Rates of depression in Stay-at-Home Mothers

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This proposal includes the introduction, literature review, and methods section.

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Contents

Abstract. 2

Literature review and the corresponding methods used. 2

References. 11

Abstract

This literature review is about the rates of depression among stay-at-home mothers. Eight types of research have been reviewed with the emphasis being put on the methods used, the variables considered, the findings generated and the existing gaps in research. Zuckerman’s (1987) research highlights the harm that is caused by depressed stay-at-home mothers to children.

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Maternal perceptions and beliefs were explored by Heneghan& Mercer (2004). Although stay-at-home mothers were aware of the dangers that their depressive conditions posed to their children’s development, they were reluctant to share their problems with the children’s pediatricians. On the other hand, Beeber&Perreira (2008 identified poverty as a key factor for the onset of maternal stress.

The review of all the articles shows that there is scanty literature on the rate of depression among stay-at-home mothers. More research is needed to determine the true scale of this problem. Until then, it may be difficult to put the right psychiatric and social policy frameworks in place.

Literature review and the corresponding methods used

Stay at home mothers can become depressed for various reasons. Sometimes, mothers are forced to suspend their careers in order to dedicate more time to their children. Bringing up children is a highly challenging job that may prove to be a tall order for career women.

The problem with staying at home all the time is that boredom sets in, punctuated only by cries of children, trips to the clinic and highly repetitive jobs. Moreover, these tasks appear unrewarding especially if the husband does not express any appreciation. According to Zuckerman (1987), marital depression is a common problem in clinical experience although there is a lack of enough research in the pediatric literature.

Depression, according to Zuckerman, can refer to either a diagnosable depression or depressive systems. Depression among mothers is a frequent phenomenon. It is also persistent and it is related to many factors such as marital disharmony and low social class. Studies have demonstrated an association between depression on the part of the mother and her child’s adverse outcomes (Zuckerman, 1987). These adverse outcomes manifest themselves in low birth weight, somatic complaints, behavior problems, accidents, poor growth, and affective illness. Child-bearing and affect characteristics of depressed mothers appear to be crucial factors in the task of mediating the poor outcomes. Pediatricians should play a distinctive role in offering help to depressed mothers together with their children.

Heneghan& Mercer (2004) explored maternal perceptions and beliefs about discussing parenting stress and depressive symptoms with the child’s pediatrician. The study was carried out against the background of the negative consequences for children that are often brought about by maternal depressive symptoms and parenting stress.

In terms of the methods used, mothers were recruited from 1 hospital-based pediatric practice and 5 different community-based pediatric practices in order to ensure that the sample was diverse. A trained, experienced facilitator conducted focus groups through the use of open-ended questions as well as a standard questionnaire. A review of the transcripts and audiotapes of the groups was carried out for outstanding themes. This review was done by 3 independent researchers who were using the immersion/crystallization technique and the grounded theory.

With the maternal domain, the main themes that emerged include emotional health, self-efficacy, and support systems. With regard to emotional health, all respondents said that a mother’s emotional health has a direct effect on the well being of the child. The self-efficacy theme was characterized by the belief among mothers that they need to accept the responsibility of monitoring their own well being as well as that of their child. With regard to support systems, mothers strongly expressed the urgent need to share parenting experiences depressive symptoms and stressors with someone. In this case, they preferred to speak with a family member or a friend rather than with the child’s pediatrician.

Heneghan& Mercer (2004) also highlighted the interaction whereby the main emerging themes included communication and trust. Open communication with a pediatrician who can listen to the mother’s problems was deemed to be a necessary measure. Mothers also expressed that they trust the pediatrician with the health of their children. However, many of them were hesitant to discuss their own symptoms relating to stress and depression.

Mothers belonging to all socioeconomic statuses expressed the fear of a judgment that a possible referral to child protection in case they talked about the issues that troubled them. Both the issues of communication and trust were mediated by an ongoing relationship between the mother and the pediatrician. Mothers were only confident of discussing their own emotional health issues only when they felt that their relationship with the pediatrician was a ‘good one’.

Heneghan& Mercer (2004) concluded that stay-at-home mothers are well aware that their own emotional health issues have consequences for their children. Although many mothers are aware of the lack of enough social support systems, their fear of talking freely about their problems with their pediatrician is worrying. The qualitative data gathered are highly valuable for developing interventions for helping pediatricians offer assistance to stay-at-home mothers at risk.

Poverty, according to Beeber&Perreira (2008), increases maternal stress mainly by heightening exposure to many negative life events, chronic strains, job loss, conflicts with partners and dangerous neighborhoods. This culminates in depressive symptoms, which are crippling and can even pose a prevalent threat to the mental health of stay-at-home mothers. Depressive symptoms tend to interfere with the manner in which strong maternal support is provided in order for the hardships of poverty to be countered. Therefore, infants and toddlers are placed at risk of delayed social, language and emotional development.

According to initial trials involving high-risk mothers, there is a promise that successive tests of various interventions will provide solutions to these mothers’ mental health risks. More importantly, it can become easy for mothers with mental problems to be identified and targeted for inclusion in the interventions.

The research article by Beeber&Perreira (2008) was driven by a sequential process of analyzing data whereby high-risk stay-at-home mothers were targeted for intervention. This intervention involved two trials on how to reduce depressive symptoms. The recruitment and design of all the intervention trials were aided by an iterative process. In this process, data were used to identify all at-risk mothers as well as validate the presence of the risk factors.

Zimmerman (2000) reports the findings of research done on marital equality and the overarching problems that stay-at-home mothers and fathers face in the quest for this equality. Stress and depression were one of these problems. In general, it was observed that the arrangements involving either a stay-at-home mother/father presented similar problems and experiences to the couples involved. However, mothers across both samples always reported higher stress, exhaustion and depression levels than fathers.

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Among Anglos, married women experience higher levels of psychological stress compared to married men (Ross, 1983). Gove and his colleagues developed the role-stress theory in order to explain this scenario by focusing on the traditional female roles that contain many stressful aspects. According to Ross, examples of these roles include being a ‘child rearer’ and housewife in a society that undervalues women’s traditional role within the home setting. In such a society, no set of effective institutions exist for dealing with the demands that come with motherhood.

According to Ross (1983), the role-stress theory has not yet been tested to date. There is a need for cross-cultural research to be done with the emphasis being put on the implications of this theory. One of the theory’s implications is that in all societies where more value is placed on the family and the work of the woman, the level of psychological distress faced by men and women will be more or less similar. This implication of Gove’s role-stress theory needs to be tested in two cultures. The first one is characterized by a relative concentration of emphasis on an individual’s achievement outside the home setting, such as the Anglo culture. The second one involves the concentration of emphasis on home and family, such as the Mexican culture.

As expected, Ross (1983) found out that the existing gap in psychological distress between married women and men was much bigger in the Anglo culture than in the Mexican culture. However, this finding did not seem to be as clear-cut as the argument propounded in the role-stress theory implies.

According to Chin (2004), the traditional role of married women who is unemployed still holds a powerful place in the global culture’s mythology. There are many clear benefits for young women who choose to follow this path. One of the benefits is that the respective roles of the husband and wife are clearly defined, with the husband being the greater authority and the breadwinner. However, these benefits come at a cost. Researchers have suggested that full-time stay-at-home mothers and homemakers face a higher risk of depression compared to employed women. The tasks that a full-time homemaker performs are always repetitive, dull, and without reward.

When her children finally leave home, the stay-at-home mother faces the risk of suffering from the ‘empty nest’ syndrome. Her employed counterpart faces few chances of encountering such a problem.  In case her marriage fails and divorce is inevitable, chances of slipping into poverty are high. Furthermore, she always finds it difficult to walk out of an abusive relationship because of her complete dependence on the husband (Chin, 2004).

Another scenario is one in which the stay-at-home mother goes to school or work. In this case, chances of stress and depression may arise because of many reasons. Women who find themselves in this scenario perform two full-time jobs. They perform a full-time task of work or learn during the day only to find another full-time task awaiting them on the domestic front. Additionally, stress and depression may arise because, although this woman is overworked, she may never attain the level of success achieved by the career woman (Chin, 2004).

Gelfand&Teti (1996) carried out a demographic study of matched groups of 73 clinically depressed and 38 non-depressed mothers of infants aged between 3 and 13 months. Some of the mothers were in a home visit intervention while the others were in usual care settings. Intervention mothers ended up improving more in daily hassles and reported depression than those in usual care settings.  Better child and maternal adjustments were accompanied by decreased depression.

Maternal punitiveness was noted to increase significantly in the depressed control but not in the other groups, thus yielding a marginal time-group interaction. Social support was noted to decrease only among depressed control mothers. The majority of the depressed mothers’ children were insecurely attached. Additionally, intervention children tended to be less avoidant or inhibited. They were also more resistant or coercive compared to children of depressed controls.

Targosz&Bebbington (2003) used the British National Survey of Psychiatric Morbidity data to assess depression assess depressive disorders as well as a social disadvantage in women who bring up children on their own. The method used in the study involved a stratified random sample of fewer than 10,000 subjects, in which case, the reports made were based on 5281 women who were interviewed in person. Psychiatric symptoms were established followed by ICD-10 diagnoses made by lay interviewers who were using the CIS-R.

Results were presented in the form of mixed anxiety/depressive episode or disorder. The overall exposure to stress was determined through the identification of the life event rate in the six months that preceded the interview. Subjects were also asked to give details of their perceived social support. Information regarding various demographic attributes was also collected. A comparison was made between lone mothers and supported mothers as well as women who were not involved in taking care of children under the age of 16.

The prevalence rate among lone mothers was 7%, three times than of any other group. There was also an increase in the frequency of mixed anxiety/depression, a milder condition. After controls were done on measures of stress, social disadvantage, and isolation, these rising rates of depressive conditions were no longer apparent. This led Targosz&Bebbington (2003) to the conclusion that lone mothers, and particularly stay-at-home moms, are increasing in numbers, a phenomenon that corresponds to a decline in marital stability. The high rates of depressive disorder and material disadvantage may have far-reaching implications for psychiatric and social policy.

Moss &Plewis (1977) assessed the level of mental ‘distress’ in a sample of stay-at-home mothers living in inner London with preschool children. Fifty-two percent of these mothers were found to have a moderate or severe mental distress problem during the 12-month period prior to the interview. Different variables that correlated with mental distress were identified and then replicated in a different sample. No relationship between social class and mental distress was identified.

In a study done by Davies &McAlpine (1998), the power relations method was used with a sample of mothers to examine the connection among gender; employment and family conditions and psychological distress. Consideration was also made on the impact of broader societal conditions on mothers’ lives with regard to differential shaping of rewards and opportunities, and therefore their distress.

According to Davies &McAlpine (1998), employment, income, and control are beneficial to a mother’s mental health. Additionally, single parenthood per se cannot be considered to be a risk factor for distress. Rather, inadequate resources increased childcare strain, and the absence of employment opportunities associated with stay-at-home mothers is a serious disadvantage that increases the risk of depression.

References

Beeber, L. &Perreira, K. (2008) Supporting the Mental Health of Mothers Raising Children in Poverty: How Do We Target Them for Intervention Studies?, Annals of the New York Academy of Sciences, 1136(2), 86 – 100

Chin, J. (2004) “Life experiences of working and stay-at-home mothers” in Lemaster, J.  The Psychology of Prejudice and Discrimination: Bias based on gender and sexual orientation, Boston: Praeger Publishers.

Gelfand, D. & M. Teti, D. (1996) Helping mothers fight depression: Evaluation of a home-based intervention program for depressed mothers and their infants, Journal of Clinical Child & Adolescent Psychology, 25(4), 406 – 422

Heneghan, A.  & Mercer, M. (2004) Will Mothers Discuss Parenting Stress and Depressive Symptoms with Their Child’s Pediatrician?, Pediatrics, 113(3), 460-467

Ross, C. (1983) Distress and the Traditional Female Role: A Comparison of Mexicans and Anglos, The American Journal of Sociology, 89(3), 670-682

Targosz, S. &Bebbington, P. (2003) Lone mothers, social exclusion and depression, Psychological Medicine, 33(4), 715-722

Zimmerman, T. (2000) Marital Equality and Satisfaction in Stay-At-Home Mother and Stay-At-Home Father Families, Contemporary Family Therapy, 22 (3)

Zuckerman, B. (1987) Maternal Depression: A Concern for Pediatricians, Pediatrics 79(1), 110-117

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