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.

  • Source
    • "The researchers found that in the case of health-related behaviors, subjective support is more important than objective support, because the supportive resources are not used by a person if they do not understand (Sadeghi et al., 2014). Adverse interpersonal factors, like low social support and high social contrast, may have deep impact on mental and physical health of women during pregnancy (Westdahl et al., 2007). The association between social support and pregnancy outcomes is complex, involving psychological and biological response to life-events and stress (Edmonds et al., 2011). "

    Preview · Article · Sep 2015
  • Source
    • "For each symptom of depression, participants indicated how often they felt or behaved in the specified way over the past week, ranging from 0 (less than 1 day a week) to 3 (most of the time, 5–7 days a week). Given that the CES-D can inflate estimates of depression, because several items reflect somatic complaints that also occur with medical conditions and pregnancy, 5 of the original 20 items were excluded (Kalichman, Rompa, & Cage, 2000; Milan et al., 2007; Mundell et al., 2011; Orr, James, & Prince, 2002; Westdahl et al., 2007). These five items included " I did not feel like eating, " " I had trouble keeping my mind on what I was doing, " " I felt that everything I did was an effort, " " My sleep was restless, " and " I could not get 'going.' "
    [Show abstract] [Hide abstract]
    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.
    Preview · Article · Jan 2014 · Journal of Clinical Psychology
  • Source
    • "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. "
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · Dec 2013 · SpringerPlus
Show more