Department of Psychology, University of California, Los Angeles, CA, United States.
Department of Psychology, University of California, Los Angeles, CA, United States.
J Affect Disord. 2021 Nov 1;294:314-321. doi: 10.1016/j.jad.2021.07.025. Epub 2021 Jul 18.
Posttraumatic stress disorder (PTSD) is associated with interpersonal dysfunction and adverse maternal health during the perinatal period (extending from conception through one year postpartum). However, PTSD is a heterogeneous disorder, and little is known about which aspects of this disorder may be particularly deleterious to the health of new mothers. Such data may inform more personalized approaches to PTSD prevention and treatment among postpartum women.
Using confirmatory factor analysis, we compared three models of PTSD symptom structure-the four-factor dysphoria model, four-factor emotional numbing model, and five-factor dysphoric arousal model-in 1,663 postpartum women from the Community and Child Health Network (CCHN). We examined associations between PTSD symptom dimensions of the best-fitting model with four correlates relevant to maternal health and functioning-parenting stress, partner relationship stress, relationship satisfaction, and contraceptive use.
Though all models fit well, the five-factor dysphoric arousal model provided optimal fit. Symptom dimensions from this model-re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal-evidenced differential associations with the maternal health indicators. Numbing symptoms were most strongly associated with indicators of poor interpersonal functioning, whereas dysphoric arousal symptoms were most strongly related to low-efficacy contraceptive use.
Our cross-sectional study assessed DSM-IV PTSD symptoms.
PTSD symptoms among postpartum women are best-represented by five factors. Numbing symptoms (e.g., restricted affect, detachment) are most strongly associated with interpersonal difficulties, whereas dysphoric arousal symptoms (e.g., agitation, irritability) are linked with low-efficacy contraceptive use. Screening for these symptoms may help promote the health of new mothers.
创伤后应激障碍（PTSD）与围产期（从受孕到产后一年）的人际功能障碍和不良产妇健康有关。然而，PTSD 是一种异质障碍，对于这种障碍的哪些方面可能对新妈妈的健康特别有害，人们知之甚少。这些数据可以为产后妇女 PTSD 的预防和治疗提供更个性化的方法。
使用验证性因子分析，我们比较了 PTSD 症状结构的三种模型——四因素抑郁模型、四因素情感麻木模型和五因素抑郁唤醒模型——在来自社区和儿童健康网络（CCHN）的 1663 名产后妇女中。我们研究了最佳拟合模型的 PTSD 症状维度与与产妇健康和功能相关的四个因素（育儿压力、伴侣关系压力、关系满意度和避孕使用）之间的关联。
尽管所有模型拟合良好，但五因素抑郁唤醒模型提供了最佳拟合。来自该模型的症状维度——再体验、回避、麻木、抑郁唤醒和焦虑唤醒——与产妇健康指标存在不同的关联。麻木症状与人际关系不佳的指标相关性最强，而抑郁唤醒症状与低效果避孕使用的相关性最强。
我们的横断面研究评估了 DSM-IV PTSD 症状。
产后妇女的 PTSD 症状最好由五个因素来表示。麻木症状（如受限情感、分离）与人际困难最相关，而抑郁唤醒症状（如激动、易怒）与低效果避孕使用相关。对这些症状进行筛查可能有助于促进新妈妈的健康。
