In the United States, more than 10% of mothers, or 8.5 million, live in poverty, placing the mothers in conditions of chronic situational stress. Low income mothers are exposed to chronic situational stress, due in part to the economic hardship and additional stressors associated with the responsibilities of motherhood. Exposure to economic hardship is associated with higher reports of pain, fatigue, sleep disturbance, depressed mood, and cognitive dysfunction, known as the psychoneurological symptoms. These symptoms can significantly impair a mother by interfering with her ability to function and mother. Compromises to a mother's functioning places her children at higher lifetime risks of impaired cognitive and emotional development; infants and toddlers are the most vulnerable to these consequences. To date, attempts to intervene on situational stress-related symptoms in low income mothers have focused on depressive symptoms. These interventions have met with varied levels of efficacy. The limited efficacy may be because interventions addressing depressive symptoms do not include pain, which is experienced by 50% of low income mothers. An alternative and novel approach is to reconceptualize the stress-related symptoms as psychoneurological symptoms in order to consider underlying biological mechanisms that could be targeted by interventions. The proposed study will describe psychoneurological symptoms in a sample of low income mothers under chronic situational stress and determine the associations of the symptoms with situational stress and with maternal and child outcomes. This study will be a secondary analysis of data from 356 low income mothers and will combine the data from two parent studies conducted at the University of North Carolina at Chapel Hill. The proposed study will analyze key variables of situational stress, psychoneurological symptoms, maternal functioning, and child behavior and development. The project has three aims: to describe the intensity of the psychoneurological symptoms by comparing a simple, data-nave approach (composite score) against a complex, innovative data-driven approach (reduced rank regression); to use multiple regression analyses to explore how variations in levels of chronic situational stress are associated with intensity of psychoneurological symptoms; and to use multiple regression analyses to determine the relationship of psychoneurological symptoms to mother's functional status (physical functioning, social functioning, role functioning, mothering) and child behavioral and developmental status. This study addresses NINR's Innovative Questions in Symptom Science concerning the impact of adverse symptoms across diverse populations by researching the behavioral dynamics of symptoms (1-1) and how lifestyle factors and environmental conditions impact symptoms (1-3). The findings from this study will be the first step towards determining personalized biomarkers of psychoneurological symptoms and, eventually, developing targeted symptom management interventions to improve quality of life for the mothers.
This project will link symptoms (pain, fatigue, sleep disturbance, depressed mood, and cognitive dysfunction) that are often experienced by low income mothers to the high levels of stress in their lives and describe the impact of those symptoms on their functioning and the health of their children. Positive outcomes of the project will support future identification of what causes these symptoms biologically and, ultimately, lead to the development of strategies to help low income mothers better manage their symptoms.
| Salomon, Rebecca E; Salomon, Alison D; Beeber, Linda S (2018) Green Care as Psychosocial Intervention for Depressive Symptoms: What Might Be the Key Ingredients? J Am Psychiatr Nurses Assoc 24:199-208 |
