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Williams L, Oro V, Blackwell CK, Liu C, Miller EB, Ganiban J, Neiderhiser JM, DeGarmo DS, Shaw DS, Chen T, Natsuaki MN, Leve LD. Influence of early childhood parental hostility and socioeconomic stress on children's internalizing symptom trajectories from childhood to adolescence. Front Psychiatry 2024; 15:1325506. [PMID: 38694000 PMCID: PMC11062022 DOI: 10.3389/fpsyt.2024.1325506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 03/26/2024] [Indexed: 05/03/2024] Open
Abstract
Introduction Children and adolescents with elevated internalizing symptoms are at increased risk for depression, anxiety, and other psychopathology later in life. The present study examined the predictive links between two bioecological factors in early childhood-parental hostility and socioeconomic stress-and children's internalizing symptom class outcomes, while considering the effects of child sex assigned at birth on internalizing symptom development from childhood to adolescence. Materials and Methods The study used a sample of 1,534 children to test the predictive effects of socioeconomic stress at ages 18 and 27 months; hostile parenting measured at child ages 4-5; and sex assigned at birth on children's internalizing symptom latent class outcomes at child ages 7-9, 10-12, 13-15, and 16-19. Analyses also tested the mediating effect of parenting on the relationship between socioeconomic stress and children's symptom classes. Other covariates included parent depressive symptoms at child ages 4-5 and child race and ethnicity. Results Analyses identified three distinct heterogenous internalizing symptom classes characterized by relative symptom levels and progression: low (35%); moderate and increasing (41%); and higher and increasing (24%). As anticipated, higher levels of parental hostility in early childhood predicted membership in the higher and increasing symptom class, compared with the low symptom class (odds ratio (OR) = .61, 95% confidence interval (CI) [.48,.77]). Higher levels of early childhood socioeconomic stress were also associated with the likelihood of belonging to the higher-increasing symptom class compared to the low and moderate-increasing classes (OR = .46, 95% CI [.35,.60] and OR = .56, 95% CI [.44,.72], respectively). The total (c = .61) and direct (c' = .57) effects of socioeconomic stress on children's symptom class membership in the mediation analysis were significant (p <.001). Discussion Study findings suggest that intervening on modifiable bioecological stressors-including parenting behaviors and socioeconomic stressors-may provide important protective influences on children's internalizing symptom trajectories.
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Affiliation(s)
- Lue Williams
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Veronica Oro
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Courtney K. Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Chang Liu
- Department of Psychology, Washington State University, Pullman, WA, United States
| | - Elizabeth B. Miller
- NYU Grossman School of Medicine, New York University, New York, NY, United States
| | - Jody Ganiban
- Department of Psychological & Brain Sciences, George Washington University, Washington, DC, United States
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - David S. DeGarmo
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tong Chen
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Misaki N. Natsuaki
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
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Knight C, Johnson KM, Keane K, Mckitt T, Fenn H. Improving Anxiety and Depression in Pregnant Mothers Participating in Nurse Home Visitation. J Psychosoc Nurs Ment Health Serv 2024; 62:49-55. [PMID: 37751580 DOI: 10.3928/02793695-20230919-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
The perinatal period is a time of significant adjustment for mothers, which may lead to alterations in mood that affect maternal mental health, which may also impact child development. The current article details the effectiveness of the addition of a psychiatric-mental health nurse practitioner (PMHNP) and mental health training for nurses on the anxiety and depression screening scores of mothers enrolled in a home visitation program. For clients with elevated anxiety and depression scores, the percentages of those who were referred to and received mental health services increased after the program's addition of the PMHNP and mental health training. Implications for future research and practice include continued focus on maternal mental health with improved access to assessment and treatment for all clients within home visitation. [Journal of Psychosocial Nursing and Mental Health Services, 62(4), 49-55.].
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Osornio AC, Lane SP, Urizar GG, Gonzalez A, Halim MLD. Developmental trajectories of internalizing distress among ethnic minoritized mothers following childbirth: Associations with early child psychological adjustment. Dev Psychopathol 2024; 36:135-143. [PMID: 36376075 PMCID: PMC10183476 DOI: 10.1017/s0954579422001031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A substantial body of work has established that mothers' internalizing distress can negatively affect children's socioemotional development. Yet few studies have examined how distinct patterns of mothers' distress over time differentially impact child behaviors across early childhood. To address this gap, the current study explored developmental trajectories of mothers' internalizing distress and examined the associations of these patterns with child adjustment outcomes. Mexican immigrant, Dominican immigrant, and African American mothers (N = 272) were annually assessed for internalizing distress over the first 6 years following childbirth. Children's psychological adjustment (internalizing, externalizing, and hyperactivity behaviors) was measured at the last yearly assessment in first grade. A growth mixture model revealed two distinct classes of distress where mothers were classified as having low stable distress (82.4%) or moderate distress that began as stable then declined when their children were 64 months old (17.6%). Children of mothers in the moderate, late decline class showed greater internalizing, externalizing, and hyperactivity behaviors in the first grade compared to children of mothers in the low stable class. Findings highlight the necessity of supporting the mental health of ethnic minoritized mothers following childbirth and further expand our knowledge of family psychopathology to promote healthy psychological adjustment in children.
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Affiliation(s)
| | - Sean P. Lane
- Purdue University, West Lafayette, IN, USA
- University of Missouri, Columbia, MO, USA
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Cluxton-Keller F, Hegel MT, Donnelly CL, Bruce ML. Video-Delivered Family Therapy for Perinatal Women With Depressive Symptoms and Family Conflict: Feasibility, Acceptability, Safety, and Tolerability Results From a Pilot Randomized Trial. JMIR Form Res 2023; 7:e51824. [PMID: 37921846 PMCID: PMC10656661 DOI: 10.2196/51824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/14/2023] [Accepted: 09/27/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Although individual-level treatments exist for pregnant and postpartum women with depression, family conflict is a significant factor that can contribute to the development and severity of perinatal depressive symptoms. Yet, there is a lack of research on family therapy for perinatal women with moderate to severe depressive symptoms and family conflict. Further, research is needed on the feasibility, acceptability, safety, and tolerability of family therapies for perinatal depression that are delivered using Health Insurance Portability and Accountability Act-compliant videoconferencing technology (VCT). OBJECTIVE This paper describes the feasibility, acceptability, safety, and tolerability of a VCT-based family therapeutic intervention, Resilience Enhancement Skills Training (REST), for perinatal women with moderate to severe depressive symptoms and moderate to high conflict with their family members. METHODS This paper includes data from an ongoing randomized trial that compares an experimental family therapeutic intervention (REST) to standard of care (VCT-based problem-solving individual therapy) for the treatment of moderate to severe depressive symptoms in perinatal women with moderate to high family conflict. Both interventions were delivered by masters-level therapists using VCT. A total of 83 perinatal women and their adult family members (N=166 individuals) were recruited for participation in the study. Feasibility, defined as therapist adherence to ≥80% of REST session content, was assessed in audio-recorded sessions by 2 expert raters. Acceptability was defined as ≥80% of families completing REST, including completion of ≥80% homework assignments and family report of satisfaction with REST. Completion of REST was assessed by review of therapist session notes, and satisfaction was assessed by participant completion of a web-based questionnaire. The Beck Depression Inventory-Second Edition was administered to perinatal women by research assistants (blind to study group assignment) to assess safety, defined as a reduction in depressive symptoms during the treatment phase. The Family Environment Scale-Family Conflict subscale was administered by therapists to participants during the treatment phase to assess tolerability, defined as a reduction in family conflict during the treatment phase. RESULTS On average, the therapists achieved 90% adherence to REST session content. Of the families who started REST, 84% (32/38) of them completed REST, and on average, they completed 89% (8/9) of the homework assignments. Families reported satisfaction with REST. The results showed that REST is safe for perinatal women with moderate to severe depressive symptoms, and none discontinued due to worsened depressive symptoms. The results showed that REST is well tolerated by families, and no families discontinued due to sustained family conflict. CONCLUSIONS The results show that REST is feasible, acceptable, safe, and tolerable for families. These findings will guide our interpretation of REST's preliminary effectiveness upon completion of outcome data collection. TRIAL REGISTRATION ClinicalTrials.gov NCT04741776; https://clinicaltrials.gov/ct2/show/NCT04741776.
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Affiliation(s)
- Fallon Cluxton-Keller
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Mark T Hegel
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Craig L Donnelly
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Martha L Bruce
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
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Guerrero AD, Herman A, Teutsch C, Dudovitz R. Evaluation of a Health Education Intervention to Improve Parental Knowledge and Attitudes About Chronic Stress and Depression Among Head Start Families. Health Promot Pract 2023; 24:261-271. [PMID: 34957866 PMCID: PMC10751026 DOI: 10.1177/15248399211061132] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Chronic stress and depression disproportionately affect families experiencing poverty, and likely contribute to disparities in early childhood developmental outcomes. Developing strategies to address chronic stress and depression may help mitigate these disparities. Early Head Start (EHS) and Head Start (HS) programs provide an important platform to address the disproportionate burden of stress and mental health issues experienced by EHS/HS families. However, few low-literacy, broad, scalable interventions improve parents' knowledge and attitudes around these topics. Objectives. We examined parents' knowledge and attitudes regarding stress and depression before and after a train-the-trainer (TTT) intervention delivered to 28 EHS/HS agencies across the United States. Methods. Following a TTT workshop, 18 agencies chose to deliver the stress training to 1,089 parents and 5 chose to deliver the depression training to 670 parents. Participating parents completed paper assessments at baseline and 3 months following the training. Paired T-tests and chi-square analyses tested whether responses significantly improved over time. Results. At baseline, 37.2% of parents reported feeling stressed most of the time and 13.4% reported feeling depressed most of the time. Following the trainings and reinforcement activities, parents' knowledge, attitudes and self-reported behaviors significantly improved, including willingness to seek help for depression, avoidance of negative health-risk behaviors and utilization of healthy stress management practices. At follow up, 18.6% of parents reported feeling stressed most of the time and 11% reported feeling depressed. Conclusion. Findings suggest this low-literacy TTT approach is potentially a promising health promotion intervention with broad dissemination potential.
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Affiliation(s)
- Alma D. Guerrero
- UCLA Mattel Children’s Hospital, Los Angeles, CA, USA
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Ariella Herman
- Anderson School of Management, University of California, Los Angeles, Los Angeles, CA, USA
| | - Carol Teutsch
- Anderson School of Management, University of California, Los Angeles, Los Angeles, CA, USA
| | - Rebecca Dudovitz
- UCLA Mattel Children’s Hospital, Los Angeles, CA, USA
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Miller V, VanWormer LA, Veile A. Assessment of attention in biological mothers using the attention network test - revised. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00826-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Leeman J, Ledford A, Sprinkle S, Gasbarro M, Knudtson M, Bernhardt E, Zeanah P, McMichael G, Mosqueda A, Beeber L. Implementing mental health interventions within a national nurse home visiting program: A mixed-methods evaluation. IMPLEMENTATION RESEARCH AND PRACTICE 2022; 3:26334895221128795. [PMID: 36540200 PMCID: PMC9762775 DOI: 10.1177/26334895221128795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Up to half of low-income mothers experience symptoms of depression and anxiety that affect their well-being and increase their children's risk for behavioral and emotional problems. To address this problem, an engaged research/practice planning team designed the Mental Health Innovation (MHI), a multicomponent implementation strategy that integrates evidence-based mental health interventions within the national Nurse-Family Partnership (NFP). The MHI includes four implementation strategies: online training modules, clinical resources, team meeting modules, and virtual consultation. METHODS A convergent, mixed methods observational design was applied to evaluate implementation outcomes, guided by the RE-AIM framework. We operationalized Reach as the number and demographics of women enrolled in NFP agencies exposed to MHI strategies. Adoption was operationalized as the number and proportion of nurses and supervisors who used MHI implementation strategies. For implementation, we assessed multilevel stakeholders' perceptions of strategy acceptability and feasibility. Data were pulled from NFP's national data management systems and collected through focus groups and surveys. Quantitative data were analyzed using counts and summary statistics. Qualitative themes were generated through content analysis. RESULTS The MHI reached agencies serving 51,534 low-income mothers (31.2% African American and 30.0% Latina). Adoption rates varied across implementation strategies. Between 60% and 76% of NFP nurses (N = 2,100) completed each online module. Between 27% and 51% of nurse supervisors (n = 125) reported using each team meeting module. Of 110 teams invited to participate in virtual consultation, 40.9% (n = 45) participated. Mothers served by agencies participating in virtual consultation differed significantly from those who did not, with lower percentages of African American and Latina. Qualitative themes suggest that MHI strategies were generally viewed as acceptable; perceptions of feasibility varied across strategies. CONCLUSIONS This study identified both strengths and opportunities for improvement. Further evaluation is needed to assess the MHI's effectiveness in improving mothers' mental health.
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Affiliation(s)
- Jennifer Leeman
- School of Nursing, University of North Carolina, Chapel Hill, NC,
USA
| | - Alasia Ledford
- School of Nursing, University of North Carolina, Chapel Hill, NC,
USA
| | - Sharon Sprinkle
- Nurse-Family Partnership National Service Office, Denver, CO,
USA
| | - Mariarosa Gasbarro
- Prevention Research Center for Family and Child Health, University of Colorado Anschutz Medical
Campus, Aurora, CO, USA
| | - Michael Knudtson
- Prevention Research Center for Family and Child Health, University of Colorado Anschutz Medical
Campus, Aurora, CO, USA
| | | | - Paula Zeanah
- College of Nursing and Allied Health Professions and Picard Center
for Child Development and Lifelong Learning, University of Louisiana, Lafayette, LA,
USA
| | | | | | - Linda Beeber
- School of Nursing, University of North Carolina, Chapel Hill, NC,
USA
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Beeber L, Ledford A, Gasbarro M, Zeanah P, Knudtson M, Sprinkle S, McMichael G, Mosqueda A, Leeman J. Developing a multicomponent implementation strategy for mental health interventions within the Nurse-Family Partnership: An application of the EPIS framework. J Nurs Scholarsh 2021; 54:445-452. [PMID: 34904787 DOI: 10.1111/jnu.12755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this article is to describe the process used to create the Mental Health Innovation (MHI), a multicomponent implementation strategy that integrates evidence-based mental health interventions into the Nurse-Family Partnership (NFP), a national home visiting program delivered by nurses to low-income mothers. ORGANIZING CONSTRUCT The Exploration, Preparation, Implementation, Sustainment (EPIS) framework outlines the multistep, stakeholder-engaged process used to develop the MHI. CONCLUSION Engaging stakeholders provided an in-depth understanding of NFP infrastructure and the needs of NFP nurses and their clients. This understanding was key to designing a multicomponent implementation strategy to integrate mental health interventions within national and local NFP infrastructure and existing care processes. CLINICAL RELEVANCE Application of implementation frameworks such as EPIS provides a guide to integrating evidence-based interventions in a systematic, intentional, and rigorous manner, which in turn may promote their wide scale use and long-term sustainability.
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Affiliation(s)
- Linda Beeber
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA
| | - Alasia Ledford
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA
| | - Mariarosa Gasbarro
- Prevention Research Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Paula Zeanah
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA
| | - Michael Knudtson
- College of Nursing and Allied Health Professions and Picard Center for Child Development and Lifelong Learning, University of Louisiana at Lafayette, Lafayette, Louisina, USA
| | - Sharon Sprinkle
- Prevention Research Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Georgette McMichael
- Prevention Research Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Alison Mosqueda
- Nurse-Family Partnership National Service Office, Denver, Colorado, USA
| | - Jennifer Leeman
- Nurse-Family Partnership, Invest in Kids, Denver, Colorado, USA
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Housing Instability and Depression among US Mothers Following a Nonmarital Birth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910322. [PMID: 34639621 PMCID: PMC8508260 DOI: 10.3390/ijerph181910322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/16/2021] [Accepted: 09/25/2021] [Indexed: 11/24/2022]
Abstract
Mothers who had a nonmarital birth experience multiple risk factors for depression, including housing instability. Yet, important questions remain about the extent of long-term housing instability and its association with future depression among at-risk mothers. Using the Fragile Families and Child Wellbeing Study data, we examine cumulative housing instability over a 15-year period following nonmarital birth and its association with maternal depression. Based on a sample of 2279 mothers who had a nonmarital birth in 20 major US cities between 1998–2000, we examined their 15-year residential moves and housing arrangements. Then, we tested the associations between the cumulative residential moves and major depressive episodes (MDE) in Year 15 using logistic regression analysis. One in every four mothers had six or more residential moves in 15 years following a nonmarital birth. For each additional move, mothers reported up to 27.9% higher odds of having a past-year MDE in Year 15, translating into the prevalence increases from 6.0% (zero move) to 20.6% (10 moves). Our findings suggest that greater attention should be paid to housing needs among mothers following a nonmarital birth, including temporary housing assistance and more fundamental programs to reduce housing instability as preventive mental health services.
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Matsuda Y, Schwartz TA, Chang Y, Beeber LS. A Refined Model of Stress-Diathesis Relationships in Mothers With Significant Depressive Symptom Severity. J Am Psychiatr Nurses Assoc 2021; 27:240-250. [PMID: 31578899 PMCID: PMC7441645 DOI: 10.1177/1078390319877228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND: Mothers' depressive symptoms affect their children's growth as well as physical and mental well-being. Moreover, mothers of young children with developmental delay or disability (DD) tend to have higher depressive symptoms. AIMS: The purpose of this study was to examine associations between maternal depressive symptoms and number of children with DD among mothers with significant levels of depressive symptoms, while accounting for maternal diathesis factors and family stress factors. METHODS: This study was a secondary analysis of pooled baseline data collected from 2004 to 2012 in the northeastern and southeastern United States from three intervention studies to reduce depressive symptoms of mothers with young children (n = 364). Multiple regression analyses were conducted to examine associations between maternal depressive symptoms and number of children with DD, followed by the post hoc pairwise comparison. RESULTS: In the model including family stress factors, we found a significant test for linear trend in the mean for maternal depressive symptoms across the number of children with DD (F[1] = 4.3, p = .0388). CONCLUSIONS: Mothers who have multiple children with DD tend to experience higher depressive symptoms; thus, interventions are needed to help prevent these mothers from experiencing higher depressive symptoms or to reduce their current depressive symptoms. Both theory-based and strength-based interventions can target conflict management at the family level, reducing maternal depressive symptoms while improving mothers' self-efficacy, which would help mothers care for their own health, manage family conflict, and seek appropriate support to manage the children's medical and developmental needs.
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Affiliation(s)
- Yui Matsuda
- Yui Matsuda, PhD, APHN-BC, MPH, University of Miami, Coral Gables, FL, USA
| | - Todd A. Schwartz
- Todd A. Schwartz, DrPH, University of North Carolina at Chapel Hill, NC, USA
| | - YunKyung Chang
- YunKyung Chang, PhD, MPH, University of North Carolina at Chapel Hill, NC, USA
| | - Linda S. Beeber
- Linda S. Beeber, PhD, PMHCNS-BC, FAAN, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Parker A. Reframing the narrative: Black maternal mental health and culturally meaningful support for wellness. Infant Ment Health J 2021; 42:502-516. [PMID: 33470438 DOI: 10.1002/imhj.21910] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Black mothers with young children have encountered pernicious, multidetermined, racial disparities in the United States for centuries. However, disorders, risks, and stressors among Black mothers with young children are presented in the extant literature with little attention to their strengths, supports, or culturally appropriate ways to intervene and this furthers racism and White supremacy. Further, incomplete and negative narratives about Black mothers are perpetuated. Therefore, this article uses the Afrocentric perspective to better understand the state of Black maternal mental health and supports for mental health. Culturally centered recommendations are presented to move the field of infant mental health toward racial justice-oriented practice, policy, and research.
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Affiliation(s)
- Amittia Parker
- School of Social Welfare, University of Kansas, Lawrence, Kansas
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Chang MW, Brown R, Wegener DT. Perceived stress linking psychosocial factors and depressive symptoms in low-income mothers. BMC Public Health 2021; 21:62. [PMID: 33407305 PMCID: PMC7789186 DOI: 10.1186/s12889-020-10118-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/22/2020] [Indexed: 11/17/2022] Open
Abstract
Background Little is known about associations between perceived stress, psychosocial factors (social support, emotional coping, coping self-efficacy, and autonomous motivation), and depressive symptoms in low-income overweight or obese mothers of young children. Using baseline data of a lifestyle intervention study, this secondary analysis investigates whether perceived stress might mediate the associations between the psychosocial factors and depressive symptoms. Methods Convenience sampling was applied. Low-income overweight or obese mothers of young children were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in Michigan, US. Survey data were collected through phone interviews. Participants (N = 740) responded to valid surveys measuring perceived stress, social support, emotional coping, coping self-efficacy, autonomous motivation, and depressive symptoms. Composite indicator structural equation modeling was performed to test for potential mediation. Results When investigating the potential role of perceived stress as a mediator, the indirect effects of social support (b = − 2.10, p < 0.01), emotion coping (b = − 3.81, p < 0.05), and coping self-efficacy (b = − 7.53, p < 0.01) on depressive symptoms through perceived stress were significant, but the indirect effect of autonomous motivation was not. Conclusion Future intervention studies aiming to alleviate depressive symptoms in low-income overweight or obese mothers of young children might consider including practical strategies to promote social support, emotional coping, and coping self-efficacy to reduce perceived stress, which might potentially decrease depressive symptoms. Trial registration Clinical Trials NCT01839708; registered February 28, 2013.
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Affiliation(s)
- Mei-Wei Chang
- College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH, 43210, USA.
| | - Roger Brown
- School of Nursing, University of Wisconsin-Madison, 701 Highland Ave, Madison, WI, 53705, USA
| | - Duane T Wegener
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
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Tirumalaraju V, Suchting R, Evans J, Goetzl L, Refuerzo J, Neumann A, Anand D, Ravikumar R, Green CE, Cowen PJ, Selvaraj S. Risk of Depression in the Adolescent and Adult Offspring of Mothers With Perinatal Depression: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e208783. [PMID: 32602910 PMCID: PMC7327545 DOI: 10.1001/jamanetworkopen.2020.8783] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
IMPORTANCE Maternal depression during pregnancy is associated with emotional and behavioral difficulties of offspring during childhood that can increase the risk of depression in adolescence and adulthood. OBJECTIVE To investigate the association between perinatal maternal depression and an increased long-term risk of depression in their adolescent and adult offspring. DATA SOURCES A systematic search of the electronic databases of PubMed and PsycINFO was conducted from May 2019 to June 2019. STUDY SELECTION A total of 6309 articles were identified, of which 88 articles were extracted for full-text review by 2 reviewers. Only articles reporting data from prospective longitudinal studies that assessed maternal depression during antenatal and/or postnatal periods and resulting offspring 12 years or older with measures of established psychometric properties were included. Exclusion criteria consisted of all other study designs, mothers with other medical and psychiatric comorbidities, and offspring younger than 12 years. DATA EXTRACTION AND SYNTHESIS Data were extracted by 2 independent reviewers, and discrepancies were mediated by an expert third reviewer. Meta-analysis was performed using Bayesian statistical inference and reported using Meta-analysis of Observational Studies in Epidemiology (MOOSE) guideline. The association of depression timing with the sex of offspring was explored using metaregression. MAIN OUTCOMES AND MEASURES Offspring depression was evaluated using standardized depression scales or clinical interviews. RESULTS Six studies with a total of 15 584 mother-child dyads were included in the meta-analysis, which found the offspring of mothers who experienced perinatal depression to have increased odds of depression (odds ratio [OR], 1.70; 95% credible interval [CrI], 1.60-2.65; posterior probability [PP] [OR >1], 98.6%). Although metaregression found no evidence for an overall association between perinatal depression timing and offspring depression (antenatal vs postnatal, PP [OR >1] = 53.8%), subgroup analyses showed slightly higher pooled odds for the antenatal studies (OR, 1.78; 95% CrI, 0.93-3.33; PP [OR >1] = 96.2%) than for the postnatal studies (OR, 1.66; 95% CrI, 0.65-3.84; PP [OR >1] = 88.0%). Female adolescent offspring recorded higher rates of depression in metaregression analyses, such that a 1% increase in the percentage of female (relative to male) offspring was associated with a 6% increase in the odds of offspring depression (OR, 1.06; 95% CrI, 0.99-1.14; τ2 = 0.31). CONCLUSIONS AND RELEVANCE In this study, maternal perinatal depression, especially antenatal depression, was associated with the risk of depression in adolescence and adulthood. More research into the mechanisms of depression risk transmission and assessments of postinterventional risk reduction could aid in the development of future strategies to tackle depressive disorders in pregnancy.
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Affiliation(s)
- Vaishali Tirumalaraju
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston
| | - Robert Suchting
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston
| | - Jonathan Evans
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Laura Goetzl
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern School of Medicine, University of Texas Health Science Center at Houston
| | - Jerrie Refuerzo
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston
| | - Alexander Neumann
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Deepa Anand
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston
| | - Rekha Ravikumar
- Department of Internal Medicine, Mercy Health St Vincent Medical Center, Toledo, Ohio
| | - Charles E. Green
- Center for Clinical Research and Evidence-Based Medicine, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston
| | - Philip J. Cowen
- Medical Sciences Division, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Sudhakar Selvaraj
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston
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14
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Thomas SP. Depression and Its Treatment Across the Globe. Issues Ment Health Nurs 2020; 41:1-2. [PMID: 31951802 DOI: 10.1080/01612840.2019.1685345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Sandra P Thomas
- University of Tennessee, Knoxville College of Nursing, Knoxville, Tennessee, USA
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15
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Arora T. Sleep Routines in Children. J Clin Sleep Med 2019; 15:821-822. [PMID: 31138393 DOI: 10.5664/jcsm.7826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Teresa Arora
- Zayed University, College of Natural and Health Sciences, Department of Psychology, Abu Dhabi, United Arab Emirates
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16
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Kim K, Lee Y. The effects of depressive symptom management interventions on low‐income mothers: A systematic review and meta‐analysis. J Adv Nurs 2019; 75:1173-1187. [DOI: 10.1111/jan.13912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 09/21/2018] [Accepted: 09/27/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Kisook Kim
- College of Nursing Chung‐Ang University Seoul South Korea
| | - Yoonyoung Lee
- Department of Nursing Science Sunchon National University Suncheon, Jeonnam South Korea
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17
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Santos HP, Kossakowski JJ, Schwartz TA, Beeber L, Fried EI. Longitudinal network structure of depression symptoms and self-efficacy in low-income mothers. PLoS One 2018; 13:e0191675. [PMID: 29360876 PMCID: PMC5779701 DOI: 10.1371/journal.pone.0191675] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 01/09/2018] [Indexed: 12/17/2022] Open
Abstract
Maternal depression was recently conceptualized as a network of interacting symptoms. Prior studies have shown that low self-efficacy, as an index of maternal functioning, is one important source of stress that worsens depression. We have limited information, however, on the specific relationships between depression symptoms and self-efficacy. In this study, we used regularized partial correlation networks to explore the multivariate relationships between maternal depression symptoms and self-efficacy over time. Depressed mothers (n = 306) completed the Center for Epidemiological Studies Depression (CES-D) scale at four time points, between four and eight weeks apart. We estimated (a) the network structure of the 20 CES-D depression symptoms and self-efficacy for each time point, (b) determined the centrality or structural importance of all variables, and (c) tested whether the network structure changed over time. In the resulting networks, self-efficacy was mostly negatively connected with depression symptoms. The strongest relationships among depression symptoms were 'lonely-sleep difficulties' and 'inability to get going-crying'. 'Feeling disliked' and 'concentration difficulty' were the two most central symptoms. In comparing the network structures, we found that the network structures were moderately stable over time. This is the first study to investigate the network structure and their temporal stability of maternal depression symptoms and self-efficacy in low-income depressed mothers. We discuss how these findings might help future research to identify clinically relevant symptom-to-symptom relationships that could drive maternal depression processes, and potentially inform tailored interventions. We share data and analytical code, making our results fully reproducible.
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Affiliation(s)
- Hudson P. Santos
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Jolanda J. Kossakowski
- Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
| | - Todd A. Schwartz
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Linda Beeber
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Eiko I. Fried
- Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
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18
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A Toddler Parenting Intervention in Primary Care for Caregivers With Depression Symptoms. J Prim Prev 2017; 38:465-480. [DOI: 10.1007/s10935-017-0481-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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19
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Acri MC, Bornheimer LA, Jessell L, Chomancuzuk AH, Adler JG, Gopalan G, McKay MM. The intersection of extreme poverty and familial mental health in the United States. SOCIAL WORK IN MENTAL HEALTH 2017; 15:677-689. [PMID: 29618956 PMCID: PMC5880535 DOI: 10.1080/15332985.2017.1319893] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Approximately 22% of children in the United States live in poverty, with high rates of caregiver depression and child disruptive behavior disorders (DBD). The current study aims to explore the relationships between living in extreme poverty and both child and parent mental health. Data are comprised of findings from the first effectiveness study of the 4Rs and 2Ss intervention, in addition to preliminary data from an implementation study currently underway (n = 484). Families with an annual income of less than $9,999 reported significantly greater child DBD scores and prevalence of clinically significant levels of caregiver depressive symptoms compared to income levels over $10,000. Findings support the recommendation for parental mental health to be attended to within the context of child mental health services.
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Affiliation(s)
- Mary C. Acri
- McSilver Institute for Poverty, Policy, & Research, New York University, New York, New York, USA
- New York University Medical Center, New York, New York, USA
| | - Lindsay A. Bornheimer
- McSilver Institute for Poverty, Policy, & Research, New York University, New York, New York, USA
- Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Lauren Jessell
- Silver School of Social Work, New York University, New York, New York, USA
| | | | - Joshua G. Adler
- College of Arts and Sciences, New York University, New York, New York, USA
| | - Geetha Gopalan
- School of Social Work, University of Maryland, Baltimore, Maryland, USA
| | - Mary M. McKay
- Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, USA
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20
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Yang J, Martinez M, Schwartz TA, Beeber L. What Is Being Measured? A Comparison of Two Depressive Symptom Severity Instruments with a Depression Diagnosis in Low-Income High-Risk Mothers. J Womens Health (Larchmt) 2017; 26:683-691. [PMID: 28448178 DOI: 10.1089/jwh.2016.5974] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Adequate assessment of depressive symptomatology is a necessary step toward decreasing income-related mental health treatment inequity. No studies have focused on comparing instruments used to detect depression in women from low-income backgrounds who are mothers of young children-a period of increased risk for depressive symptoms. METHODS To address this gap, two commonly used instruments (Center for Epidemiologic Studies Depression Scale [CES-D] and Hamilton Rating Scale for Depression [Hamilton]) were compared with a depression diagnosis (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-V]) in a sample (n = 251) of mothers from low-income backgrounds with children ranging from 1 to 54 months old. Diagnostic utility was examined in light of contextual factors associated with maternal depressive symptoms. RESULTS In this sample, CES-D had better screening sensitivity and specificity than Hamilton. Our results suggest that Hamilton may underdiagnose cases of major depressive episodes (MDE) as defined by DSM-V among black and low-income mothers compared with CES-D. In addition, we identify items in CES-D, which do not contribute to alignment with DSM-V and are appropriate targets for future improvements. Our analysis identifies interpersonal relationships and mother's age as the primary risk factors, which differentiate between CES-D and Hamilton determinations versus MDE diagnosis. In addition, we find regional differences in CES-D and Hamilton. CONCLUSIONS It is important to tailor the measure to the context, and a calibration sample should be considered for studies of sufficient size.
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Affiliation(s)
- Jenny Yang
- 1 Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Maria Martinez
- 2 School of Nursing, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Todd A Schwartz
- 1 Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.,2 School of Nursing, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Linda Beeber
- 2 School of Nursing, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
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21
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Graff JC, Bush AJ, Palmer FB, Murphy LE, Whitaker TM, Tylavsky FA. Maternal and Child Characteristics Associated With Mother-Child Interaction in One-Year-Olds. Res Nurs Health 2017; 40:323-340. [DOI: 10.1002/nur.21798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2017] [Indexed: 11/09/2022]
Affiliation(s)
- J. Carolyn Graff
- Professor, College of Nursing, Chief of Nursing, Boling Center for Developmental Disabilities; University of Tennessee Health Science Center 711 Jefferson Avenue; Memphis TN 38105
| | - Andrew J. Bush
- Professor Emeritus, Department of Preventive Medicine; University of Tennessee Health Science Center; Memphis TN
| | - Frederick B. Palmer
- Professor, Department of Pediatrics, Director, Boling Center for Developmental Disabilities; University of Tennessee Health Science Center; Memphis TN
| | - Laura E. Murphy
- Professor, Department of Child Psychiatry, Chief of Psychology, Boling Center for Developmental Disabilities; University of Tennessee Health Science Center; Memphis TN
| | - Toni M. Whitaker
- Associate Professor, Department of Pediatrics Developmental Pediatrician, Boling Center for Developmental Disabilities; University of Tennessee Health Science Center; Memphis TN
| | - Frances A. Tylavsky
- Professor, Department of Preventive Medicine; University of Tennessee Health Science Center; Memphis TN
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