Academic journal article Journal of Nursing Measurement

Psychometric Assessment of the Postpartum Depression Predictors Inventory-Revised

Academic journal article Journal of Nursing Measurement

Psychometric Assessment of the Postpartum Depression Predictors Inventory-Revised

Article excerpt

Identification of women at risk for postpartum depression requires reliable and valid assessment indices. The purpose of this article is to describe the psychometric properties of the Postpartum Depression Predictors Inventory-Revised (PDPI-R). Psychometric assessment of the PDPI-R was conducted in conjunction with the Centers for Epidemiologic Studies Depressed Mood Scale, and the Edinburgh Postnatal Depression Scale, using data from 139 pregnant women who were followed for 8 months after birth. The prenatal PDPI-R demonstrated concept, concurrent, and predictive validity. The postpartum PDPI-R demonstrated concurrent validity. Factor analysis revealed four underlying factors that did not match the original conceptualization of the instrument. Reliability of the total score resulting from the factor analysis was .83. Initial support for the reliability and validity of the PDPI-R was indicated.

Keywords: depression; measurement; postpartum; psychometric; reliability; validity

Clinical and subclinical levels of postpartum depression (PPD) affect the lives of millions of families every year. Women experience the most immediate effects of PPD. Qualitative reports describe in vivid detail the anxiety, hopelessness, and loss of interest in daily activities of these new mothers (Beck, 1992, 2002a); in the most severe cases women report fear of hurting themselves or their newborns. The effects of PPD extend beyond the woman to her family members. Goodman's (2004a) integrative review found that fathers experience depression more often if their spouse or partner is depressed in the postpartum period than their peers who have nondepressed partners, although studies of this topic are limited. Short- and long-term effects of PPD for newborns and children include altered mother-infant bonding and attachment (Bifulco et al., 2004; Lindgren, 2001), slower rate of infant growth (O'Brien, Heycock, Hanna, Jones, & Cox, 2004), and significant developmental delays through adolescence (Galler et al., 2004).

Disclosure and detection of PPD is complicated by a woman's fear of revealing depressive symptoms at what should be a joyous time of life. Some women do reveal depression symptoms only to have their health care providers dismiss their concerns (Nonacs & Cohen, 2002), attributing the symptoms to fatigue that is commonly reported in early parenthood (Elek, Hudson, & Fleck, 2002). Despite these difficulties with disclosure and detection, research studies identify major predictors of PPD (Marcus, Flynn, Blow, & Barry, 2003; Rubertsson & Waldenstrom, 2003). A clinical assessment of pregnant and postpartum women that is guided by the major predictors of PPD could help clinicians to identify women most at risk and enable intervention prior to the occurrence of depressive symptoms. Accurate assessment and early intervention may be preventative to the development of PPD. The Postpartum Depression Predictors Inventory and the Postpartum Depression Predictors Inventory-Revised were developed and modified precisely for this purpose based on the results of three meta-analyses (Beck, 1996a, 1996b, 2001). The interview-guided inventory can be used in quantitative projects with the recent specification of scoring and initial testing of sensitivity and specificity (Beck, Records, & Rice, 2006). No data are yet available for the reliability and validity of the PDPI-R. The purposes of this article are to (a) provide a brief description of the PDPI-R and (b) describe the psychometric properties of the prenatal and postpartum versions of the PDPI-R.

BACKGROUND

Conceptual Basis of the PDPI-R

The PDPI-R is composed of 13 predictors, or risk factors, for postpartum depression (Beck, 2002b). The first 10 risk factors make up the prenatal version of the PDPI-R. These prenatal predictors include marital status, socioeconomic status, self-esteem, prenatal depression, prenatal anxiety, previous depression, social support, life stress, pregnancy intendedness, and marital satisfaction. …

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