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Examining the Psychometric Properties of Three Standardized Screening Tools in a Pregnant and Parenting Population

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Abstract

Significance Although standardized tools such as the Speilberger State Anxiety scale (1970) and Cohen’s Perceived Stress Index (1983) have often been used in pregnant and postpartum populations to evaluate psychosocial risk, there exists very little literature on the reliability of these scales in this population. Given the potentially grave consequences of undiagnosed pre and postpartum mental distress, it is of paramount importance that the tools that are commonly used are evaluated for their psychometric properties within the pregnant and parenting population. Methods The psychometric properties of three mental health scales were evaluated using the All Our Babies data. The All Our Babies cohort is a prospective longitudinal study based in Calgary, Alberta. A total of 3300 women were recruited from prenatal care sites from all four quadrants of the city. Participants were mailed questionnaires at 24–26 weeks gestation, 34–36 weeks and at 4 months postpartum. Reliability for the Speilberger State Anxiety Scale, the Perceived Stress Index and the Life Optimism Test—revised were evaluated by calculating Cronbach’s alphas. Validity with related constructs were tested for the State Anxiety Scale and the Perceived Stress Index by calculating Pearson Correlation Coefficients with closely related constructs. Sample size varied from 2670 to 3376, according to the response rate and time point. Depression as a related construct was evaluated using the Edinburgh Postpartum Depression Scale. Results The Cronbach’s Alphas for the Speilberger State Anxiety scale were 0.92, 0.92 and 0.93 for 24–26 weeks, 34–36 weeks and 4 months postpartum respectively. The Alpha’s for the Perceived Stress index were 0.88, 0.88 and 0.89 respectively. The Life Optimism Test Revised was only measured in the third trimester and the Cronbach’s alpha was 0.83. The Pearson Correlation Coefficient for Anxiety with depression were r = 0.73, r = 0.72 and r = 0.77 respectively. The coefficients for stress and depression were r = 0.75, r = 0.75 and r = 0.77 respectively. Discussion/Conclusion The psychometric properties for all three scales were strong, with alphas that were comparable or higher to literature values. These data provide evidence that the use of these scales, previously validated in other populations are appropriate for use in among pregnant and parenting women at risk for mental distress.

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References

  • Abdel-Khalek, A. M. (1989). The development and validation of an Arabic form of the STAI: Egyptian results. Personality and Individual Differences, 10(3), 277–285.

    Article  Google Scholar 

  • Austin, M. P. (2004). Antenatal screening and early intervention for ‘perinatal distress, depression and anxiety: Where to from here? Archives of Women’s Mental Health, 7, 1–6.

    Article  PubMed  Google Scholar 

  • Chaaya, M., Osman, H., Naassan, G., & Mahfoud, Z. (2010). Validation of the Arabic version of the Cohen perceived stress scale (PSS-10) among pregnant and postpartum women. BMC Psychiatry, 10, 111. doi:10.1186/1471-244X-10-111.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396.

    Article  CAS  PubMed  Google Scholar 

  • Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786.

    Article  CAS  PubMed  Google Scholar 

  • Cronbach, L. (1951). Coefficient Alpha and the internal structure of tests. Psychometrika, 16(3), 297–334.

    Article  Google Scholar 

  • Dennis, C. L., Coghlan, M., & Vigod, S. (2013). Can we identify mothers at risk for postpartum anxiety in the immediate postpartum period using the State-Trait Anxiety Inventory? Journal of Affective Disorders, 150(3), 1217–1220.

    Article  PubMed  Google Scholar 

  • Gaudry, E., Vagg, P., & Speilberger, C. D. (1975). Validation of the State-Trait distinction in anxiety research. Multivariate Behavioral Research, 10(3), 331–341.

    Article  CAS  PubMed  Google Scholar 

  • Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2012). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics and Gynecology, 106(5, Pt 1), 1071–1083.

    Article  Google Scholar 

  • Gracie, S., Lyon, A., Kehler, H., Pennell, C., Dolan, S., McNeil, D., et al. (2010). All Our Babies Cohort Study: Recruitment of a cohort to predict women at risk of preterm birth through the examination of gene expression profiles and the environment. BMC Pregnancy and Childbirth,. doi:10.1186/1471-2393-10-87.

    PubMed  PubMed Central  Google Scholar 

  • Grant, K., McMahon, C., & Austin, M. P. (2008). Maternal anxiety during the transition to parenthood: A prospective study. Journal of Affective Disorders, 108(1–2), 101–111.

    Article  PubMed  Google Scholar 

  • Guttman, L. (1945). A basis for analyzing test-retest reliability. Psychometrika, 10(4), 255–282.

    Article  CAS  PubMed  Google Scholar 

  • Heron, J., O’Connor, T. G., Evans, J., Golding, J., & Glover, V. (2004). The course of anxiety and depression through pregnancy and the postpartum in a community sample. Journal of Affective Disorders, 80(1), 65–73.

    Article  PubMed  Google Scholar 

  • Herzberg, P. Y., Glaesmer, H., & Hoyer, J. (2006). Separating optimism and pessimism: A robust psychometric analysis of the Revised Life Orientation Test (LOT-R). Psychological Assessment, 18(4), 433–438.

    Article  PubMed  Google Scholar 

  • Hobel, C. J., Goldstein, A., & Barrett, E. (2008). Psychosocial stress and pregnancy outcome. Clinical Obstetrics and Gynecology, 51(2), 333–348.

    Article  PubMed  Google Scholar 

  • Lai, J. C., & Yue, X. (2000). Measuring optimism in Hong Kong and mainland Chinese with the revised Life Orientation Test. Personality and Individual Differences, 28(4), 781–796.

    Article  Google Scholar 

  • Lanes, A., Kuk, J. L., & Tamim, H. (2011). Prevalence and characteristics of postpartum depression symptomatology among Canadian women: A cross-sectional study. BMC Public Health, 11, 302. doi:10.1186/1471-2458-11-302.

    Article  PubMed  PubMed Central  Google Scholar 

  • Matthey, S., Barnett, B., Howie, P., & Kavanagh, D. J. (2003). Diagnosing postpartum depression in mothers and fathers, whatever happened to anxiety? Journal of Affective Disorders, 74, 139–147.

    Article  PubMed  Google Scholar 

  • McDonald, S. W., Kingston, D., Bayrampour, H., Dolan, S. M., & Tough, S. C. (2014). Cumulative psychosocial stress, coping resources and preterm birth. Archives of Women’s Mental Health, 17, 559–568.

    Article  PubMed  Google Scholar 

  • McDonald, S. W., Lyon, A. W., Benzies, K. M., McNeil, D. A., Lye, S. J., Dolan, S. M., et al. (2013). The All Our Babies pregnancy cohort: Design, methods, and participant characteristics. BMC Pregnancy and Childbirth, 13(Suppl 1), S2. doi:10.1186/1471-2393-13-S1-S2.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nordin, M., & Nordin, S. (2013). Psychometric evaluation and normative data of the Swedish version of the 10-item perceived stress scale. Scandinavian Journal of Psychology, 54(6), 502–507.

    Article  PubMed  Google Scholar 

  • Pickett, K. E., Wilkinson, R. G., & Wakschlag, L. S. (2009). The psychosocial context of pregnancy smoking and quitting in the Millennium Cohort Study. Journal of Epidemiology and Community Health, 63, 474–480. doi:10.1136/jech.2008.082594.

    Article  CAS  PubMed  Google Scholar 

  • Priest, S. R., Austin, M. P., Barnett, B. B., & Buist, A. (2008). A Psychosocial risk assessment model (PRAM) for use with pregnancy and postpartum women in primary care settings. Archives of Women’s Mental Health, 11, 307–317.

    Article  CAS  PubMed  Google Scholar 

  • Rini, C. K., Dunkel-Schetter, C., Wadhwa, P. D., & Sandman, C. A. (1999). Psychological adaptation and birth outcomes: The role of personal resources, stress and sociocultural context in pregnancy. Health Psychology, 18(4), 333–345.

    Article  CAS  PubMed  Google Scholar 

  • Roberti, J. W., Harrington, L. N., & Storch, E. A. (2006). Further psychometric support for the 10-item Perceived Stress Scale. Journal of College Counseling, 9(2), 135–147.

    Article  Google Scholar 

  • Ross, L. E., Gilbert-Evans, S. E., Sellers, E. M., & Romach, M. K. (2003). Measurement issues in postpartum depression part 1: Anxiety as a feature of postpartum depression. Achives of Womens Mental Health, 6, 51–57.

    Article  CAS  Google Scholar 

  • Scheier, M. F., & Carver, C. S. (1985). Optimism, coping and health: Assessment and implications of generalized outcome expectancies. Health Psychology, 4(3), 219–247.

    Article  CAS  PubMed  Google Scholar 

  • Spielberger, C., & Gorsuch, R. (1970). Test Manual for the State-Trait Anxiety Inventory. Palo Alto, California: Consulting Psychologist’s Press.

    Google Scholar 

  • Stuart, S., Couser, G., Schilder, K., O’Hara, M., & Gorman, L. (1998). Postpartum anxiety and depression: Onset and comorbidity in a community sample. Journal of Nervous and Mental Disease, 186(7), 420–424.

    Article  CAS  PubMed  Google Scholar 

  • Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach’s alpha. International Journal of Medical Education, 2, 53–55.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tough, S. C., Siever, J. E., Leew, S., Benzies, K., & Clark, D. (2008). Maternal mental health predicts risk of developmental problems at 3 years of age: Follow up of a community based trial. BMC Pregnancy and Childbirth, 8, 16. doi:10.1186/147-2393-8-16.

    Article  PubMed  PubMed Central  Google Scholar 

  • Van der Bij, A. K., de Weerd, S., Cikot, R. J. L. M., Steegers, E. A. P., & Braspenning, J. C. C. (2003). Validation of the Dutch short for of the state scale of the Speilberger State Trait Anxiety Inventory: Considerations for usage in screening outcomes. Public Health Genomics, 6(2), 84–87.

    Article  Google Scholar 

  • Warner, R., Appleby, L., Whitton, A., & Faragher, B. (1996). Demographic and obstetric risk factors for postnatal psychiatric morbidity. British Journal of Psychiatry, 168, 607–611.

    Article  CAS  PubMed  Google Scholar 

  • Wenzel, A., Haugen, E., Jackson, L., & Brendle, J. (2005). Anxiety symptoms and disorders at eight weeks postpartum. Journal of Anxiety Disorders, 19, 295–311.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Faculty of Medicine, University of Calgary, Calgary, Canada

    Ingunn Benediktsson & Suzanne Tough

  2. Department of Pediatrics, Faculty of Medicine, University of Calgary, Calgary, Canada

    Sheila McDonald & Suzanne Tough

  3. Maternal and Child Health, Research and Innovation, Public, Population and Aboriginal Health, Alberta Health Services, Calgary, Canada

    Sheila McDonald

  4. Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Canada

    Suzanne Tough

Authors
  1. Ingunn Benediktsson
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  2. Sheila McDonald
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  3. Suzanne Tough
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Correspondence to Ingunn Benediktsson.

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Benediktsson, I., McDonald, S. & Tough, S. Examining the Psychometric Properties of Three Standardized Screening Tools in a Pregnant and Parenting Population. Matern Child Health J 21, 253–259 (2017). https://doi.org/10.1007/s10995-016-2128-4

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  • DOI: https://doi.org/10.1007/s10995-016-2128-4

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