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Prevention of Depression in
Low-Income Single Mothers
Ann Peden, D.S.N.,
Principal Investigator;
Lynne Hall, Dr.P.H.,
Co-Principal Investigator;
Mary Kay Rayens, Ph.D.,
Co-investigator
Funded by the National
Institute of Nursing Research, National Institutes of
Health
Grant #1 R01 NR05065-01
(2000-2004)
Abstract
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The ultimate goal of this program of research is to decrease
the incidence of clinical depression in high risk
individuals through prevention intervention. Low-income,
single mothers are at high risk for depression, which may
have negative effects on their children.
The specific aim of this
randomized controlled prevention trial is to test the
effects of cognitive-behavioral intervention designed to
reduce negative thoughts, chronic stress, and depressive
symptoms and increase self-esteem of low-income single
mothers experiencing subclinical depressive symptoms. In
addition, the effects of the intervention on
mothers' reports of behavioral problems of their 2- to 6-year-old
children will be tested. While cognitive-behavioral
interventions with depressed individuals have been used
extensively, the effects of affirmations and thought
stopping techniques in reducing the risk of depression have
not been tested empirically.
A sample of 550 single mothers at
least 18 years of age will be recruited for the
cross-sectional phase of this study. Inclusion and exclusion
criteria are: (1) no prior treatment for psychiatric illness
and no previous psychiatric care; (2) not now or ever on
antidepressants; (3) never diagnosed with clinical
depression; (4) not suicidal; (5) never married, separated
at least six months, or divorced; (6) at least one child 2 to
6 years of age living with the mother; (7) no child under age
2; (8) not pregnant (by self-report); (9) not
currently in counseling; (10) at or below 185 percent of
federal poverty level guidelines by family size. Baseline data on
depressive symptoms, negative thoughts, self-esteem, chronic
stressors, and mothers' reports of child behavior will be
collected from all women. Recruitment will continue until
160 women with a Beck Depression Inventory score between 9
and 35 and/or a Center of Epidemiologic Studies--Depression
Scale score between 16 and 40 are identified and agree to
participate in the clinical trial. As women are recruited
for the intervention phase, each will be randomly assigned
to the control or experimental condition. The
intervention consists of six one-hour weekly group sessions
that target identification and management of negative
thinking as it affects depressive symptoms. Thought stopping
(Meichenbaum, 1977) and the use of affirmations (positive
self-talk) (Gordon & Tobin, 1991) are the primary
techniques that are taught. Experimental and control
subjects will be reinterviewed at one month, six months and
twelve months post-intervention to assess their negative
thinking, depressive symptoms, self-esteem, and chronic
stressors and to obtain reports of their children's
behavior.
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