Validation of alternative indicators of social support in perinatal outcomes research using quality of the partner relationship

Abstract

Aim This paper suggests and tests alternatives to the current research and clinical practice of assuming that married or partnered status is a proxy for positive social support. Background Having a partner is assumed to relate to better health status via the intermediary process of social support. However, women’s health research indicates that having a partner is not always associated with positive social support. Design An exploratory post hoc analysis focused on posttraumatic stress and childbearing was conducted using a large perinatal database from 2005–2009. Methods To operationalize partner relationship, four variables were analyzed: partner (‘yes’ or ‘no’), intimate partner violence (‘yes’ or ‘no’), the combination of those two factors, and the woman’s appraisal of the quality of her partner relationship via a single item. Construct validity of these four alternative variables was assessed in relation to appraisal of the partner’s social support in labor and the postpartum using linear regression standardized betas and adjusted R-squares. Predictive validity was assessed using unadjusted and adjusted linear regression modeling. Results Four groups were compared. Married abused women differed most from married, not abused women in relation to the social support and depression outcomes used for validity checks. The variable representing the women’s appraisal of their partner relationship explains the most variance in predicting depression scores. Conclusions Our results support the validity of operationalizing the impact of the partner relationship on outcomes by using a combination of partnered status and abuse status or using a subjective rating of quality of the partner relationship.

Modifiable partner factors associated with perinatal depression and anxiety: A systematic review and meta-analysis

“…"Partner" refers to someone with whom the individual shares an intimate relationship, including de facto and samesex partners (Kruse et al, 2012). This information will facilitate the development of universal prevention programs for perinatal depression and anxiety which include partner support as a target, and inform future research by establishing which aspects of partner support warrant further investigation.…”

“…Although the prevailing theoretical models of social support distinguish between emotional, instrumental, and informational support (Kruse et al, 2013;Salonen et al, 2010), informational support remains understudied. Research shows that men see their partners as their primary source of pregnancyrelated information (Forsyth et al, 2011).…”

Biological and Psychosocial Predictors of Postpartum Depression: Systematic Review and Call for Integration

“…The majority of studies on perceived partner support found significant protective effects (#75–78, 112, 142, 155, 161, 164; but see #108, 205). Received partner support (Fagan & Lee 2010, Leung et al 2005), satisfaction with partner support (Boyce 2003, Husain et al 2012, Iles et al 2011, Kruse et al 2013, Sheng et al 2010), and unmet partner support expectations during the transition to parenting (Gremigni et al 2011) have also been consistently associated with increased PPD risk. Additionally, effective partner support during pregnancy was protective against increases in depressive symptoms from pregnancy to post partum in a diverse sample (Tanner Stapleton et al 2012).…”

“…Findings are mixed for the influence of partner relationship satisfaction during pregnancy on PPD symptoms. Four large studies (Escribà-Agüir & Artazcoz 2011, Kruse et al 2013, Ramchandani et al 2009, Siu et al 2012) found that greater relationship satisfaction predicted fewer PPD symptoms, after adjusting for demographic and psychosocial covariates. Also, low partner satisfaction in the third trimester has been linked to PPD at 6 to 8 months post partum (Mehta et al 2012).…”

Trauma and Sexual Risk: Do Men and Women Veterans Differ?

“…In other groups (men who have sex with men and people using illicit drugs), social support does not play a protective role (Qioa, & Stanton, 2014). Being married or in a partnered relationship is often used as a proxy for social support (Kruse, Seng, & Kane Low, 2013) and as such has been considered a protective factor against risky sexual behavior (Santelli, Brener, Lowry, Bhatt, & Zabin, 1998). However, being in a partnered relationship without an appraisal of quality is not a reliable indicator of support, given that a domestic partner may exert either a positive or negative influence (Kruse et al, 2013).…”