Post Traumatic Stress Appraisal

27. Soderquest, Wijma, Thorbert and Wijma conducted a study (2008) to find out the risk factors in pregnancy for post-traumatic stress and depression one month after childbirth. Along with this, the relationship between post-traumatic stress and depression was observed. The method used was assessment of post-traumatic stress and depression one month post-partum along with studying the potential risks during early and later phase of pregnancy. The variables involved in the study were trait anxiety (hypothesised to be high for the results of the study), depression, fear of child-birth, child-birth related traumatic stress, stress coping capacity (hypothesised to be low), social support (hypothesised to be perceived as low), parity, education level, age, gestation week, civil status, previous
psychological/psychiatric counselling and previous experience of traumatic event along with delivery mode. The participants were recruited among the pregnant who visited OB/GYNs in the state department at Linkoping and Kalmar in Sweden. Inclusion criteria included understanding or speaking Swedish, no plans for legal termination of pregnancy and absence of obstetric complications that needed specialist ultrasound examination.
In total 1224 women participated in the study. The measures used were State-Trait Anxiety Inventory (STAI),Stress Coping Inventory (SCI) to assess the individual’s appraisal of her adaptive resources to deal with stressful situations, a self developed Social Contact Questionnaire for assessing the perceived support of the partner and family members, Traumatic Events Scale to measure the post-traumatic stress symptoms related to delivery before and after childbirth, Wijma’s Delivery Experience/Expectancy Questionnaire measuring the fear of childbirth, DSM 4 criteria of post-traumatic stress disorder (criteria A, B, C, D, E and F), Beck’s Depression Inventory for measuring depression (of which 7 items were removed because they corresponded to the somatic symptoms that could also be a related to changes during pregnancy), medical records for assessing the mode of delivery and a demographic data sheet to study the rest of the variables. The statistics used were Odds Ratio and chi-square
test. The results indicated that 1.3% of women suffered from post-traumatic stress disorder meeting criteria B, C and D of the DSM-4. The most important risk factors in pregnancy were depression in early phase of pregnancy, severe fear of childbirth and “pre”-traumatic stress (in the view of impending delivery) during the later stages of pregnancy. The prevalence rate for depression was 5.6%. Post-traumatic stress and depression were positively related at one month post-delivery and were predicted by the same risk factors. Therefore, it was seen that the risk factors for post-traumatic stress and depression can be assessed during early stages of pregnancy. High trait anxiety was seen as a risk factor for depression only. Also post-traumatic stress and depression seem to share the same underlying vulnerability factors.