Date of Award

2019

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Psychology

Specialization

Behavioral Sciences

Department

Psychology

First Advisor

Joseph Rossi

Abstract

Anxiety and depressive symptoms were investigated using the Edinburgh Postpartum Depression Scale (EPDS) in a convenience sample of 371 mothers who were referred to a maternal mentoring program for mothers with, or at risk for, postpartum depression. Social support is considered a protective factor for postpartum mothers at risk for depression but there is less research about the connection between postpartum anxiety and social support.

A factor analysis of the EPDS provided evidence of a two-factor correlated model with a three-item anxiety subscale and six-item depression subscale. Comparisons, using chi-square tests, were done of risk factors, associated with postpartum depression and anxiety to determine if the three-item anxiety subscale could be used to identify mothers at risk for PPD and anxiety. The risk factors assessed were history of mental health problems, pregnancy health problems and education level. MANOVA and MANCOVA procedures were conducted to determine if levels of family social support were different based on the mother’s classification as above or below cutoffs when using the three-item cutoff versus the cutoffs for ten-item, nine-item or six-item EPDS scales.

Using the six-item cutoff resulted in better construct validity than the three-item, nine-item or the 10-item scale. Mothers identified as above the cutoff for the six-item scale were more likely to have a history of postpartum depression and depression in pregnancy than mothers below the cutoff. The cutoffs for the six-item depression scale demonstrated statistically significant differences in family social support. Pairwise comparisons showed that mothers with high anxiety and low depression reported greater levels of family social support and spouse support in comparison to mothers with both high anxiety and high depression. In this sample, the three-item anxiety subscale was not a better predictor of risk factors associated with postpartum depression and anxiety. A nine-item two-factor scale was an improvement over the original 10-item and three-item scales.

Further refinement of the EPDS subscale of anxiety and refinement of the family social support scale would help to answer existing questions. Further research related to the correlates of anxiety would be beneficial in order to demonstrate construct validity of the anxiety portion of the EPDS. The constructs related to anxiety such as excessive reassurance-seeking and perception of control during childbirth may be promising lines of research. The family social support scale needs refinement in multiple areas. The subscales of family support, social groups, and professional support have low Cronbach’s alphas .609, .602, and .632 respectively. Improvement of the internal consistency of the scale will help with the validity of the scale. This will help with the predictive validity as well. Support from different family members, spouse/partner versus own parents, may have different benefits for mothers.

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