Brown et al 1986, Social support, self-esteem and depression

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  • Brown et al 1986-Social support and self-esteem and depression
    • AO1
      • AIM
        • To see if the level of self-esteem and the amount of social support available to a person can predict the risk of depression for up to a year after a stressful event
      • PROCEDURE
        • Took part in Islington. Women whose husbands were in a manual occupation, who had at least one child under 18 living at home, and who were aged 18-50 were sent a letter from their GP asking to take part in the study
          • Women who fitted the criteria and all single mothers were put into the sample. From this, a number were randomly selected. 435 women were found and 91% were involved in the first part.
            • The first part had 2 phases. First contact, measures of self-esteem and personal ties were measured Psychiatric history was also collected.
              • The second- collected data about any onst of psychiatric disorder i nthe 12 months following first contact. Measures of life-event stress and social support were also taken.
                • The measures were carried out carefully and by experienced interviewers. There were tests for reliability with 60 women being interviewed intensively and 21 used in a reliability. Of these 21, 11 were seen by 2 interviews and 10 were rated by a second peron using tapes of the original interviews. Satisfactory inter-rater reliability was found.
      • FINDINGS
        • 353 women agreed to follow up interview (89%) 42 were not followed up.  50 cases of depression at first contact, so were excluded.
          • 303 women were interviewed and their data analysed to see if there was onset of depression over the 12 months after first contact.
            • 50% had a severe event or major difficulty in the 12 month follow up after first contact and 32 had the onset of depression
              • out of the 32 with depression, 91% had a severe life-event. 23% without depression also suffered a severe life-event.
                • 33% of those with depression had a provoking agent and low self-esteem, where as 13% didn't. Of those without a provoking agent, 4% did, 1% didn't have low self esteem
                  • 92% had core crisis support and doung it helpful. Of Women with crisis support at first contact felt let down 42% developed depression. Those with no support 44% had depression
      • CONCLUSION
        • Those who were married had less chance of getting depression, although if they felt they had no support the risk increased
          • Clearly shows the complexity of social support situations where support is given and expectations are aroused but not fulfilled.
            • It is possible that self-esteem is an internalisationof social support, lack of support lowers self esteem. Provoking agents are necessary for the onset of depression
    • AO2
      • The interviews gave an in-depth and detailed data that were required for the analysis of such complex, inter-related concepts as self-esteem, core social support and major life events.
      • There was inter-rater reliability, which strengthens the results arising from the data
      • The data were likely to be valid, as they were gathered carefully by trained interviewers using a semi-structured interview, allowing detailed info to be explored
      • Sampling was carefully carried out by contacting all elidgible women and then carrying out random sampling. Removes bias
        • This also made it generalisable
      • It was hard to separate out the concepts that were scored as numbers and then percentage, as qual was reduced to quan data.
      • This was a study of working-class women with at least one child-so generalising this to all women is not possible

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