van Ditzhuijzen Jenneke, Ten Have Margreet, de Graaf Ron, van Nijnatten Carolus H C J, Vollebergh Wilma A M
Utrecht University, Faculty of Social and Behavioral Sciences, Utrecht, the Netherlands.
Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, the Netherlands.
Contraception. 2015 Sep;92(3):246-53. doi: 10.1016/j.contraception.2015.05.003. Epub 2015 May 19.
The objective of this study is to investigate to what extent psychiatric history affects preabortion decision difficulty, experienced burden, and postabortion emotions and coping. Women with and without a history of mental disorders might respond differently to unwanted pregnancy and subsequent abortion.
Women who had an abortion (n=325) were classified as either with or without a history of mental disorders, using the Composite International Diagnostic Interview version 3.0. The two groups were compared on preabortion doubt, postabortion decision uncertainty, experienced pressure, experienced burden of unwanted pregnancy and abortion, and postabortion emotions, self-efficacy and coping. The study was conducted in the Netherlands. Data were collected using structured face-to-face interviews and analyzed with regression analyses.
Compared to women without prior mental disorders, women with a psychiatric history were more likely to report higher levels of doubt [odds ratio (OR)=2.30; confidence interval (CI)=1.29-4.09], more burden of the pregnancy (OR=2.23; CI=1.34-3.70) and the abortion (OR=1.93; CI=1.12-3.34) and more negative postabortion emotions (β=.16; CI=.05-.28). They also scored lower on abortion-specific self-efficacy (β=-.11; CI=-.22 to .00) and higher on emotion-oriented (β=.22; .11-.33) and avoidance-oriented coping (β=.12; CI=.01-.24). The two groups did not differ significantly in terms of experienced pressure, decision uncertainty and positive postabortion emotions.
Psychiatric history strongly affects women's pre- and postabortion experiences. Women with a history of mental disorders experience a more stressful pre- and postabortion period in terms of preabortion doubt, burden of pregnancy and abortion, and postabortion emotions, self-efficacy and coping.
Negative abortion experiences may, at least partially, stem from prior or underlying mental health problems.
本研究的目的是调查精神病史在多大程度上影响堕胎前的决策难度、经历的负担以及堕胎后的情绪和应对方式。有精神障碍病史和无精神障碍病史的女性对意外怀孕及随后的堕胎可能会有不同反应。
使用综合国际诊断访谈第3.0版，将进行过堕胎的女性（n = 325）分为有精神障碍病史组和无精神障碍病史组。比较两组在堕胎前的疑虑、堕胎后决策的不确定性、经历的压力、意外怀孕和堕胎所带来的负担，以及堕胎后的情绪、自我效能感和应对方式。该研究在荷兰进行。通过结构化面对面访谈收集数据，并进行回归分析。
与无精神障碍病史的女性相比，有精神病史的女性更有可能报告更高水平的疑虑（优势比[OR] = 2.30；置信区间[CI] = 1.29 - 4.09）、更多的怀孕负担（OR = 2.23；CI = 1.34 - 3.70）和堕胎负担（OR = 1.93；CI = 1.12 - 3.34），以及更多的堕胎后负面情绪（β = 0.16；CI = 0.05 - 0.28）。她们在堕胎特定自我效能感方面的得分也较低（β = -0.11；CI = -0.22至0.00），而在以情绪为导向（β = 0.22；0.11 - 0.33）和回避导向应对方面得分较高（β = 0.12；CI = 0.01 - 0.24）。两组在经历的压力、决策不确定性和堕胎后积极情绪方面没有显著差异。
精神病史对女性堕胎前后的经历有强烈影响。有精神障碍病史的女性在堕胎前的疑虑、怀孕和堕胎负担以及堕胎后的情绪、自我效能感和应对方式方面，经历了更具压力的堕胎前后时期。
负面的堕胎经历可能至少部分源于先前或潜在的心理健康问题。
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