Psychosocial Factors of Antenatal Anxiety and Depression in Pakistan: Is Social Support a Mediator?

Introduction: Pregnancy is generally viewed as a time of fulfillment and joy; however, for many women it can be a stressful event. In South Asia it is associated with cultural stigmas revolving around gender discrimination, abnormal births and genetic abnormalities. It is also associated with several psychiatric problems in women, most notably depression and anxiety. Methodology: This cross-sectional study was done at four teaching hospitals in Lahore from February, 2014 to June, 2014. A total of 500 pregnant women seen at hospital obstetrics and gynecology departments were interviewed with a questionnaire consisting of three sections: demographics, the Hospital Anxiety and Depression Scale (HADS) and the Social Provisions Scale (SPS). All data were analyzed with SPSS v. 20. Descriptive statistics were analyzed for demographic variables. Pearson’s chi-squared test, bivariate correlations and multiple linear regression were used to analyze associations between the independent variables and scores on the HADS and SPS. Results: Mean age among the 500 respondents was 27.41 years (5.65). Anxiety levels in participants were categorized as normal (145 women, 29%), borderline (110, 22%) or anxious (245, 49%). Depression levels were categorized as normal (218 women, 43.6%), borderline (123, 24.6%) or depressed (159, 31.8%). Inferential analysis revealed that higher HADS scores were significantly associated with lower scores on the SPS, rural background, history of harassment, abortion, cesarean delivery and unplanned pregnancies (P < .05). Social support (SPS score) mediated the relationship between the total number of children, gender of previous children and HADS score. Women with more daughters were significantly more likely to score higher on the HADS and lower on the SPS, whereas higher numbers of sons were associated with the opposite trends in the scores (P < .05) Conclusion: Because of the predominantly patriarchal sociocultural context in Pakistan, the predictors of antenatal anxiety and depression may differ from those in developed countries. Rural women and working women had higher levels of antenatal anxiety and depression, which contradicts earlier findings in western countries. Our study found that higher numbers of daughters were associated with higher levels of depression and anxiety, whereas sons had a protective influence. We therefore suggest that interventions designed and implemented to reduce antenatal anxiety and depression should take into account these unique factors operating in developing countries and patriarchal societies.

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Psychosocial determinants of antenatal anxiety and depression in Pakistan: Is social support a mediator?

10.7287/peerj.preprints.463 ◽

2014 ◽

Author(s):

Ahmed Waqas ◽

Nahal Raza ◽

Haneen Wajid Lodhi ◽

Zerwah Muhammad ◽

Mehak Jamal ◽

...

Keyword(s):

Social Support ◽

Gender Discrimination ◽

Rural Women ◽

Depression Scale ◽

Developed Countries ◽

Teaching Hospitals ◽

Anxiety And Depression ◽

Stressful Event ◽

Depression And Anxiety ◽

Antenatal Anxiety

Introduction: Pregnancy is generally viewed as a time of fulfillment and joy; however, for many women it can be a stressful event. In South Asia it is associated with cultural stigmas revolving around gender discrimination, abnormal births and genetic abnormalities. It is also associated with several psychiatric problems in women, most notably depression and anxiety. Methodology: This cross-sectional study was done at four teaching hospitals in Lahore from February, 2014 to June, 2014. A total of 500 pregnant women seen at hospital obstetrics and gynecology departments were interviewed with a questionnaire consisting of three sections: demographics, the Hospital Anxiety and Depression Scale (HADS) and the Social Provisions Scale (SPS). All data were analyzed with SPSS v. 20. Descriptive statistics were analyzed for demographic variables. Pearson’s chi-squared test, bivariate correlations and multiple linear regression were used to analyze associations between the independent variables and scores on the HADS and SPS. Results: Mean age among the 500 respondents was 27.41 years (5.65). Anxiety levels in participants were categorized as normal (145 women, 29%), borderline (110, 22%) or anxious (245, 49%). Depression levels were categorized as normal (218 women, 43.6%), borderline (123, 24.6%) or depressed (159, 31.8%). Inferential analysis revealed that higher HADS scores were significantly associated with lower scores on the SPS, rural background, history of harassment, abortion, cesarean delivery and unplanned pregnancies (P < .05). Social support (SPS score) mediated the relationship between the total number of children, gender of previous children and HADS score. Women with more daughters were significantly more likely to score higher on the HADS and lower on the SPS, whereas higher numbers of sons were associated with the opposite trends in the scores (P < .05) Conclusion: Because of the predominantly patriarchal sociocultural context in Pakistan, the predictors of antenatal anxiety and depression may differ from those in developed countries. Rural women and working women had higher levels of antenatal anxiety and depression, which contradicts earlier findings in western countries. Our study found that higher numbers of daughters were associated with higher levels of depression and anxiety, whereas sons had a protective influence. We therefore suggest that interventions designed and implemented to reduce antenatal anxiety and depression should take into account these unique factors operating in developing countries and patriarchal societies.

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A Systematic Review of the Psychosocial Correlates of Academic Performance Abstract

10.31234/osf.io/frscp ◽

2021 ◽

Author(s):

Richard Tindle ◽

Eid G. Abo Hamza ◽

Ahmed A. Helal ◽

ALaa Eldin A. Ayoub ◽

Ahmed Moustafa

Keyword(s):

Social Support ◽

Systematic Review ◽

Academic Performance ◽

University Students ◽

Psychosocial Factors ◽

Anxiety And Depression ◽

Social Variables ◽

Inclusion Criteria ◽

Factors Affecting ◽

The Relationship

Understanding the psychosocial factors that positively and negatively impact on academic performance are important to help students succeed and persist within higher education. In this article, we conducted a systematic review to clarify and identify the psychosocial factors affecting university students’ academic performance. The initial search returned 1657 articles and 36 articles met the inclusion criteria. Inspection of the articles were conducted to identify the relationship between psychological and social variables on academic performance. We found that psychosocial factors were significantly related to university students’ academic performance. Specifically, academic performance was often correlated with social support, motivation, stress, satisfaction, self-efficacy, anxiety and depression, prior academic achievement, study effort, adjustment, family, and emotions.

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Anxiety and Depression in Cardiac Inherited Disease: Prevalence and Association With Clinical and Psychosocial Factors

Clinical Psychology in Europe ◽

10.32872/cpe.v1i4.38062 ◽

2019 ◽

Vol 1 (4) ◽

Author(s):

Claire E. O'Donovan ◽

Jonathan R. Skinner ◽

Elizabeth Broadbent

Keyword(s):

Social Support ◽

Psychosocial Factors ◽

Disease Severity ◽

Illness Perceptions ◽

Physical Symptoms ◽

Disease Type ◽

Psychological Support ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Time Since Diagnosis

The small number of published studies indicate increased rates of anxiety and depression among patients with cardiac inherited diseases (CID). This study aimed to assess the prevalence of anxiety and depression in a New Zealand CID cohort and seek any associations with clinical and psychosocial factors. Patients on a national CID register were sent a survey; 202 of 563 contactable patients participated (36% response rate). Ages ranged from 16 to 83 years (median 53). Most had Long QT Syndrome (43%) or Hypertrophic Cardiomyopathy (34%). Questionnaires collected demographic and psychological variables, including anxiety (GAD-7), depression (PHQ-9), illness perceptions, perceived risk and social support. The registry supplied clinical and genetic characteristics. 80 participants (42%) reported features of anxiety and/or depression. 24 (13%) reached clinical levels of depression, a greater proportion than that found in the general population. Poorer perceived social support was associated with worse anxiety (p < .001) and depression (p < .001) scores. Reporting more physical symptoms (p = .001) (commonly not caused by the CID) was associated with poorer depression scores and greater perceived consequences of the CID was associated with greater anxiety scores (p < .05). Neither anxiety nor depression were associated with time since diagnosis, disease severity or type of disease. Forty percent of the CID population live with some degree of psychopathology but this did not correlate with disease severity, type of disease nor time since diagnosis. Correlating factors which may be modifiable include illness perceptions, various physical symptoms and social support. Rates of clinical levels of anxiety and depression in this CID sample were 10% and 13% respectively. Anxiety and depression were not associated with disease type, severity or time since diagnosis. Perceived lack of support, consequences, and symptoms were associated with depression and anxiety. High rates of anxiety and depression in CID’s indicate the need for access to psychological support. Rates of clinical levels of anxiety and depression in this CID sample were 10% and 13% respectively. Anxiety and depression were not associated with disease type, severity or time since diagnosis. Perceived lack of support, consequences, and symptoms were associated with depression and anxiety. High rates of anxiety and depression in CID’s indicate the need for access to psychological support.

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Effect of psychosocial factors and heart ate variability on blood pressure control in patient with primary hypertension:A path analysis

European Heart Journal ◽

10.1093/ehjci/ehaa946.3410 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

T.Y Chen ◽

C.W Kao

Keyword(s):

Social Support ◽

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Psychosocial Factors ◽

Direct Effect ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Arterial Blood ◽

Blood Pressures

Abstract Background Hypertension (HTN) is one of the major factors driving the global burden of cardiovascular diseases. About 40% of the adults are affected by elevated blood pressure around the world. The etiology of HTN is multifactorial, including psychological distress, especially symptoms of anxiety and depression. A few meta-analyses and longitudinal studies have reported an association between symptoms of anxiety, depression and HTN. Social support is an important factor in the regulation of emotions in HTN patients. The autonomic nervous system (ANS) plays an important role in the homeostatic control of the cardiovascular system. The measurement of heart rate variability (HRV) is used to evaluate ANS regulation in clinical research.The HRV is also a predictor of cardiovascular-cause events and mortality. Previous studies have identified the association of cardiovascular diseases with social support, anxiety, and depression. Some recent studies have also evaluated the relationship between HRV and cardiovascular diseases. However, very few studies have investigated the association of psychosocial factors, HRV, and blood pressure in patients with HTN. Purpose The purpose of this study was to evaluate the effect of psychosocial factors including social support, symptoms of anxiety/depressive, and heart rate variability on mean arterial blood pressures in patients with primary hypertension. Methods A cross-sectional descriptive and correlative study was performed. Participants were recruited by convenience sampling from the Cardiovascular Outpatient Clinic at a Medical Center. Data were collected using structured questionnaires, including the Social Support and Hospital Anxiety and Depression Scales. While heart rate variability was measured by a handheld limb lead electrocardiogram recorder device, blood pressure was measured by an automatic sphygmomanometer. Data were analyzed by the structural equation path analysis by the IBM SPSS Amos 21.0 statistical software packages. Results This study included 301 patients with primary hypertension. The scores of the Social Support Scale had a significantly direct effect on the scores of Hospital Anxiety and Depression Scale. The Hospital Anxiety and Depression Scale scores had a significantly direct effect on the heart rate variability. The low frequency/ high-frequency ratio of heart rate variability had a significantly direct effect on the mean arterial blood pressures. The path model including all variables explained 45% variance in the mean arterial blood pressures and had good fit indices. Conclusion Findings from our research highlight the significance of how psychosocial factors can affect the autonomic nervous system and blood pressure control of patients with primary hypertension. These findings can aid in developing an intervention program for blood pressure management in future. Funding Acknowledgement Type of funding source: None

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Psycho-social determinants of antenatal anxiety and depression in Pakistan: Is social support a mediator?

10.7287/peerj.preprints.463v2 ◽

2014 ◽

Author(s):

Ahmed Waqas ◽

Nahal Raza ◽

Haneen Wajid Lodhi ◽

Zerwah Muhammad ◽

Mehak Jamal ◽

...

Keyword(s):

Social Support ◽

Gender Discrimination ◽

Rural Women ◽

Depression Scale ◽

Anxiety And Depression ◽

Stressful Event ◽

Depression And Anxiety ◽

Male Progeny ◽

Antenatal Anxiety ◽

Had Scale

Introduction: Pregnancy is generally viewed as a time of fulfillment and joy, however, for many women, it can be a stressful event. In South Asia, it is associated with cultural stigmas revolving around gender discrimination, abnormal births and genetic abnormalities. It is also associated with several psychiatric problems in women, most notably, depression and anxiety. Methodology: This cross sectional study was undertaken in four teaching hospitals in Lahore from February, 2014 to June, 2014. 500 Pregnant women presenting at the outdoors of obstetrics and gynecology department were interviewed. The questionnaire consisted of three sections: Demographics, Hospital anxiety and depression scale and social provision scale. Data was analyzed in SPSS v.20. Descriptive statistics were analyzed for demographics. Pearson Chi Square, Bivariate Correlations and linear regression were run to analyze associations of independent variables with scores on HAD scale and SPS. Results: There were a total of 500 respondents. Mean age of respondents was 27.41 years (5.65). Anxiety levels of participants were categorized as Normal 145 (29%), borderline 110 (22%) and anxious 245 (49%). Depression levels were categorized as 218 (43.6%) normal, 123 (24.6%) borderline, and 159 (31.8%) depressed. Inferential analysis revealed that higher scores on HAD scale were significantly associated with lower scores on social provisions scale (SPS), rural background, history of harassment, abortion, C-sections and unplanned pregnancies (P < .05). Social support also mediated the relationship between gender of previous offspring and scores on HAD scale. Women reporting higher numbers of female children were significantly associated with higher scores on HAD scale and lower on SPS scale. Whereas increasing number of male progeny were associated with low scores on depression subscale (P < .05). Conclusion: Keeping in context the predominantly patriarchal socio-cultural setting, the predictors of antenatal anxiety and depression in Pakistan may differ from those of the developed countries. Rural women and working women showed higher levels of antenatal anxiety and depression, which contradicts studies from western countries. Our study revealed higher number of female progeny was associated with higher levels of depression and anxiety while male progeny had a protective influence. We, therefore, suggest that interventions designed to reduce antenatal anxiety and depression should take these unique factors, operating in developing countries and patriarchal societies, into account in their design and implementation.

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Psycho-social determinants of antenatal anxiety and depression in Pakistan: Is social support a mediator?

10.7287/peerj.preprints.463v1 ◽

2014 ◽

Author(s):

Ahmed Waqas ◽

Nahal Raza ◽

Haneen Wajid Lodhi ◽

Zerwah Muhammad ◽

Mehak Jamal ◽

...

Keyword(s):

Social Support ◽

Gender Discrimination ◽

Rural Women ◽

Depression Scale ◽

Anxiety And Depression ◽

Stressful Event ◽

Depression And Anxiety ◽

Male Progeny ◽

Antenatal Anxiety ◽

Had Scale

Introduction: Pregnancy is generally viewed as a time of fulfillment and joy, however, for many women, it can be a stressful event. In South Asia, it is associated with cultural stigmas revolving around gender discrimination, abnormal births and genetic abnormalities. It is also associated with several psychiatric problems in women, most notably, depression and anxiety. Methodology: This cross sectional study was undertaken in four teaching hospitals in Lahore from February, 2014 to June, 2014. 500 Pregnant women presenting at the outdoors of obstetrics and gynecology department were interviewed. The questionnaire consisted of three sections: Demographics, Hospital anxiety and depression scale and social provision scale. Data was analyzed in SPSS v.20. Descriptive statistics were analyzed for demographics. Pearson Chi Square, Bivariate Correlations and Partial Correlations were run to analyze associations of independent variables with scores on HAD scale and SPS. Results: There were a total of 500 respondents. Mean age of respondents was 27.41 years (5.65). Anxiety levels of participants were categorized as Normal 145 (29%), borderline 110 (22%) and anxious 245 (49%). Depression levels were categorized as 218 (43.6%) normal, 123 (24.6%) borderline, and 159 (31.8%) depressed. Inferential analysis revealed that higher scores on HAD scale were significantly associated with lower scores on SPS, rural background, history of harassment, abortion, C-sections and unplanned pregnancies (P < .05). Social support also mediated the relationship between total numbers of children, gender of previous offspring and scores on HAD and SPS scales. Women reporting higher numbers of female children were significantly associated with higher scores on HAD scale and lower on SPS scale. Whereas increasing number of male progeny were associated with low scores on these scales (P < .05). Conclusion: Keeping in context the predominantly patriarchal socio-cultural setting, the predictors of antenatal anxiety and depression in Pakistan may differ from those of the developed countries. Rural women and working women showed higher levels of antenatal anxiety and depression, which contradicts studies from western countries. Our study revealed higher number of female progeny was associated with higher levels of depression and anxiety while male progeny had a protective influence. We, therefore, suggest that interventions designed to reduce antenatal anxiety and depression should take these unique factors, operating in developing countries and patriarchal societies, into account in their design and implementation.

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Relationship of Sense of Coherence to Other Psychosocial Indices

European Journal of Psychological Assessment ◽

10.1027/1015-5759.20.4.227 ◽

2004 ◽

Vol 20 (4) ◽

pp. 227-236 ◽

Cited By ~ 19

Author(s):

Sara Holmberg ◽

Anders Thelin ◽

Eva-Lena Stiernström

Keyword(s):

Social Support ◽

Psychosocial Factors ◽

Sense Of Coherence ◽

Living Conditions ◽

Strong Negative Correlation ◽

Cross Sectional ◽

Positive Correlation ◽

Work Related ◽

Job Demand ◽

The Mean

Summary: The concept of “sense of coherence” (SOC) has been widely recognized since it was first introduced by Antonovsky. The originality and usefulness of the SOC scale and its relation to other psychosocial measures has been the subject of lively debate. The aim of this paper was to test for associations between SOC and work-related psychosocial factors (mainly the Job Demand-Control model), general living conditions, education, and social network factors. Cross-sectional data from a population-based sample of 1782 rural males from nine counties in Sweden were analyzed with a multiple regression technique. The subjects were occupationally active at inclusion and the mean age was 50 years (range 40-60). SOC was assessed with the original 29-item questionnaire. Psychosocial variables and lifestyle factors were assessed using questionnaires and structured interviews. The mean SOC among the subjects was 152.3 (standard deviation, 19.4). A strong negative correlation was found between SOC and job demand, whereas a positive correlation with job control was demonstrated. A positive correlation with general living conditions and with social support was also found. However, there was no correlation to education and occupation. Thus, SOC was shown to be strongly correlated to work-related psychosocial factors and social support, but independent of sociodemographic factors.

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