Jean-François Saucier

Psychosocial predictors of depressive symptomatology level in postpartum women

This study explored a multifactorial model for the prediction of the intensity of depressive symptoms in postpartum women. Data were gathered from 213 pregnant women during the second trimester of pregnancy and at 6 months postpartum. Participants were assessed according to a number of psychosocial variables. A path analysis indicated that four variables had a direct effect on postpartum depressive symptomatology level: lower occupational status, prenatal depression level, more distal stressors and a personal psychiatric history. Eight variables, which reflected past and present experiences, showed an indirect effect. The implications of these findings are discussed.

Postpartum Depression Symptoms in Newcomers

Objectives: To determine if postpartum depression (PPD) symptoms are more common in newcomer women than in Canadian-born women. Methods: Refugee, nonrefugee immigrant, asylum-seeking, and Canadian-born new mothers were administered questionnaires for depression, social support, interpersonal violence, and demographic information. We created a PPD variable based on a score of ⩾10 on the Edinburgh Postnatal Depression Scale (EPDS) and performed a logistic regression analysis for PPD. Results: Immigrants (35.1%), asylum seekers (31.1%), and refugees (25.7%) were significantly more likely than Canadian-born (8.1%) women to score ⩾10 (P = 0.008) on the EPDS, with the regression model showing an increased risk (odds ratio) for refugee (4.80), immigrant (4.58), and asylum-seeking (3.06) women. Women with less prenatal care were also more likely to have an EPDS of ⩾10 (P = 0.03). Newcomer women with EPDS scores of ⩾10 had lower social support scores than Canadian-born women (P < 0.0001). Conclusions: Newcomer mothers have an increased risk for PPD symptoms. Social support interventions should be tested for their ability to prevent or alleviate this risk.

Obstetrical Complications and Violent Delinquency: Testing Two Developmental Pathways

This study focused on the interaction between specific obstetrical complications and early family adversity in predicting violent behavior during childhood and adolescence, in a sample of 849 boys from low socioeconomic areas of Montreal, Canada. Obstetrical complication data from medical records were used to create three scales using a nonlinear principal component analysis followed by rotation. Family adversity and teacher-rated physical aggression were assessed when the boys were in kindergarten and self-reports of delinquency were collected when they were 17. Elevated scores on the Deadly Risk Situation scale of obstetrical complications (preeclampsia, umbilical cord prolapse, and induced labor) increased the risk of being violent at both 6 and 17 years of age, only among boys who grew up in high adverse familial environments. Moreover, this interaction partly accounted for the continuity between violence in childhood and adolescence. Interventions for young pregnant women from deprived environments and their babies are discussed in light of these results.

PSYCHOSOCIAL FACTORS RELATED TO EMOTIONAL DISTURBANCES DURING PREGNANCY

This study explored a multifactorial model for the understanding of the factors related to the intensity of prenatal emotional disturbances. Data were gathered from 213 pregnant women during the second trimester of pregnancy. Participants were assessed according to a number of psychosocial variables. Two types of prenatal emotional disturbances were examined: depressive symptoms and ambivalence and fears related to maternity. A path analysis indicated that four risk factor domains had a direct effect on depressive symptom level: locus of control; interpersonal relationships; stressors; and psychiatric history. Four risk factor domains also had a direct effect on the level of ambivalence and fears: sociodemographics; depressive symptom level; interpersonal relationships; and family history. Several factors showed an indirect effect on one or both of the disturbances. These results indicate that the study of factors related to prenatal emotional disturbances benefits from a multifactorial model assessing direct and indirect effects.

PREFERENCE FOR A FIRST-BORN BOY IN WESTERN SOCIETIES

Many studies in the last 45 years have shown that women prefer a boy to a girl for their first-born child, suggesting that this preference is universal in Western societies. A careful examination of these studies reveals, however, that the subjects were often women who were not pregnant and/or students. A review of sixteen studies with first-time-pregnant women showed that in most cases the opposite was true, namely, that a girl was desired more often than a boy, especially during the last two decades (from 1981 to 1996). Data concerning expectant fathers, however, indicate that they prefer a boy rather than a girl. A preference for a boy first was also observe for both non-expectant males and females. Womens preference for a male child decreased and mens preference increased slightly when the two sub-periods (before 1980vs after 1981) were compared. A difference between men and women is, however, evident whatever the sub-period: men more often prefer a boy than women. These findings suggest that something specific about being pregnant is related to the preference for a girl first.

The childbearing health and related service needs of newcomers (CHARSNN) study protocol

BackgroundRefugee and asylum-seeking women in Canada may have significant harmful childbearing health outcomes and unmet health and social care needs. The most vulnerable of these women are: those who have left their countries by force (e.g., war, rape or abuse histories), are separated from their families, have limited knowledge of the host country languages, and are visible minorities. Asylum-seekers face additional stresses related to their unknown future status and are marginalized with regards to access to provincial health care systems. The prevalence and severity of health issues in this population is not known nor is the extent of response from social service and health care systems (including variation in provincial service delivery). Understanding the magnitude of health and social concerns of newcomers requires data from a representative sample of childbearing refugee and asylum-seeking women resettling in Canada to permit comparisons to be made with non-refugee immigrant and Canadian-born women. Our research questions are: (1) Do refugee or asylum-seeking women and their infants, experience a greater number or a different distribution of harmful health events during pregnancy, at birth, and during the postpartum period than non-refugee immigrant or Canadian-born women? (2) Are the harmful health events experienced postpartum by asylum-seeking women and their infants, addressed less often (compared to refugees, non-refugee immigrants, and Canadian-born women) by the Canadian health care system as delivered in each of the three major receiving cities for newcomers?Methods/designThis is a four-year multi-site prospective cohort study (pregnancy to 4 months postpartum). We will seek to recruit 2400 women [200 in each of 4 groups (refugees, asylum-seekers, non-refugee immigrants, and Canadian-born) from 1 of 12 postpartum hospital units across the 3 largest receiving cities for newcomers to Canada – Montreal, Toronto, and Vancouver].DiscussionKnowledge of the extent of harmful health events occurring to asylum-seeking, refugee, immigrant, and Canadian-born women, and the response of the health care system to those events and group differences, if they exist, will inform immigration and health policy makers as well as providers of services.

Improving Qualitative Interviews With Newly Arrived Migrant Women

There is a paucity of literature on how to conduct research with migrants, particularly those who do not speak the host country language, those who are newly arrived, and those who have a precarious immigration status. In qualitative research, interviewing is a common method for obtaining rich data and participants’ points of view. Gathering and presenting all perspectives when interviewing vulnerable migrant women on health-seeking behaviors is challenging. In this article, we explore the process of developing and implementing a data collection plan and an interview guide for a study carried out with migrant women to explore the inhibitors/facilitators for following through on professional referrals for postbirth care. Adaptability and careful attention to multiple factors throughout the process are essential to maximizing participation and enhancing the trustworthiness of the data. Appropriate health policy and care delivery can only originate from health research with diverse migrant populations.

Correlates of pre-partum depressive symptomatology: A multivariate analysis

A sample of 350 French Canadian women were interviewed at the beginning of the second trimester of pregnancy. Their level of depressive symptomatology was assessed with the Beck Depression Inventory (BDI). Several demographic and psychosocial variables were included in a multiple regression analysis in order to identify the variables which contribute to the variance in the BDI score. Results show that employment, higher self-esteem, and satisfaction with social support were related to lower levels of pre-partum depressive symptoms. Prior experiences of emotional difficulties, number of individuals with whom the subject reports a negative relationship, intensity of perinatal stress, as well as the perceived impact of stressful life events, are associated with an increase in the BDI score. It is proposed that a diathesis-stress model can account for this pattern of results. The limitations in generalizing these results to samples of non-francophone women are discussed.

Correlates of gender role orientation during pregnancy and the postpartum

This study was designed to examine the relationship between gender role orientation and psychological adjustment during pregnancy and the postpartum period in a large sample of French-speaking Caucasian mothers. Gender role was assessed with the Bem Sex Role Inventory, which classifies subjects into four categories: androgynous, masculine, feminine, and undifferentiated. A discriminant analysis showed a relationship between androgyny and the following measures of psychological adaptation: self-esteem, satisfaction with social support, and level of apprehension toward perinatal stressors. The masculine gender role was linked with self-esteem, work involvement, age, and severity of perinatal stress. No relationship was found between gender role and the level of antenatal or postnatal depressive symptomatology. Stress, marital support, and social support were among the predictors of postpartum depression, which underlined the importance of taking these variables into account when studying the well-being of mothers during the postnatal period. Results are discussed in light of previous literature on the association between gender role and motherhood. The limitations of Bems model and inventory are also considered.

Parental marital status and adolescents' optimism about their future.

This article reports the results of a questionnaire survey of a representative random sample of all the schooled French-speaking adolescents of Montreal (N=4539). The sample included adolescents from legally intact homes, separated or divorced homes, and homes in which a parent was deceased. Three indicators of future success were included; adolescents from both types of broken families were less optimistic on all three dimensions than were adolescents from intact families. These results are discussed within a socioeconomic framework.