Development of a self-administered questionnaire to measure material adjustment and material attitudes during pregnancy and after delivery

doi:10.1016/0022-3999(84)90039-4

Journal of Psychosomatic Research

Volume 28, Issue 1, 1984, Pages 43-51

https://doi.org/10.1016/0022-3999(84)90039-4 Get rights and content

Abstract

Having a baby entails very great changes in maternal intrapsychic and interpersonal adjustment, and childbearing is associated with an increased risk of psychiatric disorder. It may be possible, as pregnancy progresses, to find clues to such disturbances among the changes that occur in maternal attitudes and self-perceptions, This report describes the development and validation of a 60-item, self-administered questionnaire which aims to measure a mother's perceptions of her body, of somatic symptoms, the marital relationship, attitudes to sex and attitudes to the pregnancy and the baby.

A pilot study of 99 women in late pregnancy was followed by repeated measures taken from 119 first-time mothers who were subjects in a longitudinal survey of mental health in a routine obstetric service setting. The questionnaire was acceptable to the mothers, it was reliable (test-retest and split-half) and comparisons with independently gathered interview data showed that it had criterion-related validity. The questionnaire is appended to this report (Appendix I).

References (29)

AJ Crandon
Maternal anxiety and neonatal wellbeing
J Psychosom Res
(1979)
R Kumar et al.
Childbearing and maternal sexuality: a prospective survey of 119 primiparae
J Psychosom Res
(1981)
ER Grimm et al.
The relationship of emotional adjustment and attitudes to the course and outcome of pregnancy
Psychosom Med
(1966)
D Breen
The Birth of a First Child
(1975)
H Deutsch
(1944)
GL Bibring et al.
A study of psychological processes in pregnancy and of the earliest mother-child relationship. 1. Some propositions and comments
The Psychoanalytic Study of the Child
(1961)
J Raphael-Leff
Psychotherapy with pregnant women
JF Hooke et al.
MMPI characteristics of pregnancy
J Clin Psychol
(1962)
PA Chapple et al.
Changes of personality in pregnancy and labour
Proc Roy Soc Med
(1964)
JJ Kear-Colwell
Neuroticism in the early puerperium
Brit J Psychiat
(1965)

R Meares et al.

Pregnancy and neuroticism

Med J Aust

(1972)

D Osborne

Comparison of MMPI scores of pregnant women and female medical patients

Clin Psychol

(1977)

A Davids et al.

Consistency of maternal attitudes and personality from pregnancy to 8 months following childbirth

Develop Psychol

(1970)

A Blau et al.

Maternal attitude to pregnancy instrument

Arch gen Psychiat

(1964)

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Psychometric performance assessment of the Arabic version of the pregnancy experience scale–brief version (PES–brief) in an Arabic-speaking population
2023, Journal of Psychosomatic Research
Although tools exist to assess psychological distress during pregnancy, a scarcity of instruments are designed to measure maternal perceptions of the more positive, uplifting features of pregnancy in addition to the more negative, hassling aspects. To address this shortcoming, DiPietro et al. developed the Pregnancy Experience Scale–Brief (PES-Brief). We aimed to assess the reliability and psychometric performance of an Arabic translation of the PES–Brief among Lebanese pregnant women.
The PES-Brief, the Patient Health Questionnaire, the Lebanese Anxiety Scale, and the Multidimensional Scale of Perceived Social Support were administered to 433 participants. PES-Brief scores were computed as frequency and intensity, with Hassles to Uplifts frequency and intensity ratios.
The PES–Brief was internally consistent, with McDonald's ω = 0.87 for Uplifts and 0.81 for Hassles. Higher PES-Uplifts scores were significantly associated with lower depression and anxiety scores, and higher perceived social support; whereas higher PES-Hassles scores showed inverse correlations. The Hassles to Uplifts frequency and intensity ratios were 0.864 and 0.836, respectively, indicating that pregnant women were more uplifted than hassled. The CFA results confirmed the two-factor structure of the scale.
Our findings suggest that the Arabic PES–Brief is a psychometrically valid and reliable scale that may be employed as a legitimate indicator of pregnancy-specific uplifts and hassles among Arabic-speaking populations. Our study prompts clinicians and researchers to benefit from this tool for capturing the integral psychological/emotional experience of women during pregnancy, which may facilitate pregnant women's support when needed.
Longitudinal associations between mindfulness and changes to body image in first-time parent couples
2023, Body Image
Pregnancy and postpartum are associated with declines in body image. Research on postpartum body image focuses almost exclusively on the person who gave birth and studies examining protective factors for postpartum body image are scarce. We assessed 257 new-parent couples from mid-pregnancy to 6-months postpartum to examine whether mindfulness—a recognized contributor to psychological well-being—buffered against declines in both partners’ perceptions of mothers’ body. Mothers’ positive body image and partners’ perception of mothers’ body were collected at four time-points (second and third trimester; 3- and 6-months postpartum); both partners’ mindfulness facets—observing, describing, awareness acting, non-judgement, and non-reactivity—were assessed in the second trimester. Dyadic latent growth curve modeling revealed that both partners’ perceptions of mothers’ body were positively correlated at all moments; however, mothers’ positive body image worsened over time, whereas partners’ perception of mothers’ body remained stable. Mindfulness facets were positively associated with mothers’ positive body image (observe, describe, and non-judging) and fathers’ (non-judging) perceptions of mothers’ body in pregnancy. Mothers’ mindfulness facets (acting with awareness, non-judging) were associated with subsequent trajectories of their own body image. By identifying mindfulness facets as targetable protective factors during pregnancy, these findings have implications for future research and interventions focused on perinatal body image.
Effect of intervention delivered by frontline maternal care providers to improve outcome and parenting skills among adolescents with perinatal depression in Nigeria (the RAPiD study): A cluster randomized controlled trial
2022, Journal of Affective Disorders
Citation Excerpt :
The primary outcomes, determined at six months postpartum, was difference between participants in the intervention and control arms in the level of depressive symptoms as assessed with the EPDS and the level of parenting skills as measured by the total and subscale scores on the Infant Toddler version of the Home Inventory for Measurement of the Environment (HOME-IT) (Caldwell and Bradley, 2003). Secondary outcomes were assessed at three- and six-month postnatal periods and consisted of a) depression remission rates (EPDS score < six); b) level of disability as assessed using the WHO Disability Assessment Scale (Holden, 1991b); c) maternal attitude and adjustment to pregnancy and mother hood as measured with the Maternal Adjustment and Maternal Attitude scale (MAMAS) (Kumar et al., 1984), d) quality of life using the short form of the WHO Quality of Life scale, WHOQoL-Bref (The WHOQOL Group, 1998), and e) mother-infant interactions assessed using the Postnatal Bonding Questionnaire (PBQ) (Brockington et al., 2006). Using a questionnaire designed for the purpose, we assessed the use of family planning approaches by the adolescents following the index childbirth.
Perinatal depression is more common and is associated with greater negative consequences among adolescents than adults. Psychosocial interventions designed for adults may be inadequate at addressing the unique features of adolescent perinatal depression.
In a two-arm parallel cluster randomized trial conducted in thirty primary maternal care clinics in Ibadan, Nigeria (15-intervention and 15-control) we compared age-appropriate intervention consisting of problem-solving therapy, behavioral activation, parenting skills training, and parenting support from a self-identified adult to care as usual. Pregnant adolescents (aged <20 years) at fetal gestational age16–36 weeks with moderate to severe depression were recruited. Primary outcomes were depression symptoms (Edinburgh Postnatal Depression Scale, EPDS) and parenting practices (Infant-Toddler version of the Home Inventory for Measurement of the Environment, HOME-IT) at six-months postnatal.
There were 242 participants (intervention arm: 141; Control arm: 101), with a mean age of 18∙0 (SD-1∙2). Baseline mean EPDS score was 14∙2 (SD-2.1); 80∙1 % completed the six-month postnatal follow-up. The intervention group had lower level of depressive symptoms than the control group, mean EPDS scores: 5∙5 (SD-3∙6) versus 7∙2 (SD-4∙0) (adjusted mean difference -1∙84 (95%CI- 3∙06 to −0∙62; p = 0∙003) and better parenting practices, mean total HOME-IT scores: 29∙8 (SD-4∙4) versus 26∙4 (SD-4∙2) (adjusted mean difference 3∙4 (95%Cl- 2∙12 to 4∙69, p = 0∙001).
This study explored the effect of complex interventions making it difficult to know precisely what aspects produced the outcomes.
An age-appropriate psychosocial intervention package holds promise for scaling up care for adolescents with perinatal depression especially in resource-constrained settings.
ISRCTN16775958. Registered on 30 April 2019.
Validation of the Maternal and Partner Sex During Pregnancy Scales (MSP/PSP) in Portugal: Assessing Dyadic Interdependence and Associations with Sexual Behaviors
2021, Journal of Sexual Medicine
The Maternal and Partner Sex During Pregnancy Scales (MSP/PSP) are self-report measures of expectant couples’ attitudes towards sex during pregnancy.
This study aimed to examine dyadic non-independence of MSP/PSP scores in a sample of expectant couples, while providing an evaluation of factor structure, validity, and reliability of the Portuguese versions of the MSP/PSP. The association between partners’ attitudes and frequency of sexual behaviors was also examined.
A total of 189 expectant couples completed a survey that included a sociodemographic questionnaire, the MSP/PSP, frequency of sexual behaviors, as well as validated measures of attitudes to sex, sexual function, sexual satisfaction, depression, and perceived social support.
Dyadic interdependence was tested via Pearson correlation between MSP/PSP scores; between-dyads variability was tested via intraclass correlation of the unconditional model including only MSP/PSP scores using a multi-level model. Associations between attitudes and sexual behavior were tested using regression analysis (between-dyads outcomes) or APIM (mixed outcomes).
Factor structure, internal consistency, and validity (convergent, discriminant, and concurrent) of the Portuguese versions of the scales were assessed.
MSP/PSP scores were interdependent within-dyads. Male partners presented significantly more positive attitudes towards sex during pregnancy than pregnant women. Attitudes were linked to indices of sexual well-being for both partners (sexual functioning, sexual satisfaction) and, for both partners, more positive attitudes were associated with higher frequencies of most partnered sexual behaviors. The Portuguese MSP/PSP scales showed good factor structure, and good to excellent indices of reliability and validity.
The Portuguese MSP/PSP is adequate for use in couples. The scales can be used to screen partners with negative attitudes towards sex during pregnancy and evaluate how these attitudes relate to intra- and inter-individual sexual well-being during pregnancy.
A strength of this study is the inclusion of both expectant partners and the use of dyadic analysis. Couples who participated in the study were all in mixed-gender/sex relationships, although this was not defined as an inclusion criterion. Future studies should use the MSP/PSP in more diverse samples in order to further determine how the scale performs for couples with different characteristics.
Scores in the MSP/PSP are interdependent between mixed-sex/gender expectant couple members. More positive attitudes towards sex during pregnancy are linked to higher frequencies of partnered sexual behaviors and to both partners’ greater sexual well-being.
Tavares Inês M., Heiman Julia R., Rosen Natalie O., et al. Validation of the Maternal and Partner Sex During Pregnancy Scales (MSP/PSP) in Portugal: Assessing Dyadic Interdependence and Associations with Sexual Behaviors. J Sex Med Rev 2021;18:789–799.
Measuring bonding or attachment in the parent-infant-relationship: A systematic review of parent-report assessment measures, their psychometric properties and clinical utility
2020, Clinical Psychology Review
Citation Excerpt :
Finally, when higher quality evidence (e.g., CFA) was available for a given measure, lower quality evidence (e.g., EFA) was ignored. In terms of hypothesis testing for construct validity, the decision was made to include any published measure as a comparator instruments that measured a similar construct (e.g., other attachment measures included in the current review or a subscale from a measure not included in the review, such as the attitudes towards pregnancy and the baby subscale of the MAMA scale, Kumar et al., 1984). To receive a ‘sufficient’ rating, 75% of the correlations tested had to meet the cut-off of r ≥ 0.50 against a comparator instrument measuring a similar construct.
Meaningful, valid and reliable self-report measures can facilitate the identification of important parent-infant-relationship factors, relevant intervention development and subsequent evaluation in community and clinical contexts. We aimed at identifying all available parent-report measures of the parent-infant-relationship or bond and to appraise their psychometric and clinimetric properties.
A systematic review (PROSPERO: CRD42017078512) was conducted using the, 2018 COSMIN criteria. Eight electronic databases were searched. Papers describing the development of self-report measures of the parent-infant-bond, attachment or relationship from pregnancy until two years postpartum or the assessment of their psychometric properties were included.
Sixty-five articles evaluating 17 original measures and 13 modified versions were identified and reviewed. The studies' methodological quality (risk of bias) varied between ‘very good’ and ‘inadequate’ depending on the measurement property assessed; however, scale development studies were mostly of ‘inadequate’ quality. Although most measures had good clinical utility, the psychometric evaluation of their properties was largely poor. The original or modified versions of the Postpartum Bonding Questionnaire collectively received the strongest psychometric evaluation ratings with high quality of evidence.
This novel review revealed that only a few antenatal and postnatal measures demonstrated adequate psychometric properties. Further studies are needed to determine the most robust perinatal measures for researchers and clinicians.
Effect of prenatal distress on subjective happiness in pregnant women: The role of prenatal attitudes towards maternity and ego-resiliency
2020, Personality and Individual Differences
Citation Excerpt :
In our sample, internal consistency was 0.768. The 11-items Prenatal attitudes towards Motherhood and Pregnancy Questionnaire (Kumar et al., 1984; Polish version: Ilska & Przybyła-Basista, 2014) was used. Each item was rated on a 4-point scale, where 1 means “not at all” and 4 “very much”.
The aim of the study was to assess the significance of prenatal distress for the subjective happiness of pregnant women, taking into account the mediatory role of prenatal attitudes towards motherhood and pregnancy, as well as ego-resiliency. 234 pregnant women, who were above 24 weeks of pregnancy, completed measures of prenatal distress, pregnancy attitudes towards motherhood and pregnancy, ego-resiliency, and subjective happiness. Results revealed that prenatal distress and anxiety prenatal attitudes proved to be negative determinants of subjective happiness of pregnant women. Ego-resiliency, in turn, was a positive indicator of subjective happiness. Ego-resiliency and anxiety prenatal attitudes fully mediate the relationship between prenatal distress and happiness. These findings have important practical implications regarding the planning of health care programs for pregnant women: Specifically, medical professionals must take personality into account as a potential determinant of pregnant women's health, not only for the prevention of risks (in the case of anxiety attitudes) but also for promoting health (in the case of ego-resiliency).

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^∗: Requests for reprints should be addressed to: Dr. R. Kumar, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.

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Development of a self-administered questionnaire to measure material adjustment and material attitudes during pregnancy and after delivery

Abstract

J Psychosom Res

J Psychosom Res

The relationship of emotional adjustment and attitudes to the course and outcome of pregnancy

Psychosom Med

The Birth of a First Child

A study of psychological processes in pregnancy and of the earliest mother-child relationship. 1. Some propositions and comments

The Psychoanalytic Study of the Child

Psychotherapy with pregnant women

MMPI characteristics of pregnancy

J Clin Psychol

Changes of personality in pregnancy and labour

Proc Roy Soc Med

Neuroticism in the early puerperium

Brit J Psychiat