Elucidating posttraumatic stress symptom dimensions and health correlates among postpartum women.
Confirmatory factor analysis
Dysphoric arousal model
Maternal health
Numbing symptoms
Postpartum women
Posttraumatic stress disorder
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
01 11 2021
01 11 2021
Historique:
received:
22
10
2020
revised:
09
06
2021
accepted:
11
07
2021
pubmed:
27
7
2021
medline:
29
10
2021
entrez:
26
7
2021
Statut:
ppublish
Résumé
Posttraumatic stress disorder (PTSD) is associated with interpersonal dysfunction and adverse maternal health during the perinatal period (extending from conception through one year postpartum). However, PTSD is a heterogeneous disorder, and little is known about which aspects of this disorder may be particularly deleterious to the health of new mothers. Such data may inform more personalized approaches to PTSD prevention and treatment among postpartum women. Using confirmatory factor analysis, we compared three models of PTSD symptom structure-the four-factor dysphoria model, four-factor emotional numbing model, and five-factor dysphoric arousal model-in 1,663 postpartum women from the Community and Child Health Network (CCHN). We examined associations between PTSD symptom dimensions of the best-fitting model with four correlates relevant to maternal health and functioning-parenting stress, partner relationship stress, relationship satisfaction, and contraceptive use. Though all models fit well, the five-factor dysphoric arousal model provided optimal fit. Symptom dimensions from this model-re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal-evidenced differential associations with the maternal health indicators. Numbing symptoms were most strongly associated with indicators of poor interpersonal functioning, whereas dysphoric arousal symptoms were most strongly related to low-efficacy contraceptive use. Our cross-sectional study assessed DSM-IV PTSD symptoms. PTSD symptoms among postpartum women are best-represented by five factors. Numbing symptoms (e.g., restricted affect, detachment) are most strongly associated with interpersonal difficulties, whereas dysphoric arousal symptoms (e.g., agitation, irritability) are linked with low-efficacy contraceptive use. Screening for these symptoms may help promote the health of new mothers.
Sections du résumé
BACKGROUND
Posttraumatic stress disorder (PTSD) is associated with interpersonal dysfunction and adverse maternal health during the perinatal period (extending from conception through one year postpartum). However, PTSD is a heterogeneous disorder, and little is known about which aspects of this disorder may be particularly deleterious to the health of new mothers. Such data may inform more personalized approaches to PTSD prevention and treatment among postpartum women.
METHODS
Using confirmatory factor analysis, we compared three models of PTSD symptom structure-the four-factor dysphoria model, four-factor emotional numbing model, and five-factor dysphoric arousal model-in 1,663 postpartum women from the Community and Child Health Network (CCHN). We examined associations between PTSD symptom dimensions of the best-fitting model with four correlates relevant to maternal health and functioning-parenting stress, partner relationship stress, relationship satisfaction, and contraceptive use.
RESULTS
Though all models fit well, the five-factor dysphoric arousal model provided optimal fit. Symptom dimensions from this model-re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal-evidenced differential associations with the maternal health indicators. Numbing symptoms were most strongly associated with indicators of poor interpersonal functioning, whereas dysphoric arousal symptoms were most strongly related to low-efficacy contraceptive use.
LIMITATIONS
Our cross-sectional study assessed DSM-IV PTSD symptoms.
CONCLUSIONS
PTSD symptoms among postpartum women are best-represented by five factors. Numbing symptoms (e.g., restricted affect, detachment) are most strongly associated with interpersonal difficulties, whereas dysphoric arousal symptoms (e.g., agitation, irritability) are linked with low-efficacy contraceptive use. Screening for these symptoms may help promote the health of new mothers.
Identifiants
pubmed: 34311331
pii: S0165-0327(21)00704-7
doi: 10.1016/j.jad.2021.07.025
pmc: PMC9663210
mid: NIHMS1787953
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
314-321Subventions
Organisme : NINR NIH HHS
ID : U01 NR008929
Pays : United States
Organisme : NICHD NIH HHS
ID : U01 HD044207
Pays : United States
Organisme : NICHD NIH HHS
ID : U01 HD54019
Pays : United States
Organisme : NICHD NIH HHS
ID : R03 HD059584
Pays : United States
Organisme : NICHD NIH HHS
ID : U01 HD054791
Pays : United States
Organisme : NICHD NIH HHS
ID : U01 HD044245
Pays : United States
Organisme : NICHD NIH HHS
ID : U01 HD044253
Pays : United States
Organisme : NICHD NIH HHS
ID : U01 HD044226
Pays : United States
Organisme : NHLBI NIH HHS
ID : K01 HL130650
Pays : United States
Organisme : NICHD NIH HHS
ID : P2C HD041022
Pays : United States
Organisme : NICHD NIH HHS
ID : U01 HD044219
Pays : United States
Informations de copyright
Copyright © 2021. Published by Elsevier B.V.
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