Skip to main content

Advertisement

SpringerLink
Log in

Mastery, self-esteem, and optimism mediate the link between religiousness and spirituality and postpartum depression

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Religious and spiritual beliefs and behaviors are powerful influences in the everyday lives of people worldwide and are especially salient for women and families around the birth of a child. A growing body of research indicates that aspects of religiousness and spirituality are associated with mental health including lower risk of postpartum depression, a disorder that affects as many as 1 in 5 women after birth. The mechanisms, however, are not well understood. In this study, psychosocial resources (mastery, self-esteem, and optimism) was tested as a mechanism linking religiousness and spirituality with depressive symptoms in 2399 postpartum women from the Community Child Health Network. Results indicated that religiousness and spirituality each predicted lower depressive symptoms throughout the first year postpartum. Psychosocial resources mediated these associations. Our findings contribute to existing knowledge by establishing psychological resources as mechanisms explaining how religiousness and spirituality influence mental health in women postpartum.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Abrams, L. S., & Curran, L. (2007). Not just a middle-class affliction: Crafting a social work research agenda on postpartum depression. Health and Social Work, 32, 289–296.

    Article  Google Scholar 

  • Amankwaa, L. C. (2003). Postpartum depression among African–American women. Issues in Mental Health Nursing, 24, 297–316.

    Article  Google Scholar 

  • Baetz, M., Bowen, R., Jones, G., & Koru-Sengul, T. (2006). How spiritual values and worship attendance relate to psychiatric disorders in the Canadian population. Canadian Journal of Psychiatry, 51, 654–661.

    Article  Google Scholar 

  • Beck, C. T. (1995). The effects of postpartum depression on maternal–infant interaction: A meta-analysis. Nursing Research, 44, 298–304.

    Article  CAS  Google Scholar 

  • Beck, C. T. (2002). Postpartum depression: A metasynthesis. Qualitative Health Research, 12, 453–472. https://doi.org/10.1177/104973202129120016

    Article  PubMed  Google Scholar 

  • Cheadle, A. C., & Dunkel Schetter, C. (2017). Untangling the mechanisms underlying the links between religiousness, spirituality, and better health. Social and Personality Psychology Compass, 11, 1–10.

    Google Scholar 

  • Cheadle, A. C. D., Dunkel Schetter, C., Gaines Lanzi, R., Reed Vance, M., Sahadeo, L. S., Shalowitz, M. U., et al. (2015). Spiritual and religious resources in African American women: Protection from depressive symptoms after childbirth. Clinical Psychological Science. https://doi.org/10.1177/2167702614531581

    Article  PubMed  Google Scholar 

  • Clements, A. D., Fletcher, T. R., Childress, L. D., Montgomery, R. A., & Bailey, B. A. (2016). Social support, religious commitment, and depressive symptoms in pregnant and postpartum women. Journal of Reproductive and Infant Psychology, 34, 247–259.

    Article  Google Scholar 

  • Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 150, 782–786.

    Article  CAS  Google Scholar 

  • Crockett, K., Zlotnick, C., Davis, M., Payne, N., & Washington, R. (2008). A depression preventive intervention for rural low-income African–American pregnant women at risk for postpartum depression. Archives of Women’s Mental Health, 11, 319–325.

    Article  Google Scholar 

  • Dunkel Schetter, C., & Dolbier, C. (2011). Resilience in the context of chronic stress and health in adults. Social and Personality Psychology Compass, 5, 634–652.

    Article  Google Scholar 

  • Dunkel Schetter, C., Schafer, P., Lanzi, R. G., Clark-Kauffman, E., Raju, T. N., & Hillemeier, M. M. (2013). Shedding light on the mechanisms underlying health disparities through community participatory methods: The stress pathway. Perspectives on Psychological Science, 8, 613–633.

    Article  Google Scholar 

  • Enders, C. K. (2010). Applied missing data analysis. New York: Guilford Press.

    Google Scholar 

  • Fetzer/NIA Working Group. (1999). Multidemensional measurement of religiousness/spirituality for use in health research. Kalamazoo, MI: John E. Fetzer Institute.

    Google Scholar 

  • Field, T., Sandberg, D., Garcia, R., Vega-Lahr, N., Goldstein, S., & Guy, L. (1985). Pregnancy problems, postpartum depression, and early mother-infant interactions. Developmental Psychology, 23, 1152–1156.

    Article  Google Scholar 

  • Giurgescu, C., & Murn, N. L. (2016). Church member support benefits psychological well-being of pregnant African American women. Journal of Christian Nursing, 33, 87–91.

    Article  Google Scholar 

  • Hankerson, S. H., & Weissman, M. M. (2012). Church-based health programs for mental disorders among African Americans: A review. Psychiatric Services, 63, 243–249.

    Article  Google Scholar 

  • Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.

    Article  Google Scholar 

  • Jacobs, M., Miller, L., Wickramaratne, P., Gameroff, M. J., & Weissman, M. M. (2012). Family religion and psychopathology in children of depressed mothers: Ten-year follow-up. Journal of Affective Disorders, 136, 320–327. https://doi.org/10.1016/j.jad.2011.11.030

    Article  PubMed  Google Scholar 

  • Jesse, D. E., & Swanson, M. S. (2007). Risks and resources associated with antepartum risk for depression among rural southern women. Nursing Research, 56, 378–386. https://doi.org/10.1097/01.NNR.0000299856.98170.19

    Article  PubMed  Google Scholar 

  • Jesse, D. E., Walcott-McQuigg, J., Mariella, A., & Swanson, M. S. (2005). Risks and protective factors associated with symptoms of depression in low-income African American and Caucasian women during pregnancy. Journal of Midwifery & Women’s Health, 50, 405–410. https://doi.org/10.1016/j.jmwh.2005.05.001

    Article  Google Scholar 

  • Keefe, R. H., Brownstein-Evans, C., Lane, S. D., Carter, D. B., & Polmanteer, R. S. R. (2016). Postpartum depression and the Affordable Care Act: Recommendations for social work educators. Advances in Social Work, 16, 202–213.

    Article  Google Scholar 

  • Klassen, P. (2001). Blessed events: Religion and home birth in America. Princeton: Princeton University Press.

    Google Scholar 

  • Le, T. N., Tov, W., & Taylor, J. (2007). Religiousness and depressive symptoms in five ethnic adolescent groups. International Journal for the Psychology of Religion, 17, 209–232. https://doi.org/10.1080/10508610701402259

    Article  Google Scholar 

  • Lukwago, S. N., Kreuter, M. W., Bucholtz, D. C., Holt, C. L., & Clark, E. M. (2001). Development and validation of brief scales to measure collectivism, religiosity, racial pride, and time orientation in urban African American women. Family & Community Health, 24, 63–71.

    Article  CAS  Google Scholar 

  • MacKinnon, D. P., Krull, J. L., & Lockwood, C. M. (2000). Equivalence of the mediation, confounding and suppression effect. Prevention Science, 1(4), 173–181.

    Article  CAS  Google Scholar 

  • Mahoney, A., Pargament, K. I., & DeMaris, A. (2009). Couples viewing marriage and pregnancy through the lens of the sacred: A descriptive study. Research in the Social Scientific Study of Religion, 20, 1–45.

    Google Scholar 

  • Mann, J. R., McKeown, R. E., Bacon, J., Vesselinov, R., & Bush, F. (2007). Religiosity, spirituality, and depressive symptoms in pregnant women. The International Journal of Psychiatry in Medicine, 37, 301–313. https://doi.org/10.2190/PM.37.3.g

    Article  PubMed  Google Scholar 

  • Miller, L., Wickramaratne, P., Gameroff, M. J., Sage, M., Tenke, C. E., & Weissman, M. M. (2012). Religiosity and major depression in adults at high risk: A ten-year prospective study. American Journal of Psychiatry, 169, 89–94.

    Article  Google Scholar 

  • Mofidi, M., Devellis, R. F., Blazer, D. G., Devellis, B. M., Panter, A. T., & Jordan, J. M. (2006). Spirituality and depressive symptoms in a racially diverse US sample of community-dwelling adults. The Journal of Nervous and Mental Disease, 194, 975–977. https://doi.org/10.1097/01.nmd.0000243825.14449.de

    Article  PubMed  Google Scholar 

  • Murray, L., & Cooper, P. J. (1996). The impact of postpartum depression on child development. International Review of Psychiatry, 8, 55.

    Article  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (2015). Mplus user’s guide (6th ed.). Los Angeles, CA: Muthén & Muthén.

    Google Scholar 

  • O’hara, M. W., & McCabe, J. E. (2013). Postpartum depression: Current status and future directions. Annual Review of Clinical Psychology, 9, 379–407.

    Article  Google Scholar 

  • Onedera, J. D. (2008). The role of religion in marriage and family counseling. Boca Raton: CRC Press.

    Google Scholar 

  • Paul, I. M., Downs, D. S., Schaefer, E. W., Beiler, J. S., & Weisman, C. S. (2013). Postpartum anxiety and maternal-infant health outcomes. Pediatrics, 131, e1218–e1224. https://doi.org/10.1542/peds.2012-2147

    Article  PubMed  Google Scholar 

  • Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2–21.

    Article  CAS  Google Scholar 

  • Pearlstein, T. (2015). Depression during pregnancy. Best Practice & Research Clinical Obstetrics & Gynaecology, 29, 754–764.

    Article  Google Scholar 

  • Peterson, J., Atwood, J. R., & Yates, B. (2002). Key elements for church-based health promotion programs: Outcome-based literature review. Public Health Nursing, 19, 401–411.

    Article  Google Scholar 

  • Pew Forum on Religion & Public Life. (2008). U.S. religious landscape survey religious beliefs and practices: Diverse and politically relevant.

  • Pew Forum on Religion & Public Life. (2015). U.S. public becoming less religious. Washington: Pew Research Center.

    Google Scholar 

  • Ramey, S. L., Schafer, P., DeClerque, J. L., Lanzi, R. G., Hobel, C., Shalowitz, M., et al. (2015). The preconception stress and resiliency pathways model: A multi-level framework on maternal, paternal, and child health disparities derived by community-based participatory research. Maternal and Child Health Journal, 19, 707–719.

    Article  Google Scholar 

  • Rees, T. J. (2009). Is personal insecurity a cause of cross-national differences in the intensity of religious belief? Journal of Religion and Society, 11, 1–26.

    Google Scholar 

  • Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.

    Book  Google Scholar 

  • Scheier, M. F., & Carver, C. S. (1985). Optimism, coping, and health: Assessment and implications of generalized outcome expectancies. Health Psychology, 4, 219.

    Article  CAS  Google Scholar 

  • Simoni, J. M., & Ortiz, M. Z. (2003). Mediational models of spirituality and depressive symptomatology among HIV-positive Puerto Rican women. Cultural Diversity & Ethnic Minority Psychology, 9, 3–15. https://doi.org/10.1037/1099-9809.9.1.3

    Article  Google Scholar 

  • Smith, T. B., McCullough, M. E., & Poll, J. (2003). Religiousness and depression: Evidence for a main effect and the moderating influence of stressful life events. Psychological Bulletin, 129, 614–636. https://doi.org/10.1037/0033-2909.129.4.614

    Article  PubMed  Google Scholar 

  • Spoozak, L., Gotman, N., Smith, M. V., Belanger, K., & Yonkers, K. A. (2009). Evaluation of a social support measure that may indicate risk of depression during pregnancy. Journal of Affective Disorders, 114, 216–223.

    Article  Google Scholar 

  • StataCorp. (2013). Stata Statistical Software: Release 13. College Station, TX: StataCorp LP.

    Google Scholar 

  • StataCorp. (2015). Stata Statistical Software: Release 14. College Station, TX: StataCorp LP.

    Google Scholar 

  • Sternthal, M. J., Williams, D. R., Musick, M. A., & Buck, A. C. (2010). Depression, anxiety, and religious life: A search for mediators. Journal of Health and Social Behavior, 51, 343–359. https://doi.org/10.1177/0022146510378237

    Article  PubMed  Google Scholar 

  • Voorhees, C. C., Stillman, F. A., Swank, R. T., Heagerty, P. J., Levine, D. M., & Becker, D. M. (1996). Heart, body, and soul: Impact of church-based smoking cessation interventions on readiness to quit. Preventive Medicine, 25, 277–285.

    Article  CAS  Google Scholar 

  • Zittel-Palamara, K., Cercone, S. A., & Rockmaker, J. R. (2009). Spiritual support for women with postpartum depression. Journal of Psychology and Christianity, 28, 213–224.

    Google Scholar 

Download references

Funding

The CCHN is supported through cooperative agreements with the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD; U HD44207, U HD44219, U HD44226, U HD44245, U HD44253, U HD54791, U HD54019, U HD44226-05S1, U HD44245-06S1, R03 HD59584) and the National Institute for Nursing Research (NINR; U NR008929).

Author information

Authors and Affiliations

  1. Hope College, Holland, MI, USA

    A. C. D. Cheadle

  2. UCLA, Los Angeles, CA, USA

    C. Dunkel Schetter

Authors
  1. A. C. D. Cheadle
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Dunkel Schetter
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

The Community Child Health Network (CCHN)

Corresponding author

Correspondence to A. C. D. Cheadle.

Ethics declarations

Conflict of interest

A. C. D. Cheadle and C. Dunkel Schetter declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cheadle, A.C.D., Dunkel Schetter, C. & The Community Child Health Network (CCHN). Mastery, self-esteem, and optimism mediate the link between religiousness and spirituality and postpartum depression. J Behav Med 41, 711–721 (2018). https://doi.org/10.1007/s10865-018-9941-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-018-9941-8

Keywords

Search

Navigation