Vulnerability, life events and depression amongst Moslem Malaysian women: comparing those married and those divorced or separated

INTRODUCTION: The experiences of married and single mothers were compared in an investigation of psychosocial vulnerability, stress and depression in a community-based study of Moslem mothers in Malaysia. For the first time, a model of vulnerability-provoking agent originally developed by Brown et al. in the UK was tested in a Malaysian context.

METHODS: A cross-sectional study was carried out in the district of Johor Bahru, Malaysia. Of the 1,200 women approached from membership of community associations, 1,002 (84%) completed the questionnaires. Severe life events Recent Life Events Questionnaire (Brugha and Cragg in Acta Psychiatr Scand 82:77-81, 1990) and psychosocial vulnerability (VDQ) (Moran et al. in Br J Clin Psychol 40:411-427, 2001) were used to measure vulnerability factors. Depression was measured by the General Health Questionnaire (GHQ-30) (Havenaar et al. in Soc Psychiatry Psychiatr Epidemiol 43:209-215, 2008).

RESULTS: Single mothers had significantly higher rates of depression than those married (60.5 vs. 39.5%), as well as higher rates of severe life events and Negative Elements in Close Relationships (lack of support and conflict with children). However, married mothers had greater Negative Evaluation of Self. The two vulnerability factors were correlated to each other and to severe life events and social adversity. Logistic regression showed an interaction between severe life events in the material and relationship domains and joint vulnerability for depression outcome. The results are discussed in relation to the low recognition of psychosocial risks for depression in single mothers in Malaysia, as well as lack of appropriate services.