No abstract

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.

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.

The hypothesis that overall satisfaction with life is influenced by one's financial situation vis-a-vis significant others was tested. Respondents compared themselves financially to the relative, friend, and neighbor to whom they felt closest. Data from a 1980 community survey of persons 60 years of age and older showed that the better off financially respondents perceived themselves to be compared with the relative to whom they felt closest, the greater the life satisfaction. This effect was independent of functional health, age, sex, race, marital status, education, income, household size, and social participation. These findings suggest that life satisfaction reflects not only one's location in the broader stratification system but also one's location in a rather limited network of significant others.

Importance of support is a better predictor of outcomes than how much support a woman receives. Communication of need for support and establishing boundaries with family members are recommended.