Cairney John, Boyle Michael, Offord David R, Racine Yvonne
Health Systems Research & Consulting Unit, Centre for Addiction and Mental Health & the Dept. of Psychiatry University of Toronto, 33 Russell Street, 3rd Floor Tower, Toronto, Ontario, M5S 2S1, Canada.
Soc Psychiatry Psychiatr Epidemiol. 2003 Aug;38(8):442-9. doi: 10.1007/s00127-003-0661-0.
This study examined the effect of stress and social support on the relationship between single-parent status and depression.
A secondary data analysis of the 1994-95 National Population Health Survey was conducted. Single and married mothers who participated in the survey were derived from the general sample (N = 2,921). Logistic regression techniques were used to assess the mediating and moderating effects of stress and social support on the relationship between family structure and depression.
Bivariate analyses showed that, compared to married mothers, single mothers were more likely to have suffered an episode of depression (12-month prevalence), to report higher levels of chronic stress, more recent life events and a greater number of childhood adversities. Single mothers also reported lower levels of perceived social support, social involvement and frequency of contact with friends and family than married mothers. The results of the multivariate analyses showed that, together, stress and social support account for almost 40% of the relationship between single- parent status and depression. We also found a conditional effect of stress on depression by family structure. Life events were more strongly related to depression in married than in single mothers.
A substantial part of the association between single-parent status and depression can be accounted for by differences in exposure to stress and social support. Our results suggest that it is important to examine multiple sources of stress, as exposure to both distal and proximal stressors were higher among single mothers. Limitations and directions for future research are discussed.
本研究探讨了压力和社会支持对单亲家庭状况与抑郁症之间关系的影响。
对1994 - 1995年全国人口健康调查进行二次数据分析。参与调查的单身母亲和已婚母亲来自一般样本（N = 2921）。采用逻辑回归技术评估压力和社会支持对家庭结构与抑郁症之间关系的中介和调节作用。
双变量分析表明，与已婚母亲相比，单身母亲更有可能经历过抑郁症发作（12个月患病率），报告更高水平的慢性压力、更多近期生活事件以及更多童年逆境。单身母亲报告的感知社会支持水平、社会参与度以及与朋友和家人的联系频率也低于已婚母亲。多变量分析结果表明，压力和社会支持共同解释了单亲家庭状况与抑郁症之间近40%的关系。我们还发现压力对抑郁症的影响因家庭结构而异。生活事件与已婚母亲的抑郁症关联比单身母亲更强。
单亲家庭状况与抑郁症之间的关联很大一部分可归因于压力和社会支持方面的差异。我们的结果表明，研究多种压力源很重要，因为单身母亲接触远端和近端压力源的情况都更高。讨论了研究的局限性和未来研究方向。
