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


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.

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  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.

    PubMed  Article  Google 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.

    PubMed  Article  Google 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.

    Article  Google Scholar 

  5. 5.

    Gissler M, Hemminki E, Lonnqvist J. Suicides after Pregnancy in Finland 1987–1994: Register Linkage Study. BMJ. 1996;313:1431–1434.

    PubMed  Article  CAS  Google 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.

    PubMed  Article  CAS  Google 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.

    PubMed  Article  Google 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.

    Article  Google 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.

    PubMed  Article  Google 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):378–385

    Google 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.

    Article  Google 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.

    PubMed  Google 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.

    Article  Google 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.

    PubMed  Article  Google 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.

    Article  Google Scholar 

  21. 21.

    Williams G. Grief and Elective Abortion. AWHONN Lifelines. 2000a;4(2):37–40.

    PubMed  Article  CAS  Google Scholar 

  22. 22.

    Speckhard AC, Rue VM. Post Abortion Syndrome: An Emerging Public Health Concern. Journal of Social Issues. 1992;48(3):95–119.

    Article  Google 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.

    Article  CAS  Google 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.

    PubMed  Article  Google Scholar 

  26. 26.

    Editorial. Women Should Be Offered Post-abortion Psychological Care. Lancet. 2008;372:602.

  27. 27.

    Coyle C, Enright R. Forgiveness Intervention with Post-aborted Men. Journal of Consulting and Clinical Psychology. 1997;65:1042–1046.

    PubMed  Article  CAS  Google 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.

    PubMed  Article  CAS  Google 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; 2000

    Google Scholar 

  36. 36.

    Wells N. Pain and Distress During Abortion. Health Care for Women International. 1991;12:293–302.

    PubMed  Article  CAS  Google Scholar 

  37. 37.

    Wells N. Reducing Distress During Abortion: A Test of Sensory Information. Journal of Advanced Nursing. 1992;17:1050–1056.

    PubMed  Article  CAS  Google 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.

  41. 41.

    Fischer J, Corcoran K. Measures for Clinical Practice: A Sourcebook Vol 2. 2 ed. New York The Free Press; 1994

  42. 42.

    Cohen L, Roth S. Coping with Abortion. Journal of Human Stress. 1984;10:140–145.

    PubMed  Article  CAS  Google 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.

    PubMed  Article  CAS  Google 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):29–42

    Article  Google 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.

    PubMed  Article  CAS  Google Scholar 

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There are no conflicts of interest declared.

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Correspondence to Maureen Curley PhD, PMHCNS, BC.

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Curley, M., Johnston, C. The Characteristics and Severity of Psychological Distress After Abortion Among University Students. J Behav Health Serv Res 40, 279–293 (2013).

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  • Psychological Distress
  • Mental Health Problem
  • Suicidal Ideation
  • Beck Depression Inventory
  • Unintended Pregnancy