Family Economic Stress, Quality of Paternal Relationship, and Depressive Symptoms among African American Adolescent Fathers

Determinants of Depression Among Higher Secondary Students of Private Schools of Science Stream in an Urban Area of Western India

Background

Depression, due to its devastating consequences, emerged as the third leading cause of mortality among adolescent school-going children. This necessitates research on determinants of depression among students for effective management. The present study evaluated the various determinants associated with depression among the science students of a private school in Rajkot city, India.

Materials and Methods

A cross-sectional study was carried out among the 1219 students of a private school of science stream in Rajkot city, adopting multistage sampling methods. Students were screened using Patient Health questionnaire-9 (modified for teens) for depression. A pre-tested semi-structured questionnaire was used to assess the determinants associated with depression. Binary logistic regression analysis was done to find out predictors of depression.

Results

About 31.99% of students were found suffering from depression. Physical illness, academic performance, substance abuse, feeling study tough, difficulties in transport, food, monetary and accommodation at a hostel or home, pressure from parents for study, physical activities, sleep disturbance, and bad relations with teachers and classmates were significantly associated with depression. While parental education, physical illness, addiction to any substance, and academic performance emerged only as a predictor of depression.

Conclusion

The present study showed a significant proportion of students suffering from depressive symptoms and revealed predictors of depression among the students. These required integrated efforts to minimize the risk of depression among the students.

Perceived social support and family members of patients with mental disorders: A mixed method study

Introduction

Family members are the caregivers to patients with mental disorders at home, and the mental and spiritual pressures caused by this responsibility necessitate physical, mental, and perceived social support for these families. The present mixed method study is an attempt to elaborate on the perceived social support by Iranian families of patients with chronic mental disorders.

Materials and methods

Using a sequential mixed method explanatory study (quantitative and qualitative), 200 family members of patients with chronic mental disorders were selected through convenient sampling (quantitative phase). Data gathering was started using a demographics form and Stewart and Sherburne's perceived social support scale. The qualitative phase included 10 participants who obtained low scores in the quantitative phase and took part in private, face-to-face, in-depth, and semi-structured interviews. The data obtained in the quantitative phase were analyzed using statistical tests, and the interviews were analyzed using qualitative content analysis.

Findings

The perceived social support by the participants was at a moderate level in different fields of tangible support, information and emotional support, kindness, and positive social interactions. The results of the qualitative phase revealed social support status in 15 subcategories, 6 categories, and 2 themes of support and acceptance by family, relatives, and friends, with support and being understood by society. The results of the qualitative and quantitative sections emphasized the needs of the patient's family members (who acted as caregivers for patients) for support in family, social, and emotional areas.

Conclusion

The family members of patients with chronic mental disorders have different needs in the area of perceived social support. Such needs are more tangible in family members such as children with mentally ill parents or parents with mentally ill children. The results of this study can be used for educational and supportive planning for caregivers of patients, most of whom are family members.

Instruments to Identify Symptoms of Paternal Depression During Pregnancy and the First Postpartum Year: A Systematic Scoping Review

Men often experience depressive symptoms during the transition to parenthood, but there is a lack of synthesized knowledge of instruments used to identify such symptoms. The aim of this scoping review was to identify instruments used to measure symptoms of depressive symptoms among fathers in pregnancy and the postpartum period, and to describe the instruments' characteristics and measurement properties. We identified studies published since 1990 through searches in databases such as MEDLINE, EMBASE, and PsycINFO and in gray literature. Pairs of reviewers selected relevant studies based on predetermined inclusion criteria. For each included study, we collected information relevant to the review question, guided by the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN). We included 13 instruments, described in 59 studies with about 29,000 participants across 25 countries. There were 12 validation studies. None of the instruments were uniquely developed for assessing paternal depressive symptoms related to fatherhood. The three most extensively examined instruments were the Edinburgh Postnatal Depression Scale (EPDS), Center for Epidemiologic Studies Depression Scale, and Beck Depression Inventory. For seven of the 13 instruments, there was no information reported about the instruments' properties beyond internal consistency, but for the other six instruments the 12 validation studies reported on both reliability and validity. No studies reported on measurement error or responsiveness. EPDS was both the most extensively assessed instrument and reported to be the most reliable and valid. Further research on instruments for identifying men with depression in pregnancy and the postpartum period is warranted.

Care of Adolescent Parents and Their Children

Teen pregnancy and parenting remain important public health issues in the United States and around the world. A significant proportion of teen parents reside with their families of origin, which may positively or negatively affect the family structure. Teen parents, defined as those 15 to 19 years of age, are at high risk for repeat births. Pediatricians can play an important role in the care of adolescent parents and their children. This clinical report updates a previous report on the care of adolescent parents and their children and addresses clinical management specific to this population, including updates on breastfeeding, prenatal management, and adjustments to parenthood. Challenges unique to teen parents and their children are reviewed, along with suggestions for the pediatrician on models for intervention and care.

Psychosocial Factors Associated with Paternal Perinatal Depression in the United States: A Systematic Review

Paternal perinatal depression can occur in approximately one out of ten fathers. However, research within this population is limited. A previous systematic review suggested that United States had higher rates of paternal perinatal depression compared to other countries. Therefore, this systematic review identified psychosocial factors for depression during the perinatal period in fathers who live in the United States. A literature search was conducted from multiple databases using keywords and MeSH terms to retrieve articles up to the year 2019. Twenty five articles were included in this review. A social-ecological framework was applied to identify psychosocial factors associated with paternal depression. Individual factors include prior history of depression, having maladaptive cognitive coping styles, fathers who self-identified as African-American or Hispanic, parenting stress, substance use, and history of criminal conviction. Interpersonal factors include lack of social support, quality of relationship with the mother of the baby, coparenting conflict, quality of current and childhood relationships with their own parents, and maternal depression. Community factors include frequent daily experiences with racism, and limited access to transportation and housing. These findings underscore the importance of assessing depression and developing father-inclusive interventions that address the psychological needs of fathers.

Air pollution risks human mental health: an implication of two-stages least squares estimation of interaction effects

The study investigates the relationship between air pollution and the status of human mental health using the data of the China Migrant Dynamic Survey (CMDS), 2014. Various econometric methods were used. Particularly, the ordinary least square (OLS) was used to estimate the parametric impact of mental health. Moreover, a robustness test was used to estimate negative impact of air pollution on mental health. Results found that air pollution significantly increased psychological disorder. The concentration of PM2.5 in the air leads to higher prominence of the four negative emotions such as nervous, depression, powerless, and restless or fidgety. After introducing the instrumental variable to solve the endogenous problem, the impact of air pollution on the level of the mental illnesses was still significant and negative. Results are also evident that air pollution has heterogeneity to the negative status of residents' mental health. Specifically, it has a significant and negative impact on women, rural and urban population, and middle- and low-income groups. The study results suggest that the government must have to revise the environmental regulation policy reduce the negative impact on human health.

Influence of parental stress, depressed mood, and suicidal ideation on adolescents' suicidal ideation : The 2008-2013 Korean National Health and Nutrition Examination Survey

BACKGROUND

Maternal depression and suicidal ideation (SI) predict adolescent SI. However, the influence of paternal psychopathology is less clear. This study examines how parental psychopathology contributes to adolescent SI.

METHODS

Data from a cross-sectional, nationwide, population-based survey was used. It assessed 4,073 adolescents (12-18 years) and their parents identified through random sampling of the non-institutionalized population in Korea. Stress, depressed mood, and SI of parents and adolescents were assessed using multivariate logistic regression to determine the association of adolescents' SI with parental stress, depressed mood, and SI.

RESULTS

Adolescents who reported SI were more likely to be girls, have shorter sleep duration, more stress, and a depressed mood than were adolescents without SI. Logistic regression analysis showed estimated odds ratios for SI of 1.444 (p < .05), 1.485 (p < .05) and 1.801 (p < .05) for girls who had mothers with stress, depressed mood, and SI, respectively, and 2.113 (p < .05) and 3.091 (p < .05) for girls who had fathers with depressed mood and SI, respectively. Boys' SI was associated with father's depressed mood (OR: 2.608, p < .05).

LIMITATIONS

Cross-sectional design and use of self-report measures.

CONCLUSIONS

Girls' SI was related to both parents' stress, depressed mood, and SI except for father's stress, and boys' SI was related to father's depressed mood. Evaluations and therapeutic interventions for adolescents with SI should consider both adolescents and their parents, and family-based interventions could be one method for adolescent suicide prevention.

Racial and Ethnic Differences in Teenage Fathers' Early Risk Factors and Socioeconomic Outcomes Later in Life

Background

Understanding racial differences in teenage fathers' early risk factors and later outcomes is critical to inform programs for teenage fathers as our knowledge base on this population remains limited.

Objective

The goal of this study was to assess how teen fathers' characteristics, including family background, delinquency, living arrangements, socioeconomic resources, and arrests, vary over time by race and ethnicity.

Method

We analyzed National Longitudinal Study of Adolescent to Adult Health data. The analytic sample consisted of self-identified African American, Latino, and White males who fathered a child before the age of 20 (n = 313). Data come from three time points: adolescence, transition to adulthood, and young adulthood.

Results

Latino teen fathers came from families with lower educational attainment and greater reliance on public assistance. No statistically significant differences by race and ethnicity were found in parental involvement, school connectedness, marijuana use, and delinquency during adolescence. By their early 20s, a lower proportion of African American teen fathers were married compared to White and Latino teen fathers. By young adulthood, adjusted regression analyses showed that African American teen fathers were more likely to be arrested and earned a lower mean income than White teen fathers.

Conclusions

Findings suggest that African American teen fathers, while no more disadvantaged or delinquent than the other two groups in their adolescence, experience greater accumulation of disadvantages over the life course. Intervention programs must consider the broader social and institutional context that may contribute to the disproportionate disadvantage among African American teen fathers in their young adulthood.

Parental Educational Attainment and Mental Well-Being of College Students; Diminished Returns of Blacks

Background. According to the Minorities’ Diminished Returns (MDR) theory, the health returns of socioeconomic status (SES) are systemically smaller for Blacks compared to Whites. Less is known, however, about trans-generational aspects of such diminished gains. For example, the differential impact of parental educational attainment on differences in mental well-being between White versus Black college students remains unknown. Aims. With a national scope, this study explored racial differences in the effect of parental educational attainment on the mental well-being of college students in the United States. Methods. The Healthy Mind Study (HMS), 2016–2017, is a national telephone survey that included 41,898 college students. The sample was composed of Whites (n = 38,544; 92.0%) and Blacks (n = 3354; 8.0%). The independent variable was highest parental educational attainment. The dependent variable was mental well-being (mentally healthy days in the past month) which was measured using a single item. Age and gender were covariates. Race was the moderator. Logistic regression was used for data analysis. Results. In the pooled sample, high parental educational attainment was associated with better mental wellbeing, independent of race, age, and gender. Race, however, showed a significant interaction with parental educational attainment on students’ mental wellbeing, indicating a smaller effect of parent education on the mental wellbeing of Black compared to White college students. Conclusions. The returns of parental educational attainment in terms of mental well-being is smaller for Black college students compared to their White counterparts. To minimize the diminished returns of parental education in Black families, policies should go beyond equalizing SES and reduce the structural barriers that are common in the lives of Black families. Policies should also aim to reduce extra costs of upward social mobility, prevent discrimination, and enhance the quality of education for Blacks. As the mechanisms that are involved in MDR are multi-level, multi-level solutions are needed to minimize the racial gaps in gaining mental health benefits from higher socioeconomic levels.

Maternal Educational Attainment at Birth Promotes Future Self-Rated Health of White but Not Black Youth: A 15-Year Cohort of a National Sample

Background: Socioeconomic status (SES) is essential for maintaining health, and self-rated health (SRH) is not an exception to this rule. This study explored racial differences in the protective effects of maternal educational attainment at birth against poor SRH of the youth 15 years later. Methods: Using data from the Fragile Families and Child Wellbeing Study (FFCWS), this 15-year longitudinal study followed 1934 youths from birth to age 15. This sample was composed of White (n = 497, 25.7%), and Black (n = 1437, 74.3%) youths. The independent variable was maternal educational attainment at birth. SRH at age 15 was the dependent variable. Family structure was the covariate. Race was the focal moderator. We ran logistic regression models in the pooled sample, as well as stratified models based on race. Results: In the pooled sample, maternal educational attainment and family structure were not predictive of SRH for the youths at age 15. Race interacted with maternal educational attainment, indicating a stronger association between maternal educational attainment at birth on youth SRH for Whites compared to Blacks. In race stratified models, maternal educational attainment at birth was protective against poor SRH for White but not Black youths. Conclusion: White but not Black youths gain less SRH from their maternal educational attainment. Enhancing education attainment may not have identical effects across racial groups. The health status of Blacks may be less responsive to improvements in maternal educational attainment. Policies should go beyond investing in educational attainment by empowering Black families to better use the educational attainment that they gain. Policies and programs should reduce the costs of upward social mobility for minority families.

Blacks' Diminished Health Return of Family Structure and Socioeconomic Status; 15 Years of Follow-up of a National Urban Sample of Youth

The protective effect of family structure and socioeconomic status (SES) on physical and mental health is well established. There are reports, however, documenting a smaller return of SES among Blacks compared to Whites, also known as Blacks' diminished return. Using a national sample, this study investigated race by gender differences in the effects of family structure and family SES on subsequent body mass index (BMI) over a 15-year period. This 15-year longitudinal study used data from the Fragile Families and Child Wellbeing Study (FFCWS), in-home survey. This study followed 1781 youth from birth to age 15. The sample was composed of White males (n = 241, 13.5%), White females (n = 224, 12.6%), Black males (n = 667, 37.5%), and Black females (n = 649, 36.4%). Family structure and family SES (maternal education and income to need ratio) at birth were the independent variables. BMI at age 15 was the outcome. Race and gender were the moderators. Linear regression models were run in the pooled sample, in addition to race by gender groups. In the pooled sample, married parents, more maternal education, and income to need ratio were all protective against high BMI of youth at 15 years of age. Race interacted with family structure, maternal education, and income to need ratio on BMI, indicating smaller effects for Blacks compared to Whites. Gender did not interact with SES indicators on BMI. Race by gender stratified regressions showed the most consistent associations between family SES and future BMI for White females followed by White males. Family structure, maternal education, and income to need ratio were not associated with lower BMI in Black males or females. The health gain received from family economic resources over time is smaller for male and female Black youth than for male and female White youth. Equalizing access to economic resources may not be enough to eliminate health disparities in obesity. Policies should address qualitative differences in the lives of Whites and Blacks which result in diminished health returns with similar SES resources. Policies should address structural and societal barriers that hold Blacks against translation of their SES resources to health outcomes.

Paternal Caregivers' Parenting Practices and Psychological Functioning among African American Youth Living in Urban Public Housing

Structural factors associated with public housing contribute to living environments that expose families to adverse life events that may in turn directly impact parenting and youth outcomes. However, despite the growth in research on fathers, research on families in public housing has practically excluded fathers and the role fathers play in the well-being of their adolescents. Using a sample of 660 African American adolescents recruited from public housing, we examined the relationship between paternal caregivers' (i.e., fathers' and father figures') parenting practices and adolescents' depressive symptoms, attitudes toward deviance, and self-efficacy. Using a latent profile analysis (LPA), we confirmed a four-class model of paternal parenting practices ranging from high to low levels of monitoring and encouragement. Results from a one-way ANOVA indicated that paternal caregivers with high (compared to moderate) levels of encouragement and monitoring were associated with youth who reported less depressive symptoms, higher levels of self-efficacy, and less favorable attitudes toward deviance. Discriminant analysis results indicated that approximately half of the sample were correctly classified into two paternal caregiver classes. The findings provide evidence that some of these caregivers engage in parenting practices that support youths' psychological functioning. More research is needed to determine what accounts for the variability in levels of paternal encouragement and supervision, including environmental influences, particularly for paternal caregivers exhibiting moderate-to-low levels of paternal encouragement and monitoring.

Mental Health Service Utilization among Black Youth; Psychosocial Determinants in a National Sample

Racial disparity in mental health service utilization (MHSU) persists, and youths are not an exception to the underutilization of services. Very limited research has been conducted on the determinants of MHSU among Black youth. Using a national sample of American Black youth, the current study investigated the association between demographic factors, socioeconomic status, psychiatric disorders, and self-rated health (SRH) on MHSU. We also tested the heterogeneity of the effects of SRH and psychiatric disorders based on ethnicity, gender, and their intersection. We used data from the National Survey of American Life-Adolescents supplement (NSAL-A), 2003–2004. The study enrolled 1170 Black youth between 13 and 17 years old including 810 African Americans and 360 Caribbean Blacks. Age, gender, ethnicity, socioeconomic status, SRH, 12-month psychiatric disorders (Composite International Diagnostic Interview modified version), and MHSU (last year) were measured. Logistic regressions were used for data analysis. Ethnicity (odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.17–0.65), subjective socioeconomic status (OR = 1.43, 95% CI = 1.09–1.88), SRH (OR = 2.45, 95% CI = 1.00–6.37), and psychiatric disorders (OR = 2.17, 95% CI = 1.05–4.48) were associated with MHSU. Age, gender, and objective socioeconomic status were not associated with MHSU. Gender and ethnicity did not interact with SRH and psychiatric disorders on MHSU. Actual and perceived need both universally influence Black youths’ likelihood of MHSU, regardless of their ethnicity and gender. Ethnicity and perceived socioeconomic status also play unique roles in MHSU. Future research is needed to understand pathways to MHSU for Black youth who both have and perceive mental health needs. There is also a need to find ways to promote MHSU for those with a need for mental health services.