The role of stress and social support in predicting depression among a hypertensive African American sample

Abstract

Objective-To examine social support, stress and selected demographic variables as predictors of depression among African Americans with hypertension.Methods-Archival data collected on 194 hypertensive African Americans ranging in age from 30 to 88 years (mean age = 58.3, SD = 12.2; 63% female) were analyzed in the present study. Hierarchical regression analyses were conducted using two models of depression. The first model included basic demographic characteristics of the sample, including age, sex, educational attainment, income, and employment status. In the second model, the psychosocial variables of stress and social support were added to determine their predictive value.Results-The first model accounted for 14% of the variance in depression and identified sex and age as significant predictors. The second model, in which two psychosocial variables were added, accounted for 45.2% of the total variance, with age, stress, and social support as significant predictors.Conclusions-Stress and social support are significant predictors of depression in a hypertensive African American population, beyond the influence of various demographic variables. These results have implications for prevention and intervention strategies with the target population. KeywordsHypertension; Blood Pressure; Depression; Stress; Social Support Keywords BP = blood pressure; SBP = systolic blood pressure; DBP = diastolic blood pressure; CES-D = Center for Epidemiological Studies Depression Scale Proofs and Correspondences may be sent to: John P. Dennis, 221 North Grand Ave., Shannon Hall 224, St. Louis, MO 63103, Phone: 314-977-3686, Fax: 314-977-1006, dennisjp@slu.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Among adults living in the U.S., nearly one in three has high blood pressure (1), with 30% unaware of their condition (2). High blood pressure has been identified as a major risk factor for stroke, congestive heart failure, myocardial infarction, and chronic kidney disease (3), as well as a number of psychological problems including depression and various anxiety disorders (4-6). Early detection of those at risk for developing high blood pressure enables individuals to learn of the risks associated with this condition and the steps that they can take to prevent and/or treat it. Discovery of factors that increase the likelihood that individuals with high blood pressure will develop more serious health and/or psychological problems will promote the development of more effective interventions to prevent and treat these conditions. Therefore, identification of potential risk factors...

Assessment of Social Support and Its Association to Depression, Self-Perceived Health and Chronic Diseases in Elderly Individuals Residing in an Area of Poverty and Social Vulnerability in Rio de Janeiro City, Brazil

“…This study also supports the idea of reducing dimensions of the original SS construct in the MOS [27], [37]–[39], once the use of questions pertaining to only three dimensions does not seem to have affected the assessment of SS to elderly individuals, considering the strong association between unsatisfactory SS and depression. The advantage of the instrument reduction was felt in the context of the primary healthcare visits, in which the duration of attendance by a doctor is usually short.…”

Validation of the Perceived Stress Scale in a community sample of older adults

“…In our sample, depression was associated with higher total PSS scores, higher distress, and lower coping. This is consistent with previous findings showing correlations between depression and PSS (Hewitt et al ., ; Candrian et al ., ; Dennis et al ., ; Elavsky and Gold, ; Leung et al ., ; Lee et al ., ). In addition, consistent with earlier findings (Brajenovic‐Milic et al ., ; Chen et al ., ), we showed that there is a significant correlation between anxiety and PSS.…”

Physical Comorbidity and Health Literacy Mediate the Relationship Between Social Support and Depression Among Patients With Hypertension

“…To enhance the health literacy of patients with hypertension, we suggest that health education programs should be developed to help this population improve their health knowledge and develop self-management behaviors. In addition, training in relaxation techniques or organizational skills for managing daily life activities should also help improve the mental health of patients with hypertension (14).…”

“…Social support refers to the “social resources that persons perceive to be available or that are provided to them.” Prior studies have demonstrated the association between inadequate social support and depression among patients with hypertension ( 12 – 14 ). Poor social support has also been linked to poor adherence to anti-hypertension treatment and poor blood pressure control ( 15 – 17 ) and may thus cause poor prognosis and eventually affect the mental state of patients with hypertension.…”