Literature Review

Lee Ritchie
Lee Ritchie

Literature Review
SWG 560
Literature Review
SWG 560

I am determined to find an answer to the following question: Are middle aged women more stressed out than any other population and does that eventually lead to depression? The articles that I will be reviewing center along the issues of stress in middle aged women and the effects that are caused due to feelings of being overwhelmed. It is predicted that stress can eventually lead to issues involving depression or other health related issues over a long period of time. All three articles that I reviewed are quantitative research based. They contained studies that involved surveys in order to prove their original hypothesis.
I will initially discuss Women’s “inner balance”: a comparison of stressors, personality traits and health problems by age groups, (Kenney, 2000). The research sought to discover a comparison on issues surrounding middle aged women and determine why they seem to have a higher level of stress for their age group.
The author’s method of research was a questionnaire and ANOVAs were used to compare women by three age groups. The three groups were categorized by young women (18-29 years old), middle-age women (30-45 years old), and older women (46-66 years old).
Kenney’s (2000) study used the following method to recruit individuals: Volunteers were given a cover letter explaining the nature and purpose of the study, a questionnaire, and a stamped addressed envelope to return the completed questionnaire. To attract minority women, a small remuneration of $5 was offered as an incentive for returning a completed questionnaire.

Kenney’s study involved several instruments that were eventually used to determine their findings and form the conclusion. A 15 page questionnaire was used initially in order to have the subjects answer questions involving their stressors. It was designed for them to indicate on a Likert scale with 1 being low and 10 being high. The researchers were able to determine what stressors were normal to their everyday lives and which provided additional stress for them. They broke down the next section by measuring the different personality traits of the individuals by measuring their pessimism, fears of others opinions, and abuse history. In doing so they were able to determine the amount of pleasure each subject achieved within each role of their lives (i.e., mother, wife, and employee).
Kenney’s (2000) questionnaire required the respondents to complete the following: Section four asked women to identify health problems they experienced from a list of 20 common physical and emotional symptoms, selected from a review of the literature and similar surveys (Appendix 1). Cronbach’s alphas for internal consistency were 0-78 on physical symptoms 0.94 on emotional symptoms and 0.93 on combined symptoms. The fifth section, an ‘inner balance’ index was a semantic differential scale of 40 items adapted from Eliot’s (1995) Quality of Life Index. This index was designed to identify the balance between major stressors and resources related to one’s career, relationships, personal lifestyle, health behaviors, and personality traits.

The discussions involved with this study included finding out what was stressing for women among all age groups. It also took into consideration different personality traits and symptoms of the stress itself. Kenney (2000) discusses the following: In this study, middle-aged women had significantly more daily hassles and overall stressors than younger or older women, which were probably related to their multiple roles and responsibilities, as wives, mothers, employees, students and caretakers of elderly parents. With these multiple roles, middle-aged women reported more stressors related to managing home responsibilities, running errands/commuting children, not receiving adequate help or emotional support from their partner, and not finding time to relax.”
The eventual conclusions of that study through analysis of the ANOVAs used determined that middle-aged women had significantly higher stressors in their lives as opposed to their counterparts of young and older women.
The findings of Kenney (2000) were as follows: Middle-aged women were more stressed, juggling the multiple responsibilities and demands of their spouse, children, ageing parents, and their occupation, while trying to maintain their own ‘inner balance’.
I found that Kenney’s study backed up my original hypothesis that middle-aged women are more stressed and that it can lead to health issues with long term exposure. The article was helpful and gave me further insight in the measurability of various variables that need to be considered while doing research.
The next article that I reviewed covered information on major depression in older women. I choose the article titled, Earlier stress exposure and subsequent major depression in aging women, (Kasen, Chen, Sneed, & Cohen, 2009) due to the fact that I wanted a study that would provide information on what stress and depression can lead to later in life. While this study wasn’t as detailed as my previous review, it did provide valuable information.
The objective for this study is similar to my original hypothesis in that both consider the long term consequences of stress and major depression. The method used was a survey in which 565 women were selected at random out of a cohort of 758 mothers in the year 1975. These women all had the same basic demographical backgrounds. They were all English speaking adult females, living in upstate New York, and all had children still living in the home. In order to maintain accurate readings follow up interviews took place. All of the samples represented different ethnic groups and socioeconomic statuses. While follow up interviews did take place, not all of the respondents were able to complete them. Over 90 percent participated in at least 3 of the follow up interviews. The remaining participants were categorized as being unavailable, ill, and some refused. Research by Kasen et al., 2009, study measured the following:
1) Childhood adversity is a count of negative events occurring before age 16 reported at T4, including parental/other close family death, maltreatment, serious illness or disability, serious accident or injury, criminal/violence victimization or witnessing, parental separation/divorce, severe financial hardship, and more than three major residential relations.
2) Negative life events (NLE) were assessed for the past year at T1 and for the period since each previous interview thereafter. NLE are similar to those covered in other studies (Kendler et al., 2002) and include loss events (death of husband/partner, offspring, parent, other closer person); serious medical illness or accident/injury (self or close others); divorce/separation; other marital/family events (e.g., self/partner job loss, criminal involvement or alcohol use by husband/partner or offspring; offspring divorced); serious financial/legal problems; and life-threatening events (e.g., serious fire or other fateful event, physical assault/other victimization, witnessed violence/criminal acts).
3) Martial relationship was assessed at T2 –T5 with 6 items from the Locke-Wallace Marital-Adjustment and Marital-Predication Tests (Locke and Wallace, 1959) covering frequency of negative (arguing, name-calling/yelling, rough stuff) and positive (help each other with troubled times, affectionate with each other, spend time together) interactions with husband, ex-husband or current partner relationship, rated from 0 (never or hardly ever) to 4 (always or almost always). Positive negative interactions both affect relationship quality (Kendler et al., 2002); thus, positive items were reverse scored and combined with negative items to create a marital scale. Mean (SD) raw scores are 6.2 (3.4), 6.3 (3.6), 6.4 (3.6), and 4.9 (2.3) across T2 –T5; Cronbach’s alphas range from 0.80-0.78, indicating satisfactory internal consistency.
The discussion leads with the issues of middle-aged women. Women that experience troubled childhoods, marital issues, and other stressors are at a higher risk to develop major depression. Kenney’s (2000) study also discussed the stressors mentioned here and how they contribute to the cause of stress related mental health issues.
The conclusion or findings of this study not only supported my original hypothesis but also confirmed the research by Kenney (2000). The correlation between these results make it virtually impossible for one not to conclude that major depression is predominately caused my significant stressors and is highest among middle-aged women.
My final review article titled, Women in Midlife: Stress, Health and Life Satisfaction, (Darling, Coccia, & Senatore, 2011). The abstract of this research is similar to both Kenney (2000) and Kasen et al., (2009) studies. It mentions that middle-aged women experience greater health stress because of their previous issues surrounding long term exposure to stressors within their lives. The previous articles went much more in depth in terms of stressors for middle-aged women, while this article focuses more on the health and social well-being of middle-aged women.
Darling et al., (2011), study used the following methods during the study: An examination of family, health and stress issues of women in midlife was added to an ongoing study of weight reduction using calcium supplementation in post-menopausal women. These 125 women were generally healthy; 2-10 years post –menopause; able to live independently; free of chronic diseases and recent fractures, cancer, or any other conditions precluding them for participation in diet restriction; and were Caucasian, which is related to being at high risk for osteoporosis. The subjects were required to be free of medications known to affect bonne metabolism for the last 3 months, including, but not limited to, hormone replacement therapy, and corticosteroids. Respondents could not be currently or within the past 3 months participating in any weight reduction regimes or taking medications for weight loss. Those individuals who were suspected of eating disorders, excessive smoking and/or alcohol consumption were not included. Subjects were recruited through local community centers, interactive lectures, and newspaper advertisements. Initial phone calls to participants were used to screen for overall eligibility, assess general health status and explain the study protocols.
The 125 women in this study ranged in age from 43.8 to 65.9 years (Mean=55.8) and were predominately married (69.8%), followed by divorced (17.5 %), widowed (5.6%), never married (4.8%), separated (1.6%) and cohabitating (0.8%). In addition, 61.3% had been married only once. Of these women, 84.3% had biological children (1.8 children per family), with 40.7% having stepchildren (0.8 per family). Currently, 32.8% had children living at home. This was relatively well-educated sample of women with 3.1% having a doctoral degree, 25.2% master’s degree, 33.9% baccalaureate degree, 9.4% associate’s degree, 26.5% some college, 8.7% high or general education development and 3.2% other. Whereas 15.0% were retired, 85.0% were currently unemployed and worked an average of 19.0 hours of unpaid work. The current family income ranged from $19,000 to above $140,000 with a modal family income of $40,000 to 59,000.
Operationalized variables were measured in this study in order to explain the ranges, variables measured, and reliabilities. The discussions within this article were related to the fact that women within higher stress levels also had higher BMI levels. Those with higher BMI levels are subject to higher health related illnesses.
The results of this study again confirmed that middle-aged women with higher stressors within their daily lives are at risk for health related issues. The findings only reaffirm what my other articles also determined. Middle-aged women have a greater stress load and therefore can experience more health problems and develop long term depression. The other articles discussed during this review centered on the stressors, this article went into issues dealing with weight and sleep related issues. I chose this article to also provide insight into other issues concerning middle-aged women and stress.
All three of my articles used quantitative research methods. There was valid evidence within all of the studies to prove that middle-aged women felt a larger amount of stress compared to other age groups. They also proved that long term stress can eventually lead to major depression or other health related issues. The sampling of individuals was very thorough throughout all of them. I also found all of their methods to be quite comprehensive. The discussions and results were firm and understandable with all of the articles. Based on their methods and discussions it was easy to understand how they determined the results.
Darling, C.A., Coccia, C., & Senatore, N. (2011) Women in Midlife: Stress, Health and Life Satisfaction. Stress and Health, 28 (1) 31-40. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/smi.1398/abstract
Bibliography
Bibliography
Eliot, R.S. (1995). From Stress to Strength: How to Lighten Your Load and Save Your Life, as cited in Kenney (2000). Women’s ‘inner balance’: a comparison of stressors, personality traits and health problems by age groups. Journal of Advanced Nursing, 31(3)
Gliem, J. A., & Gliem, R. R. (2003). Calculating, interpreting, and reporting Cronbach’s Alpha Reliability Coefficient for Likert-Type Scales. Proceedings from the Midwest Research-to-Practice Conference in Adult, Continuing, and Community Education. The Ohio State University. Columbus, OH. Retrieved from https://scholarworks.iupui.edu/bitstream/handle/.../Gliem%20&%20
Kasen, S., Chen, H. , Sneed, J., & Cohen, P. (2010) Earlier stress exposure and subsequent major depression in aging women. International Journal of Geriatric Psychiatry, 25: 91-99. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/gps.2304/abstract
Kendler, K.S., Gardner, C.O., Prescott, C.A. (2002). Toward a comprehensive developmental model for major depression in women, as cited in International Journal of Geriatric Psychiatry, 25: 91-99. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/gps.2304/abstract

Kenney, Janet. (2000). Women’s ‘inner balance’: a comparison of stressors, personality traits and health problems by age groups. Journal of Advanced Nursing, 31(3). Retrieved from
http://web.ebscohost.com.go.asbury.edu:2048/ehost/detail?vid=10&sid=f2c0aa15-a2e5-47

Bibliography: Eliot, R.S. (1995). From Stress to Strength: How to Lighten Your Load and Save Your Life, as cited in Kenney (2000). Women’s ‘inner balance’: a comparison of stressors, personality traits and health problems by age groups. Journal of Advanced Nursing, 31(3) Gliem, J. A., & Gliem, R. R. (2003). Calculating, interpreting, and reporting Cronbach’s Alpha Reliability Coefficient for Likert-Type Scales. Proceedings from the Midwest Research-to-Practice Conference in Adult, Continuing, and Community Education. The Ohio State University. Columbus, OH. Retrieved from https://scholarworks.iupui.edu/bitstream/handle/.../Gliem%20&%20 Kasen, S., Chen, H. , Sneed, J., & Cohen, P. (2010) Earlier stress exposure and subsequent major depression in aging women. International Journal of Geriatric Psychiatry, 25: 91-99. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/gps.2304/abstract Kendler, K.S., Gardner, C.O., Prescott, C.A. (2002). Toward a comprehensive developmental model for major depression in women, as cited in International Journal of Geriatric Psychiatry, 25: 91-99. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/gps.2304/abstract Kenney, Janet. (2000). Women’s ‘inner balance’: a comparison of stressors, personality traits and health problems by age groups. Journal of Advanced Nursing, 31(3). Retrieved from http://web.ebscohost.com.go.asbury.edu:2048/ehost/detail?vid=10&sid=f2c0aa15-a2e5-47