Welfare Shame,Economic Hardship,and Drug Use: Their Relationship to the Psychological Distress Observed in TANF Recipients

Abstract

BACKGROUND: Recent studies conducted in Temporary Assistance to Needy Families (TANF) populations show that TANF recipients are more likely to suffer from persistent psychiatric disorders and mental health problems than are non—TANF recipients. It has been estimated that approximately 35% of TANF recipients have psychological distress symptoms, with depression being the most commonly reported disorder. OBJECTIVE: To determine if drug use may modify the welfare-distress relationship by forming an interaction with shame, economic hardship, or both. STUDY DESIGN: A survey design consisting of 534 female recipients was used. RESULTS: Drug users demonstrated higher levels of anxiety, depression, and lower self-esteem than nonusers. Neither welfare shame nor economic hardship had direct effects on psychological distress; economic hardship significantly modified the effect of drug use. CONCLUSIONS: Contrary to previously published reports, welfare shame was not associated with the psychological distress observed in this sample of welfare recipients. J Am Psychiatr Nurses Assoc, 2007; 13(5), 275-284. DOI: 10.1177/1078390307307256

Keywords

drug abuse economic hardship psychological distress shame TANF

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References

Ali, J. , & Avison, W.R. (1997). Employment transitions and psychological distress: The contrasting experiences of single and married mothers. Journal of Health and Social Behavior, 38(4), 345-362.

Anderson, N. , & Armstead, C. (1995). Toward understanding the association of socioeconomic status and health: A new challenge for the biopsychosocial approach. Psychosomatic Medicine, 57(3), 213-225.

Atkinson, J. , Lee, D. , Dayton-Shotts, C. , & French, C. (2001). Self-perceived job skills and employment barriers among non-drug using and chronic drug-using welfare to work participants. Journal of Drug Issues, 31(3), 747-755.

Atkinson, J. , Montoya, I.D. , Trevino, R.A. , & Richard, A.J. (2000). Labor force participation in a sample of substance users. American Journal of Drug and Alcohol Abuse, 26(3), 355-367.

Bartley, M. , Ferrie, J. , & Montgomery, S. (1999). Living in high unemployment economy: Understanding the health consequences. In M. G. Marmot & R. G. Wilkinson (Eds.), Social determinants of health (pp. 82-96). Oxford , UK: Oxford University Press.

Bennet, M. (1987). Afro-American women, poverty and mental health: A social essay. Women and Health, 12(3-4), 213-228.

Besley, T. , & Coate, S. (1992). Understanding welfare stigma: Taxpayer resentment and statistical discrimination. Journal of Public Economics , 48(1), 165-184.

Brown, G.W. , Ni Bhrolchain, M. , & Harris, T. (1975). Social class and psychiatric disturbance among women in an urban population. Sociology, 9, 225-254.

Brown, H. , Adams, R. , & Kellam, S.G. (1981). A longitudinal study of teenage motherhood and symptoms of distress: The Woodlawn Community Epidemiological Project. In R. Simmons (Ed.), Research in community mental health, Vol. 2, (pp. 183-213). Greenwich, CT: JAI.

10.

Burchell, B. (1994). The effects of labour market position, job insecurity, and unemployment on psychological health. In D. Gallie , C. Marsh , & C. Vogler (Eds.), Social change and the experience of unemployment (pp. 188-212). Oxford, UK: Oxford University Press.

11.

Claussen, B. (1999). Health and re-employment in a five-year follow-up of long-term unemployed. Scandinavian Journal of Public Health , 27(2), 94-100.

12.

Cole, S. , & Lejeune, R. (1972). Illness and the legitimation of failure. American Sociological Review, 37, 347-356.

13.

Coser, L.A. (1965). The sociology of poverty. Social Problems, 13, 140-148.

14.

Crutchfield, R. , & Gove, W. (1984). Determinants of drug use: A test of the coping hypothesis. Social Science & Medicine, 18(6), 503-509.

15.

Danziger, S. , Corcoran, M. , Danzinger, S. , Heflin, C. , Kalil, A. , et al. (2000). Barriers to the employment of welfare recipients . In R. Cherry & W. Rodgers (Eds.), Prosperity for all? The economic boom and African Americans (pp. 245-278). New York: Russell Sage Foundation.

16.

Danziger, S. , Kalil, A. , & Anderson, N.J. (2000). Human capital, physical health, and mental health of welfare recipients: Co-occurrence and correlates . Journal of Social Issues, 56(4), 635-654.

17.

Derogatis L.R. , Lipman R.S. , Rickels, K. , Uhlenhuth, E.H. , & Covi, L. (1974). The Hopkins Symptom Checklist (HSCL): A self-report symptom inventory. Behavioral Science, 19, 1-15.

18.

East, J. (1999). Hidden barriers to services for women in welfare reform. Families in Society, 80, 295-304.

19.

Ensminger, M.E. (1979). Welfare status and feelings of psychological distress . Washington, DC: American Sociological Association.

20.

Ensminger, M.E. (1995). Welfare and psychological distress: A longitudinal study of African-American urban mothers. Journal of Health and Social Behavior, 36(4), 346-359.

21.

Greatz, B. (1993). Health consequences of unemployment: Longitudinal evidence for young men and women. Social Science & Medicine , 36, 715-724.

22.

Gyami, P. , Brooks-Gunn, J. , & Jackson, A.P. (2001). Associations between employment and financial and parental stress in low-income single Black mothers. Women and Health, 32(1-2), 119-135.

23.

Haas, A.P. , & Hendin, H. (1987). The meaning of chronic marijuana use among adults: A psychosocial perspective. Journal of Drug Issues, 17(4), 333-348.

24.

Halvorsen, K. (1998). Impact of re-employment on psychological distress among long-term unemployed. Acta Sociologica, 41, 227-242.

25.

Hamilton, V.L. , Broman, C.L. , Hoffman, W.S. , & Renner, D.S. (1990). Hard times and vulnerable people: Initial effects of plant closing on autoworkers' mental health. Journal of Health and Social Behavior, 31, 123-140.

26.

Health and Human Services. (1995). The JOBS evaluation: How well are they faring? AFDC families with preschool-aged children at the outset of the JOBS evaluation. Washington, DC: Office of the Assistant Secretary for Planning and Evaluation and the Administration for Children and Families.

27.

Hope, S. , Power, C. , & Rodgers, B. (1999). Does financial hardship account for elevated psychological distress in lone mothers? Social Science & Medicine, 49, 1637-1649.

28.

Iversen, L. , & Sabroe, S. (1988). Psychological well-being among unemployed and employed people after a company closedown: A longitudinal study. Journal of Social Issues, 44, 141-152.

29.

Jarret, R.L. (1996). Welfare stigma among low-income, African-American single mothers. Family Relations, 45, 368-374.

30.

Jayakody, R. , Danziger, S. , & Pollack, H. (2000). Welfare reform, substance use, and mental health . Journal of Health Politics, Policy, and Law, 25(4), 623-652.

31.

Kerbo, H.R. (1972). The stigma of welfare and a passive poor. Sociology and Social Research, 60(2), 173-187.

32.

Klein, H. , Amundson, N. , & Borgen, C. (1992). The dynamics of unemployment for social assistance recipients. Journal of Employment Counseling, 29(2), 88-94.

33.

Lennon, M. (1998). Domestic arrangements and depressive symptoms: An examination of housework conditions. In B. P. Dohrenwend (Ed.), Adversity, stress, and psychopathology (pp. 409-421). New York: Oxford University Press.

34.

Link, B. , & Phelan, J. (1995). Social conditions as fundamental causes of disease . Journal of Health and Social Behavior, 35(Extra Issue: Forty Years of Medical Sociology: The State of the Art and Directions for the Future), 80-94.

35.

Lundberg, U. , & Frankenhauser, M. (1999). Stress and workload of men and women in high-ranking positions. Journal of Occupational Health and Psychology, 4, 131-141.

36.

Marshall, N. (1982). The public welfare system: Regulation and dehumanization . In D. Belle (Ed.), Lives in stress: Women and depression (pp. 96-108). Beverly Hills, CA: Sage.

37.

McCauley, J. , Kern, D. , Kolodner, K. , Dill, L. , Schroeder, A.F. , DeChant, H.K. , et al. (1995). The “battering syndrome”: Prevalence and clinical characteristics of domestic violence in primary care internal medicine practices. Annals of Internal Medicine, 123(10), 737-746.

38.

Montoya, I.D. , Bell, D.C. , Atkinson, J. , Nagy, C. , & Whitsett, D. (2002). Mental health, drug use, and the transition from welfare to work. The Journal of Behavioral Health Services & Research, 29(2), 144-156.

39.

Murphy, G. , & Athanasou, J. (1999). The effect of unemployment on mental health. Journal of Occupational and Organizational Psychology, 72, 83-99.

40.

Nicolas, G. , & JeanBaptiste, V. (2001). Experiences of women on public assistance. Journal of Social Issues, 57(2), 299-309.

41.

Pearlin, L.I. , & Johnson, J.S. (1977). Marital status, life-strains, and depression. American Sociological Review, 42(5), 704-715.

42.

Pearlin, L.I. , Menaghan, E.G. , Lieberman, M.A. , & Mullan, J.T. (1981). The stress process. Journal of Health and Social Behavior, 22, 337-356.

43.

Petterson, S.M. , & Friel, L.V. (2001). Psychological distress, hopelessness and welfare . Women and Health, 32(1/2), 79-99.

44.

Piven, F.F. , & Cloward, R.A. (1971). Regulating the poor: Functions of public welfare . New York: Vintage.

45.

Quint, J. , Bos, H. , & Polit, D.F. (1997). New chance: Final report on a comprehensive program for disadvantaged young mothers and their children. New York: Manpower Demonstration Research Corporation.

46.

Rank, M.R. (1994). A view from the inside out: Recipients' perceptions of welfare. Journal of Sociology & Social Welfare, 21(2), 27-47.

47.

Reading, R. , & Reynolds, S. (2001). Debt, social disadvantage, and maternal depression . Social Science & Medicine, 53(4), 441-453.

48.

Rodriguez, E. , Frongillo, E. , & Chandra, P. (2001). Do social programs contribute to mental well-being? The long-term impact of unemployment on depression in the United States. International Journal of Epidemiology, 30(1), 163-170.

49.

Rogers-Dillon, R. (1995). The dynamics of welfare stigma. Qualitative Sociology, 18(4), 439-456.

50.

Ross, C.E. , & Huber, J. (1985). Hardship and depression. Journal of Health and Social Behavior, 26, 312-327.

51.

Saraceno, B. , & Barbui, C. (1997). Poverty and mental illness. Canadian Journal of Psychiatry, 42, 285-290.

52.

Stromwall, L.K. (2001). Mental health needs of TANF recipients. Journal of Sociology & Social Welfare, 28(3), 129-137.

53.

Thompson, M.S. , & Ensminger, M.E. (1989). Psychological well-being among mothers with school-age children: Evolving family structures. Social Forces, 67(3), 715-730.

54.

Yaniv, G. (1998, January 25-28). Welfare fraud and welfare stigma . Paper presented at the 2nd International Research Conference on Social Security, Jerusalem, Israel.

55.

Zedlewski, S. (1999). Work-related activities and limitations of current welfare recipients. Assessing the new federalism. Washington, DC: Urban Institute.