An examination of the correlation between depression and hopelessness levels in mothers of disabled children
Main Article Content
This research was conducted to examine the correlation between depression and hopelessness levels in mothers of disabled children between the ages 5 and 7. A total of 126 mothers of children with disabilities was used in the study. They were obtained from the nursery schools of the First Education Schools of the Ministry of Education or from private schools. In this study the Beck Depression Scale (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), Beck Hopelessness Scale (Beck, Lester, & Trexler, 1974) and a General Information Form (Ceylan & Aral, 2005) were used for statistical analyses. The findings suggested a significant correlation between the depression and hopelessness levels of mothers of disabled children (p < .01).
The birth of a child with a disability is known to negatively influence the lives, emotions and behaviors of family members. All of their expectations, hopes and plans, including work and financial arrangements, are predicated on the expectation of their child having normal characteristics. A study by Magana, Seltzer, and Krauss (2004) reported that mothers of children with an intellectual disability experienced more family problems and showed more depressive symptoms. These negative feelings arise from the fact that looking after a child with a disability is very difficult and that families are not prepared for this occurrence. In their study, Saloviita, Italinna, and Leinonen (2003) observed that mothers of children with disabilities were concerned about the child’s behavioral problems while fathers were more concerned about other people’s negative attitudes. Birth of a normal or abnormal child is viewed as the mother’s personal success or failure, respectively. Thus, the mother is often blamed and belittled by society. These negative feelings cause the mothers of disabled children to suffer stress. In a number of studies about the stress levels of families with disabled children, these families were found to have very high stress and depression levels (Bebko, Konstantareas, & Springer, 1987; Beckman, 1983; Sipahi, 2002; Wilton & Renaut, 1986).
The relationship between stress and depression has been examined in several studies and in about 80% of cases, individuals experienced stress caused by a traumatic event immediately prior to the onset of depressive symptoms (the loss of a loved one, a major failure, or birth of a child with a disability) (Körog˘lu, 2004). Parenting stress (inability, role limiting, social isolation, relationship problems with spouse, and health problems) was found to be especially high for single mothers and for those with more than one disabled child (Beckman, 1983; Dellve, Samuelsson, Tallborn, Fasth, & Hallberg, 2006; Gottlieb, 1997). In other studies, emotional disorders such as unhappiness, negativity about the future, hopelessness and pessimism were found to be influential in depression (Seber, Dilbaz, Kaptanog˘lu, & Tekin, 1993).
Hopelessness, which has a role in the emergence of depression, can be defined as a lack of expectation in achieving a goal. It includes a judgment of failure or negative feelings about the future. In his study, Beck (1963) focused on hopelessness, which is generally regarded as an important reason for pessimism and a symptom of depression. He dealt with the concept of hopelessness in the area of cognitive theory and evaluated it as a person’s negative expectations for the future. In a study done by Smith, Innocenti, Boyce, and Smith (1993) it was determined that parents of a child with a disability experienced more emotional difficulties and showed more symptoms of depression compared to parents without a disabled child. Today it is believed that mothers of disabled children may attribute false meanings to their experiences and may feel hopeless about the future. The difficulties and hardships they face in tackling the problems of their children may cause depression in these mothers. Taking this into consideration, the present study aims to measure the depression and hopelessness levels in mothers of disabled children, find the correlation between them, and to make suggestions to parents.
Method
Participants
This research was conducted with mothers who had disabled children aged between 5 and 7. One hundred and twenty-six volunteer mothers of children with a disability were included in the study. They were obtained from the preschools of the First Education Schools of the Ministry of Education, or from private schools. Mothers of children with a second or additional disability and the mothers of children from a broken family were not included in the study.
Measures
In this study the General Information Form consisting of questions developed by the researchers (Ceylan & Aral, 2005) was used to collect information related to the mothers’ age, education level, employment status, as well as the sex and disability type of children. The Beck Depression Scale (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) translated into Turkish by Teg˘in (1980) was used to measure mothers’ depression. In addition the researchers employed the Beck Hopelessness Scale (Beck, Lester, & Trexler, 1974) translated into Turkish by Kutlu (1998). The reliability coefficient of the Beck Depression Scale was found to be 0.65, and internal consistency with the two split-half correlation method was
0.78 for university students and 0.61 for depressed patients (Teg˘in). After validity and reliability tests were made, it was determined that the Beck Hopelessness Scale consisted of three factors including α = 0.78 for emotions and prospects for the future, and α = 0.72 for loss of hope or motivation. The validity coefficient was 0.64 and the reliability coefficient 0.92 (Seber, 1991; Durak, 1994; Kutlu, 1998). After reliability and validity tests were made, Teg˘in and Kutlu stated that the Beck Depression Scale and Hopelessness Scale were reliable and valid for use with Turkish children.
Data Collection Method
The mothers of children with disabilities were identified by making contact with school administrators. As a first step, administrators were briefed and informed of the purpose of the research. They were then invited to supply the names and telephone numbers of families that matched the study criteria. Researchers then made contact with mothers and the aim of the research was explained. Mothers who chose to participate were invited to choose an appropriate day and hour for an interview. These were held in a quiet room at the schools of the children who were admitted into the study. Those mothers who were not able to go to the schools were interviewed at home by the researchers. All interviews were carried out by the researchers of this study. At the start of the interviews, the questions in the General Information Form were read aloud by the researchers and the mothers were asked to answer them. Thereafter, the sentences in the Beck Depression Scale were read to the mothers and they were asked to choose the sentences which best described themselves. In the same way, the sentences in the Beck Hopelessness Scale were read to the mothers and they were requested to respond as true to the expressions they thought to be relevant and false to the ones they found irrelevant. The duration of the interview was approximately thirty minutes for each mother.
Data Analysis
Personal information relating to the mothers participating in the research is given as frequencies and percentages. Analysis of the data showed a constant correlation between the mothers’ depression and hopelessness levels. The data were analyzed by using Pearson correlation coefficients.
Results and Discussion
It was found that 77.8% of the mothers were 35 years old or below, 81% did not work, 57.9% were literate or primary school graduates, 28.6% were secondary school graduates, and 13.5% were university graduates. It was determined that the majority of children with disabilities were boys (56.3%). Thirty-one percent of disabilities were related to hearing and 19% to mental retardation.
For statistical analysis, Pearson correlation coefficients were applied to establish if there was a correlation between depression and hopelessness levels. The results showed that there was a positive and significant correlation between depression and hopelessness (r = 0.72, p < .001). This suggests that when the depression levels of mothers increase, so do their hopelessness levels, and that greater hopelessness levels mean higher levels of depression.
In his study Green (1989), examined the relationship between hopelessness and depression and conducted interviews with 40 psychiatric patients, 20 outpatients and a total of 60 patients clinically described as depressed. In this study, the Beck Depression Scale and Hopelessness Scale were used and the correlation between the scales were found to be significant (r = 0.69). In a different study, Young, Cheftner, Fawcett, and Akiskal (1996) attempted to test the hypotheses that hopelessness is the basis of depression and that the level of depression is related to increased hopelessness. The findings reported that the individuals with higher levels of depression also expressed higher levels of hopelessness. Therefore hopelessness is generally considered to be a precursor to depression. A depressed person feels insufficient and worthless, and may experience hopelessness in his feelings and thoughts about the future and thus perceives life as full of obstacles and difficult problems.
Similar to other studies which concluded that people who had a tendency for depression expressed higher levels of hopelessness, this study also found that the hopelessness level was higher in those families with a tendency for depression. Consequently, it is proposed that families of children with a disability should be supported to alleviate the hardships and attendant levels of hopelessness they may face. Members of society should be given information about disabilities, their reasons, and the requirements of children with a disability. This undertaking may decrease the levels of guilt and loneliness currently experienced by mothers of disabled children, and help to influence families to look to the future in confidence that the society will accept their children. Since it is thought that psychological consultation applications are effective in alleviating mothers’ depression and anxiety levels, psychological support should also be available to these families.
This study is limited to the examination of the correlation of depression and hopelessness levels of the mothers of 5 to 7 year-old children with a disability. For this reason, further studies with larger populations may provide more accurate generalizations.
References
Bebko, Y. M., Konstantareas, M. M., & Springer, J. (1987). Parent and professional evaluations of family stress associated with characteristics of autism. Journal of Autism Developmental Disorders, 17, 565-576.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. O., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.
Beck, A. T. (1963). Thinking and depression. Archives of General Psychiatry, 9, 324-333.
Beck, A. T., Lester, D., & Trexler, L. (1974). The hopelessness scale. Journal of Consulting and Clinical Psychology, 42, 861-874.
Beckman, P. J. (1983). Influence of selected child characteristics on stress in families of handicapped infants. American Journal of Mental Deficiency, 88, 150-156.
Ceylan, R., & Aral, N. (2005). Entegre eg˘itime katılan ve katılmayan engelli çocukların annelerinin depresyon ve umutsuzluk düzeylerinin incelenmesi. Ankara: Ankara Üniversitesi, Yayın No. 9, Bilimsel Aras¸tırma ve I˙ncelemeler: 9.
Dellve, L., Samuelsson, L., Tallborn, A., Fasth, A., & Hallberg, L. R.-M. (2006). Stress and well being among parents of children with rare diseases: A prospective intervention study. Journal of Advanced Nursing, 53, 392-402.
Durak, A. (1994). Beck umutsuzluk ölçeg˘inin geçerlik ve güvenirlik çalıs¸ması. Türk Psikoloji Dergisi, 9, 1-11.
Gottlieb, A. S. (1997). Single mothers of children with developmental disabilities: The impact of multiple roles. Family Relations, 46, 5-12.
Green, S. E. (1989). The relationship between depression and hopelessness. British Journal of Psychiatry, 154, 650-659.
Körog˘lu, E. (2004). Depresyon: Nedir, Nasıl Bas¸ Edilir. Ankara, Turkey: Hekimler Yayın Birlig˘i Yayını.
Kutlu, M. (1998). Özürlü çocug˘u olan ana-babaların umutsuzluk düzeyleri. Unpublished doctoral dissertation. Ondokuz Mayıs University, Samsun, Turkey.
Magana, S., Seltzer, M. M., & Krauss, M. W. (2004). Cultural context of caregiving: Differences in depression between Puerto Rican and non-Latina white mothers of adults with mental retardation. Mental Retardation, 42, 1-11.
Saloviita, T., Italinna, M., & Leinonen, E. (2003). Explaining the parental stress of fathers and mothers caring for a child with intellectual disability: A double ABC model. Journal of Intellectual Disability Research, 47, 300-312.
Seber, G. (1991). Beck umutsuzluk ölçeg˘inin geçerlik ve güvenirlig˘i üzerine bir çalıs¸ma. Unpublished doctoral dissertation. Anadolu University, Eskis¸ehir, Turkey.
Seber, G., Dilbaz, N., Kaptanog˘lu, C., & Tekin, D. (1993). Umutsuzluk ölçeg˘i geçerlilik ve güvenirlig˘i. Kriz Dergisi, 1, 139.
Sipahi, Ö. (2002). Down sendromlu çocug˘u olan annelerde depresyon sıklıg˘ı ve ilis¸kili faktörlerin aras¸tırılması. Unpublished doctoral dissertation. Istanbul University, Istanbul, Turkey.
Smith, T. B., Innocenti, M. S., Boyce, G. C., & Smith, C. S. (1993). Depressive symptomatology and interaction behavior of mothers having a child with disabilities. Psychological Reports, 73, 1184-1186.
Teg˘in, B. (1980). Depresyonda bilis¸sel s¸emalar. Unpublished doctoral dissertation. Hacettepe University, Ankara, Turkey.
Wilton, K., & Renaut, J. (1986). Stress levels in families with intellectually handicapped preschool children and families with non handicapped preschool children. Journal of Mental Deficiency Research, 30, 163-169.
Young, M. A., Cheftner, S., Fawcett, J., & Akiskal, H. S. (1996). An item response theory evaluation of the Beck Hopelessness scale. Cognitive Therapy and Research, 16, 579-587.
Bebko, Y. M., Konstantareas, M. M., & Springer, J. (1987). Parent and professional evaluations of family stress associated with characteristics of autism. Journal of Autism Developmental Disorders, 17, 565-576.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. O., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.
Beck, A. T. (1963). Thinking and depression. Archives of General Psychiatry, 9, 324-333.
Beck, A. T., Lester, D., & Trexler, L. (1974). The hopelessness scale. Journal of Consulting and Clinical Psychology, 42, 861-874.
Beckman, P. J. (1983). Influence of selected child characteristics on stress in families of handicapped infants. American Journal of Mental Deficiency, 88, 150-156.
Ceylan, R., & Aral, N. (2005). Entegre eg˘itime katılan ve katılmayan engelli çocukların annelerinin depresyon ve umutsuzluk düzeylerinin incelenmesi. Ankara: Ankara Üniversitesi, Yayın No. 9, Bilimsel Aras¸tırma ve I˙ncelemeler: 9.
Dellve, L., Samuelsson, L., Tallborn, A., Fasth, A., & Hallberg, L. R.-M. (2006). Stress and well being among parents of children with rare diseases: A prospective intervention study. Journal of Advanced Nursing, 53, 392-402.
Durak, A. (1994). Beck umutsuzluk ölçeg˘inin geçerlik ve güvenirlik çalıs¸ması. Türk Psikoloji Dergisi, 9, 1-11.
Gottlieb, A. S. (1997). Single mothers of children with developmental disabilities: The impact of multiple roles. Family Relations, 46, 5-12.
Green, S. E. (1989). The relationship between depression and hopelessness. British Journal of Psychiatry, 154, 650-659.
Körog˘lu, E. (2004). Depresyon: Nedir, Nasıl Bas¸ Edilir. Ankara, Turkey: Hekimler Yayın Birlig˘i Yayını.
Kutlu, M. (1998). Özürlü çocug˘u olan ana-babaların umutsuzluk düzeyleri. Unpublished doctoral dissertation. Ondokuz Mayıs University, Samsun, Turkey.
Magana, S., Seltzer, M. M., & Krauss, M. W. (2004). Cultural context of caregiving: Differences in depression between Puerto Rican and non-Latina white mothers of adults with mental retardation. Mental Retardation, 42, 1-11.
Saloviita, T., Italinna, M., & Leinonen, E. (2003). Explaining the parental stress of fathers and mothers caring for a child with intellectual disability: A double ABC model. Journal of Intellectual Disability Research, 47, 300-312.
Seber, G. (1991). Beck umutsuzluk ölçeg˘inin geçerlik ve güvenirlig˘i üzerine bir çalıs¸ma. Unpublished doctoral dissertation. Anadolu University, Eskis¸ehir, Turkey.
Seber, G., Dilbaz, N., Kaptanog˘lu, C., & Tekin, D. (1993). Umutsuzluk ölçeg˘i geçerlilik ve güvenirlig˘i. Kriz Dergisi, 1, 139.
Sipahi, Ö. (2002). Down sendromlu çocug˘u olan annelerde depresyon sıklıg˘ı ve ilis¸kili faktörlerin aras¸tırılması. Unpublished doctoral dissertation. Istanbul University, Istanbul, Turkey.
Smith, T. B., Innocenti, M. S., Boyce, G. C., & Smith, C. S. (1993). Depressive symptomatology and interaction behavior of mothers having a child with disabilities. Psychological Reports, 73, 1184-1186.
Teg˘in, B. (1980). Depresyonda bilis¸sel s¸emalar. Unpublished doctoral dissertation. Hacettepe University, Ankara, Turkey.
Wilton, K., & Renaut, J. (1986). Stress levels in families with intellectually handicapped preschool children and families with non handicapped preschool children. Journal of Mental Deficiency Research, 30, 163-169.
Young, M. A., Cheftner, S., Fawcett, J., & Akiskal, H. S. (1996). An item response theory evaluation of the Beck Hopelessness scale. Cognitive Therapy and Research, 16, 579-587.
Appreciation is due to reviewers including
Mirella Zanobini
PhD
DiSA
Sezione di Psicologia
Facoltá
di Scienze della Formazione
C.so Podesta&rsquo
2 16128
Genova
Remziye Ceylan, PhD, Gazi Üniversitesi Kırs¸ehir Eg˘itim Fakültesi, I˙lkög˘ retim Bölümü Sınıf Ög˘retmenlig˘i Anabilim Dalı, 40100 Kirs¸ehir, Turkey. Phone: +90 386 212 6240; Fax: +90 312 318 1154; Email: [email protected]