Social Support Buffers the Effects of Prenatal Depressed Mood: A Mixed-Methods Study
Crystal Modde Epstein1, Michael J Rice2, Jeffrey A French3
1Crystal Modde Epstein, PhD, RN, PMHNP-BC, University of Nebraska Medical Center, Omaha, NE, USA; University of North Carolina Greensboro, NC, USA.
Journal of the American Psychiatric Nurses Association
|January 27, 2022
Summary
Social support coping helps regulate cortisol rhythms in depressed pregnant women, buffering physiological stress. Social context significantly impacts women's access to and use of this vital coping mechanism.
Area of Science:
- Psychology
- Endocrinology
- Sociology
Background:
- Women employ diverse coping strategies influenced by life-course social contexts, impacting depression's physiological effects.
- Understanding these strategies is crucial as they can either alleviate or worsen depression-related physiological responses.
Purpose of the Study:
- To investigate if coping strategies (active, disengaged, social support) moderate depression-related diurnal cortisol dysregulation.
- To explore the influence of social context on women's utilization of coping mechanisms.
Main Methods:
- A mixed-methods study involving 65 pregnant women during mid-pregnancy.
- Salivary cortisol was measured throughout the day; participants completed depression and coping strategy assessments.
- Qualitative interviews were conducted with a subset (n=20) to explore social context influences.
Main Results:
- Social support coping, unlike active or disengaged coping, moderated end-of-day cortisol levels.
- In depressed women, increased social support correlated with lower and more dynamic diurnal cortisol patterns.
- Qualitative data revealed how financial insecurity, lack of mutuality, and social identity affected social support access and use.
Conclusions:
- Findings support the stress-buffering hypothesis of social support.
- Further research should examine social determinants of social support access and early life influences on coping strategy development.
- Relationship-centered nursing care is highlighted as valuable for depressed women.
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