Psychosocial Stressors among Depressed Adolescent Mothers

Article excerpt

Depression is a major problem for adolescent mothers. In a recent study on postpartum depression, mother's age was necessarily covaried as a result of the disproportionate number of adolescent mothers in a sample of randomly recruited depressed mothers (Field et al., 1988). Early sexual activity, pregnancy, childbirth, and motherhood exemplify stressful situations that may trigger or exacerbate depression. Limited educational and financial resources, single parenthood, and lack of social support networks may also relate to adolescent depression. In turn, the infants of adolescent mothers are more likely to have cognitive, emotional, and physical problems (Baldwin & Cain, 1980; Field, Widmayer, Stringer, & Ignatoff, 1980; Furstenburg, Brooks-Gunn, & Chase-Lansdale, 1989). Further the various combinations of psychosocial stressors may predispose some adolescents to poorer functioning than others (Donovan & Jessor, 1985; Ensminger, 1990).

The problem of identifying depressed adolescent mothers for early intervention underscores the importance of using screening instruments to determine the particular profile of problems experienced.

Assessing adolescent psychosocial stressors requires a measure that takes into account several of life's activities. To aid in the assessment and referral of adolescent problem behavior, the National Institute on Drug Abuse developed a questionnaire called The Problem Oriented Screening Instrument for Teenagers (POSIT) (1987). The POSIT is comprised of 139 items addressing various problem areas. The items are summarized by a total score and grouped into 10 target problem areas relevant to adolescent life experiences: substance use/abuse, physical health, mental health, family relations, peer relations, educational status, vocational status, social skills, leisure and recreation, and aggressive behavior/delinquency. This instrument was selected because of its comprehensive nature and because depressed adolescent mothers in particular have problems in these areas. For example, the use of drugs and alcohol is problematic because depressed adolescents (including those who are pregnant) may use them as self-medication for their depression (Adams & Adams, 1991; Zuckerman, Amaro, Bauchner, & Cabral, 1989). Depression also contributes to problem behaviors such as drinking, early sexual activity, and subsequent pregnancy.

High intercorrelations have been found between alcohol and marijuana use and sexual intercourse among adolescents (Jessor & Jessor, 1977). In another study, juvenile offenses involving formal contact with the authorities were correlated with pregnancy; in addition, offenders were likely to mate with other offenders (Elster, Lamb, Peters, Kahn, & Tavare, 1987).

In a recent study, Ensminger (1990) assessed four patterns of behavior among adolescent males and females (N = 705): no problem behaviors; sexual activity; substance abuse; and assaults. The findings showed that behavior problems were intercorrelated. In fact, there were no cases in which adolescents were involved in assaultive behavior and substance abuse, but not sexual activity. There were, however, cases in which sexual activity occurred alone. For females classified as having sexual activity only, sexual activity was associated with the girls having been parented by adolescent mothers with little education. Ensminger (1990) cautioned that a variety of factors were not considered in the study which are likely to contribute to early sexual activity and pregnancy, such as disturbed family relations and social isolation.

Family structure and social support problems are the two most commonly addressed psychosocial stressors related to adolescent pregnancy. Of these, level of parental education, socioeconomic status, and family constellation are among the most frequently examined. Adolescent mothers are more likely to come from disadvantaged socioeconomic backgrounds (Barnett, Papini, & Gbur, 1991; Haggstrom, Kanouse, & Morrison, 1987; Hofferth, 1984); further, families of adolescent mothers are also less likely to encourage educational or vocational goals. …