Coping with Depression in Single Black Mothers

The Cumulative Influence of Perceived Discrimination, Stress, and Coping Responses on Symptoms of Depression Among Young African American Mothers

BACKGROUND

African American women have an elevated risk for experiencing depressive symptoms, and discrimination, stress, and coping contribute to symptoms of depression.

AIMS

We aimed to examine the associations between discrimination, stress, and coping on symptoms of depression among young African American mothers.

METHODS

In this retrospective study, we utilized a hierarchical linear regression to explore the effects of perceived racial discrimination, stress, and general and discrimination-related coping responses on depressive symptoms in a sample of African American mothers (N = 250). The data were drawn from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure study (InterGEN), a study conducted between 2014 and 2019 and based in Connecticut.

RESULTS

After accounting for maternal age, level of education, and income, greater perceived racial discrimination (p = .03), higher levels of stress (p < .001), greater engagement in avoidance coping (p < .001), and use of passive coping responses to discrimination (p = .04) were uniquely associated with increased depressive symptoms. Other forms of coping, specifically, problem-solving and support seeking, did not appear to influence depressive symptoms in this sample.

CONCLUSION

The findings highlight the negative impact of discrimination, heightened stress, and maladaptive coping on the emotional health of young African American mothers.

Experiences of postpartum mental health sequelae among black and biracial women during the COVID-19 pandemic

OBJECTIVE

The objective of this study was to qualitatively examine coping mechanisms and desired supports in pregnant and birthing Black and Biracial adolescent and young adult women during the COVID-19 pandemic.

METHODS

Black and Biracial participants ages 16-23 were recruited for virtual individual semi-structured interviews. Participants (n = 25) were asked about pre- and post-natal experiences with the healthcare system, effects of the pandemic, and participants' experiences of or desires for ideal care within the healthcare system. Interviews were transcribed verbatim and coded for qualitative analysis using nVivo. Discussions around postpartum mental health evolved organically when asked about how participants were coping postpartum.

RESULTS

Nearly half the interviewees organically reported mental health symptoms consistent with postpartum depression (PPD) during questions regarding their postpartum experience. Of the 11 interviewees who reported mental health symptoms consistent with PPD, 2 were afraid to disclose their symptoms to a healthcare provider due to fear of child protective services involvement and their belief they would be treated unfairly because of their race.

CONCLUSION

Clinicians who care for Black and Biracial adolescent and young adult mothers must be particularly attuned to structural barriers for appropriate screening and treatment of postpartum depression. Expanding investigations of intersectional influences on young mothers' perinatal health and PPD are needed.

Perinatal Depression Treatment Guidelines for Obstetric Providers

Perinatal depression is the occurrence of depressive symptoms during the antenatal or postnatal period with an annual incidence of 10% to 20%. The consequences of untreated perinatal depression are significant and include negative impacts on maternal health, pregnancy outcomes, and maternal-infant outcomes. The purpose of this article is to provide perinatal pharmacologic and psychological treatment information to help first-line providers more confidently manage depression in the perinatal period. Treatment strategies including medication management using risk versus risk conversations, psychotherapy, and colocated perinatal mental health clinics are discussed.

Barriers to Diagnosis of Postpartum Depression among Younger Black Mothers

Objective: The objective of this study was to qualitatively examine coping mechanisms and desired supports in pregnant and birthing Black and biracial adolescent and young adult women during the COVID-19 pandemic. Method: Black and biracial participants ages 16-23 were recruited for virtual individual semi-structured interviews. Participants (n=25) were asked about pre- and post-natal experiences with the healthcare system, effects of the pandemic, and participants' experiences of or desires for ideal care within the healthcare system. Interviews were transcribed verbatim and coded for qualitative analysis using nVivo. Discussions around postpartum mental health evolved organically when asked about how participants were coping postpartum. Results: Nearly half the interviewees reported mental health symptoms consistent with postpartum depression (PPD). Of the 11 interviewees who reported mental health symptoms consistent with PPD, 2 were afraid to disclose their symptoms to a healthcare provider due to fear of child protective services involvement and their belief they would be treated unfairly because of their race. Conclusion: Clinicians who care for Black and biracial adolescent and young adult mothers must be particularly attuned to structural barriers for appropriate screening and treatment of postpartum depression. Expanding investigations of intersectional influences on young mothers' perinatal health and PPD are needed.

Beliefs and willingness towards participating in genetic testing for depression in low-income and racial/ethnic minority mothers at-risk

PURPOSE

To identify mothers' salient normative, behavioral and control beliefs and willingness towards participating in genetic salivary testing for depression.

DESIGN

A qualitative, descriptive design was employed. 41 multi-ethnic mothers completed surveys that underwent directed content analysis according to The Theory of Planned Behavior. Percentages and frequency counts were used to categorize responses and calculate willingness.

FINDINGS

Salient beliefs included: Behavioral: Finding a cure/treatment for depression (29.3 %), Normative: Family would approve (46.3 %), and Church associates would disapprove (19.5 %).

CONTROL

Lacking information/explanations (34.1 %) as barriers, convenient locations (24.4 %) as facilitators. Most mothers indicated a willingness to participate (90.2 %).

CONCLUSIONS

Interventions should target families, emphasize benefits, explain purposes and procedures, and use community based participatory methods.

Socio-Demographic and Coping Correlates and Predictors of Depressive Symptoms Among Low-Income and Ethnic Minority Mothers At-Risk

This study identified coping and sociodemographic correlates and predictors of depressive symptoms in mothers at risk for clinical depression. A descriptive, cross-sectional design was employed. A convenience sample of 88 low-income or ethnic-minority mothers aged 21 to 45 completed a depression scale, demographic data sheet, and responded to an open-ended question. Content analysis, descriptive, and inferential statistics was used for data analysis. Exactly 42.5% of mothers reported high depressive symptoms (>16). Lower income levels (r = .342, p = .01) and head-of-household status (r = .220, p = .04) were significantly associated with higher depressive symptoms. Those who used social support coping had lower depressive symptoms than those who did not (t = 2.50, p = .014). Those using emotion-focused coping only had higher depressive symptoms than those using a mix of coping strategies (t = 2.60, p = .011). Healthcare providers can employ vigilant depression screening and encourage utilization of a mix of problem and emotion-focused coping strategies to reduce depressive symptoms and prevent clinical depression.

Eliciting Willingness and Beliefs towards Participation in Genetic Psychiatric Testing in Black/African American Mothers at Risk for Depression

Black/African American women are at high risk for depression, yet are underrepresented in psychiatric genetic research for depression prevention and treatment. Little is known about the factors that influence participation in genetic testing for Black/African American women at risk. The purpose of this study was to elicit the beliefs that underlie participation in genetic testing for depression in Black/African American mothers, a subgroup at high risk. Willingness to participate in genetic testing procedures was also determined. A qualitative, descriptive design was employed. Exactly 19 mothers aged 21–42 completed open-ended questionnaires. Directed content and descriptive analyses of the text were conducted based on the Theory of Planned Behavior. Salient beliefs included: behavioral advantages—diagnosing/detecting depression (31.6%), finding cure/treatment (21.1%); disadvantages—not finding follow-up treatment/help (21.1%); salient referents, who approves—family members (47.4%), agencies/organizations (26.3%); who disapproves—church associates (21.1%). Control beliefs included: barriers—unpleasant/difficult testing procedures (42.1%), limited knowledge about the purpose of testing (26.3%); facilitator—a convenient location (21.1%). Most mothers (89.5%) indicated willingness to participate in testing. Interventions can target families, address barriers, emphasize future benefits, and use convenient locations and community-based participatory research methods. Policies can address social determinants of participation to increase inclusion of these mothers in psychiatric genetic research.

The wounds that do not heal: Black expendability and the traumatizing aftereffects of anti-Black police violence

Purpose

The murders of Black people at the hands of police in 2020 have led to global protests that have called on public officials to defund or abolish the police. What has been drowned out in these conversations, however, is the traumatizing aftereffects of anti-Black police violence as a public health crisis. In this paper, I argue that the racial terrorism of anti-Black police violence is a deeply felt wound in Black communities that extends beyond the individuals who directly experience it and that this type of collective trauma must be understood as an urgent public health crisis.

Design/methodology/approach

Using published studies and online commentaries on anti-Black police violence and its mental health impacts in Canada and the United States, this paper examines the mental health impacts of anti-Black police violence at both the individual and community levels.

Findings

A public health response to the traumatizing aftereffects of anti-Black police violence and other forms of state violence must highlight important policy imperatives, such as policies of action focused on improving the public health system. It must also encompass a recognition that the public health crisis of anti-Black police violence is not solvable solely by public health agencies alone. Rather, strategic opportunities to address this crisis arise at every level of governmental interaction, including law enforcement, health care, employment, business, education and the media.

Originality/value

While the impact of anti-Black police violence on the mental health of Black individuals has been emerging in the literature over the last several years, what has been less focused on and what I address in this paper is how the threat of that violence lingers in Black communities long after the protestors have packed up their megaphones, resulting in collective trauma in Black communities.

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.

Maternal Depressive Symptoms, Adolescent Daughters' Substance Use, and Father Residence in Minority Families

Background: Maternal depression has been linked to substance use in adolescents, but the mechanisms of the relationship between maternal depression and adolescent substance use are less clear. Specifically, previous literature has overlooked the role of fathers as a potential protective or exacerbating factor in buffering this relationship. Objectives: The goal of this study was to investigate the association between maternal depressive symptoms and adolescent substance use, exploring father's residential status as a moderator for adolescents living with a mother with depressive symptoms. Method: Paper-and-pencil surveys were administered to a sample of 176 mothers and their adolescent daughters aged 14-18, predominantly identifying as African American/Black. Participants included a subset of mothers with HIV. Results: The results revealed that maternal depressive symptoms were not directly associated with adolescent substance use. However, father's residential status was found to be a significant moderator in the relationship between maternal depressive symptoms and adolescent substance use. Specifically, when fathers were involved in the daughter's life (residential or non-resident), substance use was higher in adolescents of mothers with high depressive symptoms than in those of mothers with low depressive symptoms. Conclusion: The results suggest that varied family dynamics are critical to understanding engagement in substance use among adolescent girls, including the influence of both mothers and fathers.

Exploring Expressions of Depression in Black Single Mothers

PROBLEM

This study investigates the experience of depression from the perspective of Black single mothers, an understudied diverse-sub-group who consistently report high levels of depressive symptoms that go undetected and untreated.

PARTICIPANTS

The sample consisted of 210 Black single mothers aged 18-45 who reside in urban communities.

METHODS

A descriptive, cross-sectional design was used to categorize the responses of Black single mothers to an open-ended question that asks about feelings of depression according to the four domains of the Centers for Epidemiologic Studies Depression Scale. Percentages and frequencies were used to describe the results of the analysis.

FINDINGS

The 303 usable responses were most consistent with the depressed affect domain (N = 172), followed by somatic activity (N = 108), interpersonal symptoms (N = 21), and lack of positive affect (N = 2). The most prevalent raw responses included sadness (N = 59), forms of anger (N = 48), depressed (N = 24), cry (N = 23), do not want to be around people (N = 21), lonely (N = 17), tired (N = 16), and stressed (N = 12).

CONCLUSIONS/IMPLICATIONS

Consider culture and individualized assessments to explore feelings of anger and sadness when screening for depressive symptoms in specific sub-groups of Black single mothers. Consider the use of appropriate screening tools.

Beck Depression Inventory-II: Factor Analyses with Three Groups of Midlife Women of African Descent in the Midwest, the South, and the U.S. Virgin Islands

This research encompasses a factor analysis of the Beck Depression Inventory-II (BDI-II), which involves three groups of midlife women of African descent who reside in the Midwest, the South, and the U.S. Virgin Islands. The purpose of the study was to determine the factor structure of the BDI-II when administered to a sample of women aged 40-65 of African descent who reside in the three distinct geographical regions of the United States. A correlational, descriptive design was used, and 536 women of African descent were invited to participate in face-to-face interviews that transpired in community settings. Results of the factor analysis revealed a two-factor explanation. Factor one included symptoms such as punishment feelings and pessimism (cognitive), and the second factor included symptoms such as tiredness and loss of energy (somatic-affective). The application of the Beck Depression Inventory-II among the three groups of women generated specific information about each group and common findings across the groups. Knowledge gained from the research could help to guide specific intervention programs for the three groups of women, and explicate the common approaches that could be used for the three groups.