Postpartum Perceived Stress Explains the Association between Perceived Social Support and Depressive Symptoms

  • Krista S. Leonard
    Affiliations
    Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
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  • M. Blair Evans
    Affiliations
    Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
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  • Kristen H. Kjerulff
    Affiliations
    Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania

    Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania
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  • Danielle Symons Downs
    Correspondence
    Correspondence to: Danielle Symons Downs, PhD, Professor of Kinesiology and Obstetrics and Gynecology, Department of Kinesiology, The Pennsylvania State University, 266 Recreation Building, University Park, PA 16802-5701. Phone: (814) 863-0456; fax: 814-865-1275.
    Affiliations
    Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania

    Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania
    Search for articles by this author

      Abstract

      Background

      Limited research has focused on longitudinal interrelations between perceived social support, perceived stress, and depressive symptoms beyond the first postpartum months. This study tested an alternative primary hypothesis within the stress process model examining whether perceived stress mediated the association between perceived social support and depressive symptoms from 1 to 24 months postpartum. Secondary purposes examined whether these factors 1) changed from 1 to 24 months postpartum and 2) predicted depressive symptoms.

      Methods

      Women ( N = 1,316) in a longitudinal cohort study completed validated measures of perceived social support, perceived stress, and depressive symptoms at 1, 6, 12, 18, and 24 months postpartum via telephone interviews. Analyses examined changes in psychosocial factors (repeated measures analysis of variance) and the extent to which perceived social support and perceived stress predicted depressive symptoms and supported mediation (linear regression).

      Results

      Perceived social support decreased, perceived stress increased, and depressive symptoms remained constant from 1 to 18 months, then increased at 24 months. Low perceived social support predicted 6-month depressive symptoms, whereas perceived stress predicted depressive symptoms at all time points. Perceived stress mediated the association between perceived social support and depressive symptoms across 24 months such that low perceived social support predicted perceived stress, which in turn predicted depressive symptoms.

      Conclusions

      Intervention scientists may want to focus on strengthening perceived social support as a means to manage perceived stress in an effort to prevent a long-term trajectory of depression.
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      Biography

      Krista S. Leonard, MS, is a doctoral student in the Department of Kinesiology at Penn State. She studies predictors of postpartum depression and behavioral strategies (physical activity, healthy eating, self-regulation) to help manage weight gain during pregnancy.

      Biography

      M. Blair Evans, PhD, is an Assistant Professor in the Kinesiology Department at Penn State University. Blair's interest in groups relates to how social relationships shape the behavior and wellbeing of individuals in varying populations, especially the relationships among peers in small groups.

      Biography

      Kristen H. Kjerulff, MA, PhD, is Professor, Departments of Public Health Sciences and Obstetrics and Gynecology, Penn State University, College of Medicine. She studies maternity/reproductive health care and common treatments and procedures. She was Principal Investigator of the First Baby Study.

      Biography

      Danielle Symons Downs, PhD, is a Professor of Kinesiology and Obstetrics/Gynecology and Director of the Exercise Psychology Laboratory at Penn State. She is an expert in women's health, motivation, and designing effective health behavior change interventions (exercise, weight) in women before/during/after pregnancy.