Posttraumatic stress disorder in new mothers: results from a two-stage U.S. national survey.

School of Nursing, University of Connecticut, Storrs, USA.
Birth (Impact Factor: 2.93). 09/2011; 38(3):216-27. DOI: 10.1111/j.1523-536X.2011.00475.x
Source: PubMed

ABSTRACT Prevalence rates of women in community samples who screened positive for meeting the DSM-IV criteria for posttraumatic stress disorder after childbirth range from 1.7 to 9 percent. A positive screen indicates a high likelihood of this postpartum anxiety disorder. The objective of this analysis was to examine the results that focus on the posttraumatic stress disorder data obtained from a two-stage United States national survey conducted by Childbirth Connection: Listening to Mothers II (LTM II) and Listening to Mothers II Postpartum Survey (LTM II/PP).
In the LTM II study, 1,373 women completed the survey online, and 200 mothers were interviewed by telephone. The same mothers were recontacted and asked to complete a second questionnaire 6 months later and of those, 859 women completed the online survey and 44 a telephone interview. Data obtained from three instruments are reported in this article: Posttraumatic Stress Disorder Symptom Scale-Self Report (PSS-SR), Postpartum Depression Screening Scale (PDSS), and the Patient Health Questionnaire-2 (PHQ-2).
Nine percent of the sample screened positive for meeting the diagnostic criteria of posttraumatic stress disorder after childbirth as determined by responses on the PSS-SR. A total of 18 percent of women scored above the cutoff score on the PSS-SR, which indicated that they were experiencing elevated levels of posttraumatic stress symptoms. The following variables were significantly related to elevated posttraumatic stress symptoms levels: low partner support, elevated postpartum depressive symptoms, more physical problems since birth, and less health-promoting behaviors. In addition, eight variables significantly differentiated women who had elevated posttraumatic stress symptom levels from those who did not: no private health insurance, unplanned pregnancy, pressure to have an induction and epidural analgesia, planned cesarean birth, not breastfeeding as long as wanted, not exclusively breastfeeding at 1 month, and consulting with a clinician about mental well-being since birth. A stepwise multiple regression revealed that two predictor variables significantly explained 55 percent of the variance in posttraumatic stress symptom scores: depressive symptom scores on the PHQ-2 and total number of physical symptoms women were experiencing at the time they completed the LTM II/PP survey.
In this two-stage national survey the high percentage of mothers who screened positive for meeting all the DSM-IV criteria for a posttraumatic stress disorder diagnosis is a sobering statistic.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Exposure to high levels of early life stress has been identified as a potent risk factor for neurodevelopmental delays in infants, behavioral problems and autism in children, but also for several psychiatric illnesses in adulthood, such as depression, anxiety, autism, and posttraumatic stress disorder. Despite having robust adverse effects on both mother and infant, the pathophysiology of peripartum depression and anxiety are poorly understood. The objective of this review is to highlight the advantages of using an integrated approach addressing several behavioral domains in both animal and clinical studies of peripartum depression and anxiety. It is postulated that a greater focus on integrated cross domain studies will lead to advances in treatments and preventative measures for several disorders associated with peripartum depression and anxiety.
    Behavioural brain research 04/2014; · 3.22 Impact Factor
  • Zeitschrift für Psychiatrie Psychologie und Psychotherapie 01/2014; 62(3):165-173. · 1.99 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study is to explore childbirth fears on psychological birth trauma (PBT) by adolescent age. Among adults parity and intrapartum fears including fear of dying, loss of control, pain, and limited support have been associated with negative birth appraisal and symptoms of traumatic stress, defined here as PBT. This cross-sectional study surveyed a convenience sample of 201 adolescents at a large, county hospital. Over 75% of adolescents perceived fear. Younger and older adolescents, similar in fears, were distinguished only by parity. The effects of parity, overall rating of fear, and father of baby absence were found to vary by age on birth appraisal; however, only parity varied by age on IES scores. All age adolescents can be fearful and will benefit with childbirth education and labor support to help reduce fears and subsequent PBT.
    Applied nursing research: ANR 02/2014; · 1.14 Impact Factor