Relationship: Social Support, Depression, Maldivian Mothers, Study

This report presents a comprehensive investigation into the relationship between perceived social support and depression among Maldivian mothers, comparing the experiences of single and married women. The study aims to determine the prevalence of depression and assess the impact of social support from family, friends, and significant others. The research employs the Multidimensional Scale of Perceived Social Support (MSPSS) and the Patient Health Questionnaire-9 (PHQ-9) to measure social support and depression levels, respectively. The report includes a literature review of existing research on social support and mental health, detailing the research design, methodology, and statistical analysis. The results section presents descriptive and inferential statistics, highlighting any significant differences in depression and perceived social support between the two groups. The discussion interprets the findings in light of previous research, addresses the study's limitations, and explores its implications for mental health interventions in the Maldives. The report concludes with recommendations for future research and practical applications to improve the psychological well-being of Maldivian mothers, particularly those facing the challenges of single parenthood.

Running head: PERCEIVED SOCIAL SUPPORT 1
THE RELATIONSHIP BETWEEN PERCEIVED SOCIAL SUPPORT AND
DEPRESSION AMONG MALDIVIAN SINGLE AND MARRIED MOTHERS
Student’s Name:
Instructor’s Name:
Name of University:
Course Number:
Date of Submission:
1

PERCEIVED SOCIAL SUPPORT
2
CONTENTS
ABSTRACT................................................................................................................................. 3
INTRODUCTION......................................................................................................................... 4
Research Question.................................................................................................................... 6
Hypothesis................................................................................................................................ 6
OBJECTIVES AND AIMS............................................................................................................6
Specific Aims............................................................................................................................ 6
Overall Objective...................................................................................................................... 7
BACKGROUND AND SIGNIFICANCE........................................................................................8
LITERATURE REVIEW............................................................................................................. 11
RESEARCH DESIGN AND METHODS.....................................................................................13
Design..................................................................................................................................... 13
Participants............................................................................................................................ 13
Measures................................................................................................................................ 13
Procedure............................................................................................................................... 15
Data Analysis.......................................................................................................................... 15
Ethics and Human Subjects Issues...........................................................................................15
RESULTS.................................................................................................................................. 17
Descriptive Statistics............................................................................................................... 17
Prevalence of Depression among Single and Married Mothers.................................................18
Inferential Statistics................................................................................................................ 19
DISCUSSION............................................................................................................................ 21
FURTHER RECOMMENDATION..............................................................................................24
CONCLUSION........................................................................................................................... 25
STRENGTHS AND WEAKNESSES OF THE STUDY...............................................................25
2

PERCEIVED SOCIAL SUPPORT
3
SIGNIFICANCE......................................................................................................................... 27
REFERENCE............................................................................................................................ 28
APPENDIX................................................................................................................................ 33
Appendix 1: Participants Information Sheet............................................................................33
Appendix 2: Consent Form........................................................................................................33
Appendix 3: Demographic Questionnaire................................................................................33
Appendix 4: Perceived Social Support Scale – MSPSS.............................................................33
Appendix 5: Depression Scale – PHQ-9....................................................................................33
Appendix 6: Debreifing Information sheet...............................................................................33
Appendix 7: Authors Permission to use Scale MSPSS..............................................................33
Appendix 8: Authors Permission to use Scale PHQ-9...............................................................33
3

PERCEIVED SOCIAL SUPPORT
4
ABSTRACT
4

PERCEIVED SOCIAL SUPPORT
5
INTRODUCTION
Single mother headed families is one of the structural changes in modern society, which
is growing rapidly. The country of Maldives has the highest divorce rate in worldwide, which is
per year 10.97 divorces for every 1,000 inhabitants (Guinness World Records 2002). According
to the Department of Judicial Administration, 6509 couples got married in 2019, and 5117
couples were divorced in the same year (Department of Judicial Administration 2020). After the
divorce, normally women take custody of their children or take the responsibilities to raise their
children. In the Maldives, the latest census statistics revealed that over 20 per cent of the children
lives with their mother only (National Bureau of Statistics 2014). This could be due to divorce,
separation, having children without marriage, and fathers living or working in different Islands.
According to Crosier, Butterworth, and Rodgers (2007) suggested that parental well-being was
negatively influenced by a transition to single parenthood, dissolution, and family instability.
Likewise, international literature reveals that single motherhood is linked with a greater level of
chronic stress, because of the economic hardship and decreased the level of social support from
families, friends and others (Targosz et al. 2003; Tobias et al. 2009; Rousou, Kouta and
Middleton 2016). Thus, this eventually causes psychological and physical illness amongst single
mothers (Targosz et al. 2003; Tobias et al. 2009; Rousou, Kouta, and Middleton 2016).
Depression is defined as a common mental disorder, presented by losing interest about
events that you once enjoyed, reduced energy, failure to carry out daily tasks, and having
persistent sadness for at least two weeks (WHO 2012). A survey done in the Maldives found that
five per cent of the population is suffering from depression and anxiety (Niyaz and Naz 2003).
Also, the results found women experience depression, anxiety, and somatic symptoms twice
5

PERCEIVED SOCIAL SUPPORT
6
higher than men (Niyaz and Naz 2003). Similarly, prevalence study conducted by Maldivian
National University students found that female students have a higher prevalence of depression,
anxiety, and stress (Shanoora and Nawaza 2018).
Social support is known as the process of taking care of social relationships. According to
Tardy (1985) suggested that social support is a broad, multidimensional concept which includes
emotion support and instrumental support. Emotional support consists of the support received
from intimate, confiding relationships which include love, and empathy (Tardy 1985).
Instrumental support was more pragmatic and practical or helping behavior: which includes
providing financial support and giving once a time (Tardy 1985). However, Zimet et al. (1988)
defined social support as emotional support from family, friend, and significant others. A recent
meta-analysis done by Gariépy, Honkaniemi, and Quesnel-Vallée (2016) claimed that emotional,
social support was more closely related to depression compared to instrumental social support.
However, Werner-Seidler et al. (2017) stated that some studies merge these social support
aspects, and the ability to differentiate between social support roles in depression were
precluded. This paper will focus on how emotional, social support from families, friends, and
significant others affect depression among Maldivian mothers and identify whether there is any
difference in perceived social support and depression between Maldivian single and married
mothers.
6

PERCEIVED SOCIAL SUPPORT
7
PROBLEM STATEMENT
Research Question
i. Is there a relationship between perceived social support and depression among Maldivian
mothers?
ii. Does the difference exist in perceived social support and depression between Maldivian
single married mothers?
Hypothesis
H :₀ There is no statistically significant relationship between perceived social support and
depression among Maldivian mothers
H :₁ There is a statistically significant relationship between perceived social support and
depression among Maldivian mothers
H :₀ There is no statistically significant difference in perceived social support between
Maldivian single and married mothers
H :₂ There is a statistically significant difference in perceived social support between
Maldivian single and married mothers
H :₀ There is no statistically significant difference in the level of depression between
Maldivian single and married mothers
H :₃ There is a statistically significant difference in the level of depression between Maldivian
single and married mothers
OBJECTIVES AND AIMS
Specific Aims
i. To investigate the relationship between perceived social support and depression among
Maldivian Mothers
7

PERCEIVED SOCIAL SUPPORT
8
ii. Identify the difference in perceived social support and depression between Maldivian
single and married mothers
iii. Identify the difference in the level of depression between Maldivian single and married
mothers
Overall Objective
i. Identify the prevalence rate of depression among Maldivian single and married mothers
ii. Identifying the difference in perceived social support based on three dimensions: Friends,
Family and significant others
8

PERCEIVED SOCIAL SUPPORT
9
BACKGROUND AND SIGNIFICANCE
The theorists have proposed two theoretical frameworks to explain the relationship
between social support and depression, which includes the main effect model and the stress-
buffering model (Cohen and Wills 1985). The direct or main effect of social support model states
that by promoting healthy psychological states can be beneficial regardless of whether an
individual was under stress (Cohen and Wills 1985). Whereas stress-buffering hypothesis
suggests that social support was beneficial after an event has been considered as stressful (Cohen
and Wills 1985). Nevertheless, Stroebe and Stroebe (1997) stated according to that modified
Stress Buffering model, Social support offers benefits to individuals who were suffering from
high stressful as well as low-stress situations. Moreover, Werner-Seidler et al. (2017) mentioned
that social support deals with stress to stop depression by facilitating adaptive coping strategies
or eliminating or reducing the stressful reaction. The evaluation of these models, studies found
mixed results. Some studies support the stress-buffering model, whereas other studies favour the
primary effect model (Cohen 2014; Rueger et al. 2016). These models do not appear to be
mutually exclusive, since both the model given support in the empirical literature (Cohen and
Wills 1985). Thus, evidence revealed that surrounded in a strong social support network acts as a
protective factor during the stressful or hardship time in life.
Studies found that statistically significant negative relationship between social support
and depression (Santini et al. 2015; Bell, Leroy and Stephenson 1982). Nevertheless, social
support may cause psychological illness, also believable that individuals who suffer from
psychological distress or illness might avoid social interaction (Johnson 1991). Similarly,
Almquist, Landstedt, and Hammarström (2017) longitudinally investigated the structural and
9

PERCEIVED SOCIAL SUPPORT
10
functional characteristics of social support concerning depressive symptoms and found social
support and depressive symptoms have bi-directional effects over time among women. Changes
in social support levels affect changes in depressive symptoms and vice versa. Moreover, a study
done in Cyprus revealed that single mothers perceived social support have a strong negative
independent relationship with depression (Rousou, Kouta and Middleton 2016).
Studies revealed that compared to married mothers’, single mothers experience a
disproportionately greater level of physical and psychiatric illness (Berkman 1996; Lipman
2001). Cairney et al. (1999) did a study using a large Canadian sample and investigated the
episode of major depression in the previous year among mothers. Further, authors did find single
mothers were likely to experience depression twice higher than married mothers. Similar results
were found in the study done in Germany. The results revealed that depressive symptom among
single mothers were twice higher than that of married mothers (Liang, Berger and Brand, 2019).
There are many mediate and moderate factors that influence single parent to cause psychological
distress. The factors that identified in the past literature includes, negative life event and single
parenting responsibilities (Avison 1995), child abuse and other adversities experience in early
childhood (Lipman, MacMillan, Boyle 2001; Davies, Avison, McAlpine DD 1997), financial
hardship (Hope, Power and Rodgers 1999) and reduced the level of social support (Cairney et al.
2003). Also, Cairney et al. (2003) claimed that together, stress and social support were the reason
for depression, for nearly 40 per cent of single mothers. Furthermore, inadequate social support
and history of partner were a risk factor of depression among mothers with young children
(Liang, Berger and Brand, 2019).
One of the main assumptions about single parenthood was that family members and
friends were more likely to offer help because of the absence of the partner. Also, believe that a
10

PERCEIVED SOCIAL SUPPORT
11
single mother’s family’s member will provide instrumental and emotional social support during
her difficult times. However, a study found that compared to married mothers, single mother’s
contact with families and friends were limited; and social involvement was low (Cairney et al.
2003). Additionally, they reported a lower level of perceived social support than married
mothers. Furthermore, the result also found that married mothers were more likely to be
depressed due to a life event than single mothers (Cairney et al. 2003).
Generally, existing research mainly focus on how economic hardship or how high stress
influence mental health of single motherhood, and very few studies focus on the role of social
support (Liang, Berger and Brand, 2019; Rousou, Kouta and Middleton 2016; Kim, Jeon and
Jang 2010; Cairney et al. 2003), which plays an important role in psychological well-being of
single mothers, because stress was relatively high on this group. In addition, most of the past
literature comes from Western countries (Liang, Berger and Brand, 2019; Rousou, Kouta and
Middleton 2016; Cairney et al. 2003). Therefore, it is questionable that these findings would be
generalized to Maldivian population; meanwhile, it is accepted that both social welfare systems
and societal factors vary substantially across multiple countries. International literature revealed
that social support varies cultural and socio-political context (Burstrom et al. 2010; Fritzell et al.
2007; Rousou, Kouta and Middleton 2016). Studies found that financial hardship plays a role in
depression among single mothers (Hope, Power and Rodgers 1999), while in the Maldives,
National Social Protection Agency assists single parents who are struggling financially (NSPA
2019). Therefore, this might impact on the results as well. The relationship between social
support and depression among single and married mothers were not studied in the Maldives, and
this study aims to fill this gap. Also due to the high percentage of divorce rate and an increasing
11

PERCEIVED SOCIAL SUPPORT
12
number of single mothers headed families, its vital to investigate the mental health status of
mothers because it will negatively impact on the child’s wellbeing.
LITERATURE REVIEW
Existing literature shows that the status of single motherhood exposes them to
disadvantaged social position and are predisposed to poor mental health due to factors such as
stress when in comparison to their married counteparts (Rousou, Kouta Middleton, &
Karanikola, 2013). Multiple factors have been associated with increased depression among
mothers. The association between income status and health differences between married and
single mothers was carried out in South Korea (Kim, Jeon, & Jang, 2010). Kim and friends
carried out a longitudinal survey of Korean Women and found out that single mothers were
highly exposed to poor health than married mothers. This was attributable to several factors with
the most common being subjective economic status (28%) with all the factors contributing to
41.4% risk of developing depression among single mothers. Although the results showed clearly
that single mothers suffer more depression symptoms, socioeconomic status alone is not
sufficient to explain the causal association.
A comparison of the health differences between single and married women was carried
out in three states: Britain, Sweden, Italy (Burstrom et al., 2010). The researchers used data from
national household surveys and the outcomes reported both the similarities and differences. The
health of single mothers was more deteriorated than their counterparts in all the three nations,
had greater chances of being disadvantaged economically and venturing into drug abuse. The
health inequalities were prevalent in all the countries despite the existing counter policies.
12