Justin P. Lavin

Depression prevalence and incidence among inner-city pregnant and postpartum women

A sample of 192 financially impoverished, inner-city women was assessed for clinical depression twice during pregnancy and once postpartum. At the first and second antepartum interviews, respectively, 27.6% and 24.5% of the women were depressed, controlling for pregnancy-related somatic symptoms. Postpartum depression was found among 23.4% of women. These rates are about double those found for middle-class samples. Particularly heightened risk for antepartum depression was found among single women who did not have a cohabiting partner. African American and European American women did not differ in rates of depression. Antepartum depression was a weak but significant risk factor for postpartum depression.

Stress, psychosocial resources, and depressive symptomatology during pregnancy in low-income, inner-city women.

The authors examined the prospective influence of stress, self-esteem, and social support on the postpartum depressive symptoms of 191 inner-city women (139 European Americans and 52 African Americans) over 3 waves of data collection. Depressive symptomatology was measured by multiple indicators, including self-report and clinical scales. Women became less depressed as they move from prenatal to postpartum stages and adjusted to their pregnancy and its consequences. LISREL and regression analyses indicated that stress was related to increased depression, whereas greater income and social support were related to decreased depression. Self-esteem was related to lower depression at the prenatal and postpartum periods but not to change in depression from the prenatal to the postpartum period. The results also indicated that self-esteem and social support did not have additional stress-buffering effects over and above their direct effects on depression. Finally, African American women did not differ from European American women terms of depression or in terms of how they were impacted by stress or psychosocial resources.

Reducing inner-city women's AIDS risk activities: a study of single, pregnant women.

Behavioral change reduces risk of HIV infection and development of AIDS. We compared 206 inner-city women who were randomly assigned to a 4-session AIDS-prevention group or to one of two controls, a health-promotion group or a no-intervention group. AIDS-prevention and health-promotion groups provided information, behavioral competency training, and social support. Only the AIDS-prevention group focused on AIDS-specific knowledge and skills. The AIDS-prevention group produced moderate, consistent increases in knowledge and safer sex behaviors in comparison with either the health-promotion or no-intervention group. Self-report and objective changes were sustained 6 months after intervention for both African-American and European-American women.

When it Rains, it Pours: The Greater Impact of Resource Loss Compared to Gain on Psychological Distress

The authors prospectively investigated stress in 71, mostly European American, pregnant women. Conservation of Resources (COR) theory was applied to assess the impact of resource losses and gains that occur in women’s lives. Resources were defined as those things that people value or that act as a means to obtaining that which they value and include social, personal, object, and condition resources. The authors hypothesized that women’s resource losses would better predict postpartum anger and depression than their resource gains (in the opposite direction). They also predicted that earlier resource loss would accelerate the negative impact of later resource loss on postpartum distress. Resource gain was expected to be most salient when resource losses co-occurred, such that resource gains buffered the negative impact of resource loss. The hypotheses were generally supported and argue for the primacy of resource loss in the stress process.

Safer sex knowledge, behavior, and attitudes of inner-city women.

Sexual behavior, knowledge of HIV transmission and prevention, perceived risk of AIDS, and safer sex behavior were studied in a sample of 289 single, pregnant, inner-city women. African-American and European-American women were equally represented. Women had poor AIDS knowledge. Sexual behavior placed women at risk for HIV infection due to the lack of condom or spermicide use. Women did not perceive themselves at risk for the AIDS virus, although they did recognize that heterosexuals were at risk. Their lack of risk perception was partly based on their having a single sexual partner. They did not regard their partners current or past behavior as placing them at risk. Recommendations for intervention and cultural differences were discussed.

Resource loss, resource gain, and communal coping during pregnancy among women with multiple roles.

We investigated stress, coping, and employment status in 92, mostly European American pregnant women. Conservation of Resources (COR) theory (Hobfoll, 1988, 1989) was applied as a specification of role-quality theory to examine the stressful influences of womens multiple roles. Womens resource loss predicted psychological distress better than either their resource gains or their employment status (i.e., multiple versus single roles). Full-time employed women were significantly more distressed under high loss conditions than were part-time or nonemployed women. Examining womens coping strategies based on a communal model of coping, we found that active, prosocial coping was associated with better emotional outcomes. A significant interaction was found for the effects of loss × cautious action such that loss was related to greater depression, but only among women who did not employ cautious action.

Proximal and Distal Predictors of AIDS Risk Behaviors among Inner-city African American and European American Women:

AIDS risk behavior and attitudes towards safer sex were studied in a sample of 666 African American and 626 European American women. Condom use, AIDS-related knowledge, risk perception, self-efficacy beliefs, attitudes and perceived partner attitudes, and an assertive coping style were analyzed with regard to mean differences and predictive power in both ethnic groups. Compared to European American women, African American women had less knowledge and lower self-efficacy beliefs towards safer sex behavior, but they perceived themselves to be at more risk and reported greater condom use. Further, ethnicity was found to moderate the effects of the psychological predictors on safer sex behavior. This moderator effect was tested using a structural equation modeling design. In both groups, risk perception was the strongest predictor of condom use. Among African American women, social-cognitive barriers (e.g. low self-efficacy beliefs, negative attitude towards condom use) worked as a second predictor and mediator of the effects of risk perception on condom use. In contrast, among European American women, social-cognitive factors had no effect on condom use. In general, prediction of safer sex behavior was stronger among African American women.

Weight, self-esteem, ethnicity, and depressive symptomatology during pregnancy among inner-city women.

The relationship of weight and self-esteem to depressive symptomatology was examined among 36 African American and 96 European American pregnant inner-city women. Lower self-esteem and higher deviations from medically ideal weight predicted increased dysphoria during the 3rd trimester for European American women, but only lower self-esteem predicted increased dysphoria for African American women. These results support the hypothesis that African Americans are less likely than European Americans to experience negative psychological repercussions of greater weight. Consistent with findings among nonpregnant middle-class samples, these results extend the association between heavier weight and increased risk for psychological distress to pregnant women of European American descent.

Women's barriers to safer sex

Abstract We examined womens barriers to safer sex and the development of a 14-item, multi-dimensional, barriers to safer sex scale. In Study 1, model testing and scale development was conducted on a population of 503 African and European American, inner-city, pregnant, single women. We found four factors that closely parallel theoretical barriers that are cited in the literature: a) partner and self objections, b) the appraisal that one is not at risk, c) embarrassment, and d) giving up pleasure. In Study 2, convergent and divergent validity data supported the construct validity of the theoretical model and scale. In Study 3, the four subscales were found to be reliable among an additional sample of 72 single, college women. Subscale means for the community and student samples differed significantly, indicating important population differences. More modest differences were found between African American and European American women.

Marriage, Intimate Support and Depression during Pregnancy A Study of Inner-City Women

We examined the influence of stress, intimate support and marital status on postpartum depression among 189 African American and European American, inner-city women. We selected women in three common categories: (1) married, (2) cohabitating with partner, and (3) romantically involved, but not cohabitating. Women were interviewed on two occasions during pregnancy and seven to nine weeks following delivery. Women who were not married and did not live with their partner reported less intimacy with their partner and greater depression and increases in depression. Both marriage and cohabitation limited women’s depression level. Married women also increased in intimacy during their pregnancy, but cohabitating women did not. Results were independent of ethnic status, age and income. The importance of the findings given the rise in single parenthood was discussed.