Development of a perinatal trauma screening tool: Detecting the silent struggle of perinatal post-traumatic stress disorder

Abstract

Background:

Universal screening for perinatal mental illness is recommended in Australia; however, these tools do not screen for perinatal post-traumatic stress disorder (PTSD). While existing perinatal PTSD tools show validity, they vary in diagnostic agreement, and most are focused on PTSD following childbirth. Early detection of PTSD symptoms at any phase of perinatal care is critical to improve maternal/infant outcomes and engagement with effective treatment. Unfortunately, gaps remain in practice for identifying perinatal PTSD.

Aim:

The aim of the study was to develop a screening tool to detect current symptoms of perinatal PTSD or higher risk of developing the disorder, resulting from index perinatal event(s) or experience(s) during conception, pregnancy and the postpartum.

Methods:

If any perinatal trauma was endorsed, participants completed an online questionnaire and if consenting, a semi-structured clinical telephone interview during their current pregnancy.

Findings:

Twenty-five items were submitted for exploratory factor analysis, n = 114, and the results supported a two-factor solution. After removing items with poor loadings, a 17-item, two-factor solution explained 68.36% of the total variance. Each of the components had excellent internal consistency; component one α = .954 and component two α = .897. Following a receiver operating characteristic analysis n = 52, the optimal cutoff score of ⩾11 was identified with 90.9% sensitivity and 61% specificity.

Conclusion:

Moderate predictive validity of the tool shows promise for detecting those currently experiencing symptoms of perinatal PTSD and at higher risk of developing the disorder, supporting utility in clinical settings, pending future validation.