Abstract: Testing Reciprocal Relationships between Perceived Social Support, Self-Concept, and Depression Among Adolescents Orphaned By AIDS in Uganda: A Cross-Lagged Structural Equation Model (Society for Social Work and Research 26th Annual Conference - Social Work Science for Racial, Social, and Political Justice)

638P Testing Reciprocal Relationships between Perceived Social Support, Self-Concept, and Depression Among Adolescents Orphaned By AIDS in Uganda: A Cross-Lagged Structural Equation Model

Schedule:
Sunday, January 16, 2022
Marquis BR Salon 6, ML 2 (Marriott Marquis Washington, DC)
* noted as presenting author
Moses Okumu, PhD, Assistant Professor, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL
William Byansi, MSW, PhD, Postdoctoral Research Associate, Washington University in Saint Louis, St. Louis, MO
Jennifer Nattabi, MSW, Student, Washington University in Saint Louis, St. Louis, MO
Christopher Ddamulira, BA, Data Analyst, International Center for Child Health and Development, Masaka, Uganda
Thabani Nyoni, MA, MSW, PhD student, Washington University in Saint Louis, St. Louis, MO
Flavia Namuwonge, MBA, Study Coordinator, Washington University in Saint Louis, St. Louis, MO
Jennifer Nattabi, MSW, Doctoral Student, Washington University in Saint Louis, St. Louis, MO
Rachel Brathwaite, PhD, Postdoctoral Fellow, Washington University in Saint Louis, St. Louis, MO
Thembekile Shato, MPH, Student-Doctoral, Saint Louis University, St. Louis, MO
Ding-Geng Chen, PhD, Professor, University of North Carolina at Chapel Hill, Chapel Hill, NC
Ozge Sensoy Bahar, PhD, Research Assistant Professor, Washington University in Saint Louis, MO
Purpose: Adolescents orphaned by AIDS face several stressors, all of which are predictors of psychosocial functioning, including depression, negative self-concept, and poor social support. Although evidence shows a direct relationship between perceived social support (PSS), self-concept, and depression, there is a need for longitudinal analyses in sub-Saharan Africa to clarify these relationships’ directionality. This study fills this gap by examining the causal and directional relationships between PSS, self-concept, and depression among adolescents orphaned by AIDS in Uganda.

Methods: We conducted a longitudinal mediation analysis with data from a National Institute of Health-funded Suubi-Maka (Hope for families), a three-year longitudinal cluster-randomized controlled trial conducted in Southwestern Uganda. The study included a total of 346 participants from 10 comparable public primary schools. Participants were assessed at three-time points: baseline (T1), 12- (T2), and 24-months post-baseline (T3). Validated measures on PSS, self-concept, and depression symptoms were used. Structural equation modeling (SEM) was used to construct complete longitudinal path models.

Results: Majority of participants, (n = 225; 65%) were girls aged on average, 13.38 years (SD = 1.24). At baseline, on average participants reported 12.43 (SD = 5.35) depression score, 86.25 (SD = 9.26) PSS score and 78.37 (SD = 10.62) self-concept score. The final model based on the full sample yielded good model fit indices (χ2 to df ratio = 2.24; RMSEA = 0.06, [95% CI = 0.030, 0.089]; CFI = 0.96; sRMR = 0.037). Our longitudinal SEM analysis found that PSS quality had a longitudinal effect on depression symptoms. PSS quality at T1 was negatively associated with depression symptoms at T3 (β = -0.10; p = .043). We found evidence of an indirect relationship between self-concept and PSS quality. Also, we found that self-concept at T1 was negatively associated with depression at T2 (β = -.16; p = .0001), and depression symptoms were, in turn, negatively related to PSS quality at T3 (β = -.13; p = .003). Sobel test of indirect effect (β = .02, SE = .01; p = .029) showed that there was a depression was a mediator in the relationship between self-concept and PSS quality. In the final mediation model, we found that depression symptoms at T1 reduced self-concept at T2 (β = -.34; p = .0001), which, in turn, increased PSS quality at T3 (β = .22; p = .015). The statistically significant Sobel test results supported the existence of an indirect effect from depression to PSS quality through self-concept (β = -.07, SE .03; p = .024).

Conclusion and implications: Our findings emphasize the importance of strengthening depressed adolescents’ self-concept to promote support-seeking practices. Thus, interventions should increase the availability and accessibility of contextual resources while helping resource-poor adolescents recognize and develop their strengths by teaching strategies, including self-compassion, which can promote psychological and subjective wellbeing in light of self-criticism.