Below is an overview of some of the past, present and future research that we are working on in the lab.
Racial and SES Disparities in Low-Birth Weight
My most current research is focused on understanding racial disparities in low birth weight. Low birth weight (LBW) is one of the most important factors affecting infant mortality and puts those who survive at increased risk for significant health problems. Research has consistently shown that African American infants experience a much greater likelihood of being born with low birth weight than their White counterparts. Prior research has extensively examined the link between LBW and socioeconomic status (SES), biological differences, and maternal risk factors such as smoking/alcohol/drug use. Surprisingly, none of these factors have accounted for the racial gap in LBW. As a result, researchers have turned to psychosocial explanations, specifically proposing that prolonged exposure to racial discrimination may explain these poor birth outcomes. According to the weathering hypothesis, African American women are in a constant state of vigilance due to chronic exposure to stress and discrimination, causing significant deterioration in their health over the course of their lives. However, studies testing this explanation have focused primarily on low-SES African American women and their experiences with racism. Thus, it is unclear whether perceived discrimination in general (or racism in particular) explains the racial disparity in LBW. Moreover, research has shown low-SES individuals are more likely to report hostile and dominant social interactions, but no one has linked interpersonal exchanges with discrimination and LBW. We have submitted a grant proposal to gather data on various forms of and reasons for perceived discrimination; to understand the link between discrimination and social interactions; and, to evaluate the weathering model of discrimination in low-SES White and African American women expecting their first child. We are also in the process of designing a pilot study to test these models.
Women’s Health Experiences and Daily Living Study (aka Women’s H.E.A.D.)
One of the interesting results that has appeared in my research on low-income women is the high prevalence of headaches. The presence of headaches is related to numerous social relationship variables and mental and physical health outcomes. Surprisingly, although the literature has found that women and low-SES individuals are more likely to experience headaches/migraines, there is a lack of research on the antecedents and consequences of headaches in poor women. As headaches can greatly impact women’s daily functioning, ability to work and parent, we feel it is essential to understand what impacts and is impacted by headaches in this population. We currently have a grant application under review to examine a psychosocial-health behavior model of headaches where social relationships and daily stress impact health behaviors (i.e., sleep, diet, exercise, smoking, alcohol use) which, in turn, impact the experience of headaches. To test this model, we are proposing a 2-week daily diary study of low-income women using PDA’s. We have already conducted a small pilot study on 9 low-income women to provide preliminary evidence for the pathways.
Baby Transitions in Marital Exchanges Study (aka Baby T.I.M.E.)
In this funded, collaborative study(with two sociologists), we are interested in understanding the risk and protective factors of postpartum distress in couples expecting their first child. We are exploring the role of gender attitudes, communal coping, and spousal support in determining who experiences symptoms of postpartum distress. For postpartum distress, we are focusing on depression and anxiety, as well as physical health symptoms in both mothers and fathers. For the study, we interviewed via online and telephone, 104 married/cohabiting couples experiencing the transition to parenthood. Interviews were conducted at the start of the third trimester, 1-month postpartum, 4-months postpartum, and 9-months postpartum. We have completed data collection and have already produced several publications (see below); we are also preparing two grant applications to extend this line of research.
Publications from the Baby T.I.M.E. study:
Biehle, S. N. & Mickelson, K. D. (2011). Preparing for parenthood: How feelings of responsibility and efficacy impact expectant parents. Journal of Social and Personal Relationships, 28, 668-683. doi: 10.1177/0123456789123456
Relatively little is known about what impacts perinatal outcomes in expectant mothers and fathers. In the current study, we examined the association between expected parenting efficacy and feelings of pregnancy responsibility on mental health and relationship satisfaction in 104 primiparous couples during their third trimester. Parenting efficacy was related to better perinatal mental health and relationship satisfaction for both mothers and fathers, while communal pregnancy responsibility was more important for mothers. At the couple level, being concordant on feelings of pregnancy responsibility was related to better mental health and relationship satisfaction for expectant mothers only. These results suggest the importance of examining predictors of perinatal outcomes, as well as the dynamic interplay between mothers' and fathers' feelings of pregnancy responsibility.
Click here to request a copy of this article.
Biehle, S. N. & Mickelson, K. D. (Prepublished online January 2011). Worries in expectant parents: Its relation with perinatal well-being and relationship satisfaction. Personal Relationships, (no issue yet) doi: 10.1111/j.1475-6811.2010.01335.x
Although much has been written about the impact of pregnancy on expectant parents, less is known about the worries couples experience during pregnancy. Sex differences in worries and the link between self and coparent worries on perinatal well-being and relationship satisfaction in 104 primiparous couples were examined. It was found not only do expectant mothers and fathers worry about different things, but also type of worry is related to different outcomes. Moreover, using structural equation modeling, childbirth worries and worry frequency indirectly predict lower relationship satisfaction through worse well-being. However, coparent's worries did not significantly relate to their partner's perinatal well-being or relationship satisfaction. This study suggests the importance of examining perinatal worries in parents, as well as the dyadic interaction between coparents.
Click here to request a copy of this article.
Biehle, S. N., & Mickelson, K. D. (in press). Personal and co-parent predictors of parenting efficacy across the transition to parenthood. Journal of Social and Clinical Psychology
As with the majority of the parenting literature, the focus on parenting efficacy has been almost exclusively on the experience of the mother while neglecting fathers and the potential link between partners. In the current study, we examined the influence of personal and co-parent predictors on parenting efficacy. We interviewed 104 primiparous couples during the third trimester, 1-month postpartum, and 4-months postpartum. Predictors of parenting efficacy were examined in the domains of performance accomplishment, emotional arousal, and verbal persuasion. Analyses revealed that personal and co-parent predictors of parenting efficacy changed over time and were unique for mothers and fathers. Overall, these results suggest the importance of examining actor-partner effects in the development of parenting efficacy across the transition to parenthood.
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If you are currently working on a manuscript based on the Baby TIME data, please click here to add the information about your paper to our spreadsheet.
Mothers’ Outcomes Matter Study (aka M.O.M. Study)
In the M.O.M. Study, we were interested in examining the issue of support network substitution and compensation. In this theory, it is argued that individuals when faced with a loss or deficit in their network will substitute with another support person. The question becomes whether this substitute is compensatory or not for the replaced support person. We believe that support substitution is a common situation for low-income women due to deficits in their own networks. We interviewed face-to-face 110 low-income mothers with at least one child between 1 and 16 years of age twice over a 6-month period. We recently published the results from the baseline data in Social Science and Medicine and continue to prepare manuscripts.
Publications from the M.O.M. study:
Mickelson, K. D., & Demmings, J. L. (2009). Impact of support network substitution on low-income women’s health: Are minor children beneficial substitutes? Social Science & Medicine, 68, 80-88.
Poor women have elevated stress but also face deficits in their social networks to provide help. Consequently, they may substitute their minor children as a support source in place of more traditional ties. Support substitution and compensation theory suggest this form of substitution may not lead to compensatory benefits. We hypothesized that low-income mothers experiencing high levels of acute and network stress would be more likely to rely on their minor children, and this reliance on minor children would be related to worse health outcomes through its impact on minor children's well-being. In an interview-based community study of 116 low-income mothers from Northeast Ohio, USA we found that acute stress (but not network stress) was related to greater reliance on minor children for support and the impact on minor children's well-being mediated the link with low-income mothers' worse health outcomes. These results suggest that the reason for and type of social network substitution may determine whether compensatory benefits are realized.
Click here to request a copy of this manuscript.
Williams, S. L., & Mickelson, K. D. (2008). A paradox of support seeking and rejection among the stigmatized. Personal Relationships, 15, 493-509.
Individuals perceiving stigma may be unwilling to seek support directly. Instead, they may use indirect strategies due to fear of rejection. Ironically, indirect seeking leads to unsupportive network responses (i.e., rejection). In Study 1, data collected from structured interviews of a sample of U.S. women in poverty (N= 116) showed that perceived poverty-related stigma was related to increased fear of rejection, which in turn partially mediated perceived stigma and indirect seeking. In Study 2, data gathered from structured interviews of a sample of U.S. abused women (N= 177) revealed that perceived abuse-related stigma was linked to increased indirect seeking, which in turn related to increased unsupportive network responses. By contrast, direct support seeking was related to increased supportive and decreased unsupportive responses.
Click here to request a copy of this manuscript.
Women’s Health Outcomes in Urban and Rural Environments Study (aka Women’s HOUR)
In the Women’s HOUR, we were interested in understanding the social support processes in low-income women. Much of the prior social support literature has focused on middle-class samples; thus, little systematic research exists on how low-income women access, perceive, and utilize their social support networks. We conducted face-to-face interviews with 100 low-income four times over a one-year period. Several manuscripts have published off of this data set, including papers focusing on perceived stigma of poverty and fear of rejection. We continue to produce manuscripts from this data.
Publications from the Women’s HOUR study:
Mickelson, K. D., & Williams, S. L. (2008). Perceived stigma of poverty and depression: Examination of interpersonal and intrapersonal mediators. Journal of Social and Clinical Psychology, 27, 903-930.
This study examines the perceived stigma of poverty by assessing individuals' negative feelings about being poor (
internalized stigma), and their beliefs about whether others treat them as stigmatized (
experienced stigma). In a combined sample of low-income women (
N = 210), we tested a dual-pathway model to explain how these perceived stigma dimensions are related to depression among the impoverished. We proposed that
interpersonal (i.e., impaired support availability and heightened fear of support request rejection) and
intrapersonal factors (i.e., impaired self-esteem) differentially mediate the relationship of internalized and experienced poverty stigma with depression. Structural equation modeling partially supported the model: internalized stigma and depression were partially mediated by self-esteem and fear of rejection, while experienced stigma was related to depression through fear of rejection only. In other words, internalized and experienced perceived stigma activate separate
and similar mechanisms to influence depression among the poor.
Click here to request a copy of this manuscript.
