Development of the Tilburg Pregnancy Distress Scale: the TPDS

Abstract

BackgroundPregnant women with high levels of stress, depression and/or anxiety are at increased risk for adverse perinatal outcomes and impaired neurologic and emotional development of the offspring. Pregnancy specific instruments to measure psychological functioning during gestation are scarce and do not define items based on in-depth interviews of pregnant and recently delivered women. The current study developed a pregnancy specific scale that measures psychological functioning using in-depth interviews.MethodsThree focus groups were formed to discuss issues most relevant to pregnancy distress; 22 candidate items were derived for pilot testing (study I, n = 419) its psychometric properties by means of explorative factor analyses (EFA). This resulted in a 17-item TPDS which was further explored by confirmatory factor analyses (CFA) and concurrent and construct validity assessment (study II, n = 454).ResultsEFA in study I suggested a two component solution (negative affect (NA) and partner involvement (PI)). CFA in study II resulted in a higher order model of the NA subscale into three more subscales: NA regarding confinement, delivery and general health. TPDS, EPDS and GAD-7 were all significantly correlated.ConclusionsThe TPDS constitutes a valid and user friendly instrument to assess pregnancy distress. In addition to its proven ability to pick up pregnancy specific negative affect it also includes an important sub-scale measuring perceived partner involvement.

Measuring maternal mental health using the Dutch Four-Dimensional Symptom Questionnaire (4DSQ): Pregnancy-related item bias across the perinatal period

“…As we found pregnancy-related item bias from pregnancy up until 13 weeks postpartum, we strongly recommend generic instruments to be validated before using them in this period. (Chandra and Ranjan, 2007;Kazi et al, 2009;Shelton and Herrick, 2009;Pop et al 2011;Johnson et al, 2012;Mogos et al, 2013).…”

“…Midwives in The Netherlands as well as in other countries, have expressed a need for adequate measuring instruments for the assessment of psychological conditions and for choosing the right clinical pathway (Author et al, 2010;McCauley et al, 2011;Fontein, 2012). A multidimensional approach of maternal mental health problems is preferred over one that is focused on a single dimension (Goodman and Tyer-Viola, 2010;Pop et al, 2011;Graignic-Philippe et al, 2014;Fontein, 2016). The Four-Dimensional Symptom Questionnaire (4DSQ) is a multidimensional instrument, that measures somatization, distress, anxiety and depression.…”

Validation of a short form Three Facet Mindfulness Questionnaire (TFMQ-SF) in pregnant women

“…The total score of this scale ranges from 0 to 48, with higher scores reflecting higher levels of pregnancy-related distress. The TPDS has been validated among Dutch pregnant women and showed good internal consistency overall (α = .78) (Pop et al, 2011).…”

“…To measure pregnancy-related emotional distress, the 16-item TPDS (Pop et al, 2011) was used. The TPDS consists of items about enjoying pregnancy, worries about labor, delivery and general health, concerns about finances, and partner involvement.…”

Development of a Pre- and Postnatal Bonding Scale (PPBS)

“…The Tilburg Pregnancy Distress Scale (TPDS) has been previously developed and validated for use during pregnancy and contains a domain 'partner involvement' [46]. This subscale measures the extent of perceived partner involvement in pregnancy using four items on a fourpoint Likert scale, with higher scores indicating more involvement.…”