Depressive symptoms in mothers of pre-school children

Effects of deprivation, social support, stress and neighbourhood social capital
ORIGINAL PAPER
Accepted:

Abstract

Background

Depressive symptoms in mothers of young children can have serious consequences for the health of the child. In particular, children whose mothers are experiencing depressive symptoms are at significantly greater risk of poisoning and accidental injury. A mother’s risk of developing depressive symptoms has been shown to be related to socio-economic disadvantage, high levels of stress and a perceived lack of social support. Residents who perceive their neighbourhoods to be of low social capital are more likely to report poor mental health. The aim of this study was to investigate the relationship between maternal depressive symptoms, deprivation, social support, stress and neighbourhood social capital in a group of mothers living in deprived areas of Nottingham, United Kingdom (UK).

Design and setting

A postal questionnaire at entry to a randomised controlled trial (RCT) assessed socio-demographic characteristics and a second questionnaire, 21 months later, assessed depressive symptoms, perceived lack of social support, self-reported stress and individual-level assessment of neighbourhood social capital.

Participants

A total of 846 mothers of young children living in deprived areas in Nottingham, UK, enrolled in the control group of an RCT.

Results

One-third of mothers reported high levels of depressive symptoms. Neighbourhood-level deprivation and receiving means-tested benefits were independently associated with maternal depressive symptoms. A lack of social support and high levels of self-reported stress were also strongly associated with depressive symptoms. Individual-level assessment of neighbourhood social capital was not associated with depressive symptoms amongst mothers after adjusting for self-reported stress.

Conclusions

Neighbourhood- and individual-level variables of deprivation and psychological distress are more important than mother’s assessment of the social capital of the neighbourhood in which she lives in determining the risk of depressive symptoms. Interventions aimed at supporting mothers of young children may be more effective at reducing the risks of depressive symptoms and consequent risks to the child’s health than interventions aimed at improving a neighbourhood’s social capital.

Key words

mothers depressive symptoms deprivation stress social support neighbourhood social capital 
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References

  1. 1.
    Sheppard M (1997) Depression in female health visitor consulters: social and demographic facets. J Adv Nurs 26:921–929Google Scholar
  2. 2.
    Hall LA, Gurley DN, Sachs B, et al. (1991) Psychosocial predictors of maternal depressive symptoms, parenting attitudes, and child behavior in single-parent families. Nurs Res 40:214–220Google Scholar
  3. 3.
    Dawson G, Ashman S, Panagiotides H, et al.(2003) Preschool outcomes of children of depressed mothers: role of maternal behaviour, contextual risk, and children’s brain activity. Child Dev 74:1158–1175Google Scholar
  4. 4.
    Murray L (1992) The impact of postnatal depression on infant development. J Child Psychol Psychiatry 33:543–561Google Scholar
  5. 5.
    Coghill S, Caplan H, Alexandra H, et al. (1986) Impact of maternal postnatal depression on cognitive development of young children. Br Med J (Clin Res Ed) 292:1165–1167Google Scholar
  6. 6.
    Teti D, Gelfand C, Messinger D, et al. (1995) Maternal depression and the quality of early attachment: an examination of infants, preschoolers, and their mothers. Dev Psychol 31:364–376Google Scholar
  7. 7.
    McLennan JD, Kotelchuck M (2000) Parental prevention practices for young children in the context of maternal depression. Pediatrics 105:1090–1095Google Scholar
  8. 8.
    Leiferman J (2002) The effect of maternal depressive symptomatology on maternal behaviors associated with child health. Health Educ Behav 29:596–607Google Scholar
  9. 9.
    Beautrais AL, Fergusson DM, Shannon FT (1981) Accidental poisoning in the first three years of life. Aust Paediatr J 17:104–109Google Scholar
  10. 10.
    Bithoney WG, Snyder J, Michalek J, et al. (1985) Childhood ingestions as symptoms of family distress. Am J Dis Child 139:456–459Google Scholar
  11. 11.
    Brown GW, Moran PM (1997) Single mothers, poverty and depression. Psychol Med 27:21–33Google Scholar
  12. 12.
    Harris MJ, Kotch JB (1994) Unintentional infant injuries: sociodemographic and psychosocial factors. Public Health Nurs 11:90–97Google Scholar
  13. 13.
    O’Connor TG, Davies L, Dunn J, et al. (2000) Distribution of accidents, injuries, and illnesses by family type. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. Pediatrics 106:E68Google Scholar
  14. 14.
    Russell KM (1998) Preschool children at risk for repeat injuries. J Community Health Nurs 15:179–190Google Scholar
  15. 15.
    Baker D, Taylor H (1997) The relationship between condition-specific morbidity, social support and material deprivation in pregnancy and early motherhood. ALSPAC Survey Team. Avon Longitudinal Study of Pregnancy and Childhood. Soc Sci Med 45:1325–1336Google Scholar
  16. 16.
    Baker D, North K (1999) Does employment improve the health of lone mothers? The ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. Soc Sci Med 49:121–131Google Scholar
  17. 17.
    Reading R, Langford IH, Haynes R, et al. (1999) Accidents to preschool children: comparing family and neighbourhood risk factors. Soc Sci Med 48:321–330Google Scholar
  18. 18.
    Seguin L, Potvin L, St-Denis M, et al. (1999) Depressive symptoms in the late postpartum among low socioeconomic status women. Birth 26:157–163Google Scholar
  19. 19.
    Heneghan AM, Silver EJ, Bauman LJ, et al. (1998) Depressive symptoms in inner-city mothers of young children: who is at risk? Pediatrics 102:1394–1400Google Scholar
  20. 20.
    Paarlberg KM, Vingerhoets AJ, Passchier J, et al. (1996) Psychosocial factors as predictors of maternal well-being and pregnancy-related complaints. J Psychosom Obstet Gynecol 17:93–102Google Scholar
  21. 21.
    Hall LA, Williams CA, Greenberg RS (1985) Supports, stressors, and depressive symptoms in low-income mothers of young children. Am J Public Health 75:518–522Google Scholar
  22. 22.
    Dunn J (2002) Housing and inequalities in health: a study of socioeconomic dimensions of housing and self reported health from a survey of Vancouver residents. J Epidemiol Community Health 56:671–681Google Scholar
  23. 23.
    Coiro MJ (2001) Depressive symptoms among women receiving welfare. Women Health 32:1–23Google Scholar
  24. 24.
    Panzarine S, Slater E, Sharps P (1995) Coping, social support, and depressive symptoms in adolescent mothers. J Adolesc Health 17:113–119Google Scholar
  25. 25.
    Small R, Astbury J, Brown S, et al. (1994) Depression after childbirth. Does social context matter? Med J Aust 161:473–477Google Scholar
  26. 26.
    Siefert K, Bowman PJ, Heflin CM, et al. (2000) Social and environmental predictors of maternal depression in current and recent welfare recipients. Am J Orthopsychiatry 70:510–522Google Scholar
  27. 27.
    McCulloch A (2001) Social environments and health: cross sectional national survey. BMJ 323:208–209Google Scholar
  28. 28.
    Ellaway A, Macintyre S (1998) Does housing tenure predict health in the UK because it exposes people to different levels of housing related hazards in the home or its surroundings? Health Place 4:141–150Google Scholar
  29. 29.
    Kawachi I, Kennedy BP, Glass R (1999) Social capital and self-rated health: a contextual analysis. Am J Public Health 89:1187–1193Google Scholar
  30. 30.
    Yang MJ, Yang MS, Shih CH, et al. (2002) Development and validation of an instrument to measure perceived neighbourhood quality in Taiwan. J Epidemiol Community Health 56:492–496Google Scholar
  31. 31.
    Baum F, Ziersch A (2003) Social Capital. J Epidemiol Community Health 57:320–323Google Scholar
  32. 32.
    Weich S, Lewis G (1998) Material standard of living, social class, and the prevalence of the common mental disorders in Great Britain. J Epidemiol Community Health 52:8–14Google Scholar
  33. 33.
    Watson M, Woods A,Kendrick D (2002) Injury prevention: working together on an RCT. Community Pract 75:172–175Google Scholar
  34. 34.
    Townsend P, Phillimore P, Beattie A (1988) Health and deprivation: inequality and the North, Croom Helm, LondonGoogle Scholar
  35. 35.
    Radloff L (1977) The CES-D Scale: A self-report depression scale for research in the general population. Appl Psychol Measures 1:385–401Google Scholar
  36. 36.
    Health Education Authority (1995) Health and Lifestyles: a survey of the UK population, Part 1, Health Education Authority, LondonGoogle Scholar
  37. 37.
    Bennett N, Dodd T, Flatley J, et al. (1995) Health Survey for England 1993, HMSO, LondonGoogle Scholar
  38. 38.
    Thomson H, Kearns A, Petticrew M (2003) Assessing the health impact of local amenities: a qualitative study of contrasting experiences of local swimming pool and leisure provision in two areas of Glasgow. J Epidemiol Community Health 57:663–667Google Scholar
  39. 39.
    Boyce P, Harris M, Silove D, et al. (1998) Psychosocial factors associated with depression: a study of socially disadvantaged women with young children. J Nerv Ment Dis 186:3–11Google Scholar
  40. 40.
    Orr S, James S (1984) Maternal depression in an urban pediatric practice: implications for health care delivery. Am J Pub Health 74:363–365Google Scholar
  41. 41.
    Gjerdingen DK, Chaloner KM (1994) The relationship of women’s postpartum mental health to employment, childbirth, and social support. J Fam Pract 38:465–472Google Scholar
  42. 42.
    McKenzie K, Whitley R, Weich S (2002) Social capital and mental health. Br J Psychiatry 181:280–283PubMedGoogle Scholar
  43. 43.
    Mathiesen KS, Tambs K, Dalgard OS (1999) The influence of social class, strain and social support on symptoms of anxiety and depression in mothers of toddlers. Soc Psychiatry Psychiatr Epidemiol 34:61–72Google Scholar
  44. 44.
    MacArthur C, Winter H, Bick D, et al. (2002) Effects of redesigned community postnatal care on women’s health 4 months after birth: a cluster randomised controlled trial. Lancet 359:378–385Google Scholar
  45. 45.
    Morrell C, Spiby H, Stewart P, et al. (2000) Costs and benefits of community postnatal support workers: a randomised controlled trial. Health Technol Assess 4(6)Google Scholar
  46. 46.
    Long A, McCarney S, Smyth G, et al. (2001) The effectiveness of parenting programmes facilitated by health visitors. J Adv Nurs 34:611–620Google Scholar
  47. 47.
    Barlow J, Coren E, Stewart-Brown S (2002) Meta-analysis of the effectiveness of parenting programmes in improving maternal psychosocial health. Br J Gen Pract 52(476)Google Scholar

Copyright information

© Steinkopff Verlag 2005

Authors and Affiliations

  1. 1.Division of Primary Care, 13th Floor, Tower BuildingUniversity of NottinghamNottingham NG7 2RDUK

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