The Interrelationships Among Acculturation, Social Support, and Postpartum Depression Among Marriage Immigrant Women in Taiwan: A Cohort Study
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Purpose: Adaptation to a new culture is associated with mental well-being among immigrants. Previous research consistently supports the relationship between social support and postpartum depression. However, the causal and structural relationships among acculturation, social support and postpartum depression have not been established. The study objectives were to examine (1) depressive symptomatology at 1 and 6 months postpartum; (2) structural relationships among social support, acculturation, and postpartum depressive symptomatology among immigrant mothers in Taiwan. Methods: This cohort study recruited 203 new immigrant mothers from China and Vietnam living in Taipei. Data were collected at 1 and 6 months postpartum. Postpartum depression was measured by Edinburgh Postnatal Depression Scale. Social support was measured by a scale with higher score indicating higher social support. Acculturation factors included duration of living in Taiwan, local language ability, social assimilation (integration into mainstream society), and social attitude (accepting attitude toward mainstream society). Results: The mean depression score decreased significantly from 6.67( +/- 5.80) at 1 month to 4.02(+/- 4.64) at 6 months postpartum. The structural equation modeling results showed that social support and postpartum depression were directly and negatively related. Higher social support and lower depression at 1 month postpartum were related to a positive social attitude. Social attitude was a moderator to the relationship between depression at 1 month and social support at 6 months postpartum, where a positive social attitude decreased the negative effect of depression on social support. Conclusion: Social support in early postpartum period not only directly decreases postpartum depression but also indirectly decreases postpartum depression through increasing social attitude. Social support intervention is implicated to improve social attitude and decrease postpartum depression among immigrant mothers.