Longitudinal trajectories of post-traumatic stress disorder (PTSD) after birth and associated risk factors
Journal of Affective Disorders, cilt.229, ss.377-385, 2018 (SCI-Expanded, SSCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 229
- Basım Tarihi: 2018
- Doi Numarası: 10.1016/j.jad.2017.12.074
- Dergi Adı: Journal of Affective Disorders
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus
- Sayfa Sayıları: ss.377-385
- Anahtar Kelimeler: Post-traumatic stress disorder, Trajectories, Childbirth, Risk factors, Resilience, Recovery
- Kırklareli Üniversitesi Adresli: Evet
Özet
Background Although longitudinal trajectories of post-traumatic stress disorder (PTSD) are well-established in general trauma populations, very little is known about the trajectories of birth-related PTSD. This study aimed to identify trajectories of birth-related PTSD; determine factors associated with each trajectory; and identify women more likely to develop birth-related PTSD. Method 226 women who had traumatic childbirth according to DSM-IV criterion A were drawn from a community sample of 950 women. Measures were taken of PTSD, affective symptoms, fear of childbirth and social support in pregnancy, 4–6 weeks and 6-months postpartum. Information on some obstetric and psychosocial factors were also prospectively obtained. Results Four trajectories were identified: resilience (61.9%), recovery (18.5%), chronic-PTSD (13.7%) and delayed-PTSD (5.8%). Resilience was consistently distinguished from other PTSD trajectories by less affective symptoms at 4–6 weeks postpartum. Poor satisfaction with health professionals was associated with chronic-PTSD and delayed-PTSD. When affective symptoms at 4–6 weeks postpartum were removed from the model, less social support and higher fear of childbirth 4–6 weeks after birth predicted chronic and recovery trajectories; whereas experience of further trauma and low levels of satisfaction with health professionals were predictive of chronic-PTSD and delayed-PTSD, compared to resilience. Additional variables associated with different trajectories included antenatal affective symptoms, caesarean-section, preterm birth and receiving professional help. Limitations Use of self-report measures, use of DSM-IV criteria for PTSD diagnosis, and no follow-up beyond six months are the main limitations of this study. Conclusion Identified factors may inform preventive and treatment interventions for women with traumatic birth experiences.