Research paperPsychosocial factors associated with symptoms of depression, anxiety and stress among single mothers with young children: A population-based study
Section snippets
Background
The trend of single parent households has increased substantially over the past few decades and is anticipated to rise (OECD, 2011). Approximately 20% of German families in 2013 with a dependent child were headed by a single parent compared to 14% in 1996, and over 90% of such households are fronted by mothers (Statistisches Bundesamt, 2013). Similar trends are also found in other neighbouring countries such as the United Kingdom and Scandinavia (Chzhen and Bradshaw, 2012). Poorer health
Data collection and study sample
Our analyses are based on the data from the 2015 German National Psychosocial Burdens Prevalence Study in Early Childhood, Children in Germany (KiD 0–3). This large cross-sectional study covers various dimensions of psychosocial risks among families with young children including family structure, child behaviour and indicators of parental mental health. It is regarded as the first nationally representative study for family psychosocial burdens, particularly for capturing at-risk subgroups and
Study sample and characteristics
A higher proportion of single mothers were observed to be younger and not employed while a smaller proportion were highly educated compared to partnered counterparts (Table 1). Newborns (≤12 months) appeared as the predominant child age group, particularly among partnered mothers (63.0% vs. 52.1%, p < 0.001). As for social-structural factors, approximately 70% of single mothers with young children declared receipt of welfare benefits and 84.6% earned a net equivalised income of <1000 Euros per
Discussion
In this study, an alarming majority of those living under great adversity were single mothers with young children. This particular parent sub-group reported over twice the rate of depressive and anxiety symptoms than when parenting duties were shared, corresponding to trends found in other countries (Cairney et al., 2006, Kong et al., 2017, Targosz et al., 2003, Tobias et al., 2009). Our findings also compare well to findings from Germany, despite those being largely based on single mothers in
Limitations
There are limitations to this study. First, the observational study design does not allow a causal relationship between single parenthood and mental health outcomes to be established. Second, this study did not collect information on previous diagnoses of depression and anxiety among participants, which would aid in differentiating history of depression prior to or during early parenthood particularly for parenting stress. The utilisation of mental health screening tools, although validated,
Conclusions
Overall, despite growing awareness of mental health issues, single mothers with young children are at greater disadvantage during early parenthood compared to partnered mothers, which add to greater risks of poorer mental health. Our findings imply that the relevant risks for mental health disorders and stresses are exacerbated by lack of perceived social support, history of any maltreatment and exposure to financial hardship, which are either exacerbated by the greater demands of caring for a
Funding
This study was publicly supported by the Federal Association of Paediatricians and the Federal Ministry of Family Affairs, Senior Citizens, Women and Youth (BMFSFJ). The research conducted by the corresponding author was supported with a guest student scholarship from the German Youth Institute(DJI, e.V.) in Munich.
Conflict of interests
The authors declare that they have no conflict of interests.
Contributors
L.A.L. conceptualised the research paper, conducted literature review, conducted data analyses, interpreted the data and compiled the manuscript.
U.B. contributed to the data analyses planning, supervised the data analyses and interpretation of findings, provided feedback on the manuscript and provided additional literature.
C.B. was part of the team that designed and conducted the KiD 0-3 study, supervised the data analyses and interpretation of findings, contributed to the manuscript and
Acknowledgements
The national KiD 0–3 study was conducted by the National Centre for Early Prevention (NZFH), a joint collaboration between the DJI and German Federal Centre for Health Education (BZgA). A note of appreciation is dedicated to the KiD 0–3 team at the DJI in Munich, particularly Andreas Eickhorst, Andrea Schreier, Katrin Lang and Christoph Liel for their help and support.
Ethics approval and consent
The KID 0-3 pilot study, testing whether recruitment of parents for survey research during routine infant screening appointments was feasible, was reviewed favourably by the Ärztekammer Nordrhein ethics board (ref 2013247). Additional ethical approval for the national KiD 0-3 study was not deemed necessary as it was designed as a survey research project which followed national ADM (Arbeitskreis Deutscher Markt- und Sozialforschungsinstitute e.V.) guidelines and no concerns were raised by its
Availability of data and materials
The data that support the findings of this study are available from the German Youth Institute (DJI, e.V.) with permission from the National Centre for Early Prevention (NZFH) but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of the NZFH and the DJI.
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