The Characteristics and Severity of Psychological Distress After Abortion Among University Students

  • Maureen CurleyEmail author
  • Celeste Johnston


Controversy over abortion inhibits recognition and treatment for women who experience psychological distress after abortion (PAD). This study identified the characteristics, severity, and treatment preferences of university students who experienced PAD. Of 151 females, 89 experienced an abortion. Psychological outcomes were compared among those who preferred or did not prefer psychological services after abortion to those who were never pregnant. All who had abortions reported symptoms of post-traumatic stress disorder (PTSD) and grief lasting on average 3 years. Yet, those who preferred services experienced heightened psychological trauma indicative of partial or full PTSD (Impact of Event Scale, M = 26.86 versus 16.84, p < .05), perinatal grief (Perinatal Grief Scale, M 62.54 versus 50.89, p < 0.05), dysthymia (BDI M = 11.01 versus 9.28, p < 0.05), (M = 41.86 versus 39.36, p < 0.05), and co-existing mental health problems. PAD appeared multi-factorial, associated with the abortion and overall emotional health. Thus, psychological interventions for PAD need to be developed as a public health priority.


Psychological Distress Mental Health Problem Suicidal Ideation Beck Depression Inventory Unintended Pregnancy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of Interest

There are no conflicts of interest declared.


  1. 1.
    Nations U. World Abortion Policies. 2007; Accessed May, 2010.
  2. 2.
    Bradshaw Z, Slade P. The Effects of Induced Abortion on Emotional Experiences and Relationships: A Critical Review of the Literature. Clinical Psychology Review. 2003;23(7):929–958.PubMedCrossRefGoogle Scholar
  3. 3.
    Coleman PK, Coyle CT, Shuping M, Rue VM. Induced Abortion and Anxiety, Mood, and Substance Abuse Disorders: Isolating the Effects of Abortion in the National Co-morbidity Survey. Journal of Psychiatric Research. 2009;43:770–776.PubMedCrossRefGoogle Scholar
  4. 4.
    Ferguson D, Horwood J, Boden JM. Abortion and Mental Health Disorders: Evidence from a 30-Year Longitudinal Study. British Journal of Psychiatry. 2008;193:444–451.CrossRefGoogle Scholar
  5. 5.
    Gissler M, Hemminki E, Lonnqvist J. Suicides after Pregnancy in Finland 1987–1994: Register Linkage Study. BMJ. 1996;313:1431–1434.PubMedCrossRefGoogle Scholar
  6. 6.
    Gilchrist AC, Hannaford PC, Frank P, Kay CR. Termination of Pregnancy and Psychiatric Morbidity. British Journal of Psychiatry. 1995;167:243–248.PubMedCrossRefGoogle Scholar
  7. 7.
    Dingle K, Alati A. Pregnancy Loss and Psychiatric Disorders in Young Women: An Australian Birth Cohort Study. British Journal of Psychiatry. 2008;193:455–460.PubMedCrossRefGoogle Scholar
  8. 8.
    Pederson W. Abortion and Depression: A Population-Based Longitudinal Study of Young Women. Scandinavian Journal of Public Health. 2008;36:424–428.CrossRefGoogle Scholar
  9. 9.
    Taft AJ, Watson LF. Depression and Termination of Pregnancy in a National Cohort of Young Australian Women: The Confounding Effect of Women Experiencing Violence. BioMedCentral. 2008;8:75.Google Scholar
  10. 10.
    Cougle J, Reardon D, Coleman P. Generalized Anxiety following Unintended Pregnancies Resolved through Childbirth and Abortion: A Cohort Study National Survey of Family Youth. Journal of Anxiety Disorders. 2005;19:137–142.PubMedCrossRefGoogle Scholar
  11. 11.
    Hamana L, Rausch S, Sperlich M, Defever E. Previous Experience of Spontaneous Abortion or Elective Abortion and Risk for Post Traumatic Stress and Depression During Subsequent Pregnancy. Depression and Anxiety. 2010;27:699–707.Google Scholar
  12. 12.
    van Emmerik AP, Kamphuis JH, Emmelkamp PM. Prevalence and Prediction of Re-experiencing and Avoidance after Elective Surgical Abortion: A Prospective Study. Clinical Psychology and Psychotherapy. 2008;s(15):378–385Google Scholar
  13. 13.
    Ferguson D, Horwood J, Ridder E. Abortion in Young Women and Subsequent Mental Health. Journal of Child Psychology and Psychiatry. 2006;1:16–24.CrossRefGoogle Scholar
  14. 14.
    Rue V, Coleman P, Rue J, Reardon D. Induced Abortion and Traumatic Stress: A Preliminary Comparison of American and Russian Women. Medical Science Monitor. 2004;10(10):SR5-16.PubMedGoogle Scholar
  15. 15.
    Coleman PK, Reardon DC, Cougle J. Substance Use among Pregnant Women in the context of Previous Reproductive Loss and the Desire for Current Pregnancy British Journal Health Psychology. 2005;10:255–268.CrossRefGoogle Scholar
  16. 16.
    Mulfel N. Decision-Making for Abortion in Adolescents. Health and Living Scientific Journal. 2003;3:43–48.Google Scholar
  17. 17.
    Mota N, Burnett M, Sareen J. Associations between Abortion, Mental Disorders, and Suicidal Behavior in a Nationally Representative Sample. The Canadian Journal of Psychiatry. 2010;55(4):239–247.Google Scholar
  18. 18.
    Robinson G, Stotland N, Russo N, Lang J, Occhiogrosso M. Is There an Abortion Trauma Syndrome? Critiqueing the Evidence. Harvard Review of Psychiatry. 2009;17(4):268–269.PubMedCrossRefGoogle Scholar
  19. 19.
    Franz W, Reardon D. Differential Aspects of Abortion on Adolescence. Adolescence. 1992;27(105):160–172.Google Scholar
  20. 20.
    David P, Rasmusen N, Holdt E. Postpartum and Post-abortion Psychotic Reactions. Family Planning Perspectives. 1980;13:88–91.CrossRefGoogle Scholar
  21. 21.
    Williams G. Grief and Elective Abortion. AWHONN Lifelines. 2000a;4(2):37–40.PubMedCrossRefGoogle Scholar
  22. 22.
    Speckhard AC, Rue VM. Post Abortion Syndrome: An Emerging Public Health Concern. Journal of Social Issues. 1992;48(3):95–119.CrossRefGoogle Scholar
  23. 23.
    Institute AG. Induced Abortion Worldwide. New York: The Alan Guttmacher Institute; 2009.Google Scholar
  24. 24.
    Wheeler SR, Austin JK. The Impact of Early Pregnancy Loss on Adolescents. Maternal Child Nursing. 2001;26(3):154–159.CrossRefGoogle Scholar
  25. 25.
    Charles V, Polis C, Sridhara S, Blum R. Abortion and Long-Term Mental Health Outcomes: A Systematic Review of the Evidence. Contraception. 2008;78:436–450.PubMedCrossRefGoogle Scholar
  26. 26.
    Editorial. Women Should Be Offered Post-abortion Psychological Care. Lancet. 2008;372:602.Google Scholar
  27. 27.
    Coyle C, Enright R. Forgiveness Intervention with Post-aborted Men. Journal of Consulting and Clinical Psychology. 1997;65:1042–1046.PubMedCrossRefGoogle Scholar
  28. 28.
    Gray K, Lassance A. Grieving Reproductive Loss: The Healing Process. New York: Baywood Publishing Company; 2003.Google Scholar
  29. 29.
    Burke T, Reardon D. Forbidden Grief: The Unspoken Pain of Abortion. Springfield, Ill: Acorn Books; 2002.Google Scholar
  30. 30.
    Angelo EJ. Grief after Abortion. Ethics and Medics. 1995;20(11):1–3.Google Scholar
  31. 31.
    Stevens J. Applied Multivariate Statistics for the Social Sciences. New Jersey: Lawrence Erlbaum Associates; 1996.Google Scholar
  32. 32.
    Beck AT, Ward CH, Mendelson M. An Inventory for Measuring Depression. Archives of General Psychiatry. 1961;4(5):61.Google Scholar
  33. 33.
    Major B, Cozzarelli C, Sciacchintano ML, Cooper M, Tests M, Mueller PM. Personal Resilience, Cognitive Appraisal, and Coping: An Integrative Model of Adjustment to Abortion. Journal of Personality and Social Psychology. 1990;59:452–463.PubMedCrossRefGoogle Scholar
  34. 34.
    Speilberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consultant Psychological Press; 1983.Google Scholar
  35. 35.
    Association AP. Diagnostic and Statistical Manual of Mental Disorders-IV Text-Revised. Washington, D. C. : American Psychiatric Association; 2000Google Scholar
  36. 36.
    Wells N. Pain and Distress During Abortion. Health Care for Women International. 1991;12:293–302.PubMedCrossRefGoogle Scholar
  37. 37.
    Wells N. Reducing Distress During Abortion: A Test of Sensory Information. Journal of Advanced Nursing. 1992;17:1050–1056.PubMedCrossRefGoogle Scholar
  38. 38.
    Derogatis L. Brief Symptom Inventory. Baltimore, MD: John Hopkins University; 1993.Google Scholar
  39. 39.
    Bowling A. Measuring Health: A Review of Quality of Life Measurement Scales. Philadelphia, PA: Open University Press; 1996.Google Scholar
  40. 40.
    Horowitz M, Wilner N, Alvarez W. Psychosomatic Medicine. Impact of Events Scale: A Measure of Subjective Stress;41:209–218.Google Scholar
  41. 41.
    Fischer J, Corcoran K. Measures for Clinical Practice: A Sourcebook Vol 2. 2 ed. New York The Free Press; 1994Google Scholar
  42. 42.
    Cohen L, Roth S. Coping with Abortion. Journal of Human Stress. 1984;10:140–145.PubMedCrossRefGoogle Scholar
  43. 43.
    Mulfel N, Speckhard A, Sivaha S. Predictors of PostTraumatic Stress Disorder Following Abortion in a Former Soviet Union Country. Journal of Prenatal and Perinatal Psychology. 2002;17(1):41–46.Google Scholar
  44. 44.
    Hunfeld JA, Wladimiroff JW, Passchier J. The Grief of Late Pregnancy Loss. Patient Education and Counseling. 1997;31:57–64.PubMedCrossRefGoogle Scholar
  45. 45.
    Potvin L, Lasker J, Toedter L. Measuring Grief: A Short Version of the Perinatal Grief Scale. Journal of Psychopathology and Behavioral Assessment. 1989;11(1):29–42CrossRefGoogle Scholar
  46. 46.
    Toedter LJ, Lasker JN, Janssen NJ. International Comparison of Studies Using the Perinatal Grief Scale: A Decade of Research on Pregnancy Loss. Death Studies. 2001;25:205–228.PubMedCrossRefGoogle Scholar

Copyright information

© National Council for Community Behavioral Healthcare 2013

Authors and Affiliations

  1. 1.Department of Healthcare Environments and Systems, College of Nursing, Health Professions, Nursing and Pharmacy ComplexUniversity of FloridaGainesvilleUSA
  2. 2.School of NursingMcGill UniversityMontrealCanada

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