Psychosocial and physiological stress among women leaving welfare

Contributors to Depressed Mood in Black Single Mothers

Participants: A convenience sample of 210 community dwelling Black single mothers ages 18 to 45, who reside in U.S. urban communities.Methods: A descriptive, cross-sectional design was employed. Participants responded to an open-ended question that asked about reasons for depressed mood. A directed approach to content analysis was used to categorize the responses based on existing theoretical formulations and empirical findings about the causes of depression in women. Percentages and frequencies were used to describe the results of the analysis.Findings: A total of 319 usable responses were provided. Collectively and individually the most frequent responses were consistent with Social/Environmental factors such as lack of financial resources (n = 115; 36.05%), followed by Psychological factors such as general cognitive/emotional feelings of stress (n = 60; 18.81%), and parenting stressors or daily hassles (n = 40; 12.54%). Physiologic factors such as a having physiologic or medical conditions were reported less often (n = 14; 4.39%).Conclusions/Implications: Social/Environmental and Psychological factors contribute to depressed mood more often than Physiological factors in Black single mothers. Depression prevention efforts should target the social determinants of mental health in Black single mothers who should be connected with appropriate financial, psychological, educational and social service resources in the community.

Outcomes of Depression in Black Single Mothers

Despite suggestions in the literature that depression has serious consequences, few studies have examined specific health and psychosocial outcomes of depression in Black single mothers. The purpose of this study was to estimate paths in a just-identified theoretical model of outcomes of depression for Black single mothers based on theoretical propositions and empirical findings. The model included the variables, depressive cognitions, depressive symptomatology, perceived social support, and positive health practices. Five direct and two indirect hypothesized relationships were estimated using structural equation modeling. A nonprobability sample of convenience of 159 Black single mothers aged 18 to 45 years was recruited for the study. This study used a cross-sectional correlational design. The participants responded in person or via the U.S. mail to the Center for Epidemiologic Studies-Depression scale, the Depressive Cognition Scale, the Personal Resource Questionnaire 85-Part 2, and the Personal Lifestyle Questionnaire. Beta and Gamma path coefficients were statistically significant for four out of five hypothesized direct relationships within the model ( p < .01). The direct path between depressive cognitions and positive health practices was not supported (Gamma = -.11, p > .05). The two indirect paths were weak but statistically significant ( p < .01). Depressive symptoms and perceived social support were outcomes of depressive cognitions. Positive health practices was not a direct outcome of depressive cognitions. Perceived social support and positive health practices were outcomes of depressive symptoms.

Psychophysiological Assessment of Stress Under Ecological Settings

Abstract. Stress can negatively impact one’s health and well-being, however, despite the recent evolution in stress assessment research methodologies, there is still little agreement about stress conceptualization and assessment. In an attempt to summarize and reflect on this evolution, this paper aims to systematically review research evidence of ecological approaches on psychophysiological stress assessment. Thus, a literature search of electronic databases was conducted spanning 22 years (1990–2012) and 55 studies were reviewed. Studies were considered for inclusion if they contemplated both psychological and physiological measures of stress under ecological settings. This review focuses on five themes: methodology terminology, research population, study design, measurement, and technology. Findings support the need to use a common methodology terminology in order to increase scientific rigor. Additionally, there seems to be an increasing tendency for the use of these methods by multidisciplinary teams among both clinical and nonclinical populations aiming to understand the relationship between stress and disease. Most of the studies reviewed contemplated a time-based protocol and different conceptualizations of stress were found, resulting in the use of different subjective measures. Findings reinforce the importance of combining subjective and objective measures while also controlling for possible time- or situation-dependent confounders’. Advances in technology were evident and different assessment techniques were found. The benefits and challenges of ecological protocols to assess stress are discussed and recommendations for future research are provided, aiming to overcome previous limitations and advance scientific knowledge in the area.

Synthesizing Marketing, Community Engagement, and Systems Science Approaches for Advancing Translational Research

The adoption and implementation of evidence-based interventions (EBIs) are the goals of translational research; however, potential end-users' perceptions of an EBI value have contributed to low rates of adoption. In this article, we describe our application of emerging dissemination and implementation science theoretical perspectives, community engagement, and systems science principles to develop a novel EBI dissemination approach. Using consumer-driven, graphics-rich simulation, the approach demonstrates predicted implementation effects on health and employment outcomes for socioeconomically disadvantaged women at the local level and is designed to increase adoption interest of county program managers accountable for improving these outcomes in their communities.

Validation of the Center for Epidemiologic Studies Depression Scale in black single mothers

BACKGROUND AND PURPOSE

The purpose of this study was to investigate the factor structure of the Center for Epidemiologic Studies Depression (CES-D) scale in a community sample of Black single mothers and to evaluate the scale's construct validity.

METHODS

Principal components and exploratory factor analysis were used. The participants responded to the CES-D scale and Spielberger's State-Trait Anger Expression Inventory.

RESULTS

The final sample consisted of 208 Black single mothers aged 18-45 years. A 2-factor structure was accepted. Construct validity was confirmed via significant correlations with the anger scales. A method artifact for the 2-factor solution was ruled out.

CONCLUSION

The CES-D scale is valid for use with Black single mothers. Additional psychometric evidence for the CES-D for Black single mothers is warranted.

Depressive symptoms and compromised parenting in low-income mothers of infants and toddlers: distal and proximal risks

Low-income mothers develop depressive symptoms at higher rates than the general population, adding to the existing risk that economic hardship places on their infants and toddlers. Emphasizing a few key intervention targets, an approach that is especially relevant to mothers when depressive symptoms compromise their energy and concentration, can improve interventions with populations facing adversity. The goal of this study was to identify contextual risk factors that significantly contributed to depressive symptoms and that, in combination with depressive symptoms, were associated with compromised parenting. Using baseline data from 251 ethnically diverse mothers from six Early Head Start programs in the Northeastern and Southeastern US, who were recruited for a clinical trial of an in-home intervention, Belsky's ecological framework of distal to proximal levels of influence was used to organize risk factors for depressive symptoms in hierarchical regression models. Under stress, mothers of toddlers reported more severe depressive symptoms than mothers of infants, supporting the need for depressive symptom screening and monitoring past the immediate postpartum period. Multivariate models revealed intervention targets that can focus depression prevention and intervention efforts, including helping mothers reduce chronic day-to-day stressors and conflicts with significant others, and to effectively handle challenging toddler behaviors, especially in the face of regional disciplinary norms. Presence of a live-in partner was linked to more effective parenting, regardless of participants' depressive symptom severity.

TANF over time: the tale of three studies

We compare the experiences of women from three studies who were in different stages of participation in the U.S. welfare program, Temporary Assistance for Needy Families (TANF). The setting for the studies was a large Midwest urban county, targeted chain referral sampling was used, and the combined sample of the three studies was 106 women. The instruments were a semistructured interview guide, the HANES General Well-Being Schedule and a demographic data form. Quantitative data are augmented with qualitative interview data. The findings suggest barriers to self-sustaining employment include health challenges, limited education, socio-economic marginalization, and the welfare policy itself. Nurses are well positioned to advocate for women in poverty and mitigate the health challenges they face. The findings add to the limited evidence base on which the TANF policy is based and can be used to modify the policy to increase the success of the women who participate in it.

Comparison of depressive symptom severity scores in low-income women

BACKGROUND

The Beck Depression Inventory, Second Edition (BDI-II), and the Patient Health Questionnaire-9 (PHQ-9) are considered reliable and valid for measuring depressive symptom severity and screening for a depressive disorder. Few studies have examined the convergent or divergent validity of these two measures, and none has been conducted among low-income women-although rates of depression in this group are extremely high. Moreover, variation in within-subject scores suggests that these measures may be less comparable in select subgroups.

OBJECTIVE

We sought to compare these two measures in terms of construct validity and to examine whether within-subject differences in depressive symptom severity scores could be accounted for by select characteristics in low-income women.

METHODS

In a sample of 308 low-income women, construct validity was assessed using a multitrait-monomethod matrix approach, between-instrument differences in continuous symptom severity scores were regressed on select characteristics using backward stepwise selection, and differences in depressive symptom classification were assessed using the Mantel-Haenszel test.

RESULTS

Convergent validity was high (rs = .80, p < .001). Among predictors that included age, race, education, number of chronic health conditions, history of depression, perceived stress, anxiety, and/or the number of generalized symptoms, none explained within-subject differences in depressive symptom scores between the BDI-II and the PHQ-9 (p > .05, R2 < .04). Similarly, there was consistency in depressive symptom classification (χ2 = 172 and 172.6, p < .0001).

DISCUSSION

These findings demonstrate that the BDI-II and the PHQ-9 perform similarly among low-income women in terms of depressive symptom severity measurement and classifying levels of depressive symptoms, and do not vary across subgroups on the basis of select demographics.

The relationship between 24-h urinary cortisol and bone in healthy young women

BACKGROUND

Cortisol within the normal range has been associated with reduced bone density in the elderly, but little is known about this relationship in healthy young women.

PURPOSE

The purpose of this study is to assess whether 24-h urinary free cortisol excretion (UFC) is related to bone density in 132 healthy, non-obese, regularly menstruating women, aged 19-35.

METHOD

Participants completed questionnaires (food frequency, demographics, physical activity, dietary restraint, perceived stress, and daily stress) and a 24-h urine collection. UFC was determined by high-throughput liquid chromatography and tandem mass spectrometry. Anthropometrics were completed and a dual energy X-ray absorptiometry scan measured areal bone mineral density (aBMD, g/cm(2)) and bone mineral content (BMC, g) at the lumbar spine (L1-4), hip, and total body (TB) as well as total body lean (LBM) and fat mass.

RESULTS

aBMD and BMC were significantly positively associated with height, LBM, physical activity, calcium intake, and duration of previous oral contraceptive use (except L1-4) and negatively with perceived stress. UFC was not correlated with any measured variables except urine volume (r = 0.17, p = 0.046). After adjusting for urine volume, height, LBM, ethnicity, and prior oral contraceptive use, UFC was significantly inversely associated with TB BMC (r = -0.30, p < 0.001) and aBMD (r = -0.27, p = 0.003), L1-4 aBMD (r = -0.19, p = 0.035) and BMC (r = -0.18, p = 0.049), and hip BMC (r = -0.23, p = 0.011). Further adjustment for sport activity, calcium intake and perceived stress did not change these relationships meaningfully except that L1-4 became nonsignificant (p < 0.07).

CONCLUSION

Cortisol within the normal range appears to have a minor negative influence on bone density in healthy young women.