Academic journal article Journal of Prenatal & Perinatal Psychology & Health

The Factor Structure of the Cambridge Worry Scale in Early Pregnancy

Academic journal article Journal of Prenatal & Perinatal Psychology & Health

The Factor Structure of the Cambridge Worry Scale in Early Pregnancy

Article excerpt

ABSTRACT: The current study sought to establish the psychometric properties of the Cambridge Worry Scale (CWS) in early pregnancy to determine the potential clinical usefulness of the sub-scales that comprise this measure. The CWS was administered to 129 women during early pregnancy at the antenatal booking clinic. Factor analysis revealed support for the socio-medical, health, socio-economic and relationships subscale domains. The CWS sub-scales were observed to assess dimensions distinct to those of anxiety and depression. In summary, the CWS is a valid and reliable measure of distinct domains of pregnancy-related worry.

KEY WORDS: Pregnancy, anxiety, depression, worry, Cambridge Worry Scale.


The belief that emotions, behaviour and the physical and social environment of the pregnant woman may influence the development of the fetus is widely held and cross-cultural (Paarlberg, Vingerhoets, Passchier, Dekker & Van Geijn, 1995). Increasing attention has addressed the role of psychological stressors as determinants of obstetric problems (Chung, Lau, Yip, Chui & Lee, 2001; Crandon 1979; Nimby, Lundberg, Sveger & McNeil, 1999; Weisberg & Paquette, 2002), and the long term impact of anxiety during pregnancy on children beyond childbirth and infancy (Mulder, Robles de Medina, Huizink, Van deb Bergh & Buitlaar, 2001; O'Connor, Heron, Golding, Beveridge, & Glover, 2002). In summary, the strongest effect on infant development and behaviour were found for pregnancy-specific anxieties.

The association between anxiety and adverse pregnancy outcomes are well documented, but evidence remains scant regarding the causes of pregnant women's anxieties, the clinical significance of this being that in order to allay women's anxieties health professionals make assumptions about causes (Green, Kafetsios, Statham & Snowden, 2003). Concerns expressed by pregnant women are predominantly about the baby's health, but include the delivery, miscarriage in early pregnancy and their own physical appearance. (Georgsson-Ohman, Grunewald & Waldenstrom, 2003; Glazer, 1980; Light & Fenster, 1974; Statham, Green & Kafetsios, 1997). An additional worry identified by Georgsson-Ohman and colleagues (2003) was worry about maternity services, which included shortage of beds and medical safety, although this may have been context specific. Interventions that utilise technologies intended to improve the pregnancy experience may also have an affect on women's anxieties. Ultrasound scanning has been linked with both a decrease and an increase in anxiety (Green, 1990). Women's worries seem to follow a U shaped distribution with a decrease in mid-pregnancy (Georgsson-Ohman, et al., 2003; Green et al., 2003), consistent with the characteristic U shaped curve for mood during pregnancy first described by Lubin, Gardner and Roth (1975).

A range of experiential, attitudinal, personality and mood factors have been found to be related to baby worry (Statham et al., 1997). Further evidence suggests specific areas of pregnant women's concerns correlate with anxiety but still have unique predictive value for psychological health (Glazer, 1980) and mood (Green et al., 2003) outcomes. Other recent evidence has also demonstrated discrimination between non pathological worry and anxiety in the pregnant population (Stober & Muijs, 2001) this would suggest that worry has a certain content and is worthy of a independent assessment in pregnant women, in order to ascertain its associations with clinical and psychological outcomes regardless of anxiety.

The Cambridge Worry Scale (CWS)

Following the distinction of worry and anxiety as separate constructs, measures of worry in the general population were reported to measure degree of worry (Borkovec, Metzger & Pruzinsky, 1986) and the content of worry (Tallis, Eynsenck & Matthews, 1991). The Cambridge Worry Scale was developed for use in the Cambridge Prenatal Screening Study (Statham et al. …

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