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Home Exclusive Mental Health Anxiety


SUPREME COURT’S OVERTURNING OF ROE V. WADE LINKED TO SPIKE IN ANXIETY AND
DEPRESSION

by Eric W. Dolan
February 7, 2024
in Anxiety, Depression


(Photo credit: Adobe Stock)



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In a study published in JAMA, researchers have uncovered that the Supreme
Court’s decision to overturn Roe v. Wade, known as the Dobbs decision, was
linked to a noticeable increase in anxiety and depression symptoms across the
United States. This effect was particularly pronounced among women of
reproductive age in states that had preemptively passed laws to ban abortions
upon the decision’s announcement.

The Dobbs v. Jackson Women’s Health Organization decision marked a pivotal
moment in U.S. legal history, overturning nearly 50 years of federal abortion
rights established by Roe v. Wade and Planned Parenthood v. Casey. This
monumental ruling shifted the power to regulate abortions back to individual
states, many of which had already enacted “trigger laws” designed to immediately
ban abortions if Roe was overturned.



Thirteen states had trigger laws in place at the time the Dobbs decision was
announced, including Arkansas, Idaho, Kentucky, Louisiana, Mississippi,
Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Utah, and
Wyoming.

In light of these dramatic legal shifts and the potential for widespread effects
on public health, researchers embarked on a study to assess the mental health
impacts of the Dobbs decision. Prior studies had shown that being denied an
abortion could lead to increased depression and anxiety, but the broader
implications of such a significant policy change on the general population’s
mental health were not well understood.

“I had pursued a paper employing a similar methodology to assess the impacts of
North Carolina’s controversial ‘Bathroom Bill.’ This research made it clear to
me that noteworthy policy shifts like this could have an impact on factors that
are not directly related to what they were designed to target,” said study
author Benjamin Thornburg, a PhD candidate in the Bloomberg School’s Department
of Health Policy and Management.

The new study utilized data from the Household Pulse Survey, an online survey
initiated by the U.S. Census Bureau in April 2020, amid the COVID-19 pandemic.
This survey aimed to collect real-time data on how U.S. households were faring
in terms of health and socioeconomic status. With responses from 718,753
individuals, the survey provided a rich dataset for analysis.



The researchers focused on the Patient Health Questionnaire-4 (PHQ-4), a brief
screening tool included in the survey to measure anxiety and depression
symptoms. The PHQ-4 scores range from 0 to 12, with higher scores indicating
more severe symptoms of anxiety and depression.

The analysis covered survey waves from December 29, 2021, to January 19, 2023, a
period that included the leak and official announcement of the Dobbs decision,
allowing the researchers to compare mental health outcomes before and after
these events.



In the six months following the Dobbs decision, anxiety and depression scores
increased by 8.5% in states with trigger laws, compared to a 5.4% increase in
states without such laws. Notably, women aged 18 to 45 in trigger states saw a
3.03% increase in their PHQ-4 scores, while their counterparts in non-trigger
states actually experienced a slight decrease. This suggests that the decision
had a more substantial emotional and psychological toll on women of reproductive
age in states poised to restrict abortion access.

“We found that adverse mental health impacts were driven primarily by females of
reproductive age, which is surprising insofar as it indicates that the
underlying mechanism was not necessarily salient for similarly aged males,”
Thornburg told PsyPost.

Moreover, the researchers explored the probability of individuals exceeding the
clinical threshold for anxiety and depression, as indicated by their PHQ-4
scores. It found a significant increase in the likelihood of surpassing this
threshold in trigger states relative to non-trigger states, further highlighting
the mental health risks posed by the Dobbs decision.

“Our findings revealed that the overturning of Roe led to a non-trivial increase
in the probability of testing positively for anxiety or depression using a
screening tool often used in primary care settings,” Thornburg said.
“Ultimately, this study indicates that population mental health can be impacted
distally by non-mental health policies.”

The findings offer valuable insights into the immediate and significant mental
health impacts of major policy changes, particularly those affecting personal
rights and freedoms such as the Dobbs decision. However, the study was not
without its limitations.

The researchers noted the challenges inherent in using a relatively new dataset
like the Household Pulse Survey, which, while beneficial for its timeliness and
breadth, has not been as extensively validated as other long-standing data
sources. Additionally, the survey’s design as a cross-sectional study —
capturing different individuals’ responses over time rather than tracking the
same individuals — complicates the task of attributing changes directly to the
Dobbs decision.

“Our data were comprised of different groups of adults surveyed over time, which
hampered our ability to adjust for individual level characteristics,” Thornburg
explained. “However, our sample size was large and weighted to be representative
of the population, which makes this limitation less concerning.”

Looking ahead, the study’s authors call for further research to explore the
mental health impacts of policy changes more deeply. Specifically, they suggest
future studies could benefit from longitudinal designs, providing clearer
insights into how specific policy changes directly affect mental health.
Moreover, understanding the role of political ideology and other
individual-level factors in shaping responses to such policy shifts could offer
a more nuanced view of their psychological impacts.

“We are currently working on a project assessing the impacts of the Dobbs
decision on the National Residency Match,” Thornburg said. “Medical graduates
are a geographically flexible group, often moving long distances for their
preferred residency program, and their preferences are known to be greatly
informed by a program’s geographic location. As such, we hypothesize that
programs in states with abortion bans might have a harder time attracting
applicants relative to those without, especially among medical specialties where
the education would be affected explicitly (Ob/Gyn), or are comprised of a large
proportion of residents who are women (family medicine, pediatrics, psychiatry,
etc.).”

The study, “Anxiety and Depression Symptoms After the Dobbs Abortion Rights
Decision,” was authored by Benjamin Thornburg, Alene Kennedy-Hendricks, Joanne
Rosen, and Matthew Eisenberg.





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