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Published in: Maternal and Child Health Journal 12/2017

01-12-2017

Differential Predictors of Postpartum Depression and Anxiety: The Edinburgh Postnatal Depression Scale Hebrew Version Two Factor Structure Construct Validity

Authors: Rena Bina, Donna Harrington

Published in: Maternal and Child Health Journal | Issue 12/2017

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Abstract

Objectives Postpartum anxiety (PPA) is as prevalent and disruptive as postpartum depression (PPD), although less commonly addressed. The Edinburgh Postnatal Depression Scale (EPDS), originally created to screen for PPD, was found to include anxiety and depression subscales. This study examined the construct validity of the EPDS PPD and PPA subscales by examining differential predictors of both in a structural regression model. Methods Women (n = 969) were recruited from a maternity ward in Jerusalem, Israel and completed a demographic survey; 715 (74%) women were screened for PPD and PPA at 6 weeks postpartum using the EPDS. Results History of depression was a significant predictor of PPD symptoms and PPA symptoms. Income and number of past pregnancies were significant predictors of PPA symptoms. Conclusions for practice PPD and PPA have different predictors, suggesting that the EPDS depression and anxiety subscales should be scored separately. Further assessment and treatment should be tailored to specific symptoms of depression and/or anxiety reported.
Literature
go back to reference Al Hinai, F. I., & Al Hinai, S. S. (2014). Prospective study on prevalence and risk factors of postpartum depression in Al-dakhliya governorate in oman. Oman Medical Journal, 29(3), 198–202.CrossRefPubMedPubMedCentral Al Hinai, F. I., & Al Hinai, S. S. (2014). Prospective study on prevalence and risk factors of postpartum depression in Al-dakhliya governorate in oman. Oman Medical Journal, 29(3), 198–202.CrossRefPubMedPubMedCentral
go back to reference Austin, M.P.V., Hadzi-Pavlovic, D., Priest, S. R., Reilly, N., Wilhelm, K., Saint, K., & Parker, G. (2010). Depressive and anxiety disorders in the postpartum period: How prevalent are they and can we improve their detection? Archives of Women’s Mental Health, 13, 395–401.CrossRefPubMed Austin, M.P.V., Hadzi-Pavlovic, D., Priest, S. R., Reilly, N., Wilhelm, K., Saint, K., & Parker, G. (2010). Depressive and anxiety disorders in the postpartum period: How prevalent are they and can we improve their detection? Archives of Women’s Mental Health, 13, 395–401.CrossRefPubMed
go back to reference Bener, A., Gerber, L. M., & Sheikh, J. (2012). Prevalence of psychiatric disorders and associated risk factors in women during their postpartum period: A major public health problem and global comparison. International Journal of Women’s Health, 4, 191–200.CrossRefPubMedPubMedCentral Bener, A., Gerber, L. M., & Sheikh, J. (2012). Prevalence of psychiatric disorders and associated risk factors in women during their postpartum period: A major public health problem and global comparison. International Journal of Women’s Health, 4, 191–200.CrossRefPubMedPubMedCentral
go back to reference Bina, R., & Harrington, D. (2016). The Edinburgh Postnatal Depression Scale: Screening tool for postpartum anxiety as well? Findings from a confirmatory factor analysis of the Hebrew version. Maternal and Child Health Journal, 20(4), 904–914.CrossRefPubMed Bina, R., & Harrington, D. (2016). The Edinburgh Postnatal Depression Scale: Screening tool for postpartum anxiety as well? Findings from a confirmatory factor analysis of the Hebrew version. Maternal and Child Health Journal, 20(4), 904–914.CrossRefPubMed
go back to reference Bleich, A., Gelkopf, M., & Solomon, Z. (2003). Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally representative sample in Israel. The Journal of the American Medical Association (JAMA), 290(5), 612–620.CrossRef Bleich, A., Gelkopf, M., & Solomon, Z. (2003). Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally representative sample in Israel. The Journal of the American Medical Association (JAMA), 290(5), 612–620.CrossRef
go back to reference Britton, J. R. (2008). Maternal anxiety: Course and antecedents. Depression and Anxiety, 25, 793–800.CrossRefPubMed Britton, J. R. (2008). Maternal anxiety: Course and antecedents. Depression and Anxiety, 25, 793–800.CrossRefPubMed
go back to reference Brown, T. A. (2015). Confirmatory factor analysis for applied research (2nd edn.). New York: The Guilford Press. Brown, T. A. (2015). Confirmatory factor analysis for applied research (2nd edn.). New York: The Guilford Press.
go back to reference Byrne, B. (2012). Structural equation modeling with Mplus – basic concepts, applications, and programming. New York: Taylor & Francis/Routledge. Byrne, B. (2012). Structural equation modeling with Mplus – basic concepts, applications, and programming. New York: Taylor & Francis/Routledge.
go back to reference Chui-Yi, C. (2012). A longitudinal study of maternal anxiety from the antenatal to the postpartum period: risk factors and adverse outcomes on infant temperament and development. Hong Kong: University of Hong Kong. Chui-Yi, C. (2012). A longitudinal study of maternal anxiety from the antenatal to the postpartum period: risk factors and adverse outcomes on infant temperament and development. Hong Kong: University of Hong Kong.
go back to reference Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786.CrossRefPubMed Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786.CrossRefPubMed
go back to reference Dankner, R., Goldberg, R. P., Fisch, R. Z., & Crum, R. M. (2000). Cultural elements of postpartum depression. Journal of Reproductive Medicine, 45, 97–104.PubMed Dankner, R., Goldberg, R. P., Fisch, R. Z., & Crum, R. M. (2000). Cultural elements of postpartum depression. Journal of Reproductive Medicine, 45, 97–104.PubMed
go back to reference Farr, S. L., Dietz, P. M., O’Hara, M. W., Burley, K., & Ko, J. Y. (2013). Postpartum anxiety and comorbid depression in a population-based sample of women. Journal of Women’s Health, 23(2), 120–128.CrossRefPubMed Farr, S. L., Dietz, P. M., O’Hara, M. W., Burley, K., & Ko, J. Y. (2013). Postpartum anxiety and comorbid depression in a population-based sample of women. Journal of Women’s Health, 23(2), 120–128.CrossRefPubMed
go back to reference Glasser, S., & Barell, V. (1999). Depression scale for research in and identification of postpartum depression. Harefuah, 136, 764–768. [Hebrew].PubMed Glasser, S., & Barell, V. (1999). Depression scale for research in and identification of postpartum depression. Harefuah, 136, 764–768. [Hebrew].PubMed
go back to reference Highet, N., Stevenson, A. L., Purtell, C., & Coo, S. (2014). Qualitative insights into women’s personal experiences of perinatal depression and anxiety. Women and Birth, 27, 179–184.CrossRefPubMed Highet, N., Stevenson, A. L., Purtell, C., & Coo, S. (2014). Qualitative insights into women’s personal experiences of perinatal depression and anxiety. Women and Birth, 27, 179–184.CrossRefPubMed
go back to reference Iancu, I., Bodner, E., & Ben-Zion, I. Z. (2015). Self-esteem, dependency, self-efficacy and self-criticism in social anxiety disorder. Comprehensive Psychiatry, 58, 165–171.CrossRefPubMed Iancu, I., Bodner, E., & Ben-Zion, I. Z. (2015). Self-esteem, dependency, self-efficacy and self-criticism in social anxiety disorder. Comprehensive Psychiatry, 58, 165–171.CrossRefPubMed
go back to reference Kandel-Katznelson, S., Maisel, S., Zilber, N., & Lerner, J. (2000). Validation of the Hebrew translation of the Edinburgh postnatal depression scale: Background, methods and findings. Jerusalem: Tenth Annual Conference of the Israeli Psychiatric Association. [Hebrew]. Kandel-Katznelson, S., Maisel, S., Zilber, N., & Lerner, J. (2000). Validation of the Hebrew translation of the Edinburgh postnatal depression scale: Background, methods and findings. Jerusalem: Tenth Annual Conference of the Israeli Psychiatric Association. [Hebrew].
go back to reference King, E. (2009). The effectiveness of an internet-based stress management program in the prevention of postpartum stress, anxiety and depression for new mothers. (Doctoral dissertation, Walden University, 2009). ProQuest Dissertations Publishing, 3355047. King, E. (2009). The effectiveness of an internet-based stress management program in the prevention of postpartum stress, anxiety and depression for new mothers. (Doctoral dissertation, Walden University, 2009). ProQuest Dissertations Publishing, 3355047.
go back to reference Kline, R. B. (2016). Principles and practice of structural equation modeling (4th edn.). New York, NY: The Guilford Press. Kline, R. B. (2016). Principles and practice of structural equation modeling (4th edn.). New York, NY: The Guilford Press.
go back to reference Layte, R. (2012). The association between income inequality and mental health: Testing status anxiety, social capital, and neo-materialist explanations. European Sociological Review, 28, 498–511.CrossRef Layte, R. (2012). The association between income inequality and mental health: Testing status anxiety, social capital, and neo-materialist explanations. European Sociological Review, 28, 498–511.CrossRef
go back to reference Leahy-Warren, P., & McCarthy, G. (2011). Maternal parental self-efficacy in the postpartum period. Midwifery, 27, 802–810.CrossRefPubMed Leahy-Warren, P., & McCarthy, G. (2011). Maternal parental self-efficacy in the postpartum period. Midwifery, 27, 802–810.CrossRefPubMed
go back to reference Lorant, V., Deliege, D., Eaton, W., Robert, A., Philippot, P., & Ansseau, M. (2003). Socioeconomic inequalities in depression: A meta-analysis. American Journal of Epidemiology, 157(2), 98–112.CrossRefPubMed Lorant, V., Deliege, D., Eaton, W., Robert, A., Philippot, P., & Ansseau, M. (2003). Socioeconomic inequalities in depression: A meta-analysis. American Journal of Epidemiology, 157(2), 98–112.CrossRefPubMed
go back to reference Marom, S., Gilboa-Schechtman, E., Mor, N., & Meijers, J. (2011). Cognitive behavioral therapy for adults: Therapeutic principles. Tel Aviv: Probook [Hebrew]. Marom, S., Gilboa-Schechtman, E., Mor, N., & Meijers, J. (2011). Cognitive behavioral therapy for adults: Therapeutic principles. Tel Aviv: Probook [Hebrew].
go back to reference Mathew, A. R., Pettit, J. W., Lewinsohn, P. M., Seeley, J. R., & Roberts, R. E. (2011). Co-morbidity between major depressive disorder and anxiety disorders: shared etiology or direct causation? Psychological Medicine, 41, 2023–2034.CrossRefPubMedPubMedCentral Mathew, A. R., Pettit, J. W., Lewinsohn, P. M., Seeley, J. R., & Roberts, R. E. (2011). Co-morbidity between major depressive disorder and anxiety disorders: shared etiology or direct causation? Psychological Medicine, 41, 2023–2034.CrossRefPubMedPubMedCentral
go back to reference Matthey, S. (2008). Using the Edinburgh Postnatal Depression Scale to screen for anxiety disorders. Depression and Anxiety, 25, 926–931.CrossRefPubMed Matthey, S. (2008). Using the Edinburgh Postnatal Depression Scale to screen for anxiety disorders. Depression and Anxiety, 25, 926–931.CrossRefPubMed
go back to reference Matthey, S., Fisher, J., & Rowe, H. (2013). Using the Edinburgh Postnatal Depression Scale to screen for anxiety disorders: Conceptual and methodological considerations. Journal of Affective Disorders, 146, 224–230.CrossRefPubMed Matthey, S., Fisher, J., & Rowe, H. (2013). Using the Edinburgh Postnatal Depression Scale to screen for anxiety disorders: Conceptual and methodological considerations. Journal of Affective Disorders, 146, 224–230.CrossRefPubMed
go back to reference Milgrom, J., Gemmill, A. W., Bilszta, J. L., Hayes, B., Barnett, B., Brooks, J., Ericksen, J., Ellwood, D., & Buist, A. (2008). Antenatal risk factors for postnatal depression: A large prospective study. Journal of Affective Disorders, 108, 147–157.CrossRefPubMed Milgrom, J., Gemmill, A. W., Bilszta, J. L., Hayes, B., Barnett, B., Brooks, J., Ericksen, J., Ellwood, D., & Buist, A. (2008). Antenatal risk factors for postnatal depression: A large prospective study. Journal of Affective Disorders, 108, 147–157.CrossRefPubMed
go back to reference Miller, R. L., Pallant, J. F., & Negri, L. M. (2006). Anxiety and stress in the postpartum: Is there more to postnatal distress than depression? BMC psychiatry, 6, 12.CrossRefPubMedPubMedCentral Miller, R. L., Pallant, J. F., & Negri, L. M. (2006). Anxiety and stress in the postpartum: Is there more to postnatal distress than depression? BMC psychiatry, 6, 12.CrossRefPubMedPubMedCentral
go back to reference Miniati, M., Callari, A., Calugi, S., Rucci, P., Savino, M., Mauri, M., & Dell’Osso, L. (2014). Interpersonal psychotherapy for postpartum depression: a systematic review. Archives of Womens Mental Health, 17(4), 257–268.CrossRef Miniati, M., Callari, A., Calugi, S., Rucci, P., Savino, M., Mauri, M., & Dell’Osso, L. (2014). Interpersonal psychotherapy for postpartum depression: a systematic review. Archives of Womens Mental Health, 17(4), 257–268.CrossRef
go back to reference Muthén, L.K. & Muthén, B.O. (1998–2015). Mplus User’s Guide. 7th Edn. Los Angeles: Muthén & Muthén. Muthén, L.K. & Muthén, B.O. (1998–2015). Mplus User’s Guide. 7th Edn. Los Angeles: Muthén & Muthén.
go back to reference O’Hara, M. W., & McCabe, J. E. (2013). Postpartum depression: Current status and future directions. Annual Review of Clinical Psychology, 9, 379–407.CrossRefPubMed O’Hara, M. W., & McCabe, J. E. (2013). Postpartum depression: Current status and future directions. Annual Review of Clinical Psychology, 9, 379–407.CrossRefPubMed
go back to reference O’hara, M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression: A meta-analysis. International Review of Psychiatry, 8(1), 37–54.CrossRef O’hara, M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression: A meta-analysis. International Review of Psychiatry, 8(1), 37–54.CrossRef
go back to reference Phillips, J., Charles, M., Sharpe, L., & Matthey, S. (2009). Validation of the subscales of the Edinburgh Postnatal Depression Scale in a sample of women with unsettled infants. Journal of Affective Disorders, 118, 101–112.CrossRefPubMed Phillips, J., Charles, M., Sharpe, L., & Matthey, S. (2009). Validation of the subscales of the Edinburgh Postnatal Depression Scale in a sample of women with unsettled infants. Journal of Affective Disorders, 118, 101–112.CrossRefPubMed
go back to reference Pop, V. J., Komproe, I. H., & Van Son, M. J. (1992). Characteristics of the Edinburgh Post Natal Depression Scale in the Netherlands. Journal of Affective Disorders, 26, 105–110.CrossRefPubMed Pop, V. J., Komproe, I. H., & Van Son, M. J. (1992). Characteristics of the Edinburgh Post Natal Depression Scale in the Netherlands. Journal of Affective Disorders, 26, 105–110.CrossRefPubMed
go back to reference Proeschold-bell, R. J. et al (2013). Using effort-reward imbalance theory to understand high rates of depression and anxiety among clergy. The Journal of Primary Prevention, 34(6), 439–453.CrossRefPubMed Proeschold-bell, R. J. et al (2013). Using effort-reward imbalance theory to understand high rates of depression and anxiety among clergy. The Journal of Primary Prevention, 34(6), 439–453.CrossRefPubMed
go back to reference Ross, L. E., & McLean, L. M. (2006). Anxiety disorders during pregnancy and the postpartum period: A systematic review. Journal of Clinical Psychiatry, 67(8), 1285–1298.CrossRefPubMed Ross, L. E., & McLean, L. M. (2006). Anxiety disorders during pregnancy and the postpartum period: A systematic review. Journal of Clinical Psychiatry, 67(8), 1285–1298.CrossRefPubMed
go back to reference Savitz, D. A., Stein, C. R., Ye, F., Kellerman, L., & Silverman, M. (2011). The epidemiology of hospitalized postpartum depression in New York State, 1995–2004. Annals of Epidemiology, 21, 399–406.CrossRefPubMedPubMedCentral Savitz, D. A., Stein, C. R., Ye, F., Kellerman, L., & Silverman, M. (2011). The epidemiology of hospitalized postpartum depression in New York State, 1995–2004. Annals of Epidemiology, 21, 399–406.CrossRefPubMedPubMedCentral
go back to reference Scherer, S., Urech, C., Hoesli, I., Tschudin, S., Gaab, J., Berger, T., & Alder, J. (2014). Internet-based stress management for women with preterm labour—a case-based experience report. Archives of Women’s Mental Health, 17(6), 593–600.CrossRefPubMed Scherer, S., Urech, C., Hoesli, I., Tschudin, S., Gaab, J., Berger, T., & Alder, J. (2014). Internet-based stress management for women with preterm labour—a case-based experience report. Archives of Women’s Mental Health, 17(6), 593–600.CrossRefPubMed
go back to reference Shrestha, S., Adachi, K., Petrini, M. A., & Shrestha, S. (2014). Factors associated with post-natal anxiety among primiparous mothers in Nepal. International Nursing Review, 61(3), 427–434.CrossRefPubMed Shrestha, S., Adachi, K., Petrini, M. A., & Shrestha, S. (2014). Factors associated with post-natal anxiety among primiparous mothers in Nepal. International Nursing Review, 61(3), 427–434.CrossRefPubMed
go back to reference Stein, N. R., Schorr, Y., Krantz, L., Dickstein, B. D., Solomon, Z., Horesh, D., & Litz, B. T. (2013). The differential impact of terrorism on two Israeli communities. American Journal of Orthopsychiatry, 83(4), 1–15.CrossRef Stein, N. R., Schorr, Y., Krantz, L., Dickstein, B. D., Solomon, Z., Horesh, D., & Litz, B. T. (2013). The differential impact of terrorism on two Israeli communities. American Journal of Orthopsychiatry, 83(4), 1–15.CrossRef
go back to reference Swalm, D., Brooks, J., Doherty, D., Nathan, E., & Jacques, A. (2010). Using the Edinburgh Postnatal Depression Scale to screen for perinatal anxiety. Archives of Womens Mental Health, 13, 515–522.CrossRef Swalm, D., Brooks, J., Doherty, D., Nathan, E., & Jacques, A. (2010). Using the Edinburgh Postnatal Depression Scale to screen for perinatal anxiety. Archives of Womens Mental Health, 13, 515–522.CrossRef
go back to reference Teixeira, J., Martin, D., Prendiville, O., & Glover, V. (2005). The effects of acute relaxation on indices of anxiety during pregnancy. Journal of Psychosomatic Obstetrics and Gynecology, 26(4), 271–276.CrossRefPubMed Teixeira, J., Martin, D., Prendiville, O., & Glover, V. (2005). The effects of acute relaxation on indices of anxiety during pregnancy. Journal of Psychosomatic Obstetrics and Gynecology, 26(4), 271–276.CrossRefPubMed
go back to reference Vieten, C., & Astin, J. (2008). Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study. Archives of Women’s Mental Health, 11, 67–74.CrossRefPubMed Vieten, C., & Astin, J. (2008). Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study. Archives of Women’s Mental Health, 11, 67–74.CrossRefPubMed
go back to reference Yelland, J., Sutherland, G., & Brown, S. J. (2010). Postpartum anxiety, depression and social health: findings from a population-based survey of Australian women. BMC public health, 10, 771.CrossRefPubMedPubMedCentral Yelland, J., Sutherland, G., & Brown, S. J. (2010). Postpartum anxiety, depression and social health: findings from a population-based survey of Australian women. BMC public health, 10, 771.CrossRefPubMedPubMedCentral
Metadata
Title
Differential Predictors of Postpartum Depression and Anxiety: The Edinburgh Postnatal Depression Scale Hebrew Version Two Factor Structure Construct Validity
Authors
Rena Bina
Donna Harrington
Publication date
01-12-2017
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 12/2017
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-017-2345-5

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