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Assessing psychosocial risk in pregnant/postpartum women using the Contextual Assessment of Maternity Experience (CAME)

Recent life adversity, social support and maternal feelings

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Abstract

Background

The Contextual Assessment of Maternity Experience (CAME) interview was developed to characterise the psychosocial context relevant to the maternity experience by providing a detailed picture of women’s lives during the transition to motherhood. More specifically, it was designed to enable the assessment of major risk factors for emotional disturbances in pregnant and postpartum women, especially depression, within the same instrument and using a coherent methodological framework.

Method

The CAME assesses three domains relevant to motherhood: 1) recent life adversity or stressors; 2) the quality of social support and key relationships including partner relationship; and 3) maternal feelings towards pregnancy, motherhood and the baby. Two high-risk samples of inner-city London women were used to test the psychometric qualities of the CAME components.

Results

Overall, the internal consistencies of the relevant components were high in both samples examined. The validity of the three components of the measure was evidenced by their association with either maternal characteristics or parenting assessments.

Conclusion

It was concluded that the CAME shows promise as a measure of the psychosocial risk factors involved in the maternity experience for future research in this field.

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References

  1. Affonso DD, Lovett D, Paul S, Arizmendi T, Nussbaum R, Newman L, Johnson B (1991) Predictors of depression symptoms during pregnancy and postpartum. J Obstet Gynaecol 12:255–271

    Google Scholar 

  2. Affonso DD, Mayberry LJ, Lovett S, Paul S (1994) Cognitive adaptation to stressful events during pregnancy and postpartum: Development and testing of the CASE instrument. Nurs Res 43:338–343

    PubMed  Google Scholar 

  3. Bernazzani O, Saucier JF, David H, Borgeat F (1997) Psychosocial predictors of depressive symptomatology level in postpartum women. J Affect Disord 46:39–49

    PubMed  Google Scholar 

  4. Bernazzani O, Bifulco A, Marks M, Siddle K (1998) The Contextual Assessment of the Maternity Instrument Manual, MRC Social Unit, Royal Holloway College, London

  5. Bernazzani O, Conroy S, Marks M, Siddle K,Guedeney N, Bifulco A, Asten P, Figueiredo B, Gorman L, Bellini S, Glatigny-Dallay E, Valoriani V, Kammerer M, Henshaw C and the TCS-PND group (2004) Contextual Assessment of the Maternity Experience: Development of an instrument for cross-cultural research. Br J Psychiatry 184(Suppl 46):S24–S30

    Google Scholar 

  6. Bifulco A, Brown GW, Harris TO (1987) Childhood loss of parent, lack of adequate parental care and adult depression: a replication. J Affect Disord 12:15–128

    Google Scholar 

  7. Bifulco A, Brown GW, Moran P, Ball C, Campbell C (1998) Predicting depression in women: The role of past and present vulnerability. Psychol Med 28:39–50

    PubMed  Google Scholar 

  8. Bifulco A, Bernazzani O, Moran P, Ball C (2000) Lifetime stressors and recurrent depression: preliminary findings on the Adult Life Phase Interview (ALPHI). Soc Psychiatry Psychiatr Epidemiol 35:264–275

    PubMed  Google Scholar 

  9. Broadhead J, Abas M (1998) Life events, difficulties and depression among women in an early setting in Zimbabwe. Psychol Med 28:29–38

    PubMed  Google Scholar 

  10. Brown GH, Harris TO (1978) Social Origins of Depression: A Study of Psychiatric Disorder in Women, London Tavistock Publications, London New-York

    Google Scholar 

  11. Brown GH (1981) Contextual measure of life events. In: Dohrenwend BS, Dohrenwend BP (eds) Stressful Life Events and Their Contexts. Neale Watson Academic Publications, New-York

  12. Brown GW, Harris TO, Eales MJ (1993) Aetiology of anxiety and depressive disorders in an inner-city population. 2. Comorbidity and adversity. Psychol Med 23:155–165

    PubMed  Google Scholar 

  13. Caldwell BM, Bradley RH (1984) Administration manual (rev. ed.) Home Observation for Measurement of the Environment. Little Rock: University of Arkansas

    Google Scholar 

  14. Conroy S, Marks M (2003) Maternal psychological vulnerability and early infant care in a sample of materially disadvantaged women. J Reprod Infant Psychol 21:5–22

    Google Scholar 

  15. Cowan PA, Cowan CP (1988) Changes in marriage during the transition to parenthood: Must we blame the baby? In: Michaels GY, Goldberg WA (eds) The Transition to Parenthood: Current Theory and Research. Cambridge University Press, Cambridge

  16. Cox JL,Holden JM, Sagovsky R (1987) Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786

    PubMed  Google Scholar 

  17. Curry MA, Campbell RA, Christian M (1994) Validity and reliability testing of the prenatal Psychosocial Profile. Res Nurs Health 17:127–135

    PubMed  Google Scholar 

  18. Ertem IO, Forsyth BWC, Avni-Singer AJ, Damour LK, Cicchetti DV (1997) Development of a supplement to the HOME scale for children living in impoverished urban environments. J Dev Behav Pediatr 18:322–328

    PubMed  Google Scholar 

  19. Farran D, Kasari C, Comfort M, Jay S (1986) Parent/Caregiver Involvement Scale. Vanderbilt University. Nashville, Tennessee

  20. Harris TO, Brown GW, Bifulco A (1987) Loss of parent in childhood and adult psychiatric disorder: The role of social class position and premarital pregnancy. Psychol Med 17:163–183

    PubMed  Google Scholar 

  21. Harris TO, Brown GW, Bifulco A (1990) Loss of parent in childhood and adult psychiatric disorder: A tentative overall model. Dev Psychol 2:311–328

    Google Scholar 

  22. Haglund LJ, Britton JR (1998) The perinatal assessment of psychosocial risk. Clin Perinatol 2:417–452

    Google Scholar 

  23. Kumar R, Robson R, Smith A (1984) Development of a self-administered questionnaire to measure maternal adjustment and maternal attitudes during pregnancy and after delivery. J Psychosom Res 28:43–51

    PubMed  Google Scholar 

  24. Lederman R, Lederman E, Work BA Jr, Mc Cann DS (1981) The relationship of maternal prenatal development to progress in labor and fetal-newborn health. In: Lederman R, Raff B (eds) Perinatal parental behavior. New-York:, Liss, March of Dimes Birth Defect Foundation: Original Articles Series, 17:5–28

    Google Scholar 

  25. Lederman RP, Lederman E (1984) Methods of Assessment. In Psychosocial Adaptation in Pregnancy. Assessment of seven dimensions of maternal development. In: Lederman RP (ed) Prentice-Hall Inc, New Jersey

  26. Marks MN, Siddle K, Warwick C (2003) Can we prevent postnatal depression? A randomised controlled trial to assess the impact of continuity of midwifery care on rates of postnatal depression in high risk women. J Matern Fetal and Neonatal Med 13:119–127

    Google Scholar 

  27. Nelson NM, Enkin MW, Saigal S, Bennett KJ, Milner R, Sackett DL (1980) A randomized clinical trial of the Leboyer approach to childbirth. N Engl J Med 302:655–660

    PubMed  Google Scholar 

  28. O’Connor P, Brown GW (1984) Supportive relationships: Facts or fancy? J Soc Pers Relat 1:159–175

    Google Scholar 

  29. O’Hara MW, Swain AM (1996) Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatry 8:37–54

    Google Scholar 

  30. O’Hara MW, Varner MW, Johnson SR (1986) Assessing stressful life events associated with childbearing: The Peripartum Events Scale. J Reprod Infant Psychol 4:85–98

    Google Scholar 

  31. Paykel ES, Emms EM, Fletcher J, Rassaby ES (1980) Life events and social support in puerperal depression. Br J Psychiatry 136:339–346

    PubMed  Google Scholar 

  32. Spitzer RL, Williams JBW, Gibbon M, First MB (1990) Instruction Manual for the Structured Clinical Interview for DSM-III-R (SCID). New-York State Psychiatric Institute, Biometrics Research, New-York

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Correspondence to Odette Bernazzani.

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Bernazzani, O., Marks, M.N., Bifulco, A. et al. Assessing psychosocial risk in pregnant/postpartum women using the Contextual Assessment of Maternity Experience (CAME). Soc Psychiat Epidemiol 40, 497–508 (2005). https://doi.org/10.1007/s00127-005-0917-y

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  • DOI: https://doi.org/10.1007/s00127-005-0917-y

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