At the crossroads of poverty and disability: An ecological approach to predicting maternal mental health outcomes in families who are poor and have young children with disabilities.

摘要

Families who have young children with disabilities are over-represented among families living in poverty. Mothers raising children with disabilities often demonstrate elevated levels of depression and parenting stress. Almost no studies have examined these maternal outcomes specifically among families in poverty. Furthermore, most studies explore individual- and family-level factors as predictors of mental health outcomes. This study examined stress and depression outcomes among 80 low-income mothers by employing an ecological model which looks beyond the immediate family to the impact of the family's involvement with three systems: disability- and poverty-related services and programs, maternal employment, and child care. Although these systems are likely to be highly salient in the lives of families who are poor and have children with disabilities, they have not previously been investigated together. Using regression analysis, this study addressed three main questions: (1) How does a child's disability, operationalized as the child's level of functioning, affect maternal depression and parenting stress in families in poverty? (2) Is the above relationship mediated by involvement with other systems: disability- and poverty-related services and programs, employment, and child care? (3) Are these mediated relationships moderated by the experience of using those systems?; The women in this study were found to have levels of depression on par with samples of low-income women in general, and levels of parenting stress on par with samples of women with children with disabilities in general. The systems that were examined---poverty-related services, maternal employment, and child care---were not predictive of maternal mental health and well-being on their own. However, the hassles associated with these systems proved to be predictive and, in several cases, to moderate the associations between the mediators and maternal psychological well-being. The factors in these women's lives that did prove to be predictive of psychological well-being have implications for policy, practice, and future research.