The Association Between Social Support and Distress: A Proposal

This research proposal outlines a quantitative cross-sectional study designed to investigate the relationship between perceived social support and psychological distress among single mothers in Ankara, Turkey. The study aims to recruit 30 single mothers from elementary schools, utilizing the Multidimensional Scale of Perceived Social Support (MSPSS) to assess social support and the Patient Health Questionnaire-9 (PHQ-9) to measure psychological distress. Data analysis will involve the Pearson correlation test to determine the significance of the association between variables. The proposal includes a comprehensive literature review, detailing the prevalence of psychological distress in women, the impact of single parenthood, and the existing research on social support and mental health. The study hypothesizes a significant negative correlation between perceived social support and psychological distress, anticipating that increased social support will be associated with lower levels of distress. The methodology section details participant recruitment, materials, and procedures, including the use of questionnaires and statistical tests. The expected results, possible implications, and limitations are also discussed, contributing to a well-structured research design.

Running head: PSYCHOLOGY 1
The Association Between Perceived Social Support and Psychological Distress Among
Single Mothers in Ankara, Turkey
Student’s Name:
Instructor’s Name:
Name of University:
Course Number:
Date of Submission:

PSYCHOLOGY 2
Abstract
Psychological distress is a common factor that causes mental health disorders globally.
Psychological distress is prevalent among women than men. This is attributable to multiple
causal factors that make women more vulnerable to depression. Existing literature reports a
strong association between perceived social support and depression. The increasing
psychological distress in single women has significantly been associated with their marital status.
However, no study has examined such an association in the context of Ankara, Turkey. The
proposed study will be carried out among single mothers in two elementary schools in Ankara by
recruiting single mothers to the children enrolled in the schools. A Multidimensional Scale of
Perceived Social Support (MSPSS) will be used to examine perceived social support from
friends, family, and other significant sources. Additionally, the Patient Health Questionnaire -9
(PHQ-9 will be used to determine psychological stress. The collected data will be analyzed using
the Pearson correlation test to determine the association between variables. It is expected that the
null hypothesis is rejected and thus the association between perceived social support and
psychological depression be significant.

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Table of Contents
Abstract.......................................................................................................................................................2
1.0 Introduction/Literature review...............................................................................................................4
2.0 Method..................................................................................................................................................8
2.1 Participants........................................................................................................................................8
2.2 Materials............................................................................................................................................8
2.3 Procedure...........................................................................................................................................9
2.4 Design..............................................................................................................................................10
3.0 Analysis Strategy.................................................................................................................................10
3.1 Statistical Test.................................................................................................................................10
3.2 Expected Results..............................................................................................................................10
3.3 Possible Implications.......................................................................................................................10
3.4 Possible Limitations.........................................................................................................................11
References.................................................................................................................................................12
Appendix: Pre-registration Form...............................................................................................................15

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1.0 Introduction/Literature review
The overall aim of the proposed study is to ascertain the relationship between social
support and psychological distress among single mothers in Ankara, Turkey. The proposal will
analyze three articles to ascertain the developments to the current topic of research and any
existing gap as a basis of determining the specific research topic and research questions.
Psychological distress is one of the leading forms of mental disorders globally. It is projected
that if not addressed early enough, depression is likely to be the leading cause of mental health
and disability (Ferrari et al., 2013). Psychological distress is much more prevalent in women than
in men (Pan et al., 2011) due to new stressors related to parenting (Fisher et al., 2012). The
increasing instability of marriages leading to single parenting increases the burden of single
mothers since they must have to individually cater for all the family needs. Thus, single
parenthood becomes a common risk factor for psychological distress.
Studies have hypothesized a causal relationship between depression and social support.
Social isolation and minimal social support have been associated with psychological distress.
More specifically, family kin associations haven been pointed out as significant factors for
mental health. More specifically, studies have linked single parenthood to poor mental health
(Rousou, Kouta, & Middleton, 2016). Single mothers exhibit increased levels of psychiatric
conditions such as depression in comparison with other female groups. Psychological distress
among single parents is related to financial insecurity and high levels of everyday stressors
(Rousou, Kouta, Middleton, & Karanikola, 2019). Some researchers have recommended
accessibility to social networks as a way of empowering affected individuals to deal with daily
stressors (Bromley et al., 2016). Additionally, single mothers with no extra social support for
their younger children exhibited increased depression levels (Sarsour et al., 2011). Furthermore,

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a growing body of evidence shows that single mothers are more vulnerable to drug abuse due to
depression (Bambra, 2011). To date, there are no studies on the association between social
support and psychological distress among single mothers in Ankara, Turkey.
A literature search and a quick review of the titles and abstracts generated three articles
which formed a basis for the current research design. However, only two articles were critically
assessed. Rousou, Kouta, Middleton, and Karanikola (2019) conducted a correlational study on
the state of mental health among lonely mothers in Cyprus. The authors hypothesized that
socioeconomic factors and perceived social support were major determinants of the level of
psychological distress among single mothers. The study recruited 316 single mothers living in
Cyprus using a snowball sampling method. The participants were recruited individually or
through the Single Mothers’ Association. The General Health Questionnaire was used to
examine the mental health of the participants and their perception of social support assessed
using the Social Provision Scale (SPS).
Logistic regression and chi-square tests were conducted to determine the mental status of
the single mothers and how it is determined by social factors and their view of social support.
The study found out that almost half of them (44.6%) underwent depression which was
significantly influenced by low monthly income, economic challenges, and ill-health. There was
a substantial negative independent relation between the perception of single mothers and
psychological distress. The authors recommend the need for further studies to examine the
psycholocal, social and economic factors that affect the mental health of lonely mothers to
ascertain the most appropriate social support.
The second article is by Werner-Seidler et al. (2017) and explored the association

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between social support networks and depression in Australia. The study hypothesized that
factors of social connectivity namely quality and frequency of social associations positively or
negatively affected the level of depression. More specifically, the research questions explored the
quality and incidence of social encounters, family and friendship support networks and the
variation of the relationships across age groups. The research was carried out using 8,841
participants of the National Survey of Mental Health. The association between factors of social
connectivity and depression were analyzed using logistic regression. The Patient Health
Questionnaire -9 (PHQ-9) will be used to measure depression.
The study found out a significant association between family networks and major
depression disorders (MDD). The frequency of contact with family members did not influence
the previous experiences of depression, but the total absence of family members to interact with
influenced MDD (OR 2.64, 95% CI 1.84–3.81, p<0.001). Similarly, the number of family
members to interact with influenced depression levels. Friendship networks also influenced
MDD. High frequency of contact with friends decreased the odds whereas the lack of friends to
confide increased the odds of MDD in the previous year. Friendship networks were significant
regardless of age. There is a need for future studies to explore the quality of social support and
psychological distress.
As observed above multiple studies have been carried out on the association between
psychological distress and social support. However, none has been carried out in the context of
Turkey yet statistical reports show an increase in depression levels among single mothers (Cakir,
2010). The 2006-2010 Turkish Statistical Institute survey reported 1.5 million children living
with a single parent. Furthermore, most of the Turkish researchers have focused on the

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challenges during divorce (Demirel, & Şahin, 2018). Hence, the need to examine the association
between social support and psychological distress among single mothers in Ankara, Turkey. The
hypothesis to be tested is as shown below:
Hypothesis
H : There is no statistically significant association between perceived social support and₀
psychological distress among single mothers in Ankara, Turkey
H : There is a statistically significant association between perceived social support and₁
psychological distress among single mothers in Ankara, Turkey

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2.0 Method
2.1 Participants
The proposed study will recruit 30 volunteer single mothers who will be parents to pupils
attending three elementary schools located in the Northern part of Ankara city. This sample size
is based on previous pilot study by Cakir (2010) on stress and social support among single
mothers in Ankara. The age bracket for the participants will be aged 22-50 years and Turkish
single mothers competent in English. The prospective participants will be contacted via
telephone or email and be notified of the intended study. The objective of the phone call is to
notify them of the significance of the study and assure them of privacy and confidentiality. The
phone call is likely to take 3 minutes. As a way of encouraging the participants and the school’s
receptionists will be given SONA credits.
2.2 Materials
A personal computer will be used to prepare for the report and record any progress during
the research process. Additionally, a semi-structured questionnaire will be used as a guide to
adhere to the inclusion and exclusion criteria in addition to the gathering of relevant data.
A Multidimensional Scale of Perceived Social Support (MSPSS) will be used to
examine perceived social support from friends, family, and other significant sources. The
MSPSS contains 12 items used for assessment. The instrument uses a seven-point Likert Scale
ranging from very strongly agree (1) to very strongly disagree (7). The mean total score for
social support will be obtained by summing up all the 12 items and dividing by 12 (Osman et al.,
2014). The total subscale will be summed up and then divided by 4. The total score will range
from 5.1 to 7 and the increasing scores being a likelihood of higher perceived social support and

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lower levels being typified by lower scores of perceived social supports. Internal consistency will
be determined on a scale of 80 and 95 (Tonsing, Zimet, & Tse, 2012).
Patient Health Questionnaire -9 (PHQ-9): The PHQ-9 will be used to determine
psychological stress. This is a versatile tool designed in 2001 by Kroenke, Spitzer and Williams
which consists of DSM-IV Diagnostic Criterion A signs for MDD. The instrument is significant
in the screening, measuring and monitoring depression levels. The participants will be queried
about the frequency with which they have been disturbed by the factors of depression. The
participants will have four answers to choose from: never (0), many days (1), over 50% of the
days (2), almost daily (3) (Saliba et al. 2012). The scale consists of items that describe the feeling
of the participants during the depression. The value of the scores will range from 0 -27. The total
score will be arrived at by adding up the scores of all items. Each score will represent the level of
psychological distress and classified as insignificant, average and severe.
2.3 Procedure
Questionnaires will be used to collect data. Potential participants will be contacted
through phone calls after obtaining phone numbers from the school administration. They will be
notified of the objective of the study and an awaiting shopping voucher at the end of the
research. After the participants have been informed of the study objective, they will be asked to
fill a consent form accessed through an online platform or picked from the school’s reception
desk. Those who will have signed the consent form will be given the PHQ-9 and MSPSS through
online platforms or physically picked at the school’s reception desk.

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2.4 Design
The proposed study will use a quantitative cross-sectional design with psychological
distress being the dependent variable and perceived social support being an independent variable.
A convenient sampling method will be used to select the sample.
3.0 Analysis Strategy
3.1 Statistical Test
Pearson correlation test will be carried out to determine the association between
variables. The gathered data will be analyzed using SPSS (version 20). The relationship will be
significant if the p-value is less than 0.01, and thus reject the null hypothesis. On the other hand,
a p-value greater than 0.01 will imply that the association is insignificant and thus accept the null
hypothesis. This will be obtained from the output table obtained from the analysis.
3.2 Expected Results
It is expected that the null hypothesis is rejected and thus the association between
perceived social support and psychological depression be significant. The p-value is thus likely
to be less than 0.01. Additionally, the level of depression is likely to vary depending on the
influencing factors such as low monthly income, economic challenges, and ill-health. Therefore,
the research will have proved that
3.3 Possible Implications
There are multiple social, economic and psychological factors that positively or
negatively affect the mental health of lone mothers. The expected findings of this study that there
is a strong association between perceived social support and psychological stress are important to
all families and health experts. The outcomes of this study can be used to design community

PSYCHOLOGY 11
support systems and policies that are relevant to help reduce the side effects of single parenting.
Moreover, the future findings of the current proposal can be used to develop target prevention
programs such as the formation of a single mother’s association, counseling session to help
alleviate severe consequences of depression such as suicidal thoughts.
Another implication for the proposed study is that it encourages precautionary measures
to avoid psychological distress such as screening for the risk of depression by health care experts
and recommending necessary social support such as increasing family networks. Therefore, there
is a need for the proposed study to be carried out in Ankara to help ascertain the level of
psychological distress among single mothers and to recommend possible solutions to help
address the problem.
3.4 Possible Limitations
The expected outcomes of this proposal should be assessed given its weaknesses. The
first potential limitation of the study is that the certainty of the observed associations may not be
determined. Therefore, it will not be possible to provide sufficient evidence on causality, thus
necessitating the need for further studies to explore the pathway of causality. The study will use
convenience sampling to select the sample size, thus it is not likely that the outcomes can be
generalized to all lone mothers in Ankara. It is also a realization of the researcher that the
proposed study will not include a control group of married mothers. Nevertheless, this will be the
first research carried out in Ankara on the evaluation of the relationship between psychological
distress and perceived social support among lone mothers in Ankara. The study will not consider
some significant information such as the quality of marriage association before divorce because
marital violence is commonly known to result in poor mental health.

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References
Bambra, C. (2011). Health inequalities and welfare state regimes: theoretical insights on a public
health ‘puzzle’. Journal of Epidemiology & Community Health, 65(9), 740-745.
Bromley, E., Kennedy, D. P., Miranda, J., Sherbourne, C. D., Wells, K. B., Garro, L. C., ... &
Kennedy, D. (2016). The fracture of relational space in depression: Predicaments in
primary care help seeking. Current anthropology, 57(5), 610-631.
Cakir, S. G. (2010). A pilot study on stress and support sources of single mothers in
Turkey. Procedia-Social and Behavioral Sciences, 5, 1079-1083.
Demirel, B., & Şahin, H. (2018). Determination Of Elderly Women's Views On Divorce: A
Qualitative Research. Türk Uygulamalı Sosyal Hizmet Dergisi, 1(1), 65-72.
Ferrari, A. J., Charlson, F. J., Norman, R. E., Patten, S. B., Freedman, G., Murray, C. J., ... &
Whiteford, H. A. (2013). Burden of depressive disorders by country, sex, age, and year:
findings from the global burden of disease study 2010. PLoS medicine, 10(11).
Fisher, J., Mello, M. C. D., Patel, V., Rahman, A., Tran, T., Holton, S., & Holmes, W. (2012).
Prevalence and determinants of common perinatal mental disorders in women in low-and
lower-middle-income countries: a systematic review. Bulletin of the World Health
Organization, 90, 139-149.
Osman, A., Lamis, D. A., Freedenthal, S., Gutierrez, P. M., & McNaughton-Cassill, M. (2014).