Socio-demographic characteristics of single mothers
Socio-demographic characteristics of the sample are summarized in Table
1. Single mothers that participated in this study had a mean age of 39.2 years (SD = 6.64, range: 23–59). Regarding family status, 73.1% were divorced, and as many as half were the head of a single parent family for more than 5 years (46.5%). As for the number of dependent children, the majority had the custody of either one (40.3%) or two (43.5%) children, of whom the majority were under the age of 12 years (64.9%).
Table 1
Socio-demographic characteristics of the participants and prevalence of clinically significant psychological distress (GHQ-28 ≥ 5)
| % (n=) | % | x2 | Df | P value |
Age |
23–34 | 25,4 (80) | 40.5 | 6.417 | 2 |
0.040
|
35–44 | 51,7 (163) | 57.1 | | |
45–59 | 22,9 (72) | 46.5 | | |
Educational level |
Junior high school | 7,9 (25) | 60 | 10.290 | 3 |
0.016
|
High school | 32,4 (102) | 49.5 | | |
Higher education | 23.5 (74) | 63.5 | | |
University | 36.2 (114) | 40.7 | | |
Single family status |
Separated | 9,5 (30) | 53.3 | 1.768 | 3 | 0.622 |
Widow | 9,2 (29) | 60.7 | | | |
Divorced | 73,1 (231) | 49.6 | | | |
Unmarried | 7,9 (25) | 44 | | | |
How long as single mother |
< 2 years | 20.5 (65) | 62.5 | 5.613 | 2 | 0.060 |
2–4 years | 33 (103) | 43.7 | | | |
5 or more years | 46.5 (147) | 50.5 | | | |
Children age < 12 years old |
Yes | 64.9 (204) | 49.5 | 0.302 | 1 | 0.583 |
No | 35.1 (109) | 52.8 | | | |
Employment status |
Economically inactive | 8.2 (26) | 69.2 | 6.792 | 3 | 0.079 |
Unemployed | 7.6 (24) | 50 | | | |
Working part-time | 10.4 (33) | 62.5 | | | |
Working full-time | 73.4 (232) | 46.8 | | | |
Monthly family income |
> 1000 | 27.8 (88) | 65.5 | 15.297 | 5 |
0.009
|
1000–1499 | 27.2 (86) | 50 | | | |
1500–1999 | 18.0 (57) | 42.9 | | | |
2000–2499 | 10.1 (32) | 40.6 | | | |
2500–3499 | 12.0 (38) | 47.4 | | | |
≥ 3500 | 4.4 (14) | 21.4 | | | |
Member of SMA |
No | 56.8 (179) | 46.4 | 2.598 | 1 | 0.107 |
Yes | 43.2 (136) | 55.6 | | | |
Single mothers’ allowance recipient |
Yes | 58.9 (186) | 53.3 | 1.382 | 1 | 0.240 |
No | 40.8 (129) | 46.5 | | | |
Financial child support from the father |
Yes | 51.9 (163) | 45.4 | 3.512 | 1 | 0.061 |
No | 48.1 (152) | 56 | | | |
Economic hardship during the last 12 months |
Yes | 79.7 (252) | 57.2 | 23.235 | 1 |
< 0.001
|
No | 20.3 (64) | 23.4 | | | |
Limiting-long standing illness |
Yes | 49.4 (156) | 65.2 | 26.976 | 1 |
< 0.001
|
No | 50.6 (160) | 35.8 | | | |
Physical activity |
Yes | 30.8 (97) | 56.4 | 10.626 | 1 |
0.001
|
No | 69.2 (218) | 36.5 | | | |
Smoking habit |
Yes | 39.4 (124) | 53.2 | 0.693 | 1 | 0.405 |
No | 60.6 (191) | 48.4 | | | |
Alcohol consumption |
Yes | 30.8 (97) | 53.9 | 3.639 | 1 | 0.056 |
No | 69.2 (218) | 42.3 | | | |
Single mothers’ educational background varied, but one in three of single mothers in the sample (36.2%) had University education. Regarding employment status, as much as 73.4% of the participants held full-time jobs, and despite that, 79.7% of the sample reported economic hardship to meet their daily expenses during the last 12 months. This was mainly due to the fact that more than half of the participants (55.0%) reported monthly family income less than €1500, and a further 27.8% less than €1000.
Regarding support from the state, the 40.8% of the sample have reported that they were not single mothers’ allowance recipients, and nearly half of them (48.1%) did not receive financial support from the father of their child/children.
Regarding the participants’ health status, 49.4% of the single mothers have reported a long-standing illness, and depression was the most commonly reported one with the rate of 32.2%.
Prevalence of mental distress in relation to socio-demographic characteristics
As many as 44.6% of the sample appeared to experience clinically significant symptoms of mental distress (GHQ-28 total score ≥ 5). Table
1 also presents the observed differences in mental distress according to socio-demographic characteristics of the participants. The most pronounced statistically significant differences in the prevalence of mental distress as measured by the GHQ-28 were observed for age, educational level, monthly family income, economic hardship and the presence of a long-standing illness. With a prevalence of mental distress as high as 57.1%, single mothers in the age group 35–44 seem to experience the highest levels of mental distress compared to both the younger age group (40.5%) as well as the older age group (46.5%); x
2 = 6.417, df = 2,
p = 0.040.
The prevalence of mental distress was statistically significantly higher among single mothers who had higher education (63.5%) and junior high school education (60.0%), compared to those who had university education (40.7%, x2 = 10.29, df = 3, p = 0.016). A stepwise, association was also observed in terms of decreasing monthly family income, with an observed prevalence of mental distress as high as 65.5% among those with monthly family income less than 1000 euros versus 21.4% among those with income higher than 3500 euros/month (x2 = 15.29, df = 5, p = 0.009).
Among single mothers who reported economic hardship for daily expenses in the last 12 months, the prevalence mental distress appeared twice higher than those who did not report economic hardship (57.2% vs 23.4%, x2 = 23.23, df = 1, p = < 0.001). Similarly, and not surprisingly, statistically significant higher prevalence of mental distress was observed among those reporting long standing illness (65.2% vs 35.8%, x2 = 26.97, df = 1, p = < 0.001).
No statistical associations were observed among other variables examined, such as single-family status, the age of their child/ren, whether they were members of the SMA or if they are recipients of single mothers’ allowance or financial child support from the father. Furthermore, even though not statistically significant at the 5% level the prevalence of mental distress appeared elevated among the economically inactive group compared to mothers who reported working full-time, as well as among mothers who have been in their current status for shorter period of time.
The results of the backward stepwise logistic regression analysis are presented in Table
2. Starting with thirteen socio-demographic variables, the final predictive model included five variables. The strongest negative association was observed with regards to monthly family income. There was a clear stepwise increase in the likelihood for psychophysical distress among single mothers across decreasing levels of income. In fact, mothers in the lowest income category were more than 6 times as likely to report mental distress compared to mothers in the higher income category (OR = 6.658 95% CI: 1620-27,495). A statistically significant association was also observed in terms of house tenure (used here as an additional socio-economic position indicator) with single mothers residing in rented accommodation appearing at least twice as likely to experience psychophysical distress (OR = 2.163 95%, CI: 1.106–4449) compared to mothers who own their house.
Table 2
Adjusted odds ratios (and 95% CI) of clinically significant psychological distress (GHQ-28 ≥ 5) by personal, family, economic and health behavior characteristics as estimated in multivariable backward stepwise logistic regression analysis
Monthly family income |
> 3500 | 1 | 0.202 |
2500–3499 | 2,619 (0.598–11.478) | 0.143 |
2000–2499 | 3.121 (0.680–14.323) | 0.190 |
1500–1999 | 2.609 (0.622–10.947) | 0.058 |
1000–1499 | 3.839 (0.954–15.446) |
0.009
|
< €1000 | 6.658 (1.612–27.495) | |
Age category |
23–34 | 1 | |
35–44 | 3447 (1780-6673) |
< 0,001
|
≥ 45 | 2787 (1258-6176) |
0,012
|
Duration in single mother status |
≥ 5 years | 1 | |
2–4 years | 0,705 (0,402-1238) | 0,224 |
< 2 years | 2272 (1116-4626) |
0,024
|
House tenure |
Owned | 1 | |
Rented | 2163 (1106-4230) |
0,024
|
Physical Activity |
No | 1 | |
Yes | 2152 (1264-3663) |
0,005
|
In addition, there appeared to be a statistically significant association with age. Single mothers between 35 and 44 years old, were more than three times more likely to experiences mental distress, compared with the younger age group (OR = 3.46, 95% CI: 1780-6673). The same pattern, but to a lesser degree, applies to the single mothers of ≥45 years of age (OR = 2.787, 95% CI: 1.258–6176). A statistically significant association was also observed in terms of the period in a single-parent family Specifically, it was observed that single mothers who have been in their current status for less than 2 years, experience the highest level of mental distress as they were twice as likely to score high on the GHQ-28 compared to those who have been single mothers for longer than 5 years (OR = 2.272, 95% CI: 1.116–4626).
Finally, even though somewhat surprising, a statistically significant association was observed in terms of physical activity, with mothers who report been more physically active appearing more likely to experience mental distress. Results were unchanged when using the forward method instead.
Perceived social support among single mothers and association with mental distress
In terms of the perceived social support, taking into consideration the theoretical range of the scale which is 24–96, the minimum and maximum SPS scores that have been observed based on the participants’ responses were 42–96. Therefore, these observed values were distributed into quartiles for statistical analysis purposes. Based on that, the following socio-demographic characteristics found to be significantly related with the lower levels of perceived social support: lower monthly family income, economic difficulties and therefore being a recipient of single mother allowance (p < 0.01), the family status as being unmarried mothers compared to those who were divorced, separated or widows (p = 0.007). Apart from that, single mothers who were registered member of the SMA seemed to have higher levels of perceived social support (p = 0.009).
The prevalence and odds ratios of mental distress as measured by the GHQ-28 across quartiles of the levels of SPS before and after adjusting for all socio-demographic variables are shown on Table
3. These results reveal an association with mental distress and social support.
Table 3
Prevalence and odds ratios (95%CI) of psychological distress across decreasing levels of Social Provision (SPS) as estimated before and after adjusting for socio-demographic variables in a hierarchical four-step multivariable logistic regression model
T4: Higher quartile of perceived social support (values: 87–96) | 30.5% | 1 | 1 |
Τ3 (values:78–86) | 44.0% | 1692 (0,882-3246) 0,113 | 1535 (0,657-3564) 0,322 |
Τ2 (values:71–77) | 49.4% |
2208
(1167-4175) 0,015 |
3278
(1436-7481) 0,005 |
Τ1: Lower quartile of perceived social support (values:42–70) | 78.4% |
7808
(3789-16,088) 0,000 |
7930
(3087-20,371) 0,000 |
The prevalence of mental distress displayed a clear stepwise increase across quartiles of decreasing levels of perceived social support with as many as 78.4% of mothers scoring five or higher on the GHQ-28 in the quartile with the lowest levels of social support compared to 30.5% among mothers reporting the highest levels of social support. In the logistic regression model, the likelihood of reporting mental distress was estimated at nearly eight times higher among the quartile of participants with the lowest levels of social support (OR = 7808, 95% CI: 3789 – 16,088), and more than twice higher among those in the second quartile (OR = 3278, 95% CI: 1436-7481). After adjusting for the potential confounding effect of socio-demographic variables, this association did not attenuate in the fully adjusted model (OR = 7930, 95% CI: 3087-20,371).
As shown in Table
4 below, a similar pattern of negative association between social support and mental distress is largely observed across all four subscales of the GHQ-28 (Somatic symptoms, Anxiety and Insomnia, Social disfunction and Severe depression). All associations were statistically significant (
p < 0.001), with the strongest correlations observed for the sub-scales of severe depression and social dysfunction.
Table 4
Association between GHQ-28 sub-scale scores with decreasing level of Social Provision (SPS)
T1 | 1077 | 4744 | 1265 | 5438 | 1099 | 4146 | 742 | 4874 |
T2 | 724 | 4160 | 853 | 4758 | 816 | 2472 | 343 | 3823 |
T3 | 727 | 4323 | 884 | 5944 | 743 | 3239 | 344 | 4406 |
T4 | 737 | 5010 | 737 | 5438 | 630 | 3169 | 160 | 2666 |
Overall | 811 | 4784 | 927 | 5716 | 817 | 3689 | 389 | 4497 |
P value |
< 0,001
|
< 0,001
|
< 0,001
|
< 0,001
|
Pearson | −0.260 | −0.325 | −0.451 | −0.471 |
Spearman’s rho | −0.248 | −0.323 | −0.420 | −0.470 |