Wayne M. Usui

Psychosocial Predictors of Postpartum Depression in Diverse Groups of Women

The purpose of this study was to test the extent to which a causal model developed from a theoretical formulation of postpartum depression was consistent with data collected from three groups of postpartum women. In this cross-sectional, correlational design, the samples consisted of primarily middle-class, Caucasian mothers of term infants and preterm infants, and low-income, African American mothers of term infants. Instruments included the CES-D Depression instrument, the Postpartum Support Questionnaire, Rosenberg’s Self-Esteem instrument, and a question regarding closeness to partner. The causal model was tested with structural equation modeling. Importance of support, support received, and closeness to partner were significant predictors of both self-esteem and depression. Predictors of postpartum depression are the same across diverse samples of women, as proposed in the causal model.

The Postpartum Support Questionnaire: reliability and validity

Support has been found to be related to perinatal health, resulting in the development of the Postpartum Support Questionnaire based on the four categories of support (informational, material, emotional and comparison) identified by House (1981) and Cronenwett (1985). Data from four studies (N=207) provided evidence of the psychometric properties of the instrument. Internal consistency reliability was demonstrated (alpha = .90 to .94 for total instrument). Test-retest reliability ranged from .69 to .79 for total scores and .30 to .79 for categories of support. Measures of concurrent validity with the Personal Resource Questionnaire 85 were .42 and .48 at 6 and 8 weeks postpartum. Confirmatory factor analysis using LISREL 7 supported the four categories of support, but the use of these factors separately remains to be demonstrated.

Hospice volunteers: the impact of personality characteristics on retention and job performance.

Volunteerism is the backbone of the American hospice movement. Considering the importance of continued dependence on hospice volunteers, volunteer coordinators and administrators will need to ident...

Adapting and Testing Telephone Based Depression Care Management Intervention for Adolescent Mothers

This phase 1 clinical trial combined qualitative and quantitative methods to modify a collaborative care, telephone-based, depression care management intervention for adolescent mothers and to determine the acceptability, feasibility, and initial efficacy of the intervention in a sample of adolescent mothers (n = 97) who were recruited from a Teen Parent Program. Outcomes included measures of depressive symptoms, functioning, and use of mental health services. Acceptability of the intervention was demonstrated, but feasibility issues related to the complex life challenges confronting the adolescent mother. Although only four adolescent mothers received mental health treatment, there was a trend for improved depressive symptoms over time. Results of the study provide data for the need of further refinement of the intervention before a large clinical trial is conducted for adolescent mothers with symptoms of depression.

Validation of Edinburgh postnatal depression scale for adolescent mothers

The Edinburgh Postnatal Depression Scale has widespread use internationally with adult women, but few psychometric properties have been described for samples of adolescent mothers. The purpose of this paper is to validate the psychometric properties of the EPDS in a sample of adolescent mothers (n = 149) in a southern, urban area of the United States. Internal consistency reliability was .88. Principal components analysis supported a two factor structure accounting for 60% of variance. Results of item response theory analysis suggest that the EPDS and the Center for Epidemiologic Studies of Depression Scale have similar psychometric properties. This data can be used to provide evidence of construct validity of the EPDS. The study provides a foundation for further psychometric testing of the instrument.

Intention to Seek Depression Treatment in Adolescent Mothers and a Comparison Group of Adolescent Girls

The aims of the study were (a) to determine the efficacy of the theory of reasoned action in predicting intention to seek depression treatment in adolescent mothers (n = 64) and a comparison group of adolescent girls (n = 65) and (b) to explore the role of empirically suggested variables (e.g., social support and current symptoms of depression) in increasing the explanatory power of the model. Findings between the two groups differed. Subjective norms, but not attitude, was a significant predictor of intention to seek depression treatment in adolescent mothers (F = 4.82, P = .00; R(2) = .14). In the comparison group of adolescent girls, both attitude and subjective norms predicted intention to seek depression treatment (F = 8.56, P = .00, R(2) = .22). The addition of depressive symptoms and social support increased the explanatory power of the model in the comparison group of adolescent girls (R(2) change = 0.10, P = .02) but resulted in the deletion of subjective norms from the regression equation. Implications for further research and practice are discussed.

Authoritarianism and Attitudes Toward Mental Health Services

Right-wing authoritarians have been shown to resist change and to demonstrate hostility toward out-groups and social movements that may advocate change from traditional and conventional beliefs. Using data from the Louisville Metropolitan Survey, an omnibus survey of 771 adults interviewed by telephone, the authors investigated the relationship between right-wing authoritarianism (RWA) and attitudes toward mental health services. The findings of the bivariate and regression analyses indicated that high scorers on a version of B. Altemeyers (1988) RWA index were more likely to hold negative attitudes on mental health services. In particular, the Submissive Authoritarianism scale predicted negative attitudes toward mental health services; however, scores on the Conventionality subscale were not related to attitudes toward mental health services.

Life satisfaction and age concentration of the local area.

Data from a community sample of persons 60 years old and older were analyzed to determine if the concentration of older persons in the local area (operationally defined as census tracts) was related to the respondents life satisfaction after controlling for the known effects of physical health, socio-economic status, social participation, and other microlevel variables. Results showed that the effect of age concentration is negative, but that this effect differs according to the frequency with which a respondent visits a close friend who lives outside the neighborhood and the number of voluntary associations to which the respondent belongs. The more frequently respondents visited outside the neighborhood, the greater the negative effect of age concentration. On the other hand, the more voluntary association memberships respondents had, the smaller the negative effect of age concentration.

Research Note: Social Resources and Frequency of Drug Use as Predictors of Male Admissions to Treatment Programs: A Proposed Model

Comparing males admitted to treatment for drug use in 1976 with a sample of users, never treated, both first and repeat admissions are found to be dependent on the frequency of use and a persons social resources. Adjusting for differences in the frequency of consumption, single males were treated more often than the married, and men of lower occupational and educational attainment were admitted in greater proportions than were men of higher status. Social resources not only have significant main effects but they interact among themselves and with consumption frequency to influence admission probabilities.