theoretical anpha- sis fran the traditional psychoanalytic conceptual izations to more current ego-devel oprnental. object-rel ations perspectives have helped foster an interest in the role of fathers. Such theories view the father as playing an important role in the separation/individuation process. which is intrinsic to identity formation (Ross. 1979). Research on aspects of expectant fatherhood is needed. particularly when expectant parenthood is conceptualized. not as a single event. but as a devel opnental process (Benedek. 1959; Ross. 1979). Benedek (T959. l970b) viewed parenthood as a developmental process. possessing instinctual roots related to the procreative drive. As do other stages of development. expectant fatherhood is likely to present stress. It is during devel opnental "crisis" periods that one is likely to experience regression. Given the circumstances surround- ing the pregnancy. expectant fathers are likely to experience an awakening of aggressive and sexual impulses (Ginath. l974). In addi- tion. a resurgence of primitive preoedipal conflicts (maternal envy. fear of engulfment. and deprivation) may occur (Gurwith. l976). Batman The present study concerns the developmental process of expectant fatherhood. Relatively few researchers have investigated this devel- opmental-crisis period. In this study. particular attention was focused on expectant fathers' psychophysi ol ogi cal symptomatol ogy si 9- nalling stress during their partner's pregnancy. Specific symptans described in the literature as the couvade syndrane suggest the pres- ence of a specialized phenanenon. This investigator assessed the presence of such symptans. The targeted symptans were toothaches. indigestion/heartburn. nausea. stanach aches. vaniting. diarrhea. constipation. leg aches. stomach swelling. weight gain (not planned). weight loss (not planned). sties on the eyelid. excessive fatigue. loss of appetite. and increased appetite. An effort was made to clarify whether noted symptoms represent a distinct group of symptoms that comprises a syndrome or are merely related to other symptoms associated with general anxiety. To date. investigators have assuned. perhaps erroneously. the presence of a syndrome such as couvade. In previous analyses of psychophysiological symptomatology of expectant fathers. attention has been focused on the functional nature of these symptoms. with particular attention to associated psychologi- cal experiences and processes such as anxiety. depression. guilt. aggression. dependency. and identification. Although helpful in rais- ing questions about the phenomena of expectant fatherhood. findings in the literature have spawned more controversy than they have answered questions. Noticeably absent have been investigations of the "core" concepts that motivate behavior and play a more dynamic role in the psychological symptoms experienced. This researcher considered cou- vade symptomatology and its association with personality traits or needs. Such a study was needed to acquire a fundamental understanding of the crisis nature of expectant fatherhood and the dynamics of couvade symptonatol ogy. Anecdotal reports in the literature have discussed the role of dependency needs relative to couvade symptonatology. Based on such reports and personal interest. the researcher considered personality traits related to interpersonal orientation. using Jackson's (1984) Personality Research Form. Measures of orientation to others (dependence/attachment) were obtained by assessing eight specific traits. The defining trait adjectives. as noted in the test manual (Jackson. 1984) are as follows: Affiliation: "Neighborly. loyal. warm. amicable. good-natured. friendly. conpanionable. genial. affable. cooperative. gregarious. hospitable. sociable. affiliative. good-willed" (p. 6). Nurturance: "Sympathetic. paternal. helpful. benevolent. encouraging. caring. protective. comforting. maternal. supporting. aiding. ministering. consoling. charitable. assisting" (p. 7). Exhibition: "Colorful. entertaining. unusual. spellbinding. exhibitionistic. conspicuous. noticeable. expressive. ostentatious. immodest. demonstrative. flashy. dramatic. pretentious. showy" (p. 6). Social Recognition: "Approval seeking. proper. well-behaved. seeks recognition. courteous. makes good impression. seeks respecta- bility. acconmodating. socially proper. seeks adniration. obliging. agreeable. socially sensitive. desirous of credit. behaves appropri- ately" (p. 7). Measures assessing orientation away fron others (independence/ separation) were obtained by assessing the following traits (again with trait adjectives given in the test manual): Aggression: "Aggressive. quarrel sone. irritable. argunentative. threatening. attacking. antagonistic. pushy. hot-tempered. easily- angered. hostile. revengeful. belligerent. blunt. retaliative" (p. 6). Defendence: "Self-protective. Justifying. denying. defensive. self-condoning. suspicious. secretive. has a 'chip on the shoulder.‘ resists inquiries. protesting. wary. self-excusing. rationalizing. guarded. touchy" (p. 6). In addition. one's need for direction fron others was assessed to consider further the measures of degree of dependence in contrast to measures of autonomy. Hence the following traits were measured (as described in the test manual): Autonony: 'Urlnanageable. free. sel f-rel iant. independent. autonomous. rebellious. unconstrained. individualistic. ungovernable. self-determined. non-confonning. uncompliant. undominated. resistant. lone-wolf" (p. 6). Succorance: "Trusting. ingratiating. dependent. entreating. appealing for help. seeks support. wants advice. helpless. confiding. needs protection. requesting. craves affection. pleading. help- seeking. defenseless" (p. 7). It was expected that couvade fathers would exhibit a greater need for interpersonal relations and attachment than noncouvade fathers. while exhibiting less need for independence and autonony. The find- ings of this research should make a valuable contribution to the literature on expectant fathers. particularly in relation to an ego developmental/object relations perspective of this phenonenon. LimitationLandfieneLaJJzabflJtLoLtheJndx As in any investigation. certain limitations were realized. A primary one concerned the use of volunteers as subjects for the study. Volunteers are likely to differ fron the general population of expect- ant fathers. Also. although the researcher attonpted to obtain vol un- teers in both urban and rural areas. the sampling was limited to a relatively small area in mid- and western Michigan. Such factors could limit the general izability of findings of the present study and are discussed further in Chapter V. W Chapter II contains a review of pertinent literature in which a distinction is made between the couvade ritual and couvade syndrone. The historical roots and theoretical underpinnings of couvade syndrone are best understood by considering the couvade ritual. Thus both the practice and underlying beliefs of the couvade ritual are discussed before the literature on couvade syndrone is examined in detail. The methodology of this investigation is described in Chapter III. Included is a discussion of the assessment tools. along with a state- ment of the research hypotheses and a description of the subjects used in the study. Results of the analysis of data. including graphic displays of the findings. are found in Chapter IV. Chapter V provides a sunmary of the results of this study. Special consideration is given to particular problems encountered in the study. Further topics of investigation are also suggested. CHAPTER II REVIEW OF THE LITERATURE In this section. a brief review of the couvade ritual (as distinguished fron couvade syndrone) is provided to help readers understand the historical roots and theoretical underpinnings of couvade syndrone. This is followed by an exanination of the writings on couvade syndrone--its prevalence and theoretical foundations. WWW mutual Historical and anthropological writings and investigations of ritual practices in primitive cultures have provided nunerous accounts of the couvade ritual. Driver (1964) sunmarized historical reports on couvade practices over the centuries. Studies of couvade have dichoto- mized the ritual forms based on observations of its practices. although the presence of the practices in their "pure" form is atypical. Two maJor types of couvade ritual have been described: (a) pseudomaternal and (b) dietetic. Pseudomaternal practices involve the representation or simulation of childbirth by the father. Underlying such primitive practices is the magical belief that imitating the birthing process will relieve the mother while she is in labor. Reik (1946) reported that an "animistic system of thought" is the foundation of the practice. whereby imitation of a process brings on the process itself. In this case. the process is a means of relieving maternal pain. In dietetic rituals. it is custonary for the father (and. on occasion. the mother) to avoid particular behaviors and to abstain fron certain foods. Such practices are based on the belief that the father's relationship to the child is so close that the food he con- sunes or the behaviors he performs will directly affect the child. The driving point of both forms of couvade ritual is the highly visible role and involvement of the father in the birth process. Conmon to both practices is the apparent incapacitation of the father following the child's birth. In certain cases. as well. such as in Black Carib Indian ritual practices. it is custonary for the father to be subjected to physically painful experiences (Reik. 1946). The theoretical Zeitgeist has influenced explanations of couvade practices. Before the turn of the century. such explanations centered on evolutionary thoughts. Munroe. Munroe. and Whiting (1973) sunmarized explanations postulated by Bachofen. Tylor. and Frazer. Sone explanations. such as those espoused by Bachofen in 1861. viewed couvade practices as fathers' attempts to establish or legalize their paternity in societies practicing "motherright." Munroe et al. noted that. in 1889. Tylor contended that such practices were a sigial of change in a society moving from a matrilineal to a patrilineal organization. Such views were soon overturned and replaced by more "current" theories (such as Frazer's). influenced by the emergence of Freud's dynanic conceptual izations. which focused attention on the irrational and unconscious source of behavior. Primitive instinctual theories have also been postulated as an explanation of couvade practices (Mal inowski. 1927). Theorists espousing this view believe the custon of couvade enhances a father's "natural" interest in his offspring. They also maintain that couvade custons are the result of underlying instinctual impulses between a father and his child. which are accentuated or supported by societal practices and reaffirm "the child's need for a father." With the development of Freud's psychoanalytic concepts. particularly those related to drive theory. dynanic explanations of couvade practices gained proninence. The heigitened interest in psychological factors underlying hunan behavior appears to have provided the impetus for sounder investigations and explanations of the couvade ritual. Fron this perspective. rituals are associated with man's irrational or instinctual functioning. The restrictions observed in couvade ritual are viewed as relating to the conflict present between the father's sexual and aggressive drives and society's needs and expectations. Rituals have thus been viewed as forms of displacement (Reik. 1946). In couvade practices. impulses to kill the child are countered by restrictions on behavior. at times expiative. thus pronoting the needs of society. The rekindling of oedipal conflicts is thought to be the dynanic source of behaviors. particularly when the newborn is male. Under this framework. sadistic impulses are redirected into more lO "acceptable" masochistic behaviors (i.e.. dietetic restrictions. emascul ation by relatives and friends) (Malinowski. 1927; Rei k. 1946). In psychoanalytic writing. anbivalence is characteristic of all relationships. Hostility toward the wife is also thought to be a source of conflict. Thus. in couvade practice. what ronains conscious is the loving. involved aspect of the husband's ambivalence toward his wife. The husband's hostility ronains unconscious. 'His unconscious hostility tempts him to obtain pleasure out of the sight of the wonan's pains. and thus tonptation is severely repulsed by the conscious part of his mental life" (Reik. 1946. p. 50). Given the irrational conponents of behavior. the couvade ritual serves two social purposes. The primary one is to protect the wonan and child fron the hostility and sexual aggressiveness of the father. The second is to mitigate labor pains (Reik. 1946). Psychoanalytic thoughts regarding couvade practices were chal- lenged by explanations based on identification theories. Reik (1946) believed the identification process is a plausible explanation of pseudo-maternal couvade practices. Identification theories have served as a foundation for subsequent socio-anthropological inquiries of couvade practices. Munroe. Munroe. and Whiting (1973) undertook a psychological study of couvade practices by the Black Carib Indians of British Honduras. A basic pronise of this study was that the "sociocultural" envirorment of female salience reflected in matri-oriented societies ll contributes to the development of ritual couvade. the primary underlying psychological process being cross-sexual identification. To support their views. they cited a 1958 anthropological report by Whiting. Kluchohn. and Anthony. who found that societies having puberty rites (clearly defined sex-role behaviors) did not practice ritual couvade. Their study. bridging the gap between the ritual couvade and couvade syndrone. went on to assess cross-sexed identi- fication by way of behaviors manifested and language used by males in this tribe. Reported cases of intensive (versus nonintensive) symp- tonatol ogy (i.e.. toothaches. daytime sleepiness. fatigue. food crav- ings. fever. giddiness. headaches. and voniting) were associated with significant differences in sex-role preferences and language usage. The group with intensive symptonatol ogy was also found to have expe- rienced significantly more instances of male absence. Rendering ques- tionable the results of this study were the operational definitions of sex-role identification. as well as the methodology used. which relied on "reported" rather than directly observed behaviors. The authors noted the need for further research before attributing responsibility to the role of sex-role identification in couvade practices. Couvadflxndmme Couvade syndrone. derived fron the French word miller. meaning to brood or to hatch. refers to psycho-physiol ogical symptons noted in expectant males during pregnancy. Symptons are often similar although not limited to those experienced by the expectant mother. Such symp- tons. given their timeliness and functional nature. can be assuned to 12 be a function of defense mechanisms fron a psychoanalytic orientation. Symptons are essentially attonpts to redirect internal drives. fears. and conflicts that are burgeoning for expression yet threaten the ego's integrity. The roots of the couvade syndrone appear to be embedded in history. The couvade ritual. a practice of primitive cultures. provides the prototype or foundation on which the couvade syndrone rests. One might view the couvade syndrone as a progression in onotional development and civilization fron the couvade ritual. Reik (1946) suggested that couvade practices mark a "nodal point" in man's devel opment. practices enabling man to "redirect the hate toward the wonan and the child into love." Repression is increasingly practiced as the civilization progresses. diminishing the need for more primi- tive rituals and external sources of control. Freeman (1951) con- curred with this concept. noting the protective role rituals play in dealing with instinctual drives in primitive societies. Sympton mani- festations are thus viewed as serving a similar protective function in more civilized groups or. as Freeman suggested. "civil ized neurotics." WWW As mentioned above. couvade syndrone is manifested by physiol ogi- cal symptonatology of expectant fathers during pregnancy or at the time of parturition. A variety of symptons have been docunented (Cavenar 8. Weddington. 1978; Trethowan. 1968. 1972; Trethowan 8. Conl on. 1965). In an investigation of 90 eiqaectant fathers. Trethowan 13 (1972) found that couvade symptons were likely to occur fron the end of the second to the middle of the third month of pregnancy. Symptons most counonly reported were nausea and voniting (20%). toothaches (25%). and indigestion and heartburn (25%). Symptons were likely to be experienced during the third month of pregnancy and at times persisted throughout the pregiancy. Trethowan (1968) also reviewed other studies on couvade syndrone and found incidence rates varying fron one in nine expectant fathers (Trethowan. 1958) to one in two (Dickens 8. Trethowan. 1971). Trethowan asserted that a more accurate incidence rate is about one in four or five expectant fathers. This disparity may be a result of differences in the operational defini- tions that have been used in distinguishing the couvade syndrone. Trethowan and Conlon (1965) conducted a descriptive study on the couvade syndrone. comparing 327 expectant fathers and 221 controls (matches for social and occupational status). Expectant fathers experienced significantly more symptons than controls. Most-proninent symptons noted were loss of appetite. toothaches. and nausea. The incidence rate of couvade syndrone was found to be one in nine expectant fathers or 11%. provided that the criterion for what was viewed as couvade syndrone was set at two or more symptons. A sig- nificant relationship was also found between presence of symptons and the experience of minor psychiatric disorders. namely anxiety. depres- sion. tension. insonnia. and irritability. In one-third of the cases. symptons dissipated before delivery. In another third of the cases. symptons cleared following the birth. In approximately one-fourth of 14 the cases. the symptoms persisted after birth. Concerns with this study involve the methodology used. particularly the use of matched groups (for certain factors) while not controlling for other factors. such as age and nunber of previous pregwancies (the authors noted that the control group had experienced a greater number of pregnancies). Of interest was the apparent association between couvade syndrome and mental illness. Such an association was also discussed in a review by Trethowan (1968). Anecdotal reports have noted the association between couvade symptonatology and mental illness. Towne and Afterman (1955) observed a temporal relationship between couvade symptons and psychoses. They noted. however. that most of the observed cases had previous psychiat- ric histories. Jarvis (1962) reviewed four psychiatric cases in which couvade symptomatology was related to psychiatric illness. ranging from neurosis to overt psychosis. Wainwright (1966) reported ten case histories of hospitalized male psychiatric patients who had recently become fathers. cavenar and Weddington (1978) reviewed three psychiatric histories of males who were either expectant or new fath- ers. The findings of both studies strongly suggested that symptoma- tology was closely associated with severe emotional dysfunction. Lipkin and Lamb (1982) conducted an epidemiological retrospective study on couvade syndrone. The authors found couvade syndrone to be an appropriate psychosomatic illness because it met the criteria of being common. clearly identifiable. and distinguishable from other physical dysfunctions. The medical records of 267 new fathers were 15 analyzed. based on a systematic random sample of 300 couples. Records were all part of a 36.000-member health maintenance organization. Targeted symptons were those acknowledged in the literature as being symptonatic of couvade illness: nausea. voniting. anorexia. abdoninal pain. bloating. and other symptoms (weight and bowel changes. tooth- aches. concerns about skin lesions. growths and inclusions. leg cramps. faintness. and lassitude). Each patient served as his own control. Couvade was defined as involving one or more of the above- mentioned symptoms not manifested during pre- (6 months before preg- nancy) and post- (6 months and 2 weeks after delivery) control periods. The researchers used an analysis of variance repeated-measures procedure. Aflmost 23% of the new fathers were found to have couvade symptonatology. Couvade men sought medical attention twice as often during the pregnancy as did noncouvade fathers and in comparison to their own nunber of visits before and after the pregiancy. Couvade fathers had four times as many symptoms as during control periods and received twice as many prescriptions for medication as did men without the syndrome. The authors reported that their findings were likely to underestimate the prevalence of couvade syndrome. given the size of the sample and the fact that use of services was a criterion on which findings were cited. l6 IbeoceticaLEoundationst Wm. Various theoretical models have been postulated in conceptualizing the couvade syndrone. Psychodynanic tenets using major theoretical concepts of anxiety. guilt. dependence. hostility. envy. aggression. and identification have been noted in the literature. All have viewed expectant fatherhood as a crisis period. Col man and Colman (1971) concurred with the crisis model for expectant fatherhood; they sug- gested that pregnancy is a time of great psychological change. given alternations of roles and identities. As well. they suggested that expectant fatherhood is a frustrating experience because fathers' participation is vicarious--they often defer the masculine role to the obstetri ci an. Jacobson (1950) addressed the role of pregnancy in pronoting oedipal and preoedipal fantasies. which she viewed as being driven by sexual frustrations encountered during pregnancy. The sexual frustration experienced by expectant fathers was further supported by Hartman and Nicol ay (1966) in their comparative analysis of arrest records of males (expectant versus nonexpectant). They found that expectant fathers conmitted significantly more sexual offenses than nonexpectant males. Exhibitionism and pedophilia accounted for more than 66% of these offenses. The authors attributed the findings to stress and a conconitant regression relative to sexual expression. The role of regression and subsequent erotization of previous stages of development was also cited by 211 boorg (1951). 17 Those espousing a psychodynamic/ego-developmental perspective view couvade symptons as physical manifestations of underlying enotional conflicts. Several researchers have found anxiety to be a discriminating factor exhibited by expectant fathers (Davis. 1977; Gerzi & Berman. 1981; Trethowan. 1968). Anxiety. a sympton signaling conflict. has been considered a hallmark of neurosis. Greenacre (1952) theorized a "predisposition" to anxiety; the prototype is one's birth. which marks the initial separation of the individual fron his/ her mother. He further cl aimed that anxiety increases one's level of narcissism. which in turn results in inadequate development of one's sense of reality. Under this model. individuals who are subject to greater degrees of anxiety at early periods are more likely than others to suffer fron the effects of increased narcissism. Trethowan (1972). who believed that the anxiety manifested by expectant fathers was neurotic in nature. found a strong relationship betnween sonatic symptons and anxiety. Cavenar and Butts (1977) supported Trethowan's viewpoint in a review of four clinical case studies. They found that couvade symptons were characteristic of those possessing neurotic character disorders and neuroses. Recent studies on expectant fathers have used more rigorous methodologies than the heavily weighted anecdotal reports. Gerzi and Berman (1981) undertook a conparative study of 51 expectant fathers and 51 married men without children. The two groups were matched for educational level. age. and length of time married. Using the IPAT Anxiety Scale. the Blacky Picture Test. and interviews. the 18 researchers found statistically significant differences between groups. Expectant fathers exhibited a significantly greater degree of anxdety than the married men without children. 0n the Blacky Picture Test. the experimental group exhibited strong oedipal intensity. sib- ling rivalry. and guilt feelings. In interviews. expectant fathers expressed a rearousal of infantile fantasies. feminine identification. castration fears. and oedipal themes. The findings of this study were interesting. but concerns remain about the use of matched groups and the questionable validity and reliability of measures onployed. .Dannassinnz_guiltz_anfi_£11alny. Depression associated with underlying feelings of guilt was cited in the literature as an explanation of the manifestation of couvade symptomatology. Zilboorg (1931) presented an explanation of the stress of expectant fatherhood and its concomitant symptonatology. His explanation. rooted in psy- chodynamic theory. was that the expectant father experiences strong incestuous drives. and guilt thus ensues. The accompanying guilt drives the male into a "passive homosexual state." in which he expe- riences a sense of conflict because what he wants (masculinity and parenthood) is what he fears. as well. Zilboorg stated that certain symptons were related to depression. which he saw as a form of eno- tional repression. Parental depression. he suggested. is a function of denying parenthood because of underlying guilt about incestuous feelings. The author said gastro-intestinal complaints are related to the regression to "anal-sadistic eroticism." which often accompanies depression. He discussed the role of primitive identification in 19 depression and noted its presence in both clinical psychopathology and the unconscious fantasies of patients undergoing psychoanalysis. Zil boorg went on to theorize that feelings of envy (of wife) increase the father's hatred of the child. In his analysis of psychopathology of expectant fathers. Freenan (1951) attributed difficulties to guilt and hostility. given a rearousal of oedipal conflicts. He posited that the rivalry men originally felt toward their own fathers is reactivated during pregnancy. The child is thus viewed as a new representation of the expectant father's own father. Trethowan (1972) also addressed the presence and dynamics of hostility relative to couvade symptonatology. Like Rei k. he contended that ambivalence accompanies every onotional relationship. Thus. marriage itself is subject to feelings of ambivalence. Trethowan began by assuning there is a basic antagonism between husband and wife. Couvade symptons are believed to be related to defensive attempts to assuage feelings of guilt. Guilt is aroused because of fantasies of impregnating one's wife out of hostility. coupled with the wonan's apparently increased vulnerability and jeopardy during pregnancy. Similar to Freeman (1951). Trethowan viewed symptons as being related to feelings of rivalry experienced by the expectant father. who likely views the child as a rival for his wife's attention. given her hei gntened level of introspection and withdrawal during pregnancy. 20 Identification. Associated with concerns regarding preoedi pal and oedipal development is the role of identification. Boehm (1930) addressed the notion of parturition envy. which he viewed as a negative oedi pal reaction whereby men envy a wonan's capacity to bear children. In a discussion of preoedi pal devel oornent. Mack-Brunswick (1940) suggested that the wish to have a child is a function of a primitive identification with the "active" mother. The anal phase of develop- ment. with the modes of giving and receiving. is realized in the child's wish to give his/her mother a child. In normal devel opnent. the passive role assuned by the preoedipal male. marked by identifica- tion with the active mother. is replaced by identification with the father. Fron this perspective. couvade symptonatology can be viewed as a form of regression in the identification process. Evans (1951) discussed male hysterics presenting couvade symptona- tol ogy. He said that couvade symptons are related to fears of castra- tion and onphasized that unresolved oedi pal conflicts contribute to difficulties in the identification process. Jessner et al. (1970) believed that couvade is essentially part of a husband's identifica- tion with his spouse. Jaffe (1968) said that couvade results fron masculine envy of a wonan's reproductive capacity. Fron this theo- retical approach. envy. anerging fron the first three developmental stages. is viewed as a defense against fear of castration. In discussing major theoretical views on couvade syndrone. Zalk (1980) focused on the identification process. with particular atten- tion to preoedipal concerns. Identification with and envy of the 21 pregnant partner suggest a renewal of preoedipal feelings of attach- ment to the mother. The identification process. however. is viewed positively--the regression pronotes onpathy with the expectant mother and the expectant father's involvement in the pregnancy. child care. and nurturing of the child. The possible role of regression in iden- tification was supported in a study by Gerzi (1981). He found that expectant fathers displayed greater feelings of anbivalence than non- expectant fathers relative to the rearousal of infantile fantasies. feminine identification. and castration fears. Opposing views have also been noted in the literature. Cavenar (1977) maintained that regression to oedipal and preoedipal stages of devel opnent has not been sufficiently supported by research findings. He contended that rage relative to sibling rivalry is the main factor contributing to the syndrome. The effect of sibling rivalry was supported by Gerzi's (1981) findings. as well. .EaISnnilit!.t£fl1i5£denendency. The effect of psychological needs and personality traits on behavior has been discussed in the litera- ture on couvade syndrome. In her writing on fatherhood. Benedek (1970a) addressed the role of dependency needs. Dependency. which underlies regressive tendencies. is likely to be unconscious. given its dissonance with one's ego ideal. The desire to procreate counters such regressive tendencies through one's virility. The child is thus viewed as an exannple of one's maturity. countering any anxiety aroused by regressive trends. From this perspective. the role of dependency needs warrants further attention in studies on expectant fathers. 22 Dependency needs are subject to disruptions during pregnancy. Several authors have claimed that such needs underlie couvade symptomatology. Although citing hostility and rivalry as contributory factors. Towne and Afterman (1955) noted the primary contribution of dependency needs to sympton formation. In a study of ten males hospitalized following the birth of a child. Wainwright (1966) noted a variety of trends. one being disruption of dependency needs. Ginath (1974) asserted that dependency needs relative to the feelings of abandorwnent that dependent males are likely to experience contribute to a variety of psychological dysfunctions. including psychoses. Wapner (1975) addressed the conflicts related to dependency needs contributing to dysfunctions. given strong needs for attachment. coun- tered by the expectant mother's need for support. Zalk (1980) wrote that dependency needs that are either insufficiently or ambivalently satisfied contribute to the expectant father's fears of loss of love and thus contribute to feelings of rivalry. Other investigations of the couvade syndrone have focused on the nature of specific personality dynamics and broad-range interpersonal factors relative to sympton presentation. Such studies have entailed rigorous methods of investigation. The research discussed in the following pages relied more on objective measures and less on clinical observations and anecdotal reports. Moore (1975) investigated personality variables and family relationships related to couvade syndrone. Sixty subjects were divided into two groups: expectant fathers and nonexpectant fathers. 23 These two groups were dichotomized into four subgroups: (a) couvade expectant fathers. (b) noncouvade expectant fathers. (c) symptonatic nonexpectant fathers. and (d) asymptonatic nonexpectant fathers. Groups werermatched on marital status. age. primary language. and socioeconomic factors. Subjects were equally distributed in each of the four cells. As compared to noncouvade fathers. couvade fathers were expected to display stronger dependency needs. to experience greater hostility and more conversion symptoms. to exhibit more femi- nine identification. and to express a closer feeling to their mothers while growing up and as adults. They were also expected to express a greater degree of unhappiness in regard to the pregnancy. Measures used were the Minnesota Multiphasic Personality Inventory (MMPI). the General Information Screening Form. and the Sel f-Report Couvade Syndrone Sympton Check List. Findings disclosed no significant differences between couvade and noncouvade subjects on personality variables of dependency. hostility. conversion. or femininity. Analysis of other variables. such as having been a father. nunber of moves or job changes. and incidences of stress or worry. yielded nonsignificant findings. The lack of significant differences between groups on those factors was attributed to the nunber of groups used and tine small sanple size. Other methodological questions could also be raised. including the research tools used (i.e.. the MMPI) and Moore's operational definition of couvade syndrone as the presence of two or more symptons. 24 In a study of 128 expectant fathers participating in Lanaze classes. Wapner (1975) found that husbands reporting physical symptons rated themselves as being more involved in the pregnancy than did their partners. Wapner suggested that the expectant fathers were essentially practicing the ancient couvade ritual. His explanation was based on the presuned conflict between the expectant father and his partner. The father sougnt closeness and involvonent at a time when the partner would have preferred support over close invol vonent. Davis (1977) studied expectant fatherhood fron a crisis perspec- tive. He explored progressive changes during pregnancy (early. middle. late) in an attonpt to predict those who are most likely to experience symptons and greater anxiety. depression. and hostility. The sample conprised 91 expectant fathers. including both working- and middle-c1 ass Blacks and Caucasians. Using mul ti-factorial analysis of variance on responses to the Multiple Affect Adjective Check List. statistically significant results were realized. Worki ng-cl ass fathers with unplanned pregnancies experienced greater degrees of anxiety. depression. and hostility than other sample monbers during the progression of the pregnancy. Concerning symptonatology. no sig- nificant differences were found between new and experienced fathers. However. expectant fathers with unplanned pregnancies reported sig- nificantly more symptons than did those with planned pregnancies. Working-class expectant fathers were more symptonatic than middle- class fathers. and black expectant fathers were significantly more symptonatic than white fathers. The nunber of symptons increased as 25 fine pregnancies progressed. In addition. the nunber of symptons was significantly positively correlated with anxiety and depression. whereas personal satisfaction was found to be inversely related to symptonatol ogy. Of concern in this study is the exclusive use of an adjective dneck list in considering such factors as anxiety. depres- sion. and hostility. Walton (1982) studied couvade syndrone relative to personality factors. views on fine fafiner's level of participation in childbirth. and the expectant father's phenonenol ogy of anticipated childbirth. Measuronent instrunents were the MMPI. the Early Monories Test (EMT). and semi-structured interviews. The sample comprised 44 expectant fafiners whose wives were in their third trimester. In this study. the incidence rate of symptons was 32.6%. Symptonatic subjects were placed in one of three groups (high. medium. low). based on the symptonatol ogy reported. Those in the hign group were found to have low ego strength and significantly elevated scores on the Hysteria. Depression. and Psychasthenia scales of the MWI. Data fron the EMT did not reveal significant differences between groups. as anticipated. relative to pre-oedi pal and passive-fignting themes involving fonale figures. Expectant fafiners' self-ratings on their involvonent in the pregnancy did not differ significantly between groups. This observa- tion led Walton to reject fine hypothesis that involvonent would serve to channel anxiety and thus diminish symptonatol ogy. Of interest was the association between hign couvade symptonatology and birth order. Walton found that higlnly symptonatic subjects were more likely to be 26 fine younger brother of older sisters or the older brother of all male si bl ings. The findings of Walton's study ronain questionable because of certain methodological problons. The sample was relatively small. particularly as the group-compari son method of analysis was used. One could also question fine exclusive use of the MMPI in separating fine sample into three groups and in measuring the same sample on specific personality traits. The artificial division of the sample into three groups is open to debate because the distinctness of the three groups is q uestiona bl e. Sumac: The literature on couvade syndrone contains a diversity of descriptive observations and theoretical explanations regarding its manifestations. A wide range of studies were reviewed. noting the progression of investigations. Earlier anecdotal reports were followed by more scientific investigations. Conmon to most studies has been the focus on physiological symptonatol ogy and its association with psychological experiences such as anxiety. depression. hostility. and guilt and processes such as identification. Although stimulating. fine findings of most of these studies are inconclusive and at times questionable because of the methodology used in those investigations. Discrepancies in research findings support a need for additional and more rigorous investigation of the couvade syndrone. GIAPTER III FETHODGJISY mm This study was an onpirical investigation of the couvade syn- drone. The investigator considered personality traits related to interpersonal orientation and their association with couvade symptons. The study was undertaken to assess the function of motivational fac- tors and their relationship to the symptonatol ogy under consideration. In addition. the relationship between the syndrone and both recent and historic life stressors was assessed. Data gathered by means of the General Information Questionnaire and the Personality Research Form-- Form E were used in assessing the role of such factors. SubJects A sample of 52 expectant couples was included in this study. Only cohabiting couples in their third trimester of pregnancy were asked to participate. Subjects were primarily fron urban and suburban locations in the central and western parts of Michigan. They were found througn contact with area groups providing services to expectant parents (i.e.. the Expectant Parent Organization in Lansing. Lamaze classes. family-practice physicians. obstetricians. hospitals. and clinics). Subjects were approached by a staff menber or the 27 28 primary-care provider and asked to volunteer for a study on expectant parents. If they were interested. couples were given a packet con- tai ning the research instrunents for both partners to conplete at their convenience. All subjects were assured of confidentiality and anonymity of responses because they were specifically asked not to pl ace their names on the research instrunents. Participants were asked to return the conpleted questionnaires to a staff monber or to mail than directly to the investigator in the stamped and addressed envelope provided. Subjects were informed that both partners had to conplete the two questionnaires in order to be considered for the study. Data were gathered over a 17-month period fron September 1985 through February 1987. During that time. approximately 150 question- naire packets were distributed. Of the 57 packets returned. one was disqualified because the couple were in their second trimester. Four couples were not included in the study because the expectant fathers failed to complete both questionnaires. Instrumentation W The General Information Ouestionnai re. which was developed for this study. contained questions seeking pertinent donographic and historical information. Sone items were designed to assess feelings about fine pregnancy. including whefiner or not it was planned. Dono- graphic items (marital status. occupation. and educational level) were followed by questions about events finat had occurred in fine expectant fathers' family of origin. Birfin order. parent-child relationships. 29 and enotional trauna (deaths. separations. illnesses. divorces) were considered because of their timeliness and potential effects on one's developing object relations and interpersonal orientation. Concluding the questionnaire were two check lists. The first was devised fron itens included in the Life Experiences Questionnaire (Sarason. Johnson. & Siegel. 1978) to assess timely situational stressors. Stress levels were measured for two time periods: 0-6 months and 7-12 months. Under consideration was the association of life stressors with sympton formation. The second check list comprised the physical symptons assessed in the study. Two sets of symptons were used in devising this list. The first set included those symptoms noted in the literature as being most conmonly associated with the couvade syndrone. These symptons were toothaches. indigestion/heartburn. nausea. stomach aches. vomit- ing. diarrhea. constipation. leg aches. stonach swelling. weiglnt gain (not planned). weight loss (not planned). sties on the eyelid. exces- sive fatigue. loss of appetite. and increased appetite. The second set of symptons comprised selected items fron the Hamilton Anxiety Rating Scale. These symptons were worrying. inability to relax. fear of being alone. unsatisfying sleep. difficulty in concentration. depression. feelings of weakness. chest pain. choking feeling. difficulty swallowing. frequent urination. tension headaches. and pains and aches. For both sets of symptons. ratings of only those symptons experienced by the expectant father during the pregnancy. which had not been regularly experienced before the pregnancy. were 30 considered. The use of both types of itens was unique to this inves- ti gati on. Both couvade symptons and symptons of anxiety were assessed in order to investigate fine possible relationship or link between couvade symptonatol ogy and symptons of general anxiety. W The Personality Research Form is a sel f-report personality inventory devised by Douglas Jackson (1984). The test is designed to measure personality along 20 dimensions or traits. which were based on the initial work of Murray and associates on personality structure and need theory (Buros. 1972). The test has five basic forms. which were developed betnween 1965 and 1974. It has two parallel short forms (Standard Edition) and two parallel long forms (Long Editions). The short forms provide 14 trait scores and one ”validity score" (Infre- quency Scale). The long forms contain six additional traits and an additional validity score (Desirability). The fifth form. the Wide- Range Edition. Form E. provides the same scores as the Long Edition but was devised for use with a broader range of subjects (grades 7-16 and adults) than the previous forms. which were designed to be used exclusively with a college population. Traits measured on the long form are achievenent. affiliation. aggression. autonony. dominance. endurance. exhibition. harm avoidance. impul sivity. nurturance. order play. social recognition. understanding. infrequency. abasement. change. cognitive structure. defendence. sentience. succorance. and desirability. 31 Critical reviews of the Personality Research Form have been favorable (Buros. 1972. 1978). Most have emphasized the rigorous nature of fine research that went into fine construction of the inven- tory. Its use as a research tool has also been supported (Buros. 1972. 1978). Jackson (1984) provided pertinent reliability and validity data used in constructing fine test. Reliabilities were derived by using the Spearman-Brown correction formula on the odd-even reliabilities. Table 3.1 contains fine data on two separate samples for the scales used in the present study. Table 3.1.--Reliabil ity scores of two samples on eignt pertinent scales of the Personality Research Form--Form E. A Psychiatric Sample College Sample Scale (N = 83) (N = 84) Affiliation .82 .86 Aggression .74 .63 Autonomy .61 .66 Defendence .77 .66 Exhibition .82 .85 Nurturance .79 .65 Social Recognition .81 .73 Succorance .73 .73 Jackson also provided data on fine test's convergent validity. He cited a study on a college sample by Paunonen and Jackson (1979). Validity scores. which were all significant at the .01 level. are presented in Table 3.2 for fine traits under consideration. 32 Correlations were between self-ratings on the Personality Research Form--Form E and roonmate ratings. Table 3.2.--Convergent validity scores of a college sample on eignt pertinent scales of the Personality Research Form--Form E (N = 90). Scale Validity Score Affiliation .57 Aggression .3 6 Autonomy .57 Defendence .34 Exhibition .62 Nurturance .61 Social Recognition .38 Succorance .52 Additional data supporting discriminant validity is provided in correlating Personality Research Form--Form E scores with those on a variety of inventories (i.e.. the Jackson Personality Inventory. fine Jackson Vocation Interest Survey. and the Bentl er Psychological Inventory). Two overall categories of traits were considered in this study. One category measured interpersonal orientation. broken down into attachment and separation. Traits related to attachment were affil ia- tion. nurturance. exhibition. and social recognition. Traits related to separation were aggression and defendence. The other category measured need for direction fron peopl e. The trait of succorance was related to the need for direction fron others. as opposed to the 33 more independent trait of autonomy. Jackson (1984) presented this diclnotony of factors in describing two of seven superordinate cate- gories enunerated in the Personality Researdn Form. WEB: A two-group conparison method of analysis was performed on the research data. The researcher believed this conparison of two dis- tinct groups (nonsymptonatic and highly symptonatic) to be a more appropriate analytical method than the procedures used in previous investigations. Former researchers have relied primarily on multi- group comparison methods. artificially dividing expectant fathers into various groups according to their level of symptonatology and likely violating the assunption of disti nctness between groups. In testing the hypotheses of this study. conparisons betnween scores of nonsymptonatic and hignly symptonatic expectant fathers on the eight selected personality variables was conputed. In addition. a series of analyses was performed. assessing differences on a variety of factors including but not limited to anxiety (acute and chronic) and situational stress. The results of these and other analyses are discussed in Chapter IV. Bxpotbasas The investigator was interested in fine possible role of object relations. and. in particular. issues of interpersonal attachment and separation. in regard to sympton formation during expectant parent- hood. It was anticipated that expectant fathers experiencing more 34 couvade symptons had experienced more early trauna (object loss) finan those not experiencing as many. if any. symptons. Fron this perspec- tive. couvade symptonatology is viewed as a response to the partner's pregnancy. whidn rekindl as early issues of loss. activating primitive dependency needs. The following hypotheses were formulated to guide the analysis of data for this study. W: Higlnly acute-symptonatic expectant fathers will manifest a higner degree of affiliation than will nonsymptonatic expectant fathers. W: Hignly acute-symptonatic expectant fathers will manifest a higner degree of nurturance than will nonsymptonatic expectant fathers. W: Highly acute-symptonatic expectant fathers will manifest a higner degree of e>dni bition than will nonsymptonatic expectant fathers. Hypothesju: Highly acute-symptonatic expectant fathers will manifest a higher degree of social recognition than will nonsymp- tonatic expectant fathers. W: Hignly acute-symptonatic expectant fathers will manifest a higner degree of succorance finan will nonsymptonatic expectant fathers. W: Highly acute-symptonatic expectant fathers will manifest a lower degree of aggression than will nonsymptonatic expectant fathers. Hypothesisl: Highly acute-symptonatic expectant fathers will manifest a lower degree of defendence than will nonsymptonatic expectant fathers. 111mm: Highly acute-symptonatic expectant fathers will manifest a lower degree of autonomy than will nonsymptonatic expectant fathers. GIAPTER IV RESULTS This chapter contains the data of the research investigation. Descriptive information on fine couples studied is followed by an explanation of fine procedures followed in assigning expectant fathers to their respective groups. Next. each of the main hypotheses is restated. followed by the results of the analysis for that hypothesis. The remaining sections contain the results of additional analyses. Dascflptimlnmmatimummple Fifty-two cohabiting couples in their third trimester of preg- nancy voluntarily participated in this investigation. The average age of the participants was 28 years. Fifty of the couples were married. Three individuals were single. and one was divorced. The average length of marriage was 4.2 years. In terms of education. subjects had attended sclnool an average of 14.6 years. Table 4.1 presents addi- tional information on these factors. Table 4.2 shows a frequency distribution on the nunber of years couples had been married. Infor- mation regarding racial or ethnic origin. religious affiliation. and occupation is presented in Tables 4.3. 4.4. and 4.5. respectively. 35 36 Table 4.l.--Identifying data on expectant parents (in years) (N = 104). Mean Standard Deviation Age 28.0 4.80 Married 4.2 2.95 Education 14.6 2.50 Table 4.2.--Frequency distribution on number of years married for married expectant parents. (N = 50) Years Frequency 1 5 2 9 3 9 4 10 5 3 6 S 7 2 8 2 9 1 10 3 15 1 Table 4.3.--Racia1 or ethnic origins of expectant parents (N = 104). Race 1 Frequency Caucasian 100 Black 1 Indian (Asian) 2 Other 1 37 Table 4.4.--Religious affiliation of expectant parents (N = 104). Religious Affiliation Frequency None Protestant Catholic Jewish Atheist Other Not reported amammgfi Table 4.5.--Occupation of expectant parents (N = 104). Occupation Frequency Professional/technical 28 Managerial ' 13 Service/clericalllaborer 44 Student 4 Not working 15 In this investigation. attention was centered on the symptoma- tology presented by expectant fathers. Unique to this investigation was the dichotomy of symptonatology under consideration. Expectant fathers were thus assigned separate couvade scores. Couvade I are scores related to fine severity and frequency of chronic symptons. C6uvade II are scores that pertain to the frequency and severity of more acute symptoms. Attention was focused on the acute scores (Cou- vade II). given their timeliness in relation to the period of the pregnancy. 38 Couvade scores (both Couvade I and II) were derived fron the sympton checklist found in the General Information Questionnaire. Targeted symptoms were toothaches. indigestion/heartburn. nausea. stonadn aches. voniting. diarrhea. constipation. leg aches. stonach swelling. weight gain. weight loss. sties on the eyelid. excessive fatigue. loss of appetite. and increased appetite. Subjects were asked to rate the frequency of symptons on a 4-point scale (never. rarely. sonetimes. frequently). The severity of symptons was rated on a 3-point scale (mild. moderate. severe). Ratings on frequency and severity were multiplied. Couvade I scores were derived by sunning individual products for each of the symptoms noted above. Ocuvade II scones were derived similarly. except that only those symptoms that had not been experienced during the previous 6 months were con- sidered. A reliability analysis of the two separate factors (Couvade I and Couvade II) was performed. For Couvade I. .r: = .64. whereas the reliability for Ocuvade II diminished substantially..t = .38. The scale as originally presented did not prove as reliable when consid- eringnnore acute symptomatology in contrast to chronic symptomatology. Therefore. a series of item analyses was performed to derive a more reliable scale for Ocuvade II. minimizing the loss of information. Two items were deleted (stomach swelling and weight loss) because they did not contribute any variance to the scale. hwornore symptoms were renoved (toothaches and stonach aches). increasing the reliability to L = .47. The final set of symptons considered in deriving the 39 Couvade II scores was as follows: indigestion/heartburn. nausea. voniting. diarrhea. constipation. leg aches. weignt gain. sties on the eye. excessive fatigue. loss of appetite. and increased appetite. In further discussions of Couvade II. this revised form is the only one under consideration. Table 4.6 shows the frequency distribution of both Couvade I and Couvade II for comparison. Table 4.6.--Frequency distribution of Couvade I and Couvade II (N = 52). Frequency Couvade I Couvade II 0 7 27 l 3 4 2 5 6 3 3 3 4 1 1 5 2 2 6 4 1 7 4 2 8 l 1 9 1 - 10 - 1 11 2 l 12 4 - 13 2 l 14 1 - 15 - 2 16 l - 18 3 - 19 2 - 20 3 - 21 2 - 40 1 - Total 52 52 Mean = 8.9 Mean = 2.5 .S...D.. = 8.2 5.12.. = 4.03 4O Anxiety scores assigned to expectant fathers were derived fron different itens on the same checklist of symptons used for couvade scores. Symptoms targeted were worrying. inability to relax. fear of being alone. unsatisfying sleep. difficulty in concentration. depres- sion. feelings of weakness. chest pain. choking feeling. difficulty swallowing. frequent urination. tension headache. and pains and aches. The frequency and severity of symptoms were assessed on 4- and 3-point scales. respectively. The sun of the products of these two scales across each anxiety symptom yielded an anxiety score. Once again. a distinction was made between chronic and acute symptonatology. Anxiety I was more chronic anxiety experienced during the pregnancy. and Anxiety II was more acute anxiety. Reliability tests were also performed on the eight personality traits under consideration: affiliation. nurturance. exhibition. social recognition. succorance. aggression. defendence. and autonomy. Table 4.7 presents each of these traits and their respective relia- bilities. along with the reliabilities for Anxiety I and Anxiety II. The data on the expectant fathers' partners were subjected to a similar analysis for couvade and anxiety symptoms. With regard to couvade scores. C6uvade II for partners was derived from the same revised list of symptons for expectant fathers. This was implemented to maintain consistency in the analysis of the Couvade II factor. Table 4.8 shows the reliabilities for all couvade and anxiety factors. along with those for fine eight personality traits. 41 Table 4.7.--Reliability scores for personality traits of expectant fathers. Factor Reliability Score Anxiety I .80 Anxiety II .64 Affiliation .72 Nurturance .69 Exhibition .80 Social recognition .56 Succorance .64 Aggression .69 Defendence .57 Autonomy .77 Table 4.8.--Reliability scores for Couvade I and II. Anxiety I and II. and personality traits of partners of expectant fathers. Factor Reliability Score Couvade I .72 Couvade II .62 Anxiety I .85 Anxiety II .67 Affiliation .74 Nurturance .75 Exhibition .84 Social recognition .76 Succorance .78 Aggression . 76 Defendence .69 Autonony .80 BequtLoLHxnntbesiLIestJng The data analysis was based on a conparative model using two groups. Previous researchers arbitrarily divided symptonatic fathers 42 into groups whose distinction was questionable. posing problens in the interpretation of results. To avoid such difficulties as arti- ficially dividing subjects into multiple groups. a two-group design was implenented. The groups were derived fronn scores on Couvade II. Group I conprised 27 nonsymptonatic fathers. Included in Group II were eight hignly symptonatic fathers who had scores of 7 or more on the Couvade II factor. The intention was to conpare clearly distinct groups of expectant fathers. The most conservative approach was to conpare nonsymptonatic expectant fafiners to highly symptonatic indi- vidual 5. Group I comprised 52% of the original sample. Group II totaled 15.4% of the 52 fathers sampled. Table 4.9 contains descrip- tive information regarding these two groups. Table 4.9.--Descri ptive data on asymptonatic and symptonatic couvade symptonatol ogy . Age Years Married Education Asymptonatic Mean = 27.9 Mean = 4.1 Mean = 14.9 5..D..=3.7 .S...Q.=2.4 LIL=2o9 Symptonatic Mean = 30.9 Mean = 2.4 Mean = 13.6 .S...D.=7.2 S...D..=l.5 .S...D...=l.5 An analysis of differences in means was performed using standard .t-tests for independent sanples. The null and alternative hypotheses are symbolically written as follows: 43 An .E-test analysis of variance between groups was performed on each of the dependent variables under consideration. This analysis was undertaken to eliminate any violation of the assunptions of honogeneous variances between groups (an assunption underlying the .t-test). The analyses of the eignt main hypotheses concerning personality factors and couvade symptonatology were performed using a one-tailed .t-test with significance set at .05. given that a specific di rection- ality was anticipated. Symbolically. Hypotheses 1 through 5 can be written as: “0 = u' - p2 = O H] '3 pl - “2 < O For Hypotheses 6'through 8. the direction of the hypotheses was reversed. Those hypotheses can be symbolically written as: "O ' pl - p2 = 0 H1 ' “r ' “2 > o In the following paragraphs. each of the major hypotheses under consideration in this investigation is restated. followed by the results of the analysis of data for that hypothesis. fiymthesiLl: Highly acute-symptonatic expectant fathers will manifest a higher degree of affiliation than will nonsymptonatic expectant fathers. Highly acute-symptonatic expectant fathers did not manifest a higner degree of affiliation than nonsymptonatic expectant fathers. (See Table 4.10.) Therefore. Hypothesis 1 was rejected. 44 Table 4.10.--Resu1ts of .t-test for Hypothesis 1. Mean 5.12. .t-V a1 ue .df. l-Tai 1 Prob. Asymptonatic 7.9 3.6 -063 33 027 Symptonatic 8.7 1.8 W: Highly acute-symptonatic expectant fathers will manifest a higner degree of nurturance than will nonsymptonatic expectant fathers. Highly acute-symptonatic expectant fathers manifested a higner degree of nurturance than nonsymptonatic expectant fathers. (See Table 4.11.) Therefore. Hypothesis 2 was accepted. Table 4.11.--Resu1ts of .t-test for Hypothesis 2. Mean 5.0. t-V a1 ue .di I-Tail Prob. Asymptonatic 8.7 3.3 -l.68 33 .05* Symptonatic 10.8 2.9 *Significant at the .05 level. Hypothesisl: Highly acute-symptonatic expectant fathers will manifest a higner degree of exhibition finan will nonsymptonatic expectant fathers. Hi gnly acute-symptonatic expectant fathers did not manifest a higner degree of exinibition than nonsymptonatic expectant fafiners. (See Table 4.12.) Therefore. Hypothesis 3 was rejected. 45 Table 4.12.--Results of t-test for Hypothesis 3. Mean .S.._D_. .t-Val ue .dt l-Tail Prob. Asymptonatic 7.19 3.8 -.04 33 .48 Symptonatic 7.25 5.0 W: Highly acute-symptonatic expectant fathers will manifest a higher degree of social recognition than will nonsymp- tonatic expectant fathers. Highly acute-symptonatic expectant fathers did not manifest a higher degree of recognition than nonsymptonatic expectant fathers. (See Table 4.13.) Therefore. Hypothesis 4 was rejected. Table 4.13.--Results of .t-test for Hypothesis 4. Mean $.12. _t-V a1 ue of I-Tail Prob. Asymptonatic 7.29 2.68 .04 33 .48 Symptonatic 7.25 2.43 W: Highly acute-symptonatic expectant fathers will manifest a higher degree of succorance than will nonsymptonatic expectant fathers. Hignly acute-symptonatic expectant fathers did not manifest a hi gner degree of succorance than nonsymptonatic expectant fafiners. (See Table 4.14.) Therefore. Hypothesis 5 was rejected. 46 Table 4.14.--Results of t-test for Hypothesis 5. Mean 1.12. .t-Val ue _d_f l-Tail Prob. Asymptonatic 6.4 3.25 1.12 33 .13 Symptonatic 5.0 2.56 mm: Highly acute-symptonatic expectant fathers will manifest a lower degree of aggression than will nonsymptonatic expectant fathers. Highly acute-symptonatic expectant fathers did not manifest a lower degree of aggression than nonsymptonatic expectant fathers. (See Table 4.15.) Therefore. Hypothesis 6 was rejected. Table 4.15.--Results of t-test for Hypothesis 6. Mean 5,0. _t-Val ue .df, I-Tail Prob. Asymptonatic 8.37 3.14 -04] 33 .34 Symptonatic 8.87 2.90 W: Highly acute-symptonatic expectant fathers will manifest a lower degree of defendence than will nonsymptonatic expectant fathers. Highly acute-symptonatic expectant fathers did not manifest a lower degree of defendence than nonsymptonatic expectant fathers. (See Table 4.16.) Therefore. Hypothesis 7 was rejected. 47 Table 4.16. Results of t-test for Hypothesis 7. Mean .S...D.. .t-V a1 ue .df l-Tail Prob. Asymptonatic 5.89 2.91 -.89 33 .19 Symptonatic 6.87 2.03 Hypothesisl: Highly acute-symptonatic expectant fathers will manifest a lower degree of autonony than will nonsymptonatic expectant fathers. Highly acute-symptonatic expectant fathers did not manifest a lower degree of autonomy than nonsymptonatic expectant fathers. (See Table 4.17.) Therefore. Hypothesis 8 was rejected. Table 4.17.--Results of .t-test for Hypothesis 8. Mean SJ). ,t-Val ue d1 l-Tail Prob. Asymptonatic 6.48 3.54 -088 33 019 Symptonatic 7.75 3.73 BasultsmtjuanmantanLComnanathnastas Additional analyses were performed on variables for which dif- ferences between groups were anticipated but not specifically hypothe- sized. Significant findings are reported in the folloring paragraphs. Two-tailed tests were performed. with significance set at the .05 alpha level. 48 As shown in Table 4.18. highly acute-symptonatic expectant fathers experienced significantly more chronic couvade symptonatol ogy than did nonsymptonatic expectant fathers. Highly acute-symptonatic expectant fathers experienced signifi- cantly more chronic anxiety symptons than did nonsymptonatic expectant fathers. (See Table 4.19.) Table 4.18.--Resu1 ts of .t-test for chronic couvade symptonatol ogy (Couvade I). Mean .S...D.. .t-Val ue _d_f 2-Tail Prob. Asymptonatic 6.37 6.6 -4.25 33 .000 Symptonatic 18.88 9.5 f Table 4.19.--Results of t-test for chronic anxiety symptons (Anxiety 1). Mean .S_._D_. .t-V a1 ue _d_£ 2-Tail Prob. Asymptonatic 10.59 11.26 -2016 33 0038 Symptonatic 20.00 8.93 Highly acute-symptonatic expectant fathers' partners had signifi- cantly more dnronic anxiety symptonatol ogy than did the partners of nonsymptonatic expectant fathers. (See Table 4.20.) 49 Table 4.20.-Results of .t-test for partner's Anxiety 1. ' Mean Ln. _1;-v a1 no a: 2-Tail Prob. Aymptornatic 8.52 16.09 Sym ptonati c 43 .37 13 .36 In the analysis of differences in personality traits on partners of the two groups under consideration. one subject in the hignly acute symptonatic group was deleted. The analysis proceeded in such a fashion because this one subject had only partially conpleted the Personality Research Form. Hence. for greater accuracy. the seven remaining subjects in this group were compared to the partners of the asymptonatic expectant fathers. The following significant result was found. The partners of highly acute-symptonatic expectant fathers had significantly less need for nurturance than did the partners of non- symptonatic expectant fathers. (See Table 4.21.) Table 4.21.--Results of .t-test for partner's nurturance. Mean S...D.. .t-V a1 ue .dt 2-Tail Prob. Asymptonatic 11.7 2.43 1.99 32 .05 Symptonatic 9.7 2.29 50 WW Pearson correl ational analyses were performed on the data. as well. This was done as additional analyses. bearing in mind certain limitations given the sampling distribution of all expectant fathers in this study. The analysis was performed. and results have been provided to note possible significant associations between variables. Significant findings are provided in Table 4.22. Of particular interest are the findings of significant relation- ships between couvade symptonatology of expectant fathers and their anxiety symptons. Although both chronic and acute couvade and anxiety symptons were significantly related to one another. the strongest relationships were noted between the acute types of symptons and those between chronic symptons. Significant relationships were found between acute stress and chronic and acute anxiety. Long-term stress was found to be signifi- cantly rel ated to both chronic couvade and anxiety symptonatol ogy. Significant findings were also realized between expectant fafiners and their partners' functioning. Partners' chronic couvade symptona- tology was significantly related to fine expectant fathers' chronic anxiety as well as chronic and acute couvade scores. Partners' chronic anxiety scores were significantly related to the expectant fathers' anxiety symptons. both chronic and acute. Partners' acute anxiety significantly related to the expectant fathers' acute and chronic couvade scores. 51 2. .3. than. a... «ma. «8.- «mo. .N. __ 53.22 «.3. «MN. 2%... - N. . .2. i..- 8... «ram. _ 33.22 w_. ow. _~.n mm. «aw. ~_.n m_.n ~_. _. oom>:0u «RN. ~N. ~_.n on. m_. mo.n o..- «emm. _ ovm>30u mcuccz ~_n~ msuco: one mucocm scam owmwumuuov_4 A > .V t _ a __ moccum _ mmocum co_umcmoom mucocma scum mo__x u acoam oe_h :o_umu:cm >ucmcmoca acmo< oE_h .A~m w.mv mconum» unouuoaxo _.m "mo—ammcm> acoucoooc cob «My muco_o_uwoou co_uo_occou cemcmoann.-.: o_nch 52 ._u>o_ .oo. ago an acou_c_cm_m.... ._o>u_ moo. one an .cau_c_ca_m... ._o>o_ .o. one no ”cau_a_=m_m.. ._o>o. mo. ago no u=~u_c_=a_m. NN.n m..- n..- «eNM. NN. «MN. .0. No. .o.n ««««_m. o.. «aueoe. >uo_xc< Mo. No. mo.n m_. «eMM. «aeeam. m_. «eamM. no. «eemm. «eeaoJ. o._ >uonxc< «9N.n ««:MM.n «eewM.n o_. «mN. ««««M:. 5.. «MN. __. eoM. «aeeMa. «««MM. ovmuocu No. «««MM.- .N.- M.. «.M. «eeaNJ. «MN. «:N. «MN. «eaewe. «MN. eaeemo. ovohaou :o_a cone :0.» .moz N_-N .. _ ._ . coco oucm ._ . n_amcxw ncaucaz nm___uu< ._ mmocum >uo_xc< >uo_xc< occ>=0u ovm>30u incubus nuoucaz >uo_xc< >uo_xc< n.506uhfim m..—OCULQ& m.LOCuLflm m.LOCuLN& n.50cHLma m.LOCHme m.LOCUL@m m.LUCH..Qm .uo==.acou--.s~.s o_a~» 53 Relative to the personality traits considered. only nurturance was significantly related to all factors of acute and chronic couvade and anxiety symptonatol ogy. Significant negative correlations were found between expectant fafiners' acute couvade symptonatol ogy and their partners' scores on the personality traits of nurturance. affiliation. and endni bition. Sane anticipated significant relationships were not found. As in the conparative analysis. no significant relationships were found between level of education and couvade symptons. As well. the amount of time an expectant fafiner had lived alone before marriage was not associated significantly with couvade symptonatol ogy. Separation fron parents proved to be significantly related only to chronic and acute anxiety and not to couvade symptons. Surprisingly. the trait defend- ence was significantly related to chronic couvade scores but in an opposite direction to the one anticipated. Other personality trait scores were not significantly related to couvade or anxiety symptona- tol ogy. Sumatra This chapter contained fine results concerning group differences between highly acute-symptonatic expectant fathers and nonsymptonatic expectant fathers. Al thougn only one of fine main hypotheses was supported. additional analyses on these two groups yielded several significant findings. First. highly acute-symptonatic fathers (a) experienced more chronic couvade symptons. (b) experienced more chronic anxiety. and (c) exhibited greater degrees of nurturance than 5': did nonsymptonatic expectant fathers. In addition. the partners of hignly acute-symptonatic expectant fathers experienced more chronic anxiety and exhi bited a lesser degree of nurturance than did the partners of nonsymptonatic expectant fathers. Althougn not statistically significant. a few anticipated trends were noted. Highly acute symptonatic expectant fathers had a higher average score on acute anxiety finan did nonsymptonatic expectant fathers. As well. the partners of the hignly acute symptonatic group generally had higner scores on acute couvade symptons finan did the partners of asymptonatic expectant fathers. Secondary analyses were performed to assess further the relation- ship between the symptonatology of all expectant fathers in this study relative to a nunber of variables under consideration. Results sup- ported the association of nurturance with the experience of acute cou- vade symptonatology. As well. the association between expectant fathers' acute couvade symptonatology and their partners' functioning was noted. CHAPTER V SUMMARY. LIMITATIONS. CWCLUSIONS. MD REmMMENDATIONS Sumacx The purpose of this study was to broaden the understanding of events relative to the crisis-devel oprnent period of expectant parent- hood. Although many researchers have focused on this general topic. few have centered attention on expectant fathers. The study was undertaken to answer questions about expectant fathers' experiences. with particular attention to psychophysiol ogical changes manifested at the time of pregnancy. The interest in psychophysiol ogical manifestations was raised by anecdotal reports the investigator encountered in fine literature. as well as in personal contacts. Noted in the literature was the dis- proportionate nurnber of anecdotal reports in conpari son to empirical investigations. The literature to date has raised more questions than have been answered. in part because of the methodology of the studies and the variables assessed. Of particular interest was the very concept of a syndrone such as the couvade syndrone. Was it truly a syndrone with timely and specific symptons associated with fine onset of expectant parenthood. or was it merely an exacerbation of more chronic symptonatol cg? Were the lists of symptons too inclusive? If so. which symptons were more related to the couvade syndrone? In 55 56 addition. in an attenpt to understand the psychological dynamics of symptons. motivational factors were considered. The measurenent of personality traits was chosen to broaden the understanding of this phenonenon. Other related concerns were the association of a part- ner's symptonatology and personality dynamics with the presentation of couvade symptons in expectant fathers. The role of situational stress was another factor considered in this study on the couvade syndrone. This investigation was undertaken with the questions noted above in mind. A sample of 52 expectant parents was used in this study. Subjects were cohabiting and in their third trimester of pregnancy. All volunteered without conpensation. Two questionnaires were used in obtaining data on dependent variables. In the assessment of couvade symptonatology. a distinction was made between chronic and acute onset. Only acute symptonatology was considered. given its timeliness with the pregnancy. The distribution of expectant fathers on acute couvade symptonatol ogy resulted in 27 expectant fathers being asymptonatic and 25 symptonatic. A two-group conpari son method of analysis was selected. given the frequency distribution of expectant fathers on acute couvade symptonatology. The intention was to compare the most symptonatic expectant fathers with nonsymptonatic expectant fathers. The researcher decided to include only finose expectant fathers whose acute symptonatic couvade scores were 7 or more. The selection of such individuals was thought to provide the most effective contrasts between symptonatic and nonsymptonatic expectant fafiners. 57 Conparative analyses of the two groups were performed for all main hypotheses. Secondary analyses of the variables in question were also performed using this two-group comparative method. Results indicated that highly acute-symptonatic expectant fathers (a) experi- enced more chronic couvade symptons. (b) experienced more chronic anxiety symptons. and (c) endnibited greater need for nurturance than did nonsymptonatic expectant fathers. The partners of highly acute-symptonatic expectant fathers (a) experienced more chronic anxi- ety symptons and (b) exhibited less of a degree for nurturance than did the partners of nonsymptonatic expectant fathers. A series of correl ational analyses was performed. using the entire sample of expectant fathers. to consider their functioning in relation to a nunber of variables. Oertain relationships were noted. which supported the findings of the between-groups conparative analyses. The association between the expectant father's degree of nurturance and his experience of acute couvade symptonatology was noted. In addition. a significant positive relationship was found between chronic and acute anxiety symptonatology and the experience of acute couvade symptons. The correl ational analyses were particularly useful in consider- ing the association of stress. acute and chronic. and sympton fonna- ti on. The association between chronic stress and chronic couvade symptonatology as well as acute stress with chronic anxiety is espe- cially interesting to note. given that chronic anxiety and couvade 58 symptons were experienced in greater degree by highly acute- symptonatic expectant fathers. One cannot help but consider the function of both acute and more long-term stressors in the acute cou- vade symptonatol ogy of expectant fathers. Coupled with such findings are those related to the partners of expectant fafiners. Partners' chronic couvade and anxiety symptonatol ogy was significantly associ- ated with the expectant fathers' chronic anxiety. while the farmer's chronic couvade and stress scores were significantly related to the latter's chronic couvade symptonatology. The association of stress with anxiety and couvade symptonatol ogy. coupled with the associations noted between expectant fathers' chronic couvade scores and their partners' functioning. suggests the presence of both longstanding and more acute external stressors in relation to couvade symptonatology. as well as factors within the dyad or partnership playing a role in sympton manifestation of expectant fathers. Stress was not found to be directly significantly related to expectant fathers' acute couvade symptonatology. However. in reviewing the various significant associ- ations noted above. an interaction between stress. chronic couvade and anxiety. and partner's functioning is suggested in relation to acute couvade sympton manifestation. Limitations As in any research undertaking. certain limitations were realized and had to be scrutinized. particularly with regard to the general iza- bility of results. The study involved subjects who had volunteered for fine investigation. It is likely that this was a specialized 59 sample fron the population of expectant parents because of the use of volunteers. as well as the limitations of the geographic area in which the sanple was gafinered. In addition. fine time span of 17 months sheds emphasis on the specialized nature of this sample. The collec- tion of data was hanpered primarily by expectant fafiners who refused to participate. The results were not fron a random sample and likely were biased because of fine sanple obtained in this investigation. The sample size of 52 fathers posed particular limitations because the groups (symptonatic versus nonsymptonatic) were unequal. Findings were likely to be conservative. given the limited nunber of highly acute-symptonatic expectant fathers. The limited nunber of hignly acute-symptonatic expectant fathers may have been a result of factors other than the size of the original sample. Difficulties with sel f-reports. in particular retrospective ones. pose particular barriers to investigations of such phenonena. Recollections may often be unclear or incomplete. influenced by an individual's affective functioning. which in turn affects one's sel f-perceptions. Expectant parenthood. being a time of crisis. may affect one's accuracy on sel f- reports. A second concern possibly playing a role in affecting sel f- perceptions may be the expectant fathers' defensiveness. particularly in regard to acknowledging the experience of possibly psychosonatic symptonatol ogy. It is probably less threatening to acknowledge clearly physical experiences. Yet as questions regarding physical functioning are presented with interest as to the interface of these experiences and pregnancy. the functional nature of symptons is raised 60 and may be defended against. This defensiveness is likely to be evident in sophisticated samples. This study sampled expectant fathers who averaged slightly above 14 years of education. The pos- si ble role of defensiveness in the reporting of symptonatology should be considered. As in all studies. the methodology enployed in this study posed certain limitations. The use of volunteers and the limited nunber of highly acute-symptonatic expectant fathers were two such limitations. Other limitations likely to affect studies of this nature were the possible inaccuracies and inconsistencies in sel f-reports. along with the possible role of defensiveness in the sel f-disclosure of symptons that are functional in nature. .Qonclusions CouxadLdenxistLEastncs The results of this investigation. although hindered by certain limitations. have been useful in gaining a better understanding of factors likely to contribute to the psychophysiol ogical experiences of expectant fathers. The phenonenon of the psychophysiological experi- ences of expectant fathers. well known in the literature as couvade syndrone. was found in this study to be associated with symptons of chronic anxiety. Hignly acute-symptonatic fathers experienced significantly more chronic anxiety symptons than did asymptonatic expectant fathers. The highly acute-symptonatic group displayed more chronic couvade symptons than did the nonsymptonatic group. The 61 interrelationship between anxiety and couvade symptonatology was further supported by the correl ational analyses on these factors. Consequently. at issue and under consideration is the use of the term "syndrone" related to couvade symptonatol ogy. The strong association found in this study between chronic symptonatology and couvade symp- tons does not support the qualification of the symptonatol ogy as a specific definable set of phenonena or syndrone. The findings suggest that the psychophysiol ogical experiences of expectant father may be a function of. and at times an exacerbation of. more longstanding dys- functions. particularly anxiety. The study findings also suggest the need to consider and conpare levels of functioning before the targeted period under consideration or else risk making false assunptions about the interaction of symptons and specific events. BensonaIJtLEactonsz: Expectantiathsrs Higlnly acute-symptonatic expectant fathers exhibited signifi- cantly more need for nurturance than did nonsymptonatic expectant fathers. Their average score of 11 on the nurturance scale was at the 72nd percentile. in conparison to the Slst percentile for the average score of nonsymptonatic expectant fathers on a normative scale for males (Jackson. 1984. p. 12). Such men could be characterized as caring. protective. and sympathetic. The role of such factors in relation to couvade symptonatology has been noted in the literature. often being termed "sympathy pains." Under consideration in this investigation was the expectant fathers' degree of interpersonal 62 orientation. However. the differences and associations of couvade symptonatol ogy did not support such other personality traits as affiliation. exhibition. and social recognition. Nor were differences found in the contrasting traits of aggression and defendence. Fron this study. only one specific interpersonal trait. nurturance. was suggested as being associated with couvade symptonatol ogy. Hence a particular quality on only one aspect in one's interpersonal orienta- tion toward others is at issue in the analysis of couvade symptonatol- ogy. Functioning relative to orientation away fron others as aggres- sion and defendence is not at issue. In contrasting nurturance with the ofiner traits in this cluster. a quality of passivity was noted. Lacking was the active quality found in traits of affiliation. exhibi- tion. social recognition. aggression. and defendence. The passive attempts in associating or relating appear similar to that noted in the psychoanalytic explanations of couvade symptons regarding regres- si on to a passive-honosexual stage of the expectant father's emotional development. Although more research is necessary in understanding the role of development and trait formation. such findings are helpful in directing research in this area along a psychodynamic/object-relations perspective. Unfortunately. anticipated differences between groups relative to early trauna (i.e.. separation fron parents. losses) were not supported. Associations between separation and anxiety (both acute and chronic) were found but were not realized in relation to acute couvade symptonatol ogy. An association between these variables would have provided needed direction in understanding the underlying 63 dynamics of possible regression occurring during the period of expectant fatherhood. There were no significant findings to report relative to the second cluster of traits under consideration: succorance and autonony. Although no relationships or differences were found. the results may be helpful in theorizing and specifying to what stage in devel current the possible regression occurred. The regression features associated wifin succorance are of a more primitive dependent nature (suggested. as well. in the defining adjectives of the trait) than those of nurturance. A more "incorporative" receiving mode as opposed to the passive "giving" mode characteristic of nurturance is suggested in a more "clinical" analytic analysis of traits. Conmon to both is the suspected role of dependency in a regression process. Given the findings on nurturance. the regression may likely be centered on phases of separation/individuation rather than more primitive "i ncorporative " symbiotic ones. The lack of any significant relationship of trauna or losses with acute couvade symptonatology raises questions as to the sources of regression in relation to couvade symptonatol ogy. The regression may be a function of longstanding and more pervasive dynamics within fine expectant father's family of origin. which is recapitulated in adult relationships. The regression could possibly be triggered by the perception of events regarding expectant fatherhood. as well as the functioning of his partner. The role of the expectant father's partner appears to be an integral part of the dynamics of couvade 64 symptonatology. as supported by the noted correlational findings on anxiety. couvade symptonatol ogy. and personality variables. EensonaIiMastoLsL-Eacsonalitx IcaitsJLEantnachLfligblLAcuta: SymptomatiLExpestantiatbsts Perhaps the most intriguing finding in this study was that related to the partners of expectant fafiners. Of particular interest was the significant trait difference noted between the partners of highly acute-symptonatic expectant fathers in conpari son to fine part- ners of nonsymptonatic expectant fathers. A significant difference was noted with fine trait of nurturance. Partners of highly acute symptonatic expectant fathers scored lower finan the partners of asymptonatic expectant fathers. In relation to fenale norms (Jackson. 1984). the groups' average scores on affiliation were at the 63rd percentile for the asymptonatic group of males and the 40th percentile for highly acute-symptonatic expectant fathers. The correl ational analysis of this trait with acute couvade symptonatology provided significant negative correlations. further supporting the distinctions noted in the conparative analysis. As well. significant negative cor relations were found on traits of affiliation and exinibiti on. The correlational analyses failed to show differences or associa- tions relative to the other personality traits. At issue are traits related to interpersonal orientations with a characteristic quality of withholding and reticence in one's interpersonal style. Uncertainty renains as to the nature of this interpersonal orientation. whefiner it is longstanding or a function of more acute changes as pregnancy. 65 In discussing these results. the question as to the nature and stability of traits. particularly during developmental "crisis" periods. is raised. The hign degree of nurturance exhibited by acute- symptcmatic expectant fathers may have been a reaction to the sensed emotional distance fran their partners. The question ranains whether this relationship was present before the coupl e's cohabitation or was a function of the pregnancy. Wanen with less need for nurturance may be attracted to the nurturance found in a male acquaintance and may indeed seek out such males to fill a personal void. Equally plausible are fine emotional effects of pregnancy. pranpting a shift in attention away fran the relationship in favor of a more introspective or focused attention to one's self. A shift in one's interpersonal orientation could occur for some fanal es. given dnanges (psychological. anotional) that are experienced during the progression of their pregnancy. This shift in orientation may rekindle earlier fears of object loss for the expectant father and trigger a regression to a more passive nurturing mode of interaction. Besmmendations The study of expectant parenthood is undoubtedly stimulating. The crisis nature of this devel opnental process lends itself to a variety of avenues of investigation. Of special interest in this study was the psychophysi ol ogi cal experiences of expectant fathers. wifin particular attention to associated personality traits. Results. althougn interesting. are not conclusive. yet they may provide needed 66 direction in the investigation of such phenonena in fine future. A main point of enphasis to be made. resulting frcm the findings of this study. is that the investigation of fine general area of expectant parenthood should be undertaken. assessing factors for both partners in a relationship. The exclusive attention on either expectant mother or expectant father may provide only limited information and in so doing run the risk of making inaccurate assunptions relative to personality factors and dynamics of expectant parenthood. The implications of the results of this study are likely to affect both fineoretical and applied areas in psychology. Certainly more research is needed to verify the results of this investigation. as well as to expand the general knowledge of the field of expectant parenthood. Ideally. a longitudinal investigation of the symptonatol- ogy experienced by expectant fathers would be beneficial. The design of such a study could allow for more accurate reporting of symptons. particularly if symptonatol ogy was monitored weekly or monthly. Personality variables could be assessed at each trimester of the pregnancy to note possible fluctuations in traits. The use of in-depth clinical interviews would be helpful in obtaining more infor mation relative to early childhood history. with particular emphasis on anotional trauna and/or losses. Subjects for such a study would ideally be a random sample fran a large pool of expectant parents (i.e.. a large university clinic or a health maintenance organiza- tion). Although such a study would present certain limitations. it could provide additional information on this subject. 67 The goal of this type of research is to provide information to practitioners in fine field. In this situation. both physicians and psychotherapists should be aware of the possible association of physiological symptons they are witnessing in fineir patients with the pregnancy of a partner. Although the exact source of symptons ranains in question. there appears to be sufficient evidence to suggest that expectant fathers may be experiencing physical symptons associated with expectant fafinerhood. be it a specific cluster of symptons known as couvade syndrone or more likely an exacerbation of chronic symptons related to anxiety. If symptons are noted that are functional in nature. psychotherapy may be useful in mitigating difficulties the expectant father is experiencing. More research is needed with enphasis on personality dynamics of expectant couples. to provide added direction to practitioners involved in the care of expectant parents. With such concerns in mind. expectant fathers will be less likely to be overlooked or "forgotten" as a group. and the importance of their role. both during and following a pregnancy. will be realized and accepted. APPENDIX 68 MICHIGAN STATE UNIVERSITY COLLEGE OI EDUCATION ‘ DEPARTMENT OI COUNSELING. EAST LANSING ' MICHIGAN - 48824-1054 EDUCATIONAI PSYCHOLOGY AND SPEClAl EDUCATION August 6, 1985 Dr. Henry E. Bredeck, Chairperson University Committee on Research on Human Subjects 232 Administration Building Campus Dear Dr. Bredeck: Norm Gilbert's dissertation committee and I have read and approved his dissertation proposal and believe that it protects the rights of the subjects involved. Sincere v, 69 MICHIGAN STATE UNIVERSITY umvnsmr COMMITTEE ON mum: INVOLVING usr LANSING . :1me . «us-ms Huuxnsuuamm(ucunn w onmsmnou smmmc (5m ass-ms August 22,.1985 Normand Gilbert Graduate Student Dept. of Counseling and Educational Psychology Campus 7 ‘ Dear Mr. Gilbert: Subject: "A Study of Expectant Parents." I am pleased to advise that I concur with your evaluation that this project is exempt from full UCRIHS review) and approval is herewith granted for conduct of the project. You are reminded that UCRIHS approval is valid for one calendar year. If you plan to continue this project beyond one year. please make provisions for obtaining appropriate UCRIHS approval prior to August 22. 1986. Any changes in procedures involving human subjects must be reviewed by the UCRIHS prior to initiation of the change. UCRIHS must also be notified promptly of any problems (unexpected side effects. complaints.’ etc.) involving human subjects during the course of the work. Thank you for bringing this project to my attention. If I can be of any future help, please do not hesitate to let me know. Sincerely, We Henry E..Bredeck Chairman, DGRIHS mt cc: Dr. Richard Johnson 70 A STUDY OF EXPECTANT PARENTS Dear Expectant Parent. The period of pregnancy is no doubt a time of many changes. However. there have been few studies that have been done in order to understand the changes and their effects on both expectant mothers and expectant fathers. This study aims to do this needed work with your help. That is why this request is made of both you and your partner. The infor- mation you provide regarding the changes and possible stressors you have faced during this time in your life will be helpful to other expectant parents in the future. Your participation will involve answering questions found in two written questionnaires. Both questionnaires require very brief answers. Questions will center on you. your family. as well as recent changes you have experienced. The total time commitment is likely to be approximately 2 hours and can be completed at your home. The information you provide will be completely anonymous and will be combined with information provided by other expectant parents. There is no penalty for nonparticipation or quitting. Your decision will in no way affect the treatment or care you are receiving. Please keep in mind that this is an anonymous survey. and as such do not place your name on any of the questionnaires. Your voluntary participation in this investigation is both needed and appreciated. If you have questions regarding this study or need assistance in completing the questionnaires. please call me at home: (5l7) 349-Sl46 (call collect). Upon completion. please mail the entire package of questions and answers in the addressed and stamped envelope provided. Completion and return of materials constitutes consent for participation in this research project. Thank you for your cooperation. Sincerely. Normand Gilbert Graduate Student--Michigan State Univ. College of Education; School of Health Education. Counseling Psychology. and Hunan Performance Under the supervision of Richard Johnson. Ph.D. .7] ‘IMEQBIANI: Before you begin. please read the following. --In order to be included in the study..bntb parents must complete both questionnaires. --Given that no names will be utilized. please be sure to check the MALE/FEMALE items on both forms. This will help in keeping responses of partners separate. --The second questionnaire has a separate question booklet and answer forms. You have been given two answer forms (one for each of you) and one question booklet (that you are asked to share). To be noted is that each question is to be answered TRUE or FALSE by placing an X in the appropriate box. --You are asked to answer thetquestionnaires privately without the help of your partner. --If you have any questions or are uncertain of what is being asked. please call me at home: (5T7) 349-5146. .CQMELEIED_EQBMS: --Place each of the GENERAL INFORMATION OUESTIONNAIRES and both answer sheets of the PRF--FORM E in the PRF--FORM E question booklet. --Pl ace the booklet in the addressed and stamped envelope provided. --Please mail. --Your cooperation in this study is appreciated. SEX: 72 GENERAL INFORMATION QUESTIONNAIRE MALE FEMALE The following questions will consider information regarding the pregnancy as well as issues regarding your family history. 10. 11. 12. AGE: ARE YOU CURRENTLY AN EXPECTANT PARENT? YES NO WAS THIS A PLANNED PREGNANCY? YES NO IF SO, HOW LONG DID IT TAKE TO ACHIEVE PREGNANCY? HOW ARE YOU FEELING ABOUT THE PREGNANCY? 1-------------------------------- ------ - ---------- 5 VERY HAPPY 2 3 4 VERY UNHAPPY MARITAL STATUS: SINGLE MARRIED DIVORCED ARE YOU LIVING WITH YOUR PARTNER? YES NO IN WHAT TRIHESTER OF PREGNANCY ARE YOU OR YOUR PARTNER IN? FIRST SECOND THIRD HAVE YOU EVER BEEN DIVORCED? YES NO IF 50, HOW MANY TIMES? IF CURRENTLY MARRIED, HOW MANY YEARS? HOW MANY PEOPLE LIVE WITH YOU? WHO ARE THESE PEOPLE? (CHECK ALL THAT APPLY TO YOUR SITUATION) ____SPOUSE/PARTNER CHILDREN OF BOTH YOU AND YOUR SPOUSE/PARTNER HOW MANY YOUR CHILDREN FROM A PREVIOUS RELATIONSHIP HOW MANY SPOUSE/PARTNER'S CHILDREN FROM A PREVIOUS RELATIONSHIP HOW MANY .____YOUR PARENTS ONE ROTR ____YOUR SPOUSE/PARTNER'S PARENTS ONE BOTH ____OTHER PLEASE SPECIFY RELATIONSHIP IF ANY Row MANY 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 73 YOUR OCCUPATION HIGHEST GRADE COMPLETED RELIGIOUS AFFILIATION None Jewish Protestant Atheist Catholic Other - Specify RACE/ETHNIC GROUP White/Caucasian Black/Negro Oriental Other - Specify AGE WHEN YOU LEFT HOME? UNDER WHAT CIRCUMSTANCES? SCHOOL MARRIAGE WORK OTHER DID YOU EVER LIVE ALONE BEFORE YOU WERE MARRIED? YES NO IF SO, HOW LONG? YOUR FATHERS'S AGE WHEN YOU WERE BORN YOUR MOTHERS'S AGE WHEN YOU WERE BORN (Some of the following questions refer to your parents. If stepparents or grandparents or Others were the ones who had a greater influence in you life, please answer questions based on this relationship.) YOUR FATHER'S OCCUPATION (If deceased or retired, previous occupation) MOTHER'S OCCUPATION IF APPROPRIATE, 3923 ACE wHEN YOUR MOTHER DIED_____ IF APPROPRIATE, 3995 ACE wHEN YOUR FATHER DIED_____ NUMBER or HILEs SEPARATING you AND YOUR PARENTS THE NUMBER OF MONTHLY CONTACTS (FACE TO FACE OR BY PHONE, MAIL) YOU HAVE ON AN AVERAGE WITH YOUR PARENTS. 0- 5 6-10 11-15 15- OR MORE 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 714 FATHER'S LEVEL OF INVOLVEMENT IN RAISING THE CHILDREN LOW MODERATE HIGH MOTHER'S LEVEL OF INVOLVEMENT IN RAISING THE CHILDREN LOW MODERATE HIGH HOW MANY BROTHERS AND SISTERS DO YOU HAVE? PLEASE LIST THEIR SEX AND AGE SEX AGE ANY DECEASED BROTHERS OR SISTERS? YES NO IF SO, PLEASE NOETHEIR SEX AND YOUR AGE WHEN THEY DIED Sex Your age when they died Sex lYour age when they died WHILE LIVING WITH YOUR PARENTS, WERE YOUR PARENTS SERIOUSLY ILL? YES NO IF 80, YOUR AGE AT THAT TIME WHILE LIVING WITH YOUR PARENTS, WERE ANY OF YOUR BROTHERS OR SISTERS SERIOUSLY ILL? YES NO IF SO, YOUR AGE AT THE TIME WHILE LIVING WITH YOUR PARENTS, WHO DID YOU FEEL CLOSEST TO EMOTIONALLY? AND NOW DID YOUR PARENTS EVER UNDERGO A MARITAL SEPARATION? YES NO IF SO, HOW LONG DID IT LAST YOUR AGE AT THE TIME DID YOUR PARENTS EVER DIVORCE? YES NO IF 80, YOUR AGE AT THE TIME CAN YOU RECALL EVER BEING SEPARATED OR WERE YOU EVER TOLD THAT YOU WERE SEPARATED FROM EITHER PARENT FOR ANY SIGNIFICANT PERIOD OF TIME (one week or more)? YES NO IF SO, PLEASE SPECIFY THE LENGTH OF TIME YOUR AGE AT THE TIME The - 38. 40. 41. 42. 43. 44. 45. 75 following questions will focus attention on YOUR physical health. Please list any major illness you have had and when. Please list any surgery that your have had and when. Please list any medications you are taking at the present time. Your partner's health prior to the pregnancy POOR FAIR AVERAGE GOOD EXCELLENT Your health prior to the pregnancy POOR PAIR AVERAGE GOOD EXCELLENT Your partner's health during the pregnancy POOR FAIR AVERAGE GOOD EXCELLENT Your health during the pregnancy POOR FAIR AVERAGE GOOD EXCELLENT 76 46. Listed below are a number of events which sometimes bring about change in the lives of those who experience them and which necessitate social readjustment. Please Check those events which you have experienced and the time period during which you have experienced each event. As well. please indicate the extent to which you viewed the event as having either a positive or negative impact on your life at the time the event occurred. O to to nos NO HWHCT RIHTHE MMIRAUHX SLK}HLY HIHTPWS ~ \I TI EXHNQEIX MMIRNHHN NBBUTVE SOIWHKT NHHUTVE NEHUTVE EXHEWELY FUSYHNE FORDflLEMRE