Dikmen-Yildiz Pelin, Ayers Susan, Phillips Louise
Centre for Maternal and Child Health Research, School of Health Sciences, City, University London, London, UK.
Eur J Psychotraumatol. 2017 Apr 3;8(1):1306414. doi: 10.1080/20008198.2017.1306414. eCollection 2017.
: Evidence suggests that 4% of women develop posttraumatic stress disorder (PTSD) after childbirth, with a potentially negative impact on women and families. Detection of postpartum PTSD is essential but few measures have been validated in this population. : This study aimed to examine psychometric properties of the Turkish version of the Posttraumatic Diagnostic Scale (PDS) to screen for birth-related PTSD among postpartum women and identify factorial structure of PTSD after birth. : PDS was administered to 829 postpartum women recruited from three maternity hospitals in Turkey. Participants with PTSD (= 68) and a randomly selected group of women without PTSD (= 66), underwent a structured clinical interview (SCID). : PDS demonstrated high internal consistency (α = .89) and test-retest reliability between 4-6 weeks and 6-months postpartum (= .51). PDS showed high concurrent validity with other measures of postpartum psychopathology, (829) = .60 for depression and (829) = .61 for anxiety. Satisfactory diagnostic agreement was observed between diagnoses obtained by PDS and SCID, with good sensitivity (92%) and specificity (76%). Exploratory and confirmatory factor analyses revealed that the latent structure of birth-related PTSD was best identified by a three-factor model: re-experiencing and avoidance (RA), numbing and dysphoric-arousal (NDA) and dysphoric-arousal and anxious-arousal symptoms (DAA). : The findings supported use of PDS as an effective screening measure for birth-related PTSD among postpartum women.
有证据表明,4%的女性在产后会患上创伤后应激障碍(PTSD),这可能会对女性及其家庭产生负面影响。产后创伤后应激障碍的检测至关重要,但在这一人群中经过验证的检测方法很少。本研究旨在检验创伤后诊断量表(PDS)土耳其语版本的心理测量特性,以筛查产后女性中与分娩相关的创伤后应激障碍,并确定产后创伤后应激障碍的因子结构。对从土耳其三家妇产医院招募的829名产后女性进行了创伤后诊断量表测试。患有创伤后应激障碍的参与者(n = 68)和一组随机选择的无创伤后应激障碍的女性(n = 66)接受了结构化临床访谈(SCID)。创伤后诊断量表显示出较高的内部一致性(α = 0.89),在产后4 - 6周和6个月时的重测信度为0.51。创伤后诊断量表与其他产后精神病理学测量方法具有较高的同时效度,与抑郁的相关系数r(829)= 0.60,与焦虑的相关系数r(829)= 0.61。创伤后诊断量表和结构化临床访谈得出的诊断之间观察到令人满意的诊断一致性,敏感性良好(92%),特异性良好(76%)。探索性和验证性因素分析表明,与分娩相关的创伤后应激障碍的潜在结构最好通过三因素模型来识别:重新体验和回避(RA)、麻木和烦躁性唤醒(NDA)以及烦躁性唤醒和焦虑性唤醒症状(DAA)。研究结果支持将创伤后诊断量表用作产后女性中与分娩相关的创伤后应激障碍的有效筛查工具。