1
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Nagpal TS, Incollingo Rodriguez AC. Prenatal weight stigma can affect relationship quality and maternal health outcomes. BMC Pregnancy Childbirth 2024; 24:678. [PMID: 39425073 DOI: 10.1186/s12884-024-06859-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 09/24/2024] [Indexed: 10/21/2024] Open
Abstract
BACKGROUND Weight stigma is defined as negative misconception and stereotypes associated with weight, and it is commonly experienced during pregnancy. Weight stigma during pregnancy may be sourced from trusted close relationships including family members, partners, and friends. Social support is a necessary psychosocial factor for optimal health and wellbeing throughout pregnancy, and weight stigma sourced from these integral relationships may negatively affect health outcomes. The purpose of this study was to assess the impact of weight stigma from close others on maternal health outcomes. METHODS A survey was administered via Qualtrics to pregnant women (≥ 13 weeks, residence within the United States or Canada, ≥ 18 years old, singleton pregnancy). During pregnancy, participants completed questionnaires identifying whether they had experienced weight stigma from a close relationship (i.e., family, partners, or friends), how often, and relationship quality scales for each source. At three months postpartum, they were surveyed about their pregnancy outcomes including gestational diabetes, gestational hypertension, preeclampsia, chronic pain, anxiety/depression. They also completed the Edinburgh Postpartum Depression Scale (EPDS), and a linear regression was performed with frequency of weight stigma. Logistic regressions were performed between frequency of weight stigma and health outcomes. If significant, relationship quality was tested as a potential mediator. Significance was accepted as p < 0.05. RESULTS 463 participants completed both surveys of which 86% had experienced weight stigma from close others. Frequency of weight stigma was significantly associated with chronic pain (β = 0.689, p < 0.001), and anxiety/depression (β = 0.404, p = 0.005). The relationship between frequency of weight stigma in pregnancy and chronic pain was mediated by quality of all relationships. Family relationship quality mediated between frequency of weights stigma and anxiety/depression. Frequency of weight stigma was significantly associated with depression symptom severity measured by the EPDS (β = 0.634, p < 0.001). CONCLUSION These findings underscore the issue of weight stigma and show that experiencing this from trusted close others is associated with poor health outcomes like chronic pain. Advocacy efforts to mitigate weight stigma in pregnancy and strengthen close relationships to improve maternal health and wellbeing is warranted.
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Affiliation(s)
- Taniya S Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Angela C Incollingo Rodriguez
- Psychological & Cognitive Sciences, Department of Social Science & Policy Studies, Worcester Polytechnic Institute, 100 Institute Road, Worcester, MA, 01609, USA.
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2
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Haynes P, Hart A, Eryigit-Madzwamuse S, Wood M, Maitland J, Cameron J. The contribution of a complex systems-based approach to progressive social resilience. Health (London) 2024; 28:754-774. [PMID: 37649331 PMCID: PMC11323425 DOI: 10.1177/13634593231195784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
The use of resilience in social practice has evolved from a theoretical framework at the intersection between individuals and their social ecology. Critics argue this theory still results in policies and practices that are too individualised, with the potential for negative social consequences. This paper further critiques contemporary understanding of resilience theory and its application. It juxtaposes complex systems theory with a social inequalities oriented resilience practice. This provides a paradoxical approach. It is acknowledged that state and public policy decisions and actions can be anti-resilient, undermining community and social resilience that already exists in the form of social relationships, self-organisation and co-production. Nevertheless, collective social resilience also illustrates the potential of local and service user organisations to contribute to an overall transformational change process.
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Affiliation(s)
- Philip Haynes
- Philip Haynes, Centre of Resilience for Social Justice, University of Brighton, Falmer, Brighton BN1 9PH, UK.
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3
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Shiffman N, Gluska H, Margalit S, Mayer Y, Daher R, Elyasyan L, Elia N, Sharon Weiner M, Miremberg H, Kovo M, Biron-Shental T, Gabbay-Benziv R, Helpman L. Unfolding of maternal-infant bonding amidst the COVID-19 pandemic: Social support as a risk and protective factor. Dev Psychopathol 2024:1-9. [PMID: 38654408 DOI: 10.1017/s0954579424000853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND Social, familial, and physiological stressors may put maternal-infant bonding at risk. Therefore, it is plausible that the stressful conditions brought on by COVID-19 could influence maternal-infant bonding. This study aimed to elucidate the contribution of COVID-19-related experience to variance in maternal-infant bonding, beyond that of established risk factors and as moderated by social support. METHODS This longitudinal, multicenter study examined the relationship of demographic and obstetric variables, social support, postpartum depression, as well as COVID-19-related fear, exposure, and subjective difficulty with mother-infant bonding six months following birth. Participants (N = 246) were women who delivered during the pandemics' strict lockdown period and were recruited 10 weeks after a liveborn delivery and followed up six months later. RESULTS Relationship between fear of COVID-19 and maternal-infant bonding was moderated by social support: Amongst mothers with high levels of social support, fear of COVID-19 negatively predicted bonding. DISCUSSION Results indicate that social support, while overall a protective factor for mother-infant bonding, may lose its buffering effect when fear of COVID-19 is high. This relationship was maintained even when early bonding experiences such as forced separation and the risk incurred by postpartum depression were accounted for. Implications for providers are discussed.
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Affiliation(s)
- N Shiffman
- Psychiatry and Mental Health Division, Rambam Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - H Gluska
- Obstetrics and Gynecology, Meir Medical center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shiri Margalit
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Y Mayer
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
| | - R Daher
- The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
- Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - L Elyasyan
- The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
- Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - N Elia
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel
| | - M Sharon Weiner
- Obstetrics and Gynecology, Meir Medical center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - H Miremberg
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel
| | - M Kovo
- Obstetrics and Gynecology, Meir Medical center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - T Biron-Shental
- Obstetrics and Gynecology, Meir Medical center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - R Gabbay-Benziv
- The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
- Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - L Helpman
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
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4
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Duh-Leong C, Canfield CF, Fuller AE, Gross RS, Reichman NE. Early Childcare Precarity and Subsequent Maternal Health. Womens Health Issues 2024; 34:115-124. [PMID: 37978038 PMCID: PMC10978296 DOI: 10.1016/j.whi.2023.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/30/2023] [Accepted: 10/05/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE We examined prospective associations between early childcare precarity, or the security and reliability of childcare arrangements, and subsequent maternal health. STUDY DESIGN We conducted a secondary analysis of survey responses from mothers of 2,836 children in the Future of Families and Child Wellbeing study. We assessed the following childcare measures: insecure childcare, insecure childcare with missed work, inadequate childcare, and emergency childcare support. We used linear and logistic regression models with robust standard errors to examine associations between these measures when the index child was age 3 and maternal health outcomes (overall health, depression, and parenting stress) later when the child was age 9. We then examined additive experiences of childcare measures across child ages 1 and 3 on maternal health outcomes. RESULTS Early inadequate childcare was associated with higher odds of later poor maternal overall health (adjusted odds ratio [aOR], 1.64; 95% confidence interval [CI], 1.11-2.41). All early childcare precarity measures were associated with higher odds of maternal depression (insecure childcare [aOR, 1.64; 95% CI, 1.23-2.18]; insecure childcare with missed work [aOR, 1.58; 95% CI, 1.13-2.22]; and inadequate childcare [aOR, 1.75; 95% CI, 1.22-2.51]). Emergency childcare support was associated with lower odds of adverse maternal health outcomes (poor overall health [aOR, 0.65; 95% CI, 0.48 to 0.88]; depression [aOR, 0.73; 95% CI, 0.54 to 0.99]; and parenting stress [B -0.45; 95% CI, -0.80 to -0.10]). Prolonged experiences had stronger associations with maternal health than shorter experiences. CONCLUSION Early childcare precarity has long-term adverse associations with maternal health, and emergency childcare support seems to be favorable for maternal health. These findings highlight childcare precarity as a social determinant of women's health for researchers, clinicians, and decision-makers.
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Affiliation(s)
- Carol Duh-Leong
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, New York.
| | - Caitlin F Canfield
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, New York
| | - Anne E Fuller
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Rachel S Gross
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, New York
| | - Nancy E Reichman
- Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey; Child Health Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
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5
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Waynforth D. Alloparental Support and Infant Psychomotor Developmental Delay. HUMAN NATURE (HAWTHORNE, N.Y.) 2024; 35:43-62. [PMID: 38353866 PMCID: PMC11052766 DOI: 10.1007/s12110-024-09468-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 04/29/2024]
Abstract
Receiving social support from community and extended family has been typical for mothers with infants in human societies past and present. In non-industrialised contexts, infants of mothers with extended family support often have better health and higher survival through the vulnerable infant period, and hence shared infant care has a clear fitness benefit. However, there is scant evidence that these benefits continue in industrialised contexts. Better infant health and development with allocare support would indicate continued evolutionary selection for allocare. The research reported here used multiple logistic regression analysis to test whether a lack of family and other social support for mothers was associated with an increased risk of developmental delay in 9-month-old infants in the UK Millennium Cohort (analysis sample size, 15,696 infants). Extended family-based childcare during work hours and more maternal time spent with friends were the most influential kin and social support variables: infants of mothers with kin-based childcare versus all other childcare arrangements had a lower risk of developmental delay (OR = 0.61, 95% CIs: 0.46-0.82). Infants of mothers who spent no time with friends when compared with those who saw friends every day had double the odds of delay. Greater paternal involvement in infant care was associated with a lower odds of developmental delay. In conclusion, shared care of infants and social support for mothers may influence fitness-related traits in industrialised societies rather than being factors that influenced selection only in the past and in societies which retain close kin networks and a strong local community focus.
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Affiliation(s)
- David Waynforth
- School of Medicine, Faculty of Health Sciences, Bond University, Gold Coast, QLD, 4229, Australia.
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6
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Melnick EM, Doom JR. "Associations between maternal perceptions of social support and adolescent weight status: A longitudinal analysis". SSM Popul Health 2024; 25:101647. [PMID: 38495803 PMCID: PMC10943960 DOI: 10.1016/j.ssmph.2024.101647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/12/2024] [Accepted: 02/27/2024] [Indexed: 03/19/2024] Open
Abstract
Social support is a well-established predictor of improved physical health outcomes among adults. Establishing whether maternal social support may have an inter-generational positive impact on their child's physical health will provide important information for developing potential interventions and policies. Elevated body mass index (BMI) is one indicator of child health that is linked to increased risk for cardiovascular disease and other morbidities later in life. There is some evidence that maternal social support is associated with improved child and adolescent weight status; however, no studies have examined whether specific aspects of social support are more impactful than others or whether support availability is differentially impactful across developmental stages. The present study examined whether maternal perceptions of specific types of social support (i.e., financial support, non-monetary instrumental support, partner emotional support, and having a close supportive contact) were associated with lower adolescent BMI z-scores using longitudinal data collected over a 15-year period from the Future of Families and Child Wellbeing Study (n = 3146), which includes a high proportion of families experiencing socioeconomic disadvantage. Findings from linear regression models using specific types of social support measured across six waves of data collected over a 15-year period indicated that maternal perceptions of greater financial support were associated with lower adolescent BMI z-scores at 15 years (B = -0.05, 95% CI: -0.10, -0.004, P = 0.04), while the other types of support were not. Additional timing analyses demonstrated that perceived financial support during late childhood to adolescence was associated with lower adolescent BMI z-scores (B = -0.06, 95% CI: -0.11, -0.01, P = 0.01), whereas associations between support during infancy and early childhood were not detected. Study findings provide important insights for developing interventions and policies that improve maternal social supports to benefit child health.
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Affiliation(s)
- Emily M. Melnick
- Department of Psychiatry, University of Colorado Anschutz, 13001 E 17th Pl, Aurora, CO, 80045, USA
- Department of Psychology, University of Denver, 2155 S. Race St., Denver, CO, 80210, USA
| | - Jenalee R. Doom
- Department of Psychology, University of Denver, 2155 S. Race St., Denver, CO, 80210, USA
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7
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Fierloos IN, Windhorst DA, Fang Y, Hosman CMH, Jonkman H, Crone MR, Jansen W, Raat H. The association between perceived social support and parenting self-efficacy among parents of children aged 0-8 years. BMC Public Health 2023; 23:1888. [PMID: 37775741 PMCID: PMC10541688 DOI: 10.1186/s12889-023-16710-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 09/06/2023] [Indexed: 10/01/2023] Open
Abstract
Strengthening social support has been recognized as a potentially effective strategy to enhance parenting self-efficacy, but empirical evidence is limited. This study examined the association between perceived social support and parenting self-efficacy.Data of 647 parents of children aged 0-8 years, gathered in the CIKEO cohort study in the Netherlands, were analysed. Data were collected between October 2017 and December 2019. Multivariable linear regression models were used to examine the association between social support and parenting self-efficacy. The mean age of the participants was 33.8 years (SD = 4.9); 94.9% mothers. At the start of the study, 15.1% parents perceived low to moderate social support. Parents who experienced lower levels of social support at the start of the study reported lower parenting self-efficacy at follow-up (β: 0.13; 95% CI: 0.05, 0.21), independent of potential socio-demographic confounders. Experiencing an increase in perceived social support during the study period was associated with an increase in parenting self-efficacy (β: 0.15; 95% CI: 0.10, 0.21). Our findings indicate perceived social support is associated with parenting self-efficacy among parents of children aged 0-8 years. Future longitudinal studies need to confirm our findings and may examine which social support interventions are effective in strengthening parenting self-efficacy.
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Affiliation(s)
- Irene N Fierloos
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands
| | - Dafna A Windhorst
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Public Health, TNO Child Health, Leiden, The Netherlands
| | - Yuan Fang
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands
| | - Clemens M H Hosman
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Psychology, Radboud University Nijmegen, Nijmegen, The Netherlands
- Hosman Prevention and Innovation Consultancy, Berg en Dal, The Netherlands
| | | | - Matty R Crone
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Wilma Jansen
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands
- Department of Youth, City of Rotterdam, Rotterdam, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands.
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Sanfilippo KRM, McConnell B, Darboe B, Huma HB, Glover V, Stewart L. The experience of maternal mental distress in The Gambia: A qualitative study identifying idioms of distress, perceptions of contributing factors and the supporting role of existing cultural practices. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002329. [PMID: 37676895 PMCID: PMC10484451 DOI: 10.1371/journal.pgph.0002329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/03/2023] [Indexed: 09/09/2023]
Abstract
Maternal mental health problems are experienced frequently in the perinatal period and can be up to twice as common in women from low- and middle-income countries. The terms used to describe mental illness symptoms and the factors that contribute to developing these symptoms are affected by culture and context. Based on 14 focus group discussions held with pregnant women, health professionals and cultural leaders, this qualitative study aimed to understand women's experiences of mental distress during the perinatal period in The Gambia. To do this it aimed to 1) identify the most commonly used idioms of distress, 2) identify the factors believed to affect women's perinatal mental health and 3) explore the role of existing cultural practices, including musical practices, that were identified as locally significant in supporting maternal and mental health. Sondomoo tenkung baliyaa (Mandinka) and xel bu dalut (Wolof) were identified as the most commonly used idioms of distress which roughly translate to lack of a steady mind/heart. Using thematic analysis, six themes (Poverty of the healthcare system, Shifting cultural context, Economic factors, Social factors, Spiritual factors, and Cultural practices involving music) were identified to describe the factors that shape women's experience of mental health during the perinatal period. Lack of economic resources, the prevailing poverty of the health system, an unsupportive husband and spiritual attack by evil spirits or witches were common reasons given for a woman experiencing maternal mental distress. Various existing cultural practices involving music, such as fertility societies, naming ceremonies and community music-making, were recognised as valuable for supporting women's mental health during the perinatal period. This work emphasises that initiatives to support perinatal mental health should be grounded in an understanding of local community cultural practices, knowledge, and experiences.
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Affiliation(s)
| | - Bonnie McConnell
- School of Music, The Australian National University, Canberra, Australia
| | - Buba Darboe
- The Ministry of Health and Social Welfare, Banjul, The Gambia
| | - Hajara B. Huma
- The Ministry of Health and Social Welfare, Banjul, The Gambia
- The National Centre for Arts and Culture, Banjul, The Gambia
| | - Vivette Glover
- Institute of Reproductive and Developmental Biology, Imperial College London, London, United Kingdom
| | - Lauren Stewart
- Psychology Department, Goldsmiths, University of London, London, United Kingdom
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Duh-Leong C, Fuller AE, Johnson SB, Coble CA, Nagpal N, Gross RS. Social Capital and Sleep Outcomes Across Childhood in United States Families. Acad Pediatr 2023; 23:1226-1233. [PMID: 36641090 PMCID: PMC10333451 DOI: 10.1016/j.acap.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/02/2022] [Accepted: 01/02/2023] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To examine whether aspects of social capital, or benefits received from social relationships, are associated with regular bedtime and sleep duration across childhood in US families with lower income. METHODS Cross-sectional study using the 2018-19 National Survey of Children's Health in participants with incomes <400% federal poverty level. Separately for early childhood (0-5 years), school-age (6-12 years), and adolescence (13-17 years), we used weighted logistic regression to examine associations between social capital (measured by family social cohesion, parent social support, child social support) and sleep (measured by regular bedtime, sleep duration, adequate sleep per American of Academy of Sleep guidelines). Path analysis tested whether regular bedtime mediated associations between social capital and sleep duration. RESULTS In our sample (N = 35,438), 84.9% had a regular bedtime, 60.2% had adequate sleep. Family social cohesion was associated with sleep duration and adequate sleep (infancy: adjusted odds ratio [aOR] 2.18 [95% confidence interval [CI], 1.32, 3.60]; school age: aOR 2.03 [95% CI, 1.57, 2.63]; adolescence: aOR 2.44 [95% CI, 1.94, 3.09]). In toddlerhood, parent social support was associated with adequate sleep (aOR 1.44 [95% CI, 1.06, 1.96]). In adolescence, child social support was associated with regular bedtime (aOR 1.70 [95% CI, 1.25, 2.32]. Across childhood, associations between family social cohesion and sleep duration were partially mediated by regular bedtime. CONCLUSIONS Family social cohesion was associated with adequate sleep across childhood, this was partially mediated by regular bedtime. Associations between social support and sleep outcomes varied by development stage. Future work should consider how supportive relationships may influence child sleep outcomes.
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Affiliation(s)
- Carol Duh-Leong
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine (C Duh-Leong, N Nagpal, and RS Gross), New York, NY.
| | - Anne E Fuller
- Division of Paediatric Medicine, Department of Paediatrics, Hospital for Sick Children, University of Toronto (AE Fuller), Toronto, Ontario, Canada
| | - Sara B Johnson
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins University School of Medicine (SB Johnson), Baltimore, Md
| | - Chanelle A Coble
- Division of Adolescent Medicine, Department of Pediatrics, NYU Grossman School of Medicine (CA Coble), New York, NY
| | - Nikita Nagpal
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine (C Duh-Leong, N Nagpal, and RS Gross), New York, NY
| | - Rachel S Gross
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine (C Duh-Leong, N Nagpal, and RS Gross), New York, NY
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Dionisi AM, Smith CJ, Dupré KE. Weathering the storm alone or together: Examining the impact of COVID-19 on sole and partnered working mothers. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2408-2429. [PMID: 35353912 PMCID: PMC9088265 DOI: 10.1002/jcop.22829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 12/17/2021] [Accepted: 02/11/2022] [Indexed: 05/07/2023]
Abstract
Sole employed mothers and their families face numerous challenges. Yet, the unprecedented circumstances of the COVID-19 pandemic may be adding additional risk to the already precarious day-to-day reality of this population. Thus, we examine the implications of this crisis for the mental health and job-related well-being of both sole and partnered working mothers. Participants were 206 mothers who continued to work during the pandemic. A moderated mediation model was analyzed. Work-family conflict (WFC) during the pandemic differentially related to mothers' parenting stress, based on romantic partnership status; when mothers were sole parents, the relationship between WFC and parenting stress was exacerbated. Moreover, this stress mediated the relationship between WFC and both poor mental health and decreased work engagement for sole employed mothers. Findings broaden our understanding of the implications of the COVID-19 pandemic for sole and partnered employed mothers, and how this crisis may be increasing disparities between working sole-parent and dual-partner families.
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11
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Morales MF, Girard LC, Raouna A, MacBeth A. The association of different presentations of maternal depression with children's socio-emotional development: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001649. [PMID: 36963088 PMCID: PMC10021281 DOI: 10.1371/journal.pgph.0001649] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 02/03/2023] [Indexed: 03/01/2023]
Abstract
Maternal depression from the perinatal period onwards is a global health priority associated with an increased likelihood of suboptimal socio-developmental outcomes in offspring. An important aspect of this association is the extent to which sustained maternal depression impacts on these outcomes. The current review synthesised the evidence on maternal depression from the perinatal period onwards and offspring internalising, externalising, and social competence outcomes. We also identified sources of methodological bias. A systematic review following PRISMA guidelines was conducted. Longitudinal studies targeting biological mothers with depressive symptomology, detailing onset, using repeated validated measures, and assessing children's outcomes between three and 12 years were included. Twenty-four studies met inclusion criteria. Findings supported the validity of different presentations of maternal depression, including consistent identification of a group of chronically depressed mothers across countries. Mothers within this group reported poorer internalising, externalising, and social competence outcomes for their offspring, with the highest levels of child problems associated with greater maternal chronicity and symptom severity. Results differed by measurement type with mothers rating poorer outcomes in comparison to teachers reports. For timing of depression, evidence was inconsistent for independent effects of antenatal or postnatal depression on child outcomes. There was substantial variability in study quality assessment. Assessing different presentations of maternal depression is essential for capturing the longitudinal associations between maternal depression and offspring outcomes to inform targets of early intervention. Chronicity, severity, and concurrent maternal depression have important implications for children's development and should be targeted in future programme planning. Further research in low- and middle-income countries is warranted.
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Affiliation(s)
- María Francisca Morales
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom
| | - Lisa-Christine Girard
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom
| | - Aigli Raouna
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom
| | - Angus MacBeth
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom
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Mengesha EW, Tessema GA, Assefa Y, Alene GD. Social capital and its role to improve maternal and child health services in Northwest Ethiopia: A qualitative study. PLoS One 2023; 18:e0284592. [PMID: 37083885 PMCID: PMC10120927 DOI: 10.1371/journal.pone.0284592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/04/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Social capital is a set of shared values that allows individuals or groups receive emotional, instrumental or financial resources flow. In Ethiopia, despite people commonly involved in social networks, there is a dearth of evidence exploring whether membership in these networks enhances uptake of maternal and child health (MCH) services. This study aimed to explore perspectives of women, religious leaders and community health workers (CHWs) on social capital to improve uptake of MCH services in Northwest Ethiopia. METHODS We employed a qualitative study through in-depth interviews with key informants, and focus group discussions. A maximum variation purposive sampling technique was used to select 41 study participants (11 in-depth interviews and 4 FGDs comprising 7-8 participants). Data were transcribed verbatim and thematic analysis was employed using ATLAS.ti software. RESULTS Four overarching themes and 13 sub-themes of social capital were identified as factors that improve uptake of MCH services. The identified themes were social networking, social norms, community support, and community cohesion. Most women, CHWs and religious leaders participated in social networks. These social networks enabled CHWs to create awareness on MCH services. Women, religious leaders and CHWs perceived that existing social capital improves the uptake of MCH services. CONCLUSION The community has an indigenous culture of providing emotional, instrumental and social support to women through social networks. So, it would be useful to consider the social capital of family, neighborhood and community as a tool to improve utilization of MCH services. Therefore, policymakers should design people-centered health programs to engage existing social networks, and religious leaders for improving MCH services.
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Affiliation(s)
- Endalkachew Worku Mengesha
- Department of Reproductive Health and Population Studies, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gizachew A Tessema
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Yibeltal Assefa
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Getu Degu Alene
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine & Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Morales MF, MacBeth A, Swartzman S, Girard LC. Multi-Trajectories of Conduct Problems, Hyperactivity/Inattention, and Peer Problems Across Childhood: Results from the Growing Up in Scotland Birth Cohort. Res Child Adolesc Psychopathol 2023. [PMID: 35920956 DOI: 10.1007/s10802-022-00956-8/tables/5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Using a person-centred approach, this study inspected multi-trajectories of conduct problems, hyperactivity/inattention and peer problems, and associated risk factors for group membership. The sample included 3,578 children (50.8% males) from a population birth cohort in Scotland (Growing Up in Scotland). The parental version of the Strengths and Difficulties Questionnaire (SDQ) was used when children were 4, 5, 6, 7, and 10 years old. Antecedent factors at the perinatal, child, and family levels were collected using parental reports, observation, and standardised assessments at 10, 24, and 36 months. A group-based multi-trajectory analysis was employed. Findings showed that a six-group model best fit the data. Identified groups included non-engagers, normative, decreasing externalising/low peer problems, low externalising/moderate peer problems, moderate externalising/increasing peer problems and multimorbid moderate-high chronic. Findings suggest multimorbidity between externalising behaviours and peer problems in the more elevated groups. Two common protective factors emerged across all groups: caregiver mental health and parent-infant attachment. Identified risk factors were specific to group membership. Risk factors for the most elevated group included single-parent status, social deprivation, previous neonatal intensive care unit admission, child sex, whilst children's expressive language was a protective factor. Taken together, findings contribute to the emerging literature modelling trajectories of externalising behaviours and peer problems simultaneously and have important practical implications for prevention of problems in childhood, by identifying targets at the perinatal, child, and family levels.
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Affiliation(s)
- María Francisca Morales
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Medical School (Doorway 6), Teviot Place, Edinburgh, EH8 9AG, UK.
| | - Angus MacBeth
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Medical School (Doorway 6), Teviot Place, Edinburgh, EH8 9AG, UK
| | - Samantha Swartzman
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Medical School (Doorway 6), Teviot Place, Edinburgh, EH8 9AG, UK
| | - Lisa-Christine Girard
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Medical School (Doorway 6), Teviot Place, Edinburgh, EH8 9AG, UK
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14
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Multi-Trajectories of Conduct Problems, Hyperactivity/Inattention, and Peer Problems Across Childhood: Results from the Growing Up in Scotland Birth Cohort. Res Child Adolesc Psychopathol 2023; 51:55-69. [PMID: 35920956 PMCID: PMC9763152 DOI: 10.1007/s10802-022-00956-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 10/16/2022]
Abstract
Using a person-centred approach, this study inspected multi-trajectories of conduct problems, hyperactivity/inattention and peer problems, and associated risk factors for group membership. The sample included 3,578 children (50.8% males) from a population birth cohort in Scotland (Growing Up in Scotland). The parental version of the Strengths and Difficulties Questionnaire (SDQ) was used when children were 4, 5, 6, 7, and 10 years old. Antecedent factors at the perinatal, child, and family levels were collected using parental reports, observation, and standardised assessments at 10, 24, and 36 months. A group-based multi-trajectory analysis was employed. Findings showed that a six-group model best fit the data. Identified groups included non-engagers, normative, decreasing externalising/low peer problems, low externalising/moderate peer problems, moderate externalising/increasing peer problems and multimorbid moderate-high chronic. Findings suggest multimorbidity between externalising behaviours and peer problems in the more elevated groups. Two common protective factors emerged across all groups: caregiver mental health and parent-infant attachment. Identified risk factors were specific to group membership. Risk factors for the most elevated group included single-parent status, social deprivation, previous neonatal intensive care unit admission, child sex, whilst children's expressive language was a protective factor. Taken together, findings contribute to the emerging literature modelling trajectories of externalising behaviours and peer problems simultaneously and have important practical implications for prevention of problems in childhood, by identifying targets at the perinatal, child, and family levels.
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15
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Ali-Saleh O, Goldblatt H, Baron-Epel O. "My problem is that I live next door to my mother-in-law": Arab women's postpartum experiences with positive and negative social interactions and the impact on their well-being: A qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3985-e3994. [PMID: 35289013 DOI: 10.1111/hsc.13792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/24/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
Social support is commonly associated with women's postpartum health. Yet such support can also have unintended effects and trigger negative reactions. This study provides a qualitative examination of the positive and negative social interactions described by Arab postpartum women. Participants were Arab women recruited at Mother and Child Healthcare Clinics (MCHC). Inclusion criteria were married women over the age of 18 with a healthy newborn who described both positive and negative social experiences. Exclusion criteria were signs of postpartum depression. Data were gathered using semi-structured in-depth interviews that were audio-recorded and transcribed verbatim. Themes and categories were extracted based on interpretative phenomenological analysis. The impact of lived experiences on the well-being of postpartum women was explored. Data analysis revealed three main themes: (1) Support from the family and community: positive impact on the mother; (2) Negative social interactions as invasion of mother's personal space; (3) Impact of negative social interactions on mother's relationship with her family. A deeper understanding of the social environment of these women and the factors that affect their well-being during the critical postpartum period can help MCHC staff offer culturally appropriate support and relevant interventions.
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Affiliation(s)
- Ola Ali-Saleh
- Northern District Health Bureau, Ministry of Health, Nof HaGalil, Israel
- Department of Nursing, the Max Stern Academic College of Emek Yezreel, Jezreel Valley, Israel
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16
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Liu CH, Koire A, Erdei C, Mittal L. Unexpected changes in birth experiences during the COVID-19 pandemic: Implications for maternal mental health. Arch Gynecol Obstet 2022; 306:687-697. [PMID: 34724569 PMCID: PMC8558094 DOI: 10.1007/s00404-021-06310-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 10/22/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE This study examined the rates of unexpected birth experiences due to the COVID-19 pandemic and its association with women's postpartum mental health symptoms (depression, generalized anxiety, and PTSD). METHODS Our cross-sectional analysis included postpartum women (N = 506) who reported on birth plan changes attributed to the COVID-19 pandemic through the PEACE (Perinatal Experiences and COVID-19 Effects) Study, an online survey that took place between May 2020 and May 2021. Covariates included sociodemographic variables, number of days since the pandemic, pre-pregnancy mental health history, and protective factors such as social support, distress tolerance, and resilience. RESULTS Prevalent COVID-19 pandemic changes in the birth experience included not having support people (e.g., partners and friends) permitted to participate in the baby's delivery (33.5%), reduced access to preferred medications before or after delivery (9.7%), unavailable health care providers for the baby's birth as planned (9.6%), and other changes (13.8%). The reduced access to medications was associated with those reporting higher levels of depressive (β = .10, p < .01) and PTSD symptoms (β = .07, p < .05). Separation from their baby for a long period after delivery (β = .10, p < .05) and other changes (β = .10, p < .01) were associated with higher levels of PTSD symptoms. CONCLUSION Unexpected changes to the birth experience due to the COVID-19 pandemic may have small but persistent effects on depressive and PTSD symptoms. Given increased vigilance and its association with subsequent PTSD, acknowledging any fear of viral contagion within the hospital setting but informing women the plans for ensuring safety may be preventive for later mental health symptomatology.
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Affiliation(s)
- Cindy H Liu
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA.
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Carmina Erdei
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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17
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Doiron KM, Stack DM, Dickson DJ, Bouchard S, Serbin LA. Co-regulation and parenting stress over time in full-term, very low birthweight preterm, and psycho-socially at-risk infant-mother dyads: Implications for fostering the development of healthy relationships. Infant Behav Dev 2022; 68:101731. [PMID: 35850046 DOI: 10.1016/j.infbeh.2022.101731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 05/03/2022] [Accepted: 05/31/2022] [Indexed: 11/17/2022]
Abstract
From birth, mothers and infants co-regulate their interactions that are shaped by their socio-emotional development, relationship history, current circumstances, and goals. However, few studies have longitudinally explored co-regulation in the context of medical and psycho-social risk. The present 4-wave longitudinal study sought to shed light on factors associated with co-regulation over time in infants from 6- to 48-months. The objectives were to 1) identify differences in co-regulation among low- and at-risk infant-mother dyads, 2) explore changes in co-regulation over time, and 3) explore the associations between infant-mother co-regulation and parenting stress in these low- and at-risk groups over time. Participants included three groups of infant-mother dyads (full-term [FT], n = 48; very low birthweight/preterm [VLBW/preterm] born 26-32 weeks, weighing 800-1500 g, n = 61; psycho-socially at-risk where parents had histories of socioeconomic disadvantage, n = 54) followed longitudinally at 6-, 12-, 18-, and 48-months of age. Dyads engaged in a free play in their homes that was coded for co-regulation using Fogel, de Koeyer, Secrist, Sipherd, Hafen, and Fricke's (2003) Revised Relational Coding System (RRCS), and mothers reported on their level of parenting stress. Results from MANOVAs at each time point indicated significant differences between the groups at 18-months, with psycho-socially at-risk dyads engaging in more one-sided interactions than FT and VLBW/preterm dyads, and more dysregulation and miscommunication than VLBW/preterm dyads. Multi-level models of co-regulation revealed that dyads became progressively less synchronous from 6- to 12-months, followed by greater synchrony and mutual reciprocity from 12-months onwards. Parenting stress was associated with less synchrony and less mutual reciprocity amongst the at-risk groups. Maternal education was associated with greater engagement and girls tended to engage in more synchronous interactions than boys. Our results underscore the value and implications of considering background risk and concurrent parent perceptions in the development and reciprocity of parent-infant co-regulation and their subsequent relationships from infancy onwards.
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Affiliation(s)
- Kelly M Doiron
- Department of Psychology and Centre for Research and Human Development (CRDH), Concordia University, Canada.
| | - Dale M Stack
- Department of Psychology and Centre for Research and Human Development (CRDH), Concordia University, Canada.
| | - Daniel J Dickson
- Department of Psychology and Centre for Research and Human Development (CRDH), Concordia University, Canada
| | - Samantha Bouchard
- Department of Psychology and Centre for Research and Human Development (CRDH), Concordia University, Canada
| | - Lisa A Serbin
- Department of Psychology and Centre for Research and Human Development (CRDH), Concordia University, Canada
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18
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Radey M, Ledermann T, McWey L. Informal support and obligation contribute to fewer child behavior problems over time. FAMILY RELATIONS 2022; 71:1004-1017. [PMID: 36034315 PMCID: PMC9414893 DOI: 10.1111/fare.12659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study used longitudinal data from a sample of low-income mothers and their children to examine how informal support and obligation, or informal networks, contribute to children's behavior. We also tested the potential mediating role of maternal parenting stress. BACKGROUND Many studies document the importance of informal support for maternal stress and child behavior to offset the negative impact of poverty for low-income families. Evidence suggests the importance of also considering the obligations that such informal support access may impart. METHOD Using data from the Welfare, Children, Families Study, a longitudinal study of diverse, low-income, urban mothers in three cities (n = 2,142), we used a parallel process latent growth curve model approach to examine how informal support and obligation contributed to maternal stress and child behavior. RESULTS Models indicated that mothers with healthy safety nets, including informal support and manageable obligations, had children with fewer behavior problems, and parenting stress partially accounted for the positive effects. CONCLUSIONS Results highlight the importance of considering reciprocity norms among low-income mothers; one-sided support or obligation can be problematic for both maternal stress and child behavior problems. IMPLICATION Results suggest the merit of empirically supported interventions to teach relationship skills and facilitate healthy relationships among low-income mothers.
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Affiliation(s)
- Melissa Radey
- College of Social Work, Florida State University, Tallahassee, FL
| | - Tom Ledermann
- College of Health and Human Sciences, Florida State University, Tallahassee, FL
| | - Lenore McWey
- College of Health and Human Sciences, Florida State University, Tallahassee, FL
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19
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Buehler C, Girod SA, Leerkes EM, Bailes L, Shriver LH, Wideman L. Women's Social Well-Being During Pregnancy: Adverse Childhood Experiences and Recent Life Events. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:582-592. [PMID: 35814611 PMCID: PMC9258794 DOI: 10.1089/whr.2022.0023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Adverse experiences during childhood and recent stressful life events are each associated with women's reduced well-being and poorer health during pregnancy. Few studies, however, have focused upon pregnant women's social well-being, and inclusion of both independent variables in the same analysis is rare. This study focuses upon adverse experiences during childhood as well as recent life events in relationship to four aspects of social well-being: social support, couple aggression for partnered women, neighborhood safety, and food insecurity. MATERIALS AND METHODS A diverse community sample of 176 pregnant women completed questionnaires during their third trimester. A cross-sectional design was used that included retrospective reports of childhood experiences, as well as reports of recent life events and current well-being. RESULTS Adverse experiences during childhood were uniquely associated with couple aggression (β = 0.206, p = 0.026) and lower neighborhood safety (β = -0.185, p = 0.021). Recent stressful life events were uniquely associated with lower social support (β = -0.247, p = 0.001) and greater food insecurity (β = 0.494, p = 0.000). For social support and food insecurity, there was a significant indirect pathway from adverse childhood experiences through recent stressful life events. Adverse child experiences and recent stressful life events did not interact. CONCLUSIONS A life-course perspective that considers women's experiences across their life span is critical for use by both researchers and health practitioners. Adverse childhood experiences and recent stressful life events are important for understanding social features of pregnant women's daily lives.
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Affiliation(s)
- Cheryl Buehler
- Department of Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Savannah A. Girod
- Department of Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Esther M. Leerkes
- Department of Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, North Carolina, USA
- School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Lauren Bailes
- Department of Psychological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Lenka H. Shriver
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, North Carolina, USA
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20
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Surkan PJ, Park S, Ridgeway K, Ribeiro M, Fidalgo TM, Martins SS, Caetano SC. Caregiver Social Capital and Supportive Relationships are Associated with Better Child Social-Emotional Development. Child Psychiatry Hum Dev 2022:10.1007/s10578-021-01292-6. [PMID: 35088156 DOI: 10.1007/s10578-021-01292-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2021] [Indexed: 11/27/2022]
Abstract
This study examined how different domains of social capital and of social support among caregivers are associated with social-emotional development in children ages 4-6 and how caregiver depressive symptoms modify these associations. Using a stratified random sample of preschools, data included a cross-sectional study of 1147 child-caregiver pairs (543 girls) in a low-income municipality in Brazil. Crude and adjusted linear regression models revealed that all domains of social support and two domains of social capital were associated with less social-emotional development delay in children. Given a significant proportion of children in low- and middle-income countries do not meet developmental milestones, strengthening caregiver social capital and support in these settings may have the potential to improve child social-emotional development.
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Affiliation(s)
- Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
| | - Soim Park
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Kathleen Ridgeway
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Marcos Ribeiro
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Thiago M Fidalgo
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Silvia S Martins
- Department of Epidemiology, Columbia University, New York, NY, 10023, USA
| | - Sheila C Caetano
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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21
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Tani F, Ghinassi S, Ponti L. The Role of Maternal Perceived Social Support on the Relation Between Prenatal Depressive Symptoms and Labor Experience. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2021. [DOI: 10.1027/2512-8442/a000103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Depression during pregnancy is a severe risk factor for negative outcomes in women and children. In particular, prenatal symptoms of depression are linked to a more complicated labor experience, characterized by more painful labor and more frequent recourse to epidural analgesia and/or oxytocin. Although this link is evident, less is known about possible mediators of this relationship. Aims: This study investigated the mediating role of perceived maternal social support on the relationship between prenatal maternal depression and labor experience. Methods: Participants were 152 Italian nulliparous women ( Mage = 31.68 years, SD = 4.94). Data were collected at two different times: T1 (at week 30–33 of gestation) women completed the Beck Depression Inventory and the Maternal Social Support Scale; T2 (at childbirth) clinical data regarding labor was registered from hospital records (duration of labor in hours and administration of oxytocin and epidural analgesia in hours). Results: The Structural Equation Modeling showed that prenatal symptoms of depression are linked to a more complicated labor experience (β = .31, p < .001). However, the quality of the maternal social support can mediate this relationship (indirect effect: β = .17, p < .000). Limitations: The complexity of the proposed model, the characteristics of the sample, the variables investigated, and the questionnaires used are discussed. Conclusion: The perception of having a good social network is an important predictor of women’s health in the transition to motherhood, decreasing the negative effect of maternal prenatal depressive symptoms on the quality of women’s labor experience.
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Affiliation(s)
- Franca Tani
- Department of Health Sciences, University of Florence, Italy
| | - Simon Ghinassi
- Department of Health Sciences, University of Florence, Italy
| | - Lucia Ponti
- Department of Humanities, University “Carlo Bo” of Urbino, Italy
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22
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Ross AM, DeVoe ER, Steketee G, Spencer R, Richter M. "This is not your Life…and it becomes your Life": A Qualitative Exploration of Deployment-related Stress and Support needs in National Guard and Reserve spouses who are Mothers of Young Children. FAMILY PROCESS 2021; 60:1364-1380. [PMID: 33247431 DOI: 10.1111/famp.12622] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The adverse effects of deployment-related stress (DRS) on military service members, spouses, and children are well documented. Findings from a recent Consensus Report on Military Families by the National Academies of Science, Engineering, and Medicine (2019) underscore the priority of gaining a more comprehensive understanding of the diversity of today's military families and their needs and well-being. While social support is generally regarded as helpful during times of stress, it has not been studied extensively in National Guard/Reserve spouses who are parents of young children. This qualitative study of 30 women examines the unique ways in which DRS affects women who are National Guard/Reserve spouses and mothers of young children, as well as the processes through which they encountered support to manage these stressors. Salient themes spanned experiences involving deployment cycle phases of separation and reintegration and included both anticipated and unanticipated changes in family-related division of labor, dynamics, and communication patterns. These were complicated by geographic, social, and cultural isolation and misguided efforts to support spouses initiated by civilians. Women managed these stressors primarily through seeking, acquiring, and repurposing existing sources of informal social support for themselves and formal supports for their children, with varying degrees of success.
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Affiliation(s)
- Abigail M Ross
- Fordham University Graduate School of Social Service, New York, NY, USA
| | - Ellen R DeVoe
- Boston University School of Social Work, Boston, MA, USA
| | - Gail Steketee
- Boston University School of Social Work, Boston, MA, USA
| | - Renée Spencer
- Boston University School of Social Work, Boston, MA, USA
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Ssegujja E, Mulumba Y, Guttmacher S, Andipatin M. The role and attributes of social networks in the provision of support to women after stillbirth: experiences from Uganda. BMC Womens Health 2021; 21:352. [PMID: 34615502 PMCID: PMC8496046 DOI: 10.1186/s12905-021-01498-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/17/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Communities exert stigma on mothers after stillbirth despite their potential to offer social support to the grieving family. Maternal healthcare-seeking behaviors are socially reinforced rendering a social network approach vital in understanding support dynamics which when utilized can improve community response to mothers experiencing stillbirth. However, the form and direction of social support for women when in need is not clear. The study explored the role and attributes of women's social networks in the provision of support to mothers who have experienced a stillbirth in Uganda. METHODS An exploratory cross-sectional study design adopting a social network approach was conducted. Data collection following established procedures was conducted on a convenient sample of 17 mothers who had experienced a stillbirth six months before the study. Frequencies and bivariate analysis were conducted to determine the factors influencing the provision of social support from 293 network members elicited during the alter generation. We then performed a Poisson regression on each of the social support forms and the explanatory variables. Network structure variables were calculated using UCINET version 6 while Netdraw facilitated the visualization of networks. RESULTS Overall, social support was available from all network relations mentioned by the respondents. No major variations were observed between the two time periods during pregnancy and following a stillbirth. The most common support received was in form of intangible support such as emotional and information support, mainly from females who were married and from the naturally occurring networks such as family and friends. We also observed that social support followed patterns of network relational characteristics including trust, frequency of contact and alters counted on for support more likely to provide the same. CONCLUSIONS A great potential for social support exists within women's social networks to help address stillbirth risk factors during pregnancy and cope after experiencing the same. Alter characteristics like being female, married, and from naturally occurring networks together with relational characteristics such as trust, frequency of contact, and count on alter for support were predictors of eventual social support. Interventions aiming at addressing stillbirth risks at the community level ought to harness these network characteristics for benefits to the mothers.
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Affiliation(s)
- Eric Ssegujja
- Makerere University School of Public Health, Kampala, Uganda.
- School of Public Health, University of the Western Cape, Cape Town, South Africa.
| | - Yusuf Mulumba
- Uganda Cancer Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Sally Guttmacher
- School of Global Public Health, New York University, New York, NY, USA
| | - Michelle Andipatin
- Department of Psychology, University of the Western Cape, Cape Town, South Africa
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24
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Robledo-Gil T, Kemet S, Pensak M, Cutler A, McNamara B, Kennedy HP, Lundsberg L, Gariepy A. " Un abrazo a la distancia": An Exploration of Spanish-Speaking Women's Experiences with Pregnancy and Social Isolation in an Urban U.S. Setting. HISPANIC HEALTH CARE INTERNATIONAL 2021; 20:107-114. [PMID: 34520260 DOI: 10.1177/15404153211041013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Research on Spanish-speaking Latina/Hispanic women's experiences during pregnancy is limited. Methods: We recruited women from urban, walk-in pregnancy testing clinics from June 2014 to June 2015. Women aged 16-44 years, at less than 24 weeks gestational age, who spoke either English or Spanish were eligible and completed an enrollment questionnaire and individual interview according to language preference. During qualitative interviews, we explored pregnancy intentions, initial reactions to a new pregnancy, and feelings about the impact of this pregnancy on relationships and daily life. Qualitative narrative content analysis was conducted using Atlas.ti software. Results: Among interviews with 31 Spanish-speaking Latina/Hispanic pregnant women, participants' average age was 28 years old with a mean gestational age of 7 weeks. We identified social isolation as the most common theme, characterized by four interwoven and overlapping subthemes: (1) sola-the experience of feeling alone; (2) familismo cercano-the importance of close relationships; (3) familismo lejano-overcoming long distance relationships; and (4) mi patria-preserving homeland cultural connectedness. Conclusions: Spanish-speaking Latina/Hispanic pregnant women described experiencing multiple aspects of social isolation. Language preference may suggest risk of social isolation, necessitating provider awareness and support initiatives to improve social support and lessen social isolation among newly pregnant, Spanish-speaking Latina women.
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Affiliation(s)
| | | | | | - Abigail Cutler
- Department of Obstetrics, 164556Gynecology and Reproductive Sciences, 25047Yale School of Medicine, New Haven, CT, USA
| | | | | | - Lisbet Lundsberg
- Department of Obstetrics, 164556Gynecology and Reproductive Sciences, 25047Yale School of Medicine, New Haven, CT, USA
| | - Aileen Gariepy
- Department of Obstetrics, 164556Gynecology and Reproductive Sciences, 25047Yale School of Medicine, New Haven, CT, USA
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Gebhardt A, Langius-Eklöf A, Andermo S, Arman M. Health and suffering are associated with social support: a cross-sectional study of women and mothers with exhaustion and pain. BMC Womens Health 2021; 21:259. [PMID: 34174840 PMCID: PMC8235816 DOI: 10.1186/s12905-021-01398-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite women are generally overrepresented in behavioral, mental, and musculoskeletal disorders, motherhood as a central part of women's life is poorly understood in relation to exhaustion and long-lasting pain. Mothers' health impairments imply suffering both for herself and her family. A profound understanding of health is needed taking mothers' subjective health experience, their suffering and life situation into account to give women, their families and society better prerequisites to alleviate exhaustion and long-lasting pain. The aim of the study was to describe health and suffering of women and mothers undergoing rehabilitation for long-lasting pain and exhaustion and its correlation with perceived social support. METHODS The study had a cross-sectional design with an exploratory approach. A main sample consisted of 166 women undergoing rehabilitation for exhaustion and long-lasting pain and a reference sample included 129 women working and studying within health care professions. Both samples included women with and without children. Women's subjective health and suffering was assessed from a caring science perspective using the recently developed and validated Health and Suffering Scale. Two additional scales measuring exhaustion and social support were distributed among the two samples. Descriptive statistics and multiple linear regression models, including health and suffering and perceived social support, were analyzed. RESULTS Mothers undergoing rehabilitation for pain and exhaustion reported significantly poorer health and more suffering compared to healthy mothers, but similar health and suffering when compared with childless women in rehabilitation. Health and suffering were correlated with perceived social support among both healthy and exhausted mothers. In both samples, the correlation between health and suffering and social support was stronger among mothers than among women without children. CONCLUSIONS Women and mothers living with exhaustion and long-lasting pain show signs of unbearable suffering and perceived insufficient social support. Social support from various sources particularly helps mothers to create meaning in life and make their suffering bearable. Hence, health care must address the fact that mothers are dependent on their immediate social environment and that this dependency interacts with their health and suffering on an existential level.
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Affiliation(s)
- Anja Gebhardt
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden.
| | - Ann Langius-Eklöf
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden
| | - Susanne Andermo
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden
- Department of Global Public Health, Karolinska Institutet, 17165, Solna, Sweden
| | - Maria Arman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden
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The Reshaping of Daily Time during the COVID-19 Pandemic: Lone Parent’s Work-Family Articulation in a Low-Intensity Lockdown. SOCIAL SCIENCES-BASEL 2021. [DOI: 10.3390/socsci10070239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic and related restrictions have triggered simultaneous changes across multiple life domains within a very short timeframe. This major shock has seriously challenged the ability of families to adapt to unanticipated changes over which they had little control. Switzerland instigated a low-intensity lockdown in response to COVID-19 in the spring of 2020. The resulting alterations to family life included changes to employment situations and working conditions (such as layoffs, temporary unemployment and home-based work) and the need to arrange home-schooling and childcare. This study examines how a sample of individuals with a trajectory of lone parenthood living in French-speaking Switzerland adapted their everyday lives to accommodate the shifting demands in the domains of employment and family responsibilities. Interviews were conducted between April and June 2020 for the longitudinal project “The multiple paths of lone parenthood”. Using this data, we analysed the COVID-related changes to work and family life, focusing on their time structuring. We found that parents who remained employed faced the greatest time pressures, although their experiences varied significantly depending on the adaptability of their work schedules, as well as the child(ren)’s age(s) and degree of autonomy. Home-based work and home-schooling resulted in more flexible schedules, although parents with the greatest work and family demands sought more time-structured organisation to facilitate their articulation. Social support was a crucial buffer for parents with conflicting demands across domains.
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Budds K. Validating social support and prioritizing maternal wellbeing: beyond intensive mothering and maternal responsibility. Philos Trans R Soc Lond B Biol Sci 2021; 376:20200029. [PMID: 33938273 PMCID: PMC8090819 DOI: 10.1098/rstb.2020.0029] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 11/12/2022] Open
Abstract
In this piece, I reflect on the current model of motherhood that prevails in Western countries, often termed 'intensive mothering'. I will briefly trace the history of this approach, focusing in particular on how theory from developmental psychology has, to some extent, functioned to reinforce it by foregrounding the mother-child dyad and emphasizing the importance of maternal practices for children's developmental outcomes. I will then consider the particular implications of this cultural approach to motherhood for women's experiences of motherhood and maternal wellbeing. Finally, I reiterate that we need to continue to challenge this western-centric model of motherhood, which risks both isolating and overburdening women, by highlighting the ways in which both women and children benefit from wider social support systems, yet also by making it permissible for women to access social support without compromising a 'good mother' identity. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.
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Affiliation(s)
- Kirsty Budds
- Social Sciences, Leeds Beckett University, Leeds, West Yorkshire, LS1 3HE, UK
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28
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Gettler LT, Lew-Levy S, Sarma MS, Miegakanda V, Doxsey M, Meyer JS, Boyette AH. Children's fingernail cortisol among BaYaka foragers of the Congo Basin: associations with fathers' roles. Philos Trans R Soc Lond B Biol Sci 2021; 376:20200031. [PMID: 33938276 PMCID: PMC8090812 DOI: 10.1098/rstb.2020.0031] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 12/15/2022] Open
Abstract
Children and mothers' cortisol production in response to family psychosocial conditions, including parenting demands, family resource availability and parental conflict, has been extensively studied in the United States and Europe. Less is known about how such family dynamics relate to family members' cortisol in societies with a strong cultural emphasis on cooperative caregiving. We studied a cumulative indicator of cortisol production, measured from fingernails, among BaYaka forager children (77 samples, n = 48 individuals) and their parents (78 samples, n = 49) in the Congo Basin. Men ranked one another according to locally valued roles for fathers, including providing resources for the family, sharing resources in the community and engaging in less marital conflict. Children had higher cortisol if their parents were ranked as having greater parental conflict, and their fathers were seen as less effective providers and less generous sharers of resources in the community. Children with lower triceps skinfold thickness (an indicator of energetic condition) also had higher cortisol. Parental cortisol was not significantly correlated to men's fathering rankings, including parental conflict. Our results indicate that even in a society in which caregiving is highly cooperative, children's cortisol production was nonetheless correlated to parental conflict as well as variation in locally defined fathering quality. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.
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Affiliation(s)
- Lee T. Gettler
- Department of Anthropology, University of Notre Dame, Notre Dame, IN, USA
- The Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA
| | - Sheina Lew-Levy
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
- Department of Archaeology and Heritage Studies, Aarhus University, Højbjerg, Denmark
| | | | - Valchy Miegakanda
- Institut National de Santé Publique, Brazzaville, Republic of the Congo
| | | | - Jerrold S. Meyer
- Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - Adam H. Boyette
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
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Buston K, MacLachlan A, Henderson M. How do Pregnant Women with Additional Health or Social Care Needs Experience Parenting Groups: Evidence from Delivery of Enhanced Triple P for Baby and Mellow Bumps as Part of the Trial of Healthy Relationships Initiatives in the Very Early Years (THRIVE). CHILD CARE IN PRACTICE : NORTHERN IRELAND JOURNAL OF MULTI-DISCIPLINARY CHILD CARE PRACTICE 2021; 28:721-738. [PMID: 36605761 PMCID: PMC7614018 DOI: 10.1080/13575279.2021.1933902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
There is still relatively little known about when, why, how and in what circumstances parenting interventions are effective. Support within the group context has been theorised as a key mechanism. This paper explores how pregnant women with additional health or social care needs participating in two group parenting interventions-Mellow Bumps or Enhanced Triple P for Babies-experienced being in a parenting group, and how this shaped how they engaged with the interventions; and it examines how group delivery may have facilitated or inhibited the effectiveness of the interventions, and for whom it did so. Session evaluation forms (n = 708) and a post-intervention questionnaire (n = 117) were completed by participants. In-depth interviews were conducted following the MB/ETPB antenatal sessions (n = 19), and 6-12 months after the birth of their baby (n = 15). Group delivery of these parenting interventions had the potential to support participants, particularly those with multiple additional health and social care needs. There are, however, important caveats including patchy attendance reducing the supportiveness of the groups, and few discernible longer terms changes. More group sessions, less patchy attendance, and more encouragement from facilitators for the women to keep in touch, and to join other community parent-child groups after the birth of their baby are likely to have increased feelings of support and connectedness.
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Affiliation(s)
- Katie Buston
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Alice MacLachlan
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Marion Henderson
- School of Social Work and Social Policy, University of Strathclyde, Glasgow, UK
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Maternal Distress and Social Support Are Linked to Human Milk Immune Properties. Nutrients 2021; 13:nu13061857. [PMID: 34072410 PMCID: PMC8226629 DOI: 10.3390/nu13061857] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/23/2021] [Accepted: 05/26/2021] [Indexed: 12/31/2022] Open
Abstract
Possible alterations of maternal immune function due to psychological stress may reflect immunoactive factor levels in breast milk. This study aimed to assess the association between maternal distress and breast milk levels of secretory IgA (SIgA), IgM, IgG, and lactoferrin (LF). We hypothesized that this association is moderated by maternal social support achieved from others during lactation. The study group included 103 lactating mothers and their healthy five-month-old infants. Maternal distress was determined based on the State Anxiety Inventory and the level of salivary cortisol. Social support was assessed using the Berlin Social Support Scales. Breast milk samples were collected to test for SIgA, IgM, IgG, and LF using the ELISA method. Milk immunoactive factors were regressed against maternal anxiety, social support, salivary cortisol, and infant gestational age using the general regression model. Maternal anxiety was negatively associated with milk levels of LF (β = -0.23, p = 0.028) and SIgA (β = -0.30, p = 0.004), while social support was positively associated with milk IgG (β = 0.25, p = 0.017). Neither anxiety nor social support were related to milk IgM. No association was found between the level of maternal salivary cortisol and immunoactive factors in milk. Our results suggest that maternal psychological wellbeing and social support may affect milk immune properties.
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31
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Ward L. StARTalking: An Arts and Health Program to Support Undergraduate Mental Health Nursing Education. Issues Ment Health Nurs 2021; 42:358-364. [PMID: 32865484 DOI: 10.1080/01612840.2020.1806962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Community arts and health programs are recognized as powerful contributors to mental health and wellbeing, reducing social isolation and strengthening community connection. They attract individuals with diverse lived experience and are invaluable learning environments for consumers and undergraduate mental health nursing students. This paper reports on the evaluation of StARTalking, a community arts and health program in Melbourne, Australia. The study aimed to better understand the consumer and student experience participating in the program. The themes, Finding connection/Taking time out, clearly indicate that embedding arts and health in mental health nursing education supports consumer and student learning, health and wellbeing.
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Affiliation(s)
- Louise Ward
- School of Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC, Australia
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32
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Alfayumi-Zeadna S, Froimovici M, Rourke NO, Azbarga Z, Okby-Cronin R, Salman L, Alkatnany A, Grotto I, Daoud N. Direct and indirect determinants of prenatal depression among Arab-Bedouin women in Israel: The role of stressful life events and social support. Midwifery 2021; 96:102937. [PMID: 33667825 DOI: 10.1016/j.midw.2021.102937] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Prenatal depression (PND) negatively affects the health and well-being of both mother and child. The aim of this study was to identify the direct and indirect determinants of prenatal depression symptoms (PNDS) among Arab-Bedouin women in southern Israel. DESIGN Data collection was conducted in two women's health centers from October 2017 to February 2018. SETTING Participants were recruited during visits to women's health centers in southern Israel. PARTICIPANTS We recruited 376 Arab-Bedouin women as part of a larger study of perinatal health and well-being. We recruited 376 Arab-Bedouin women as part of a larger study of perinatal health and well-being. All women were 18+ years of age and 26-38 weeks of gestational age. MEASUREMENTS PNDS were measured by an Arabic version of the Edinburgh Postnatal Depression Scale. We computed path analyses to identify direct and indirect determinants of PND and estimated the contribution of stressful life events and social support. RESULTS Positive direct associations emerged between stressful life events, history of depression and gestational age, and PNDS; direct inverse associations were found between social support, PND awareness, and education, and PNDS. History of depression was the single strongest direct predictor of PNDS yet when considering combined direct and indirect effects, the contribution of stressful life events is greater. Stressful life events (via history of depression and PND awareness) and education (via PND awareness) had both direct and indirect effects on PNDS. Age of the mother indirectly affects PNDS via education and PND awareness. Polygamy emerged as neither a direct nor indirect predictor of PNDS. CONCLUSIONS PNDS in the underserved and understudied Bedouin women has serval direct and indirect predictors. Interventions aiming at reducing stress and increasing social support, via PND awareness might be successful in reducing PND and possibly future postpartum depression.
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Affiliation(s)
- Samira Alfayumi-Zeadna
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
| | | | - Norm O' Rourke
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel; Multidisciplinary Center for Research on Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | | | | | | | | | - Itmar Grotto
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel; Israeli Ministry of Health, Jerusalem, Israel
| | - Nihaya Daoud
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
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33
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Zheng Z, Zhang R, Liu T, Cheng P, Zhou Y, Lu W, Xu G, So KF, Lin K. The Psychological Impact of the Coronavirus Disease 2019 Pandemic on Pregnant Women in China. Front Psychiatry 2021; 12:628835. [PMID: 34276429 PMCID: PMC8282994 DOI: 10.3389/fpsyt.2021.628835] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 05/28/2021] [Indexed: 12/19/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has been reported to have negative psychological impact on mental health. Nonetheless, there are few studies investigating the impacts on pregnant women. This study investigated the psychological impact of COVID-19 pandemic on pregnant women, and the associated risk factors that moderated this impact. Methods and Materials: A total of 2,798 pregnant participants were recruited from the Guangzhou Women and Children's Medical Center. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) and Insomnia Severity Index (ISI) were used to assess depression, generalized anxiety disorder and insomnia, respectively, during and before the COVID-19 pandemic. The Impact of Event Scale-Revised (IES-R) was used to assess psychological stress during the COVID-19 pandemic. Results: During the COVID-19 pandemic, over one third of pregnant participants reported mild depression, around 20% experienced mild generalized anxiety, about one third reported problems with sleeping, and more than 15% felt mild psychological stress. The occurrence of psychological problems was significantly higher during the COVID-19 pandemic when compared to before the outbreak. The previously described pattern that pregnant women in the first trimester are more likely to report depression, and those in the third trimester are more likely to report insomnia and psychological stress, was also recognized in our study population. Mental health issues existing before the outbreak were risk factors, while family support was a protective factor in the occurrence of the measured mental health problems during the COVID-19 pandemic. Conclusion: Our data suggest pregnant women's mental health is inevitably affected during the COVID-19 pandemic. Pregnant women in the first and third trimester and those who experienced mental issues before the outbreak may be particularly affected.
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Affiliation(s)
- Zheng Zheng
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Ruoxi Zhang
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Tao Liu
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Pei Cheng
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Yanhong Zhou
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Weicong Lu
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Guiyun Xu
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Kwok-Fai So
- Guangdong-Hong Kong-Macau Institute of Central Nervous System Regeneration, Jinan University, Guangzhou, China.,The State Key Laboratory of Brain and Cognitive Sciences, Department of Ophthalmology, University of Hong Kong, Hong Kong, China
| | - Kangguang Lin
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Guangdong-Hong Kong-Macau Institute of Central Nervous System Regeneration, Jinan University, Guangzhou, China
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Diop S, Turmes L, Juckel G, Mavrogiorgou P. [Postpartum depression and migration]. DER NERVENARZT 2020; 91:822-831. [PMID: 31720700 DOI: 10.1007/s00115-019-00828-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Psychiatric research and care increasingly explore the connection between mental health and migration; however, it is striking that only a small number of analyses exist on the effect of migration on mental ailments specific to women. For example, even though postpartum depression regularly occurs among women with a migration background, in Germany and internationally there is a lack of knowledge on the epidemiology, particularly with respect to factors causing or contributing to postpartum depression among women with a migration background. Prospectively, culturally specific treatment options for women with a migration background are necessary to prevent chronification and subsequent harm to the mother and other family members. With this aim in mind, psychologists, psychiatrists and gynecologists should be aware of the specific factors contributing to the development of postpartum depression among women with a migration background. This overview article focuses on key aspects of postpartum depression, such as epidemiology, symptoms, risk factors and treatment concepts, while contextualizing them with respect to women's experience of migration.
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Affiliation(s)
- Shirin Diop
- Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum der Ruhr-Universität Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Deutschland
| | - Luc Turmes
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, LWL-Klinik Herten, Im Schloßpark 20, 45699, Herten, Deutschland
| | - Georg Juckel
- Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum der Ruhr-Universität Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Deutschland.
| | - Paraskevi Mavrogiorgou
- Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum der Ruhr-Universität Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Deutschland
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35
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Yoshioka-Maxwell A. Social Work in Action: Social Connectedness and Homelessness Amidst a Pandemic: Are the Social Impacts of Quarantine on Homeless Populations Being Adequately Addressed? HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2020; 79:329-331. [PMID: 33205051 PMCID: PMC7668111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Amanda Yoshioka-Maxwell
- Department of Social Work, Myron B. Thompson School of Social Work, University of Hawai'i at Mānoa, Honolulu, HI
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36
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Therrien AS, Buffa G, Roome AB, Standard E, Pomer A, Obed J, Taleo G, Tarivonda L, Chan CW, Kaneko A, Olszowy KM, Dancause KN. Relationships between mental health and diet during pregnancy and birth outcomes in a lower-middle income country: "Healthy mothers, healthy communities" study in Vanuatu. Am J Hum Biol 2020; 33:e23500. [PMID: 32918311 DOI: 10.1002/ajhb.23500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 12/15/2022] Open
Abstract
Poor maternal mental health during pregnancy is associated with adverse birth outcomes, including lower birthweight and gestational age. However, few studies assess both mental health and diet, which might have interactive effects. Furthermore, most studies are in high-income countries, though patterns might differ in low- and middle-income countries (LMICs). OBJECTIVES To analyze relationships between mental health and diet during pregnancy with birth outcomes in Vanuatu, a lower-middle income country. METHODS We assessed negative emotional symptoms of depression, anxiety, and stress (referred to as "distress") and dietary diversity during pregnancy, and infant weight and gestational age at birth, among 187 women. We used multivariate linear regression to analyze independent and interactive relationships between distress, dietary diversity, and birth outcomes, controlling for sociodemographic and maternal health covariates. RESULTS There were no direct linear relationships between dietary diversity or distress with infant birthweight or gestational age, and no curvilinear relationships between distress and infant outcomes. We observed interactive relationships between distress and dietary diversity on birthweight, explaining 2.1% of unique variance (P = .024). High levels of distress predicted lower birthweights among women with low dietary diversity. These relationships were not evident among women with moderate or high dietary diversity. CONCLUSIONS Relationships between mental health and diet might underlie inconsistencies in past studies of prenatal mental health and birthweight. Results highlight the importance of maternal mental health on birthweight in LMICs. Interactive relationships between mental health and diet might ultimately point to new intervention pathways to address the persistent problem of low birthweight in LMICs.
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Affiliation(s)
- Ann-Sophie Therrien
- Department of Physical Activity Sciences, University of Quebec in Montréal, Montreal, Quebec, Canada
| | - Giovanna Buffa
- Department of Anthropology, Binghamton University, Binghamton, New York, USA
| | - Amanda B Roome
- Bassett Research Institute, Mary Imogene Bassett Hospital, Cooperstown, New York, USA
| | - Elizabeth Standard
- Department of Anthropology, Binghamton University, Binghamton, New York, USA
| | - Alysa Pomer
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Jimmy Obed
- Ministry of Health, Port Vila, Republic of Vanuatu
| | - George Taleo
- Ministry of Health, Port Vila, Republic of Vanuatu
| | | | - Chim W Chan
- Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Akira Kaneko
- Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan.,Island Malaria Group, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Kathryn M Olszowy
- Department of Anthropology, New Mexico State University, Las Cruces, New Mexico, USA
| | - Kelsey N Dancause
- Department of Physical Activity Sciences, University of Quebec in Montréal, Montreal, Quebec, Canada
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37
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Chivers BR, Garad RM, Boyle JA, Skouteris H, Teede HJ, Harrison CL. Perinatal Distress During COVID-19: Thematic Analysis of an Online Parenting Forum. J Med Internet Res 2020; 22:e22002. [PMID: 32857707 PMCID: PMC7481017 DOI: 10.2196/22002] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/17/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022] Open
Abstract
Background The COVID-19 global pandemic has impacted the whole of society, requiring rapid implementation of individual-, population-, and system-level public health responses to contain and reduce the spread of infection. Women in the perinatal period (pregnant, birthing, and postpartum) have unique and timely needs for directives on health, safety, and risk aversion during periods of isolation and physical distancing for themselves, their child or children, and other family members. In addition, they are a vulnerable group at increased risk of psychological distress that may be exacerbated in the context of social support deprivation and a high-risk external environment. Objective The aim of this study is to examine the public discourse of a perinatal cohort to understand unmet health information and support needs, and the impacts on mothering identity and social dynamics in the context of COVID-19. Methods A leading Australian online support forum for women pre- through to postbirth was used to interrogate all posts related to COVID-19 from January 27 to May 12, 2020, inclusive. Key search terms included “COVID,” “corona,” and “pandemic.” A three-phase analysis was conducted, including thematic analysis, sentiment analysis, and word frequency calculations. Results The search yielded 960 posts, of which 831 were included in our analysis. The qualitative thematic analysis demonstrated reasonable understanding, interpretation, and application of relevant restrictions in place, with five emerging themes identified. These were (1) heightened distress related to a high-risk external environment; (2) despair and anticipatory grief due to deprivation of social and family support, and bonding rituals; (3) altered family and support relationships; (4) guilt-tampered happiness; and (5) family future postponed. Sentiment analysis revealed that the content was predominantly negative (very negative: n=537 and moderately negative: n=443 compared to very positive: n=236 and moderately positive: n=340). Negative words were frequently used in the 831 posts with associated derivatives including “worried” (n=165, 19.9%), “risk” (n=143, 17.2%), “anxiety” (n=98, 11.8%), “concerns” (n=74, 8.8%), and “stress” (n=69, 8.3%). Conclusions Women in the perinatal period are uniquely impacted by the current pandemic. General information on COVID-19 safe behaviors did not meet the particular needs of this cohort. The lack of nuanced and timely information may exacerbate the risk of psychological and psychosocial distress in this vulnerable, high-risk group. State and federal public health departments need to provide a central repository of information that is targeted, consistent, accessible, timely, and reassuring. Compensatory social and emotional support should be considered, using alternative measures to mitigate the risk of mental health disorders in this cohort.
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Affiliation(s)
- Bonnie R Chivers
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Rhonda M Garad
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia.,Department of Obstetrics and Gynaecology, Monash Health, Clayton, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia.,Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Australia
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
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Lundsberg LS, Cutler AS, Stanwood NL, Yonkers KA, Gariepy AM. Association of Pregnancy Contexts with Depression and Low Social Support in Early Pregnancy. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2020; 52:161-170. [PMID: 33047499 DOI: 10.1363/psrh.12155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 04/29/2020] [Accepted: 07/11/2020] [Indexed: 06/11/2023]
Abstract
CONTEXT Research into the relationship between pregnancy intention and perinatal depression or low social support is limited. Women's perspectives on pregnancy and their associations with perinatal depression could help in developing targeted efforts for screening and intervention. METHODS In 2014-2015, 161 women seeking pregnancy testing or abortion care at clinics in New Haven, Connecticut, were surveyed. They were asked about pregnancy context (intentions, planning, wantedness, desirability, timing and happiness), and the Edinburgh Depression Screen (EDS) and the Modified Kendler Social Support Index (MKSSI) were used to identify possible antenatal depression and low social support, respectively. Multivariable logistic regression analysis was employed to examine associations between pregnancy context and these outcomes. RESULTS On average, participants were 27 years old and at nine weeks' gestation. One-fifth reported a previous diagnosis of depression or anxiety, and 22% and 33% screened positive for depression (EDS scores of 13 or higher and 10 or higher, respectively); 52% received low social support (MKSSI score of 3.2 or less). Regression analysis found that pregnancies described as unintended, poorly timed or undesired were associated with depression at the higher cutoff (odds ratios, 3.2-4.5); all unfavorable pregnancy measures were associated with depression at the lower cutoff. Ambivalence regarding pregnancy timing, intention, wantedness and desirability was associated with increased odds of depression by either EDS score. Unplanned pregnancies and those about which the woman was ambivalent were associated with low social support. CONCLUSIONS Findings support the need to screen women for depression early in pregnancy and to integrate assessments of pregnancy context into the evaluation of potential risk factors.
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Affiliation(s)
- Lisbet S Lundsberg
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT
| | - Abigail S Cutler
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT
| | - Nancy L Stanwood
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT
| | - Kimberly A Yonkers
- Department of Psychiatry and Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT
| | - Aileen M Gariepy
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT
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Nyman T, Pegg S, Kiel EJ, Mistry-Patel S, Becker-Schmall LJ, Brooker RJ. Perceived social support moderates neural reactivity to emotionally valenced stimuli during pregnancy. Psychophysiology 2020; 57:e13647. [PMID: 32715514 DOI: 10.1111/psyp.13647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 05/28/2020] [Accepted: 06/24/2020] [Indexed: 01/17/2023]
Abstract
Reactivity to emotional information, measurable at the level of neural activity using event-related potentials, is linked to symptoms of affective disorders. Behavioral evidence suggests that contextual factors, such as social support, can alter emotional reactivity such that affective responding is normalized when social support is high. This possibility remains largely untested at the neural level, specifically through approaches that can offer insight into the mechanistic processes contributing to individual differences in emotional reactivity. Yet, such knowledge could be useful for prevention and intervention efforts, particularly with groups at risk for increased emotional reactivity, such as pregnant mothers for whom emotional distress predicts both maternal and child outcomes. Expectant mothers took part in a longitudinal study that tested whether the late positive potential (LPP), a neural index of reactivity to emotional information, was moderated by maternal perceptions of social support. In the third trimester of pregnancy, lower perceived social support was associated with an absence of a traditional LPP effect, which differentiates valenced from neutral stimuli. Findings suggest that perceptions of social support may normalize emotional processing at the neural level and highlight the potential importance of social support modulation of emotional reactivity during times of known biological change.
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Affiliation(s)
- Tristin Nyman
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Samantha Pegg
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | | | - Sejal Mistry-Patel
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Lisa J Becker-Schmall
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, IA, USA
| | - Rebecca J Brooker
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
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Slavin V, Creedy DK, Gamble J. Single Item Measure of Social Supports: Evaluation of construct validity during pregnancy. J Affect Disord 2020; 272:91-97. [PMID: 32379626 DOI: 10.1016/j.jad.2020.03.109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 02/02/2020] [Accepted: 03/28/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Lack of social support during pregnancy is associated with psychosocial vulnerability. The Single Item Measure of Social Supports (SIMSS) is included in a core outcome set to facilitate case-adjustment based on social support. Validity of the SIMSS has not been evaluated in childbearing women. We aimed to evaluate the construct validity of the SIMSS during pregnancy. Secondary aim was to evaluate an alternative short-measure of social support. METHODS Recruited women (n = 309) attending antenatal care were invited to complete the SIMSS, Multidimensional Scale of Perceived Social Support (MSPSS), Antenatal Risk Questionnaire (ANRQ), and Edinburgh Postnatal Depression Scale (EPDS). Convergent validity of SIMSS with MSPSS and hypothesis testing for psychosocial risk and depressive symptoms were conducted. RESULTS Correlations were moderate between the SIMSS and MSPSS (rs = .35), but weak between the SIMSS and EPDS (rs = -.18); and SIMSS and ANRQ (rs = -.22). In contrast, correlations were moderate between the MSPSS and EPDS (rs = -.39) and ANRQ (rs = -.45). A shortened 3-item version of the MSPSS showed good psychometric properties and internal consistency reliability (a = .86). LIMITATIONS Findings relate to one Australian birthing sample during pregnancy. Replication of this study in larger, diverse maternity populations, including postpartum is recommended. CONCLUSIONS The SIMSS is a poor measure of social support during pregnancy with poor predictive ability to detect maternal vulnerability including depression and psychosocial risk. A revised 3-item version of the MSPSS was found to be a valid and reliable measure of social support.
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Affiliation(s)
- Valerie Slavin
- Transforming Maternity Care Collaborative, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld, 4131, Australia; Women, Newborn & Children's Services, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Qld, 4215, Australia..
| | - Debra K Creedy
- Transforming Maternity Care Collaborative, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld, 4131, Australia
| | - Jenny Gamble
- Transforming Maternity Care Collaborative, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld, 4131, Australia
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Scott S, Arrieta A, Kumar N, Menon P, Quisumbing A. Multidimensional predictors of common mental disorders among Indian mothers of 6- to 24-month-old children living in disadvantaged rural villages with women's self-help groups: A cross-sectional analysis. PLoS One 2020; 15:e0233418. [PMID: 32574218 PMCID: PMC7310838 DOI: 10.1371/journal.pone.0233418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 05/05/2020] [Indexed: 01/11/2023] Open
Abstract
Common mental disorders (CMD) among mothers cause disability, negatively affect child development, and have high long-term economic costs. Little is known about how factors across multiple life dimensions, modeled together, are differentially related to maternal mental health in high poverty contexts. Further, there is limited evidence on determinants of CMD in areas where self-help groups (SHGs) exist to promote women's wellbeing. Filling this evidence gap is important given the high prevalence of CMD and the rapid expansion of SHGs in rural India. Cross-sectional data were collected from 1644 mother-infant pairs living in disadvantaged rural villages across five Indian states-Jharkhand, Madhya Pradesh, West Bengal, Odisha, and Chhattisgarh-surveyed in the Women Improving Nutrition through Group-based Strategies study. CMD were assessed using the 20-item Self Reporting Questionnaire (SRQ). We examined 31 factors across four life dimensions: work (work type, time spent in labor, domestic and caretaking activities), agency (SHG membership, decision-making, gender attitudes), health/nutrition (underweight, fertility, diet diversity, child illness), and household/environment (dependency ratio, wealth, food security, shocks, water, sanitation). Survey-adjusted multivariate logistic and ordinary least squares regression models were fit to examine predictors of CMD or SRQ score. On average, mothers were 26 (range 18-46) years old and their children were 15 (range 6-24) months old. CMD defined as ≥ 8 positive SRQ responses were reported by 262 women (16%). Protective factors included being engaged in agricultural labor as a main occupation relative to being a housewife (AOR 0.18, 95% CI 0.10-0.32), more time working (0.85, 0.77-0.93), higher decision-making (0.33, 0.16-0.69), SHG membership (0.73, 0.56-0.96), and having an improved toilet (0.49, 0.33-0.72). Risk factors included food insecurity (1.13, 1.07-1.20) and shocks to non-farm livelihoods (2.04, 1.10-3.78). Practitioners and policymakers should aim to improve food security, economic wellbeing and social capital, such as that created through SHG membership, to improve maternal mental health. Future research should aim to understand why working outside the home, albeit in agricultural work, appears to protect maternal mental health in this context.
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Affiliation(s)
- Samuel Scott
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, United States of America
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, New Delhi, India
| | - Alejandra Arrieta
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, United States of America
| | - Neha Kumar
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, United States of America
| | - Purnima Menon
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, United States of America
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, New Delhi, India
| | - Agnes Quisumbing
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, United States of America
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Gausman J, Austin SB, Subramanian SV, Langer A. Adversity, social capital, and mental distress among mothers of small children: A cross-sectional study in three low and middle-income countries. PLoS One 2020; 15:e0228435. [PMID: 31999768 PMCID: PMC6992203 DOI: 10.1371/journal.pone.0228435] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 01/15/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Maternal mental health is becoming recognized as a global health priority. Mental distress among mothers of young children may be exacerbated by exposure to adversity. Social capital may buffer the impact of adversity on mental distress during the postnatal period and beyond. This paper examines the relationship between adversity, cognitive social capital and mental distress among mothers of young children in three low and middle-income countries. METHODS This study uses data from the Young Lives study on 5,485 women from Ethiopia, India, and Vietnam. Logistic regression was used to examine the association between exposure to stressful life events (SLEs) and mental distress in women between 6 months and 1.5 years post-partum. Logistic and linear regression was used to examine the potential for effect modification by social capital. RESULTS The proportion of women with mental distress during the period between 6-18 months following the birth of a child in the sample was 32.6% in Ethiopia, 30.5% in India and 21.1% in Vietnam. For each additional SLE to which a woman was exposed, the odds of MMD increased by 1.28 (95% CI: 1.22, 1.36; p<0.001) in Ethiopia, 1.17 (1.11, 1.25; p<0.001) in India, and 1.98 (1.75, 2.25; p<0.001) in Vietnam. Exposure to family SLEs was significantly associated with MMD in all three countries with odds ratios of 1.76 (95% CI: 1.30, 2.38; p<0.001), 1.62 (95% CI: 1.12, 2.33; p<0.01 in India), 1.93 (95% CI: 1.27, 2.92; p<0.01), respectively. In Ethiopia and India, economic SLEs were also significantly associated with MMD after adjustment (Ethiopia OR: 1.68; 95% CI: 1.12, 2.52; p<0.01 and India OR: 1.44; 95% CI: 1.01, 2.05; p<0.05), while in India, crime SLEs (OR: 1.93; 95% CI: 1.27, 2.92; p<0.01) were associated with MMD. Cognitive social capital was found to modify the association between SLEs and symptomology of mental distress in Ethiopia, India and Vietnam. CONCLUSIONS This study suggests that adversity may increase the risk of maternal mental distress in three LMICs, while social capital may buffer its effect.
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Affiliation(s)
- Jewel Gausman
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, United States of America
| | - S. Bryn Austin
- Division of Adolescent and Young Adult Medicine, Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston Children’s Hospital, Boston, MA, United States of America
| | - S. V. Subramanian
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, United States of America
| | - Ana Langer
- Women and Health Initiative, Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, United States of America
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DeMaria AL, Rivera S, Naoum Z, Ramos-Ortiz J, Meier S, Dykstra C. Contextualising challenges of reproduction and motherhood in Florence, Italy: a qualitative study. EUR J CONTRACEP REPR 2020; 25:8-19. [PMID: 31922439 DOI: 10.1080/13625187.2019.1709814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: This study sought to understand attitudes, behaviours and expectations regarding reproductive planning, infertility and motherhood among women living in Italy.Methods: Researchers conducted 55 in-depth interviews among 46 reproductive-aged women living in or around Florence, Italy, currently using the Italian health care system, and nine Italian health care professionals. Researchers used an expanded grounded theory approach to understand women's reproductive experiences, with the social-ecological model serving as a conceptual lens for data analyses.Results: Fertility care inadequacy and financial instability impacted participants' attitudes towards reproduction. Women's shifting roles and reduced marital salience prompted decisions to delay or forgo childbearing. For pregnant women and women with children, perceived postpartum challenges included employment discrimination, childrearing costs and variable paternal support. Some participants discussed increased parental responsibility sharing, but many noted lingering expectations that women prioritise motherhood above other pursuits.Conclusion: Findings provide insight into Italian women's reproductive attitudes and behaviours and the declining fertility rate in the current economic and social environment. Practical recommendations for policy and socio-cultural interventions should address reproductive barriers such as affordable childcare, improved fertility assistance, maternal employment protection, and better utilization of existing support structures.
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Affiliation(s)
- Andrea L DeMaria
- Department of Public Health, Purdue University, West Lafayette, IN, USA
| | - Sydney Rivera
- School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Zeina Naoum
- Department of Public Health, Purdue University, West Lafayette, IN, USA
| | - Jaziel Ramos-Ortiz
- Division of Consumer Science, Purdue University, West Lafayette, IN, USA
| | - Stephanie Meier
- Division of Consumer Science, Purdue University, West Lafayette, IN, USA
| | - Chandler Dykstra
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
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Ayers S, Crawley R, Webb R, Button S, Thornton A. What are women stressed about after birth? Birth 2019; 46:678-685. [PMID: 31612558 DOI: 10.1111/birt.12455] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 08/30/2019] [Accepted: 09/03/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Having a baby is associated with a variety of stressors, change, and adjustment. This study aimed to identify what women find stressful during the early postpartum period in contemporary Western society. METHODS Women (n = 148) 6-12 weeks postpartum wrote anonymously about a situation they found stressful as part of the Health after Birth Trial (HABiT) of expressive writing. Transcripts were analyzed for categories of stressors and cross-cutting themes. RESULTS Five categories of stressors were identified. Stressors in pregnancy, labor, and the early postpartum period (49.3%) included physical and emotional difficulties, and insensitive treatment by health professionals. Stressors related to adjusting to life with a baby (35.8%) included difficulties coping with a new baby, parenting, juggling responsibilities, changes to physical health, and loneliness. Stressors related to the baby's health (32.4%) included infant digestive problems, acute health problems, long-term impact, and neonatal intensive care unit experiences. Stressors related to breastfeeding (23.7%) included pressure to breastfeed, feeling like a 'bad mum' for not breastfeeding, or wanting to breastfeed and not being able to. Other stressors related to changing relationships (18.2%): with their partner, children, and other family members. Cross-cutting themes that emerged in different stressor categories were women making negative self-appraisals (eg, a bad mum, failure), feeling guilty, and lack of support from others. DISCUSSION Our findings emphasize the importance of exploring stressors and psychological well-being with women to provide support, help women's adjustment postpartum, and ensure interventions are offered when appropriate.
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Affiliation(s)
- Susan Ayers
- Centre for Maternal and Child Health Research, City, University of London, London, UK
| | | | - Rebecca Webb
- Centre for Maternal and Child Health Research, City, University of London, London, UK
| | - Susan Button
- Department of Adult Nursing and Paramedic Science, University of Greenwich, London, UK
| | - Alexandra Thornton
- Centre for Maternal and Child Health Research, City, University of London, London, UK
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Reimann M, Marx CK, Diewald M. Work-to-family and family-to-work conflicts among employed single parents in Germany. EQUALITY, DIVERSITY AND INCLUSION: AN INTERNATIONAL JOURNAL 2019. [DOI: 10.1108/edi-02-2019-0057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to examine whether and how employed single-parents differ from parents in two-parent families in their experience of work-to-family conflict (WFC) and family-to-work conflict (FWC). Looking at job-related as well as family-related demands and resources, this research investigated to what degree these demands and resources contribute to differences in WFC and FWC, how their relevance in predicting conflicts varies between single parents and other parents and the role of compositional differences in work and family demands and resources.
Design/methodology/approach
Cross-sectional linear regression analyses were applied to analyze a random sample of employees in large work organizations in Germany. The sample included 3,581 parents with children up to the age of 25, of whom 346 were single parents.
Findings
The results indicated that single parents face more FWC, but not more WFC, than other parents. For all parents, job demands such as overtime, supervising responsibilities and availability expectations were associated with higher levels of WFC, whereas job resources such as job autonomy, support from supervisors and flexible working hours were associated with lower levels of WFC. In predicting FWC, family demands and resources played only a minor role. However, results provide only scant evidence of differences between single parents and other parents in terms of the effects of job and family demands and resources.
Originality/value
This study offers interesting insights into the diversity of WFC and FWC experiences in Germany. It provides first evidence of the impact of job and family demands and resources on both directions of work–family conflicts among employed single parents as a specific social group.
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Doi S, Fujiwara T, Isumi A, Ochi M. Pathway of the Association Between Child Poverty and Low Self-Esteem: Results From a Population-Based Study of Adolescents in Japan. Front Psychol 2019; 10:937. [PMID: 31133920 PMCID: PMC6511812 DOI: 10.3389/fpsyg.2019.00937] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 04/08/2019] [Indexed: 12/26/2022] Open
Abstract
Child poverty leads to various negative consequences, including low self-esteem, which is a risk factor for mental illness, suicide, or poor academic achievement. However, little is known about why child poverty leads to low self-esteem. We aimed to elucidate the association of child poverty and low self-esteem based on the ecological model, which includes family-level, school-level, and community-level factors. Data were obtained from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in 2016, and participants included 1,652 children in fourth grade (534 pairs), sixth grade (530 pairs), and eighth grade (588 pairs) living in Adachi City, Tokyo, Japan. A questionnaire survey was implemented to assess child poverty, parental mental health, parental involvement with children, parental social capital by caregivers, and self-esteem and school social capital by children. The structural equation model was applied to elucidate the association between child poverty and low self-esteem, using family-level (parental mental health and parental involvement with children), school-level (school social capital), and community-level (parental social capital) factors. Child poverty was associated with low self-esteem. Child poverty leads to poor parental involvement, which can be indirectly associated with poor parental mental health and poor parental social capital, and poor parental involvement was directly or indirectly associated with low self-esteem through poor school social capital. To mitigate the impact of child poverty on low self-esteem, comprehensive health policies targeting family-level (parental mental health and parental involvement with children), school-level (school social capital), and community-level (parental social capital) factors may be effective.
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Affiliation(s)
- Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Manami Ochi
- Department of Health and Welfare Services, National Institute of Public Health, Saitama, Japan
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Goodday SM, Bondy S, Sutradhar R, Brown HK, Rhodes A. Exposure to maternal depressive symptoms in childhood and suicide-related thoughts and attempts in Canadian youth: test of effect-modifying factors. Soc Psychiatry Psychiatr Epidemiol 2019; 54:191-200. [PMID: 30357436 DOI: 10.1007/s00127-018-1612-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 10/08/2018] [Indexed: 01/24/2023]
Abstract
PURPOSE To (1) determine the association between exposure to maternal depressive symptoms in childhood and offspring suicide-related thoughts (SRT) and attempts (SA) in youth and young adults and (2) identify effect measure modifiers (offspring sex, family structure, maternal perceived social support, and social cohesion) of the association in 1. METHOD A cohort was constructed by linking all cycles from the National Longitudinal Survey of Children and Youth, a Canadian nationally representative survey, from 1994 to 2009 in 16,903 subjects 0 to 25 years. Exposure to maternal-reported depressive symptoms was measured when offspring were between 0 and 10 years. Offspring self-reported incident and recurrent SRT and SA were measured between 11 and 25 years. Time-to-event models under a counting process framework were used to estimate adjusted hazard ratios (HR) and relative rates (RR) and 95% confidence intervals (CI). Effect measure modifiers were examined across adjusted stratum-specific estimates. RESULTS In offspring exposed to maternal depressive symptoms, the adjusted rates of incident SRT and SA (HR: 1.67, 95% CI 1.37, 2.08; HR: 1.93, 95% CI 1.43, 2.50) and of recurrent SRT and SA (RR: 1.61, 95% CI 1.33, 1.96; RR: 1.87, 95% CI 1.40, 2.36) were significantly elevated compared to non-exposed offspring. The stratum-specific rates of incident and recurrent SRT and SA were significantly elevated in females but not in males. CONCLUSIONS Girls exposed to maternal depressive symptoms in childhood are a target group for childhood suicide preventive strategies. Family-based preventions, and strategies to identify and effectively treat maternal depressive episodes could be beneficial for suicide prevention in offspring.
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Affiliation(s)
- Sarah Margaret Goodday
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. .,Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Susan Bondy
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Rinku Sutradhar
- Department of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - Hilary K Brown
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Psychiatry, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Anne Rhodes
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Psychiatry, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,The Offord Centre for Child Studies, McMaster University, Hamilton, Canada
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Rode JL, Stricklin SM, Nicely S. Social network and emotional intelligence in pregnancy and postpartum. INTERPERSONA: AN INTERNATIONAL JOURNAL ON PERSONAL RELATIONSHIPS 2018. [DOI: 10.5964/ijpr.v12i2.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Although evidence supports the role of social support in perinatal women's well-being, the dynamics of these relationships remain unclear. We examined changes in social support and social network from prenatal to postpartum periods from 168 perinatal women. Individual differences in emotional intelligence (EI) were examined as moderating these changes. Results suggest that functional social support increases in postpartum while social network decreases. EI significantly moderated change in functional social support from fathers such that functional social support from a woman's father was significantly higher in women with higher EI. Changes in social network were not significantly affected by EI.
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Madhavan S, Clark S, Hara Y. Gendered Emotional Support and Women's Well-Being in a Low-Income Urban African Setting. GENDER & SOCIETY : OFFICIAL PUBLICATION OF SOCIOLOGISTS FOR WOMEN IN SOCIETY 2018; 32:837-859. [PMID: 31327892 PMCID: PMC6641544 DOI: 10.1177/0891243218786670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Emotional support is crucial to the well-being of low-income, single women and their children in most contexts. Support from women may be especially important for single mothers because of precarious ties to their children's fathers, the prevalence of extended matrifocal living arrangements, and gendered norms that place men as providers of financial rather than emotional support. However, in contexts marked by economic insecurity, spatial dispersion of families, and changing gender norms and kinship obligations, such an expectation may be problematic. Applying theories of emotional capital and family bargaining processes, we address three questions: 1) what is the gender composition of emotional support that single mothers receive? 2) how does gender composition change over time? and 3) does the gender composition of emotional support affect self-reported stress of single mothers? Drawing on data from a unique dataset on 462 low-income single mothers and their kin from Nairobi, Kenya, we uncover three key findings. One, whereas the bulk of strong emotional support comes from female kin, about 20% of respondents report having male dominant support networks. Two, nearly 30% of respondents report change in the composition of their emotional support over six months favoring men. Three, having a male dominant emotional support network is associated with lower stress. These results challenge what is commonly taken for granted about gender norms and kinship obligations in non-Western contexts.
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50
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Dias A, Geard N, Campbell PT, Warr D, McVernon J. Quantity or quality? Assessing relationships between perceived social connectedness and recorded encounters. PLoS One 2018; 13:e0208083. [PMID: 30496262 PMCID: PMC6264807 DOI: 10.1371/journal.pone.0208083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 11/12/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction Higher levels of social connectedness are associated with better physical and mental health outcomes, but measures of connectedness are often study specific. Prior research has distinguished between perceived and received (quantifiable) measures of social connectedness, with differing impacts on health, sometimes mediated by place of residence. This analysis investigated the relationship between perceptions of social support/connection and quantifiable measures of social encounters, by neighbourhood, to inform understanding of place-based differences in connectedness and health outcomes. Methods Negative binomial regression models were used to determine associations between perceptions of social connectedness (perceived community connections and social involvement) and the number of recorded daily social encounters as a proxy for received support/connectedness. Analyses were undertaken across two Local Government Areas (LGAs) in Melbourne with disparate socio-economic profiles to examine potential modification of social connectedness measures by neighbourhood of residence. Results Two measures of perceived connectedness had a clear relationship with recorded daily social encounters–feeling a sense of community belonging (RR 1.20 (1.04, 1.37), p = 0.010) and having family or friends close by (RR 1.30 (1.10,1.54), p = 0.002 “neither” compared to “disagree”, (RR 1.15 (1.04, 1.26), p = 0.006 “agree” compared to “disagree”). Involvement in a local church, sporting or social club was associated with a greater number of daily social encounters for respondents who participated a few times a year (RR 1.17 (1.05,1.32), p = 0.006) or often (RR 1.23 (1.12,1.36), p<0.001) compared to never. In the less affluent LGA, active contributions to neighbours and community through assistance and volunteering were a frequent driver of social connection. Differences in patterns between the two areas were found with some measures of perception showing stronger relationships with recorded daily encounters in one area but not the other. Conclusions These results indicate substantial complexity in the relationship between perceptions of social connectedness and recorded daily social encounters/received connectedness, meaning that one cannot be reliably extrapolated from the other. Drivers of individuals’ social connections also varied by area of residence. These findings offer new insights into potential mediators of the association between connectedness and wellbeing.
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Affiliation(s)
- Alison Dias
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Nicholas Geard
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- School of Computing and Information Systems, The University of Melbourne, Melbourne, Australia
- Victorian Infectious Diseases Reference Laboratory Epidemiology Unit at The Peter Doherty Institute for Infection and Immunity, The University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | - Patricia Therese Campbell
- Victorian Infectious Diseases Reference Laboratory Epidemiology Unit at The Peter Doherty Institute for Infection and Immunity, The University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
- Infection and Immunity Theme, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Deborah Warr
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Jodie McVernon
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Victorian Infectious Diseases Reference Laboratory Epidemiology Unit at The Peter Doherty Institute for Infection and Immunity, The University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
- Infection and Immunity Theme, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
- * E-mail:
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