Elevated risk of postpartum depressive symptoms among Arab women in Israel: The role of maternal role satisfaction and psychological flexibility

Abstract

Objectives

Postpartum depressive symptoms (PPDS) are more prevalent among ethnic minority women, yet the psychological processes contributing to this disparity, particularly potential protective factors, remain insufficiently understood. Guided by Lazarus and Folkman's (1984) stress and coping model, this study examined the contribution of maternal role satisfaction and psychological flexibility to PPDS among Jewish and Arab mothers in Israel. In addition, we tested whether maternal role satisfaction mediates, and psychological flexibility moderates, the association between ethnicity and PPDS.

Method

A cross-sectional study was conducted in Israel with 476 postpartum women (288 Jewish, 188 Arab), recruited through convenience sampling via social media. The participants completed validated Hebrew or Arabic questionnaires assessing PPDS, maternal role satisfaction, and psychological flexibility. The analyses included t-tests, correlations, hierarchical regression, and a conditional process analysis testing mediation and moderation effects.

Results

Arab mothers reported higher PPDS and greater role satisfaction than Jewish mothers. Additionally, 23.9 % of Arab mothers and 9.7 % of Jewish mothers scored above the clinical cutoff for probable postpartum depression. Maternal role satisfaction (β = −0.61, p < .001) and psychological flexibility (β = −0.35, p < .001) were associated with lower PPDS. Maternal role satisfaction partially mediated the association between ethnicity and PPDS (β = −0.08, CI [−0.14, −0.05]), such that Arab mothers reported higher role satisfaction, which was associated with lower PPDS; however, psychological flexibility did not moderate this association.

Conclusions

Culturally sensitive interventions strengthening maternal role satisfaction may help to reduce postpartum distress and support resilience among minority mothers.