Development of a Brief Measure of Postpartum Distress

Abstract

The 10-item PDM comprises general distress and obsessive-compulsive factors that were obtained from a wider pool of depressive and anxiety items. These data suggest that the PDM may be a helpful tool in identifying a broader range of postpartum distress, including obsessive-compulsive symptoms that were formerly neglected in clinical screening measures. More studies are needed to confirm its clinical utility.

Postpartum Psychosocial and Behavioral Health: A Systematic Review of Self-Administered Scales Validated for Postpartum Women in the United States

“…Readability of scales, such as the Beck Depression Inventory (BDI), BDI-II, CES-D, ESI, EPDS, PDSS, PHQ-9, and PHQ-2, as reported in the reviewed articles (or in other sources we were able to locate) generally placed low reading demands on users. Still, Allison, Wenzel, Kleiman, and Sarwer (2011) noted that the widely studied EPDS (Cox, Holden, & Sagovsky, 1987) Table 3 presents characteristics of samples used in studies validating postpartum scales. Overall, samples sizes varied from more than 1,300 (Davis, Pearlstein, Stuart, O'Hara, & Zlotnick, 2013) to 17 (Barrick, Kent, Crusse, & Taylor, 2012).…”

“…In addition, existing reviews did not identify the use of idiomatic language or forms of expression that, although not captured in traditional psychometric statistical analyses, may impair scale application in some population subgroups. Such concerns have been reported for the 10-item EPDS in U.S. populations (see Allison, et al, 2011). Analyses using methods such as cognitive interviewing (Willis, 2005) would aid in identifying such psychometric issues that may impair applicability of scales in certain populations.…”

“…Finally, many of the studies we reviewed also reported detailed analyses of scale properties that exceeded the scope of our review (e.g., Allison et al, 2011;Beck & Gable, 2001a;Cahill, Freeland-Graves, Shah, Lu, & Klohe-Lehman, 2009;Chaudron et al, 2010;Davis et al, 2013;Flynn, Sexton, Ratliff, Porter, & Zivin, 2011;Ji et al, 2011, O'Hara et al, 2012Tandon, Cluxton-Keller, Leis, Le, & Perry, 2012;Venkatesh, Zlotnick, Triche, Ware, & Phipps, 2014) and thus are not reflected in this paper.…”

Lifetime substance use as a predictor of postpartum mental health

“…Estimates suggest that anywhere from 10 to 20% of women will experience postpartum depression in the year following the birth of a child (Ashley et al 2015;Gavin et al 2005;Gaynes et al 2005). Postpartum women also are at elevated risk for other mood disorders (Stone and Menken 2008), including anxiety (prevalence of 4.4-11.1%) (Reck et al 2008;Ross and McLean 2006;Wenzel et al 2005), obsessive compulsive disorder (OCD) (prevalence of 2.3-3.9%) (Allison et al 2011;Ross and McLean 2006;Zambaldi et al 2009), and posttraumatic stress disorder (PTSD) (prevalence of 0.0-6.9%) (Alcorn et al 2010;Ross and McLean 2006). Indeed, the American Academy of Pediatrics estimated that 400,000 babies are born each year to a mother who is clinically depressed or anxious, making postpartum mood disorders the most "underdiagnosed obstetric complication in America" (Earls 2010(Earls , p. 1032.…”

Predictors of post-natal depression are shaped distinctly by the measure of ‘depression’

“…It has long been recognized that neuroticism predisposes strongly to both anxiety and depression states (Hirschfeld et al, 1989) and, as the EPDS measures anxiety as well as depression constructs (Stuart et al, 1998), such a finding suggests either some confounding of the predictor and outcome measures or that the EPDS measure is better viewed as capturing post-natal distress rather than depression per se. Indeed in a development study for a measure of Postpartum Distress, the correlation between the final measure of distress and the EPDS was 0.92 (Allison et al, 2011). This is not, of necessity, a downside of the EPDS measure, as many practitioners are equally concerned by 'distress' post-natally, be it anxiety, depression or another source of distress.…”