Global and relationship-specific perceptions of support and the development of postpartum depressive symptomatology

ORIGINAL PAPER

Abstract

Background

A lack of social support has consistently been demonstrated to be an important modifiable risk factor for postpartum depression. As such, a greater understanding of specific support variables may assist health professionals in the development of effective preventive interventions. The purpose of this paper was two-fold: (1) to determine if women discriminated between global and relationship-specific perceptions of support, and (2) to examine the influence of global and relationship-specific perceptions of support in the immediate postpartum period on the development of depressive symptomatology at 8 weeks postpartum.

Methods

As part of a longitudinal study, a diverse sample of 594 mothers completed questionnaires that included the Edinburgh Postnatal Depression Scale (EPDS) and global and relationship-specific (e.g., partner, mother, and other women with children) measures of support.

Results

Mothers clearly discriminated between global and relationship-specific perceptions of support and those with depressive symptomatology at 8 weeks had significantly lower perceptions of both global and relationship-specific support at 1-week postpartum. Using discriminant function analysis, four variables, reliable reliance from partner, nurturance from partner, attachment to other women with children, and EPDS score at 1-week postpartum, differentiated between mothers who experienced depressive symptomatology at 8 weeks and those who did not.

Conclusion

Relationship-specific interventions may be beneficial if they include strategies that target a positive partner relationship through preceptions of reliable alliance and feeling needed and provide opportunites for interaction with other mothers. Maternal mood at 1 week postpartum was the largest predictor of depressive symptomatology at 8 weeks.

Key words

postpartum depression global support social support discriminant function analysis 

References

  1. 1.
    Beck CT (2001) Predictors of postpartum depression: an update. Nurs Res 50:275–285PubMedCrossRefGoogle Scholar
  2. 2.
    Brugha TS, Sharp HM, Cooper SA, Weisender C, Britto D, Shinkwin R, Sherrif T, Kirwan PH (1998) The Leicester 500 Project. Social support and the development of postnatal depressive symptoms, a prospective cohort survey. Psychol Med 28:63–79PubMedCrossRefGoogle Scholar
  3. 3.
    Chan S, Levy V (2004) Postnatal depression: a qualitative study of the experiences of a group of Hong Kong Chinese women. J Clin Nurs 13:120–123PubMedCrossRefGoogle Scholar
  4. 4.
    Chan SW, Levy V, Chung TK, Lee D (2002) A qualitative study of the experiences of a group of Hong Kong Chinese women diagnosed with postnatal depression. J Adv Nurs 39:571–579PubMedCrossRefGoogle Scholar
  5. 5.
    Chen CH, Wu HY, Tseng YF, Chou FH, Wang SY (1999) Psychosocial aspects of Taiwanese postpartum depression phenomenological approach: a preliminary report. Kao-Hsiung i Hsueh Ko Hsueh Tsa Chih [Kaohsiung J Med Sci] 15:44–51Google Scholar
  6. 6.
    Cheung NF (1997) Chinese zuo yuezi (sitting in for the first month of the postnatal period) in Scotland. Midwifery 13:55–65PubMedCrossRefGoogle Scholar
  7. 7.
    Cohen S, Underwood L, Gottlieb B (eds) (2002) Social support measurement and intervention: A guide for health and social scientists. Oxford University Press, New YorkGoogle Scholar
  8. 8.
    Cooper P, Murray L (1997) Prediction, detection, and treatment of postnatal depression. Arch Dis Child 77:97–99PubMedGoogle Scholar
  9. 9.
    Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786PubMedGoogle Scholar
  10. 10.
    Cutrona CE (1984) Social support and stress in the transition to parenthood. J Abnorm Psychol 93:378–390PubMedCrossRefGoogle Scholar
  11. 11.
    Cutrona CE, Troutman BR (1986) Social support, infant temperament, and parenting self-efficacy: a mediational model of postpartum depression. Child Dev 57:1507–1518PubMedCrossRefGoogle Scholar
  12. 12.
    Cutrona CE, Russell D (1987) The provisions of social relationships and adaptation to stress. In: Jones W, Perlman D (eds) Advances in personal relationships. JAI Press, Greenwich, CT, pp 37–67Google Scholar
  13. 13.
    Davis MH, Morris MM, Kraus LA (1998) Relationship-specific and global perceptions of social support: associations with well-being and attachment. J Pers Soc Psychol 74:468–481PubMedCrossRefGoogle Scholar
  14. 14.
    Dennis CL (2003) Peer support within a health care context: a concept analysis. Int J Nurs Stud 40:321–332PubMedCrossRefGoogle Scholar
  15. 15.
    Dennis CL, Janssen PA, Singer J (2004) Identifying women at-risk for postpartum depression in the immediate postpartum period. Acta Psychiatr Scand 110:338–346PubMedCrossRefGoogle Scholar
  16. 16.
    Gjerdingen DK, Froberg DG, Fontaine P (1991) The effects of social support on women’s health during pregnancy, labor and delivery, and the postpartum period. Fam Med 23:370–375PubMedGoogle Scholar
  17. 17.
    Graff LA, Dyck DG, Schallow JR (1991) Predicting postpartum depressive symptoms: a structural modelling analysis. Percept Mot Skills 73:1137–1138PubMedCrossRefGoogle Scholar
  18. 18.
    Harris B, Huckle P, Thomas R, Johns S, Fung H (1989) The use of rating scales to identify post-natal depression. Br J Psychiatry 154:813–817PubMedGoogle Scholar
  19. 19.
    Heh SS, Coombes L, Bartlett H (2004) The association between depressive symptoms and social support in Taiwanese women during the month. Int J Nurs Stud 41:573–579PubMedCrossRefGoogle Scholar
  20. 20.
    Holopainen D (2002) The experience of seeking help for postnatal depression. Aust J Adv Nurs 19:39–44PubMedGoogle Scholar
  21. 21.
    Huang YC, Mathers N (2001) Postnatal depression—biological or cultural? A comparative study of post-natal women in the UK and Taiwan. J Adv Nurs 33:279–287PubMedCrossRefGoogle Scholar
  22. 22.
    Hundt GL, Beckerleg S, Kassem F, Abu Jafar AM, Belmaker I, Abu Saad K, Shoham-Vardi I (2000) Women’s health custom made: building on the 40 days postpartum for Arab women. Health Care Women Int 21:529–542PubMedCrossRefGoogle Scholar
  23. 23.
    Kaewsarn P, Moyle W, Creedy D (2003) Traditional postpartum practices among Thai women. J Adv Nurs 41:358–366PubMedCrossRefGoogle Scholar
  24. 24.
    Kit LK, Janet G, Jegasothy R (1997) Incidence of postnatal depression in Malaysian women. J Obst Gynaecol Res 23:85–89Google Scholar
  25. 25.
    Lee D, Yip S, Chiu H, Leung T, Chan K, Chau I, Leung H, Chung T (1998) Detecting postnatal depression in Chinese women. Validation of the Chinese version of the Edinburgh Postnatal Depression Scale. B J Psychiatry 172:433–437Google Scholar
  26. 26.
    Logsdon MC, McBride AB, Birkimer JC (1994) Social support and postpartum depression. Res Nurs Health 17:449–457PubMedCrossRefGoogle Scholar
  27. 27.
    Logsdon MC, Usui W (2001) Psychosocial predictors of postpartum depression in diverse groups of women. West J Nurs Res 23:563–574PubMedGoogle Scholar
  28. 28.
    Matthey S, Panasetis P, Barnett B (2002) Adherence to cultural practices following childbirth in migrant Chinese women and relation to postpartum mood. Health Care Women Int 23:567–575PubMedCrossRefGoogle Scholar
  29. 29.
    Matthey S, Kavanagh DJ, Howie P, Barnett B, Charles M (2004) Prevention of postnatal distress or depression: an evaluation of an intervention at preparation for parenthood classes. J Affect Disord 79:113–126PubMedCrossRefGoogle Scholar
  30. 30.
    Mauthner NS (1997) Postnatal depression: how can midwives help? Midwifery 13:163–171PubMedCrossRefGoogle Scholar
  31. 31.
    Mauthner NS (1998) Re-assessing the importance and role of the marital relationship in postnatal depression: Methodological and theoretical implications. J Reprod Infant Psychol 16:157–175Google Scholar
  32. 32.
    Mauthner NS (1999) “Feeling low and feeling really bad about feeling low”: women’s experiences of motherhood and postpartum depression. Can Psychol 40:143–161Google Scholar
  33. 33.
    McIntosh J (1993) Postpartum depression: women’s help-seeking behaviour and perceptions of cause. J Adv Nurs 18:178–184PubMedCrossRefGoogle Scholar
  34. 34.
    Mills EP, Finchilescu G, Lea SJ (1995) Postnatal depression—An examination of psychosocial factors. S Afr Med J 85:99–105PubMedGoogle Scholar
  35. 35.
    Misri S, Kostaras X, Fox D, Kostaras D (2000) The impact of partner support in the treatment of postpartum depression. Can J Psychiatry 45:554–558PubMedGoogle Scholar
  36. 36.
    Morgan M, Matthey S, Barnett B, Richardson C (1997) A group programme for postnatally distressed women and their partners. J Adv Nurs 26:913–920PubMedCrossRefGoogle Scholar
  37. 37.
    Morse CA, Buist A, Durkin S (2000) First-time parenthood: influences on pre- and postnatal adjustment in fathers and mothers. J Psychosom Obstet Gynaecol 21:109–120PubMedGoogle Scholar
  38. 38.
    Munro B (2001) Statistical methods for health care research, 4th edn. Lippincott, New YorkGoogle Scholar
  39. 39.
    Murray D, Cox JL, Chapman G, Jones P (1995) Childbirth: life event or start of a long-term difficulty? Further data from the Stoke-on-Trent controlled study of postnatal depression. Br J Psychiatry 166:595–600PubMedCrossRefGoogle Scholar
  40. 40.
    Murray L, Carothers AD (1990) The validation of the Edinburgh Post-natal Depression Scale on a community sample. Br J Psychiatry 157:288–290PubMedGoogle Scholar
  41. 41.
    Nahas V, Amasheh N (1999) Culture care meanings and experiences of postpartum depression among Jordanian Australian women: a transcultural study. J Transcult Nurs 10:37–45PubMedCrossRefGoogle Scholar
  42. 42.
    Nahas V, Hillege S, Amasheh N (1999) Postpartum depression. The lived experiences of Middle Eastern migrant women in Australia.J Nurse Midwifery 44:65–74PubMedCrossRefGoogle Scholar
  43. 43.
    O’Hara M, Swain A (1996) Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatry 8:37–54Google Scholar
  44. 44.
    O’Hara MW, Rehm LP, Campbell SB (1983) Postpartum depression. A role for social network and life stress variables. J Nerv Ment Dis 171:336–341PubMedCrossRefGoogle Scholar
  45. 45.
    Oates MR, Cox JL, Neema S, Asten P, Glangeaud-Freudenthal N, Figueiredo B, Gorman LL, Hacking S, Hirst E, Kammerer MH, Klier CM, Seneviratne G, Smith M, Sutter-Dallay AL, Valoriani V, Wickberg B, Yoshida K (2004) Postnatal depression across countries and cultures: a qualitative study. Br J Psychiatry Suppl 46:s10–s16PubMedCrossRefGoogle Scholar
  46. 46.
    Paykel ES, Emms EM, Fletcher J, Rassaby ES (1980) Life events and social support in puerperal depression. Br J Psychiatry 136:339–346PubMedCrossRefGoogle Scholar
  47. 47.
    Pierce GR, Sarason IG, Sarason BR (1991) General and relationship-based perceptions of social support: are two constructs better than one? J Pers Soc Psychol 61:1028–1039PubMedCrossRefGoogle Scholar
  48. 48.
    Righetti-Veltema M, Conne-Perreard E, Bousquet A, Manzano J (1998) Risk factors and predictive signs of postpartum depression. J Affect Dis 49:167–180PubMedCrossRefGoogle Scholar
  49. 49.
    Ritter C, Hobfoll SE, Lavin J, Cameron RP, Hulsizer MR (2000) Stress, psychosocial resources, and depressive symptomatology during pregnancy in low-income, inner-city women. Health Psychol 19:576–585PubMedCrossRefGoogle Scholar
  50. 50.
    Rodrigues M, Patel V, Jaswal S, de Souza N (2003) Listening to mothers: qualitative studies on motherhood and depression from Goa, India. Soc Sci Med 57:1797–1806PubMedCrossRefGoogle Scholar
  51. 51.
    Romito P, Saurel-Cubizolles MJ, Lelong N (1999) What makes new mothers unhappy: psychological distress one year after birth in Italy and France. Soc Sci Med 49:1651–1661PubMedCrossRefGoogle Scholar
  52. 52.
    Small R, Astbury J, Brown S, Lumley J (1994) Depression after childbirth. Does social context matter? Med J Aust 161:473–477PubMedGoogle Scholar
  53. 53.
    Small R, Johnston V, Orr A (1997) Depression after childbirth: the views of medical students and women compared. Birth 24:109–115PubMedCrossRefGoogle Scholar
  54. 54.
    Stuchbery M, Matthey S, Barnett B (1998) Postnatal depression and social supports in Vietnamese, Arabic and Anglo-Celtic mothers. Soc Psychiatry Psychiatr Epidemiol 33:483–490PubMedCrossRefGoogle Scholar
  55. 55.
    Tabachnick B, Fidell L (2001) Using multivariate statistics, 4th edn. Allyn & Bacon, BostonGoogle Scholar
  56. 56.
    Tammentie T, Paavilainen E, Astedt-Kurki P, Tarkka MT (2004) Family dynamics of postnatally depressed mothers—discrepancy between expectations and reality. J Clin Nurs 13:65–74PubMedCrossRefGoogle Scholar
  57. 57.
    Ugarriza DN (2004) Group therapy and its barriers for women suffering from postpartum depression. Arch Psychiatr Nurs 18:39–48PubMedCrossRefGoogle Scholar
  58. 58.
    Weiss R (1974) The provisions of social relationships. In: Rubin Z (ed) Doing unto others. Prentice Hall, Englewood Cliffs, NJ, pp 17–26Google Scholar
  59. 59.
    Yoshida K, Yamashita H, Ueda M, Tashiro N (2001) Postnatal depression in Japanese mothers and the reconsideration of ‘Satogaeri bunben’. Pediatr Int 43:189–193PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Faculty of NursingUniversity of TorontoTorontoCanada
  2. 2.Faculty of NursingUniversity of New BrunswickFrederictonCanada

Personalised recommendations