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산후우울증 유병률 및 관련요인에 대한 메타연구: 사회적 지지와 양육스트레스를 중심으로

A Meta-Analytic Review of Prevalence of Postpartum Depression and its Related Factors: Social Support and Parenting Stress

김동민|김수임|강민철
한국상담학회 (Korean Counseling Association (KCA))|2012.02|상담학연구 (Korea Journal of Counseling)|제13권 제1호|pp. 149-168|DOI 10.15703/kjc.13.1.201202.149

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키워드

메타분석meta-analysissocial support사회적 지지parenting stress양육스트레스다층모형postpartum depressionmulti-level model산후우울증
주제분류교육학

초록

본 연구는 메타분석을 통하여 산후우울증의 유병률 및 산후우울증과 사회적 지지, 양육스트레스 간의 관계에 대한 국내외 연구 결과들을 종합하고 지금까지의 연구 성과를 확인하는 데 목적이 있다. 이를 위해 설정한 연구문제는 다음과 같다. 1) 산후우울증 유병률 추정치는 국가, 산후우울증 척도, 산후 경과기간에 따라 달라지는가? 2) 산후우울증과 사회적 지지간의 진상관 추정치는 사회적 지지 유형에 따라 달라지는지가? 3) 산후우울증과 양육스트레스 간의 진상관 추정치는 얼마인가? 4) 한 쪽 변인을 통제한 상태에서 사회적 지지 및 양육스트레스가 산후우울증과 갖는 상관의 크기는 얼마나 되는가? 총 52편의 논문을 대상으로 분석한 결과 첫째, 산후우울증 유병률 추정치는 국가와 진단도구에 따라 유의하게 다른 것으로 나타났다. 둘째, 산후우울증과 사회적 지지 간의 상관 정도는 지지 유형에 따라 유의한 차이를 보였다. 셋째, 양육스트레스와 사회적 지지 간의 상관계수에 대한 추정치는 .42였으며, 이러한 추정치는 연구에 따라 차이를 보이지 않았다. 넷째, 사회적 지지를 통제한 상태에서의 양육스트레스와 산후우울증 간의 부분상관계수는 여전히 유의한 수준을 보였으나, 양육스트레스를 통제한 상태에서의 사회적 지지와 산후우울증 간의 부분상관계수는 상당히 적은 수준을 나타냈다. 이와 관련한 시사점 및 추후연구를 위한 제언에 대해 논하였다.

Abstract

The present study summarized the results of domestic and international studies on the prevalence of postpartum depression and relations among postpartum depression, social support, and parenting stress through meta-analysis. Research questions were as follows: 1) Did the estimates for prevalence of postpartum depression vary depending on countries, instruments measuring postpartum depression, and the postpartum period?; 2) did the estimates for the correlation coefficient between postpartum depression and social support vary depending on who provides support?; 3) what was the mean estimate for correlation between postpartum depression and parenting stress?; 4) what were the correlation coefficients between postpartum depression and its related factors, social support and parenting stress, controlling for the effect of the other variable? The results obtained by analysing 52 studies showed that 1) the differences in the estimates for prevalence of postpartum were significant and were explained by the countries and instruments assessing depression; 2) the correlation between postpartum and social support varied depending on who offers support; 3) the grand mean of the estimated correlation coefficients between postpartum depression and parenting stress was .42 and the estimates were consistent across studies; 4) the part correlation between postpartum depression and parenting stress after controlling for the effect of social support was still significant, while the part correlation between postpartum depression and social support controlling for parenting stress was no longer significant. Implications and limitations of the current study are discussed with suggestions for future research.

참고문헌 (68)

  1. 고용남, "독서치료 집단상담 프로그램의 효과에 대한 메타분석", 상담학연구, 12(2), pp.489~504 (2011), 한국상담학회
  2. 권정혜, "심리사회적 요인이 산후우울에 미치는 영향 : 산후우울에 대한 스트레스-취약성모델 검증", 한국심리학회지 : 임상, 16(2), pp.55~66 (1997)
  3. 김지양, "산후 우울감을 예측하는 심리적 요인 연구:사회적지지, 자아존중감, 스트레스를 중심으로", 한국심리학회지: 건강, 13(1), pp.111~140 (2008), 한국건강심리학회
  4. 남궁연옥, "도시지역 일부 산모들의 산후우울과 사회적 지지와의 관련성", 한국모자보건학회지, 11(2), pp.149~161 (2007), 한국모자보건학회
  5. 박성연, "아동과 어머니의 기질 및 어머니의 양육스트레스에 따른 양육행동에 관한 연구", 대한가정학회지, 34(4), pp.203~215 (1996)
  6. 유성경, "집단주의-개인주의 성향과 상담에 대한 태도와의 관계", 한국심리학회지 : 상담 및 심리치료, 12(1), pp.19~32 (2000)
  7. 유애리, "에딘버러 척도를 이용한 산후우울증 위험인자의 평가", 대한주산의학회잡지, 21(1), pp.74~80 (2010), 대한주산의학회
  8. 이정윤, "기혼여성의 부모역할 스트레스와 우울의 관계:부모역할 자긍심의 매개 및 중재효과", 상담학연구, 9(2), pp.339~352 (2008), 한국상담학회
  9. 정명희, "산욕기 산모의 임신시 정서상태, 분만준비도, 산후 사회적 지지도 및 산후 우울감과의 관계연구", 여성건강간호학회지, 11(1), pp.38~45 (2005), 한국여성건강간호학회
  10. 정애경, "진로미결정 및 관련변인에 관한 국내연구 메타분석", 상담학연구, 9(2), pp.551~564 (2008), 한국상담학회
  11. Abidin, R. R., "Parenting Stress Index(PSI)-Manual and administration booklet" (1983), Pediatric Psychology Press
  12. Affonso, D. D., "An international study exploring levels of postpartum depressive symptomatology", Journal of Psychosomatic Research, 49(3), pp.207~216 (2000)
  13. Baron, R. M., "The moderator-mediator variable distinction in psychological research : Conceptual, strategic, and statistical considerations", Journal of Personality and Social Psychology, 51(6), pp.1173~1182 (1986)
  14. Beck, A. T., "An inventory for measuring depression", Archives of General Psychiatry, 4(6), pp.561~569 (1961)
  15. Belsky, J., "Marital change across the transition to parenthood", Marriage and Family Review, 12(3), pp.133~156 (1988)
  16. Campbell, S. B., "Prevalence and correlates of postpartum depression in first-time mothers", Journal of Abnormal Psychology, 100(4), pp.594~599 (1991)
  17. Chaudron, L. H., "Predictors, prodromes and incidence of postpartum depression", Journal of Psychosomatic Obstetrics & Gynecology, 22(2), pp.103~112 (2001)
  18. Chen, C. H., "The prevalence and predictors of postpartum depression", Nursing Research, 2(3), pp.263~274 (1994)
  19. Collins, N. L., "Social support in pregnancy : Psychosocial Correlates of birth outcomes and postpartum depression", Journal of Personality and Social Psychology, 65(6), pp.1243~1258 (1993)
  20. Cox, J. L., "Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale", British Journal of Psychiatry, 150(6), pp.782~786 (1987)
  21. Cummings, E. M., "Marital conflict, gender, and children's appraisals and coping efficacy as mediators of child adjustment", Journal of Family Psychology, 8(2), pp.141~149 (1994)
  22. Dankner, R., "Cultural elements of postpartum depression : A study of 327 Jewish Jerusalem women", Journal of Reproductive Medicine, 45(2), pp.97~104 (2000)
  23. Fatoye, F. O., "Difficult delivery and some selected factors as predictors of early postpartum psychological symptoms among Nigerian women", Journal of Psychosomatic research, 60(3), pp.229~301 (2006)
  24. Flanagan, T. J., "Differential impairments in emotion face recognition in postpartum depressed women", Journal of Affective Disorders, 128(3), pp.314~318 (2011)
  25. Gelfand, D. M., "Sources of parenting stress for depressed and nondepressed mothers of infants", Journal of Clinical Child Psychology, 21(3), pp.262~272 (1992)
  26. Glass, G. V., "Meta-analysis in social research" (1981), Sage
  27. Halbreich, U., "Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms", Journal of Affective Disorders, 91(2), pp.97~111 (2006)
  28. Hearn, G., "Postnatal depression in the community", British Journal of General Practice, 48, pp.1064~1066 (1998)
  29. Heinicke, C. M., "Determinants of the transition to parenthood, In Handbook of parenting: Vol. 3. Status and social conditions of parenting", pp.277~303 (1995), Erlbaum.
  30. Hendrick, V., "Postpartum and nonpostpartum depression : Differences in presentation and response to pharmacologic treatment", Depression and Anxiety, 11(2), pp.66~72 (2000)
  31. Hopkins, J., "Role of infant-related stressors in postpartum depression", Journal of Abnormal Psychology, 96(3), pp.237~241 (1987)
  32. House, J. S., "Social relationships and health", Science, 241, pp.540~545 (1988)
  33. Hung, C., "The effects of postpartum stress and social support on postpartum women's health status", Journal of Advanced Nursing, 36(5), pp.676~684 (2001)
  34. Iles, J., "Posttraumatic stress symptoms and postpartum depression in couples after childbirth : The role of partner support and attachment", Journal of Anxiety Disorders, 25(1), pp.520~530 (2011)
  35. Kahn, J. H., "Emotional self-disclosure and emotional relations with symptoms of depression and anxiety", Journal of Counseling Psychology, 56(4), pp.573~584 (2009)
  36. Kanner, A. D., "Comparison of two modes of stress measurement : Daily hassles and uplifts versus major life events", Journal of Behavioral Medicine, 4(1), pp.1~39 (1981)
  37. Kelly, R. H., "The detection and treatment of psychiatric disorders and substance use among pregnant women cared for in obstetrics", American Journal of Psychiatry, 158(2), pp.213~219 (2001)
  38. Lanes, A., "Prevalence and characteristics of postpartum depression symptomatology among Canadian women : A cross-sectional study", BMC Public Health, 11, pp.302~310 (2011)
  39. Leigh, B., "Risk factors for antenatal depression, postnatal depression, and parenting stress", BMC Psychiatry, 8, pp.1471~1482 (2008)
  40. Leahy-Warren, P., "Postnatal depression in first-time mothers : prevalence and relationships between functional and structural social support at 6 and 12 weeks postpartum", Archives of Psychiatric Nursing, 25(3), pp.174~184 (2011)
  41. Levy-Shiff, R., "Individual and contextual correlates of marital change across the transition to parenthood", Developmental Psychology, 30(4), pp.591~601 (1994)
  42. Logsdon, M. C., "Social support and postpartum depression", Research in Nursing & Health, 17(6), pp.449~457 (1994)
  43. Martins, C., "Effects of early maternal depression on patterns of infant-mother attachment : A meta-analytic investigation", Journal of Child Psychology and Psychiatry, 41(6), pp.736~746 (2000)
  44. Milgrom, J., "Parenting stress and postnatal depression", Stress Medicine, 12(3), pp.177~186 (1996)
  45. Miyake, Y., "Employment, income, and education and risk of postpartum depression : The Osaka maternal and child health study", Journal of Affect Disorders, 130(1), pp.133~137 (2011)
  46. Murray, L., "The impact of postnatal depression and associated adversity on early mother-infant interactions and later infant outcome", Child Development, 67(5), pp.2512~2526 (1996)
  47. Nielsen, D., "Postpartum depression : identification of women at risk", International Journal of Obstetrics & Gynaecology, 107(10), pp.1210~1217 (2000)
  48. Norbeck, J. S., "Psychosocial predictors of pregnancy outcomes in low-income Black, Hispanic, and White women", Nursing Research, 38(4), pp.204~209 (1989)
  49. O'Hara, M. W., "Controlled prospective study of postpartum mood disorders : Psychological, environmental, and hormonal variables", Journal of Abnormal Psychology, 100(1), pp.63~73 (1991)
  50. O'Hara, M. W., "Controlled prospective study of postpartum mood disorders : Comparison of childbearing and non-childbearing women", Journal of Abnormal Psychology, 99(1), pp.3~15 (1990)
  51. Paffenbarger, R., "The effects of obstetric and perinatal events on risk of mental illness in women of childbearing age", American Journal of Public Health and the Nation's Health, 56(3), pp.400~407 (1966)
  52. Patternson, G. R., "Stress: A change agent for family process, In Stress, coping and development in children", pp.235~262 (1983), McGraw-Hill
  53. Raudenbush, S. W., "Hierarchical Linear Models" (2002), Sage Publication
  54. Rutter, D. R., "Commentary : Some focus and process considerations regarding effects of parental depression on children", Developmental Psychology, 26(1), pp.60~67 (1990)
  55. "Scottish Intercollegiate Guidelines Network (SIGN Publication No.60). Edinburgh"[URL]
  56. Simpson, J. A., "Adult attachment, the transition to parenthood, and depressive symptoms", Journal of Personality and Social Psychology, 84(6), pp.1172~1187 (2003)
  57. Singer, T., "The neuronal basis and ontogeny of empathy and mind reading : Review of literature and implications for future research", Neuroscience Biobehavioral Review, 30(6), pp.855~863 (2006)
  58. Smith, L. E., "Continuity of parental social support and depressive symptoms among new mothers", Journal of Family Psychology, 22(5), pp.763~773 (2008)
  59. Stein, A., "The relationship between post-natal depression and mother-child interaction", British Journal of Psychiatry, 158(1), pp.46~52 (1991)
  60. Sue, S., "In search of cultural competence in psychotherapy and counseling", American Psychologist, 53(4), pp.440~448 (1998)
  61. Terry, D. J., "Depressive symptomatology in new mothers : A stress and coping perspective", Journal of Abnormal Psychology, 105(2), pp.220~231 (1996)
  62. Tracey, T. J., "Help-seeking and problem perception among Asian Americans", Journal of Counseling Psychology, 33(3), pp.331~336 (1986)
  63. Wei, M., "Adult attachment, social self-efficacy, self-disclosure, loneliness, and subsequent depression for freshman college students : A longitudinal study", Journal of Counseling Psychology, 52(4), pp.602~614 (2005)
  64. Whiffen, V. E., "Is postpartum depression a distinct diagnosis?", Clinical Psychology Review, 12(5), pp.485~508 (1992)
  65. Whiffen, V. E., "Comparison of postpartum depression : Clinical presentation, psychiatric history, and psychosocial functioning", Journal of Consulting and Clinical Psychology, 6(3), pp.485~494 (1993)
  66. Whitton, A., "The pathway to care in post-natal depression : Women's attitudes to post-natal depression and its treatment", British Journal of General Practice, 46, pp.427~428 (1996)
  67. Yonkers, K. A., "Onset and persistence of postpartum depression in an inner-city maternal health clinic system", American Journal of Psychiatry, 158(11), pp.1856~1863 (2001)
  68. Zung, W. W. K., "Self-rating depression scale in an outpatient clinic", Archives of General Psychiatry, 13(6), pp.508~515 (1965)

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