Date of Award


Document Type

Open Access Dissertation




College of Arts and Sciences

First Advisor

Cheryl Armstead


Recent multi-ethnic epidemiologic studies indicate an increased risk for the onset of new as well as recurrent episodes of clinical depression among midlife women. However, little is known about the risk factors that influence the occurrence, severity, and course of depression in midlife among African American women (AAW). The purpose of the current study was to statistically model three prevailing conceptual views of stress and depression: 1) life course, 2) stress exposure, and 3) stress generation). The research investigated the abilities of these conceptual models to predict depressive symptoms severity, current depressed days, and major depression among midlife AAW. Data were analyzed from the 2010 Behavioral Risk Factor Surveillance System (BRFSS), a state based, random-digit-dialed telephone survey of the American adult population. BRFSS 2010 survey responses from 4,149 midlife AAW were examined in the current analyses. Thirty three percent reported current depressive symptoms. Eighteen percent reported being diagnosed with a depressive disorder in their lifetime, and 8.4% met criteria for major depressive disorder. Exploratory factor analyses reduced the summary scores representing each of the three stress models. Regression analyses were performed to test the ability of the aforementioned stress models to predict the three measures of depression. These analyses indicated that the life course stress model significantly predicted increased symptom severity, Wald x2 =5.08, p<.05, current number of depressed days (F 1, 134)= 5.23, p<.05., and meeting criteria for major depressive disorder, b=.39, Wald=3.93, p<.05. This study highlights the importance of the life course stress model that include childhood adversity as a risk factor for later major depression. The findings also suggest that mental health service delivery and intervention research should focus on both enhancing African American midlife women’s resilience to life stress and ameliorating the maladaptive impacts of early adverse experiences.