Objective: City Birth Trauma Scale is a recently developed scale specifically designed for evaluation of posttraumatic stress disorder (PTSD) following childbirth based on the DSM-5 criteria (Ayers, Wright, & Thornton, 2018). Previous studies showed a two-factor structure of PTSD symptoms in postpartum women; however, more complex models were not tested. This study aimed to validate the Croatian version of the City Birth Trauma Scale and determine the latent factor structure of postpartum PTSD. Method:In a cross-sectional study, 603 women completed online questionnaires comprising City Birth Trauma Scale, Impact of Event Scale-Revised (IES-R), Edinburgh Postnatal Depression Scale (EPDS), and the anxiety subscale from the Depression, Anxiety, and Stress Scale (DASS-21).Results: Confirmatory factor analysis confirmed the bifactor model of Birth-related symptoms (re-experiencing and avoidance) and General symptoms was an excellent fit to the data. Both subscales and the total scale showed high internal consistency (α = .92).Convergent and divergent validity testing showed high validity, especially for Birth-related symptoms. Discriminant validity was confirmed with primiparous women and women who gave birth by instrumental vaginal delivery and emergency caesarean section having significantly higher scores on Birth-related symptoms, but not on General symptoms, suggesting high discriminant validity of the Birth-related symptoms subscale. Conclusions:The City Birth Trauma Scale is a reliable and valid measure. Both total scale score and subscale scores can be calculated. It is highly recommended for use in postpartum population.

SUMMARY – Previous findings on peripartum anxiety are inconsistent in respect to the prevalence and course of peripartum anxiety with comorbidity of depression. Our aim was threefold: (1) to examine the course of elevated anxiety during pregnancy, immediately after childbirth, and six weeks postpartum; (2) to establish comorbidity of postpartum anxiety and postpartum depression (PPD); and (3) to examine predictors of anxiety 6 weeks postpartum. A sample of women (N=272) who were below the cut-off score for clinical depression during pregnancy were assessed in the third trimester of pregnancy, then 2 days and 6 weeks postpartum. Questionnaires on anxiety, pregnancy specific distress, stress, coping styles, social support, and depression were administered at each assessment. Obstetric data were collected from the participants’ medical records. The estimated rate of high anxiety was 35% during pregnancy, 17% immediately after childbirth, and 20% six weeks postpartum, showing a decrease in anxiety levels after childbirth. Comorbidity of anxiety and PPD was 75%. Trait anxiety and early postpartum state anxiety are significant predictors of postpartum anxiety. Anxiety is a common peripartum psychological disturbance. Anxiety symptoms overlap with PPD, but not completely, indicating that screening for postpartum mental difficulties should include both depression and anxiety.

Amongst all women, anxiety sensitivity (physical concerns dimension) was identified as an important vulnerability factor for FOC. As such, the level of anxiety sensitivity, and any resulting fear or expectations of pain, should be assessed in expectant mothers by clinicians in prenatal settings. Furthermore, anxiety sensitivity should be an important target for psychological interventions aimed at managing FOC.

ObjectivesA previous individual participant data meta‐analysis (IPDMA) identified differences in major depression classification rates between different diagnostic interviews, controlling for depressive symptoms on the basis of the Patient Health Questionnaire‐9. We aimed to determine whether similar results would be seen in a different population, using studies that administered the Edinburgh Postnatal Depression Scale (EPDS) in pregnancy or postpartum.MethodsData accrued for an EPDS diagnostic accuracy IPDMA were analysed. Binomial generalised linear mixed models were fit to compare depression classification odds for the Mini International Neuropsychiatric Interview (MINI), Composite International Diagnostic Interview (CIDI), and Structured Clinical Interview for DSM (SCID), controlling for EPDS scores and participant characteristics.ResultsAmong fully structured interviews, the MINI (15 studies, 2,532 participants, 342 major depression cases) classified depression more often than the CIDI (3 studies, 2,948 participants, 194 major depression cases; adjusted odds ratio [aOR] = 3.72, 95% confidence interval [CI] [1.21, 11.43]). Compared with the semistructured SCID (28 studies, 7,403 participants, 1,027 major depression cases), odds with the CIDI (interaction aOR = 0.88, 95% CI [0.85, 0.92]) and MINI (interaction aOR = 0.95, 95% CI [0.92, 0.99]) increased less as EPDS scores increased.ConclusionDifferent interviews may not classify major depression equivalently.

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This is the accepted version of the paper.This version of the publication may differ from the final published version.Permanent repository link: https://openaccess.city.ac.uk/id/eprint/23962/ Link to published version: http://dx. AbstractBackground: There is some evidence posttraumatic stress disorder (PTSD) following childbirth may impact on the mother-infant bond. However, the evidence is inconsistent over whether PTSD or co-morbid depressive symptoms are primarily related to impaired bonding.This study therefore aimed to examine the relationship between PTSD symptoms, depressive symptoms and mother-infant bonding. Methods:A cross-sectional online study included 603 mothers of infants aged 1 to 12 months. Measures were taken of PTSD (City Birth Trauma Scale, Ayers et al., 2018) which has two subscales of birth-related PTSD symptoms and general PTSD symptoms; depression (Edinburgh Postnatal Depression Scale, Cox et al., 1987) and mother-infant bonding (Postpartum Bonding Questionnaire, Brockington et al., 2001). Results: Impaired bonding was related to both dimensions of PTSD symptoms and depressive symptoms in bivariate analysis. Path analysis testing the model of whether depressive symptoms mediated the effect of PTSD symptoms on mother-infant bonding found a differential role of birth-related and general PTSD symptoms. Birth-related PTSD symptoms did not have any effect on bonding or depressive symptoms. In contrast, general PTSD symptoms had a direct effect on bonding and an indirect effect on bonding via depressive symptoms. Limitations: Self-report measures of PTSD and depression symptoms were used. Conclusions: Further research regarding different aspects of postpartum PTSD, depression and other disorders in the context of mother-infant bonding are needed. Future preventive programs should focus on diminishing symptoms of postpartum PTSD and depression so that the motherinfant bonding remains optimal.Highlights  Both PTSD and depressive symptoms are related to impaired mother-infant bonding. A differential role of birth-related and general PTSD symptoms was found. Birth-related PTSD symptoms did not have effect on bonding or depressive symptoms. General PTSD symptoms had an indirect effect on bonding via depressive symptoms.

Anxiety levels associated with noninvasive but not after invasive, prenatal diagnostics tests decrease immediately following the procedure.

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