Analysis

Analysis of Intervention on Stressed Pregnant

Women’s Social Networks

Robert C Drugan, Ph.D.

David H Townson, Ph.D.

Department of Psychology

Department of Animal & Nutritional Sciences

University of New Hampshire, Durham NH

Department of Occupational Therapy

Amy Ma, OTS

Barbara Prudhomme White, Ph.D.

Intervention Group (N = 6):•Self-designed and meaningful stress management package, including their choice of 1-2 funded activities each week such as massage, hair/nail care, yoga, and gym membership. •Weekly phone calls and/or e-mails asking about mothers’ weeks, including any cigarette/alcohol/drug use.•Submission of weekly journals reflecting upon their week.•MP3 players to record and listen to self-affirmations weekly.

Control Group (N = 7):•Weekly phone calls and/or e-mails asking about mothers’ weeks, including any cigarette/alcohol/drug use.•Weekly submission of journals reflecting upon the past two weeks.•No funded interventions, no self-affirmation tasks.

IntroductionThe literature suggests that environmental events and psychological stress can affect the developing fetus (2, 6). While stress itself is adaptive, chronic stress is problematic for health. Developing research also supports the influence of social supports on maternal stress (4). Knowledge of how behavioral and social factors affect maternal stress may help pregnant women optimally manage their mental health throughout pregnancy and inform potential interventions.

Study Purpose:To explore whether stress management interventions that were self-designed based on interests, and thus occupational-based, could reduce stress perception and enhance social relationship quality in pregnant women.

•Psychometric behavioral data was coded and analyzed. •Group comparisons were done on PSS, STAI, LOT-R ratios and social supports using nonparametric inferential statistics. •Questions were collapsed across measures to create summary variables that were graphed for trend analysis.•Narrative data were used in the analysis as possible explanations to statements and answers in the questionnaires.

MethodsThis study used data from an unpublished 2008 study by Dr. White and colleagues.

•Thirteen white women between 18-31 years of age, recruited from NH through prenatal healthcare providers.•All scored 1.5 standard deviations above mean on PSS (1) and STAI (7).•One participant was married, 10 had partners and two were single parents. •4 participants were expecting their first child. All were heterosexual couples.•Participants were randomly placed in either control or the intervention group.

Participants submitted questionnaires each trimester made up of various assessment tools:•The Perceived Stress Scale (PSS; 1)•The State-Trait Anxiety Inventory (STAI; 7)•Perceived Health Scale•The Life Orientation Test-Revised (LOT-R;5)•The Norbeck Social Support Questionnaire (NSSQ; 3)•The Edinburgh Depression Scale

Optimism/Pessimism Ratio • Developed by dividing LOT-R Optimism Score by LOT-R Pessimism Score to

create a ratio• The higher the value, the more optimistic the mother was feeling relative to

pessimism.Social Network Score

• Developed by summing the NSSQ scores of women’s self-identified top three social supports.

• If the woman’s partner was in the top three, his score was doubled before being added to the other scores.

Participants

Measures

Intervention

Intervention Group: Variable trends over the pregnancy by individual case

Control Group: Variable trends over the pregnancy by individual case

Control Group (n=4-7)

Intervention Group (n=4-6)

Significance

Perceived Stress Scale 27.20(4.43) 19(6.16) p = .034*

State-Trait Anxiety State: 60 (8.33)Trait: 55( 10)

State: 43.83 (9.32)Trait: 40.60 (8.11)

p = .017*p = .015*

Contact InformationB. Prudhomme White, Department of Occupational Therapy, University of New Hampshire, Durham NH 03824

Acknowledgements

References1. Cohen, S; Kamarck, T., & Memmelstein, R. (1983). Global measure of perceived

stress. Journal of Health and Social Behavior 24, 386-396.

2. Glover, V. (1997). Maternal stress or anxiety in pregnancy and emotional development of the child. British Journal of Psychiatry, 171, 105-106.

3. Norbeck, J. S. (1995). Scoring Instructions for the Norbeck Social Support Questionnaire (NSSQ), revised 1995. Unpublished manual available online through the UCSF School of Nursing website: www.nurseweb.ucsf.edu

4. Rini, C., Schetter, C., Hobel, C. J., Glynn, L. M., & Sandman, C. A. (2006). Effective social support: Antecedents and consequences of partner support during pregnancy. Personal Relationships, 13, 207-229. doi:10.1111/j.1475-6811.2006.00114.x

5. Scheier, M. F., Carver, C. S., & Bridges, M. W. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A re-evaluation of the Life Orientation Test. Journal of Personality and Social Psychology, 67, 1063-1078.

6. Schneider, M. L., Moore, C. F., & Kraemer, G. W. (2003). On the relevance of prenatal stress to developmental psychopathology: A primate model. In D. Cicchetti & E. Walker (Eds.), Neurodevelopmental mechanisms in psychopathology (pp. 155-186). New York, NY: Cambridge University Press.

7. Spielberger, C.D. (1977). State-Trait Inventory for Adults. Redwood City, CA: Mind Garden.

•Sincere thanks to the women who participated and to those who supported them.•Thank-you to UNH for a Presidential Excellence Research Award; to the Carsey Institute at UNH; and to Mary Schneider at the University of Wisconsin, Madison, WI.•Thank-you to the UNH Hamel Center & McNair Graduate Opportunity Program.•Thank-you to K.E. Vroman for inspiration in poster design.•Artwork courtesy of Barbara Getrost: info@pregnantearth.com.

ResultsThere were no significant group differences between Social Network scores & Optimism/Pessimism Ratios for any of the time periods.  However there were significant group differences between PSS & STAI scores within time period 2.  The intervention group showed lowered PSS & STAI scores than the control group.In addition, both groups displayed a trend of lower stress and anxiety perceptions on these two measures over the entire pregnancy.

Variable trend charts revealed no discernible patterns on the measures that differed between both groups. Both groups showed some modest variability in the measures across pregnancy, or they remained relatively stable.

Time period 1: up to 12 weeks gestation Time period 2: from 13-27 weeks Time period 3: from 28 weeks to delivery Time period 4: 2-3 months after delivery