Contextualized Stress, Global Stress, and Depression in Well-Educated, Pregnant, African-American Women

• Published in: Women's health issues Vol. 22; no. 3; pp. e329 - e336
• Main Authors: Jackson, Fleda Mask, PhD, MS, Rowley, Diane L., MD, MPH, Curry Owens, Tracy, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2012
• Subjects: Adult; African Americans - psychology; Black American people; Childbirth; Children; Cross-Sectional Studies; Depression; Depression - diagnosis; Depression - ethnology; Depression - psychology; Educational Status; Female; Focus Groups; Georgia; Humans; Income; Marital Status; Obstetrics and Gynecology; Personality Inventory; Predictive Value of Tests; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - ethnology; Pregnancy Outcome - ethnology; Pregnant women; Psychiatric Status Rating Scales; Regression Analysis; Severity of Illness Index; Social Environment; Stress; Stress, Psychological - ethnology; Young Adult; Georgia
• ISSN: 1049-3867; 1878-4321
• DOI: 10.1016/j.whi.2012.01.003

Abstract Purpose Well-educated, pregnant, African-American women are disproportionately at risk for adverse birth outcomes and depression linked to stress has been established as a significant contributor to poor birth outcomes. Since racial and gendered stress have been identified as threats to birth outcomes, a cross-sectional study was conducted that utilized the Jackson, Hogue, Phillips Contextualized Stress Measure (JHP), a measurement of racial and gendered stress, and the Perceived Stress Scale (PSS), an assessment of global stress, to detect their associations and predictions for depression as measured by the Beck Depression Inventory II (BDI-II). Method We recruited 101 pregnant, well-educated, African-American women from ob-gyn offices who were administered the JHP, the PSS, and the BDI-II. Correlational, chi-square, and stepwise regression analyses were conducted with the measures and the demographic variables of relationship status, the presence of other children, and annual household income. Findings The results revealed significant linear and covariate associations for the JHP, PSS, and BDI-II. Correspondingly, chi-square analysis found significant associations for the JHP and the BDI-II and the presence of other children, relationship status, and annual household income. Results from the regression models found that the contextualized and global stress measures were both predictive of depression. Demographic characteristics did not predict depression. Conclusion The results argue for prenatal depression and stress screening. Furthermore, the link between contextualized stress and depression alerts health care providers and local communities to be responsive to the particular stressors that pose risks for pregnant African-American women and their babies.