Screening for Post-Traumatic Stress Disorder following Childbirth using the Peritraumatic Distress Inventory.
Screening for Post-Traumatic Stress Disorder following Childbirth using the Peritraumatic Distress Inventory.
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使用创伤后应激障碍筛查分娩后的创伤后应激障碍。
DOI：
10.1101/2023.04.23.23288976
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Dekel,Sharon
中科院分区：
文献类型：
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作者：
Jagodnik,KathleenM;Ein-Dor,Tsachi;Chan,SabrinaJ;Ashkenazy,AdiTitelman;Bartal,Alon;Dekel,Sharon
背景创伤性分娩后的创伤后应激障碍(PTSD)可能损害母婴健康，但目前尚缺乏孕产妇分娩相关PTSD(CB-PTSD)的筛查。创伤经历引起的急性情绪困扰与创伤后应激障碍密切相关。创伤周围窘迫问卷(PDI)评估非产后个体的急性窘迫，但它对可能支持CB-PTSD的妇女的分类尚不清楚。方法3039名妇女提供有关她们心理健康和分娩经历的信息。他们完成了关于最近分娩事件的PDI和创伤后应激障碍症状筛查，以确定CB-PTSD。通过探索性图形分析和自举分析，揭示了PDI的因素结构和CB-PTSD分类的最佳临界值。结果因子分析显示，基于PDI的修订版，有两个高度相关的稳定因素：(1)负面情绪；(2)身体唤醒和威胁评估。改良的PDI评分为15+，具有很高的敏感性和特异性：在产后第一个月，CB-PTSD筛查阳性者占88%，阴性筛查者占93%。限制：在这项横断面研究中，产后不同时间使用PDI。未来的工作应该检验PDI在尽可能接近分娩时间筛查妇女的预测作用，并在复杂分娩后的人群中建立临床界值。结论使用我们改进的PDI工具进行关于妇女对分娩的情绪反应的简短自我报告筛查可以在产后早期发现那些可能支持CB-PTSD的人。这可能是管理症状以最终预防慢性表现的第一步。
BackgroundPost-traumatic stress disorder (PTSD) following traumatic childbirth may undermine maternal and infant health, but screening for maternal childbirth-related PTSD (CB-PTSD) remains lacking. Acute emotional distress in response to a traumatic experience strongly associates with PTSD. The Peritraumatic Distress Inventory (PDI) assesses acute distress in non-postpartum individuals, but its use to classify women likely to endorse CB-PTSD is unknown.Methods3039 women provided information about their mental health and childbirth experience. They completed the PDI regarding their recent childbirth event, and a PTSD symptom screen to determine CB-PTSD. We employed Exploratory Graph Analysis and bootstrapping to reveal the PDI's factorial structure and optimal cutoff value for CB-PTSD classification.ResultsFactor analysis revealed two strongly correlated stable factors based on a modified version of the PDI: (1) negative emotions and (2) bodily arousal and threat appraisal. A score of 15+ on the modified PDI produced high sensitivity and specificity: 88 % with a positive CB-PTSD screen in the first postpartum months and 93 % with a negative screen.LimitationsIn this cross-sectional study, the PDI was administered at different timepoints postpartum. Future work should examine the PDI's predictive utility for screening women as closely as possible to the time of childbirth, and establish clinical cutoffs in populations after complicated deliveries.ConclusionsBrief self-report screening concerning a woman's emotional reactions to childbirth using our modified PDI tool can detect those likely to endorse CB-PTSD in the early postpartum. This may serve as the initial step of managing symptoms to ultimately prevent chronic manifestations.