Social Support and Social Conflict as Predictors of Prenatal Depression

Department of Psychology, University of Connecticut, Storrs, Connecticut, United States
Obstetrics and Gynecology (Impact Factor: 5.18). 08/2007; 110(1):134-40. DOI: 10.1097/01.AOG.0000265352.61822.1b
Source: PubMed


To estimate how social support and social conflict relate to prenatal depressive symptoms and to generate a brief clinical tool to identify women at increased psychosocial risk.
This is a prospective study following 1,047 pregnant women receiving care at two university-affiliated clinics from early pregnancy through 1 year postpartum. Structured interviews were conducted in the second trimester of pregnancy. Hierarchical and logistic regressions were used to examine potential direct and interactive effects of social support and conflict on prenatal depressive symptoms measured by the Center for Epidemiologic Studies-Depression Scale.
Thirty-three percent of the sample reported elevated levels of depressive symptoms predicted from sociodemographic factors, social support, and social conflict. Social support and conflict had independent effects on depressive symptoms although social conflict was a stronger predictor. There was a "dose-response," with each increase in interpersonal risk factor resulting in consequent risk for probable depression based on symptom reports (Center for Epidemiologic Studies-Scale greater than or equal to 16). A composite of one social support and three conflict items were identified to be used by clinicians to identify interpersonal risk factors for depression in pregnancy. Seventy-six percent of women with a composite score of three or more high-risk responses reported depressive symptoms.
Increased assessment of social support and social conflict by clinicians during pregnancy can identify women who could benefit from group or individual interventions to enhance supportive and reduce negative social interactions.

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    ABSTRACT: The current study investigates the relationship between romantic attachment style and depressive symptoms between both members of pregnant adolescent and young adult couples. Participants were 296 pregnant young females (mean age = 18.7) and their male partners (mean age = 21.3; 592 total participants) who were recruited from obstetrics and gynecology clinics in Connecticut. The dimensions of avoidant and anxious romantic attachment were assessed using the Experiences in Close Relationships Inventory. Depressive symptoms were measured using the Center for Epidemiological Studies-Depression Scale. Results showed that avoidant attachment and anxious attachment were significantly positively related to depressive symptoms. Multilevel modeling for partner effects revealed that anxious attachment and depressive symptoms in partners were significantly positively associated with depressive symptoms CONCLUSION: Findings underscore the importance of considering couples-based approaches to supporting the transition to parenthood and developing the necessary self and relationship skills to manage attachment needs and relationship challenges.
    Journal of Clinical Psychology 01/2014; 70(1). DOI:10.1002/jclp.21979 · 2.12 Impact Factor
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    • "Housewives appeared to be at highest risk of prenatal depression considering their frequency exposure to known risk factors such as low level of education, immigrant status, low income, stressful life events, lack of social support and marital strain which, in our study, were once again independently associated with prenatal depressive symptoms (Bennett et al. 2004; Rich-Edwards et al. 2006; Lancaster et al. 2010; Marcus et al. 2003; Westdahl et al. 2007; Zelkowitz et al. 2004). Even after adjusting for these factors, housewives had a greater prevalence of major depressive symptoms than working women. "
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    ABSTRACT: The objectives of our study were to compare the prevalence of major depressive symptoms between subgroups of pregnant women: working women, women who had stopped working, housewives and students; and to identify risk factors for major depressive symptoms during pregnancy. The CES-D scale (Center for Epidemiological Studies Depression scale) was used to measure major depressive symptoms (CES-D score ≥23) in 5337 pregnant women interviewed at 24-26 weeks of pregnancy. Multivariate logistic regression models were developed to identify risk factors associated with major depressive symptoms. Prevalence of major depressive symptoms was 11.9% (11.0-12.8%) for all pregnant women. Working women had the lowest proportion of major depressive symptoms [7.6% (6.6-8.7%); n = 2514] compared to housewives [19.1% (16.5-21.8%); n = 893], women who had stopped working [14.4% (12.7-16.1%); n = 1665], and students [14.3% (10.3-19.1%); n = 265]. After adjusting for major risk factors, the association between pregnant women's employment status and major depressive symptoms remained significant for women who had stopped working (OR: 1.61; 95% CI 1.26 to 2.04) and for housewives (OR: 1.46; 95% CI 1.10 to 1.94), but not for students (OR: 1.37; 95% CI 0.87 to 2.16). In multivariate analyses, low education, low social support outside of work, having experienced acute stressful events, lack of money for basic needs, experiencing marital strain, having a chronic health problem, country of birth, and smoking were significantly associated with major depressive symptoms. Health professionals should consider the employment status of pregnant women when they evaluate risk profiles. Prevention, detection and intervention measures are needed to reduce the prevalence of prenatal depression.
    SpringerPlus 12/2013; 2(1):201. DOI:10.1186/2193-1801-2-201
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    • "Chronic exposure to psychosocial stress is common in humans, especially in mothers, and one of the strongest predictors of depression in mothers is social conflict (Westdahl et al. 2007). Several clinical studies have linked pre-or postpartum depression with exposure to various stressors during pregnancy or the postpartum period (Paykel et al. 1980; O'Hara et al. 1983; O'Hara 1986; Seguin et al. 1995; Beck 1996, 2001; O'Hara and Swain 1996; Robertson et al. 2004; Westdahl et al. 2007; Klier et al. 2008). Furthermore, postpartum mood disorders have been correlated with high levels of social conflict (within the family and/or workplace) in combination with low levels of social "
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    ABSTRACT: Maternal mood disorders such as depression and chronic anxiety can negatively affect the lives of not only mothers, but also of partners, offspring, and future generations. Chronic exposure to psychosocial stress is common in postpartum mothers, and one of the strongest predictors of postpartum depression is social conflict. The objective of the current study was to evaluate the effects of chronic social stress (CSS) during lactation on the maternal behavior (which consists of maternal care and aggression toward a novel conspecific) of lactating rats, as well as on the growth of the dams and their offspring. It was hypothesized that chronic daily exposure to a novel male intruder would alter the display of maternal behavior and impair growth in both the dam and offspring during lactation due to the potentially disruptive effects on maternal behavior and/or lactation. The data indicate that CSS during lactation attenuates maternal care and the growth of both dams and pups, and increases self-grooming and maternal aggression toward a novel male intruder. These results support the use of CSS as a relevant model for disorders that impair maternal behavior and attenuate growth of the offspring, such as postpartum depression and anxiety.
    Stress (Amsterdam, Netherlands) 08/2011; 14(6):677-84. DOI:10.3109/10253890.2011.605487 · 2.72 Impact Factor
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