title: Neuroticism and low educational level predict the risk of posttraumatic stress disorder in women after miscarriage or stillbirth.
abstract: OBJECTIVE
  This study aimed to determine whether neuroticism and educational level predict posttraumatic stress disorder (PTSD) in women following an unsuccessful pregnancy.
  
  
  METHODS
  Via advertisements, pregnant women with a gestational period shorter than 12 weeks were asked to participate in a study regarding their perception of pregnancy. After they had agreed, they were sent questionnaires, including a scale for neuroticism and their highest attained educational level. Every other month during the pregnancy and 1 month after the expected date of birth, they were sent brief questionnaires about the pregnancy. Participants for whom the pregnancy had ended unsuccessfully were contacted by phone and asked to participate in a follow-up study with a PTSD scale.
  
  
  RESULTS
  Of the 1339 women studied, 126 (9%) experienced an unsuccessful pregnancy; 8 of these dropped out of the study (response rate, 94%); 1 had not indicated her educational level. The remaining 117 women filled out the PTSD scale after about 1 month. Thirty-one women (26%) met the DSM-IV criteria for PTSD and 86 women did not. Logistic regression analysis revealed that PTSD was significantly associated with higher neuroticism, lower educational level and longer duration of gestation.
  
  
  CONCLUSIONS
  For patients with a high educational level and low neuroticism score, the risk of developing PTSD was negligible, while for those with a low educational level and a high score for neuroticism, the estimated risk was about 70%. Care and guidance should focus primarily on the latter group.
authors.affiliation: Clinical Psychology, Utrecht University, PO Box 80.140, 3508 TC Utrecht, The Netherlands. i.m.engelhard@fss.uu.nl <i.m.engelhard@fss.uu.nl>
authors.forename: Iris M
authors.initials: IM
authors.lastname: Engelhard
authors.forename: Marcel A
authors.initials: MA
authors.lastname: van den Hout
authors.forename: Erik G W
authors.initials: EG
authors.lastname: Schouten
mesh_terms: D000022:Abortion, Spontaneous / Q000523:psychology*; D000328:Adult; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D009426:Netherlands; D009497:Neurotic Disorders / Q000175:diagnosis / Q000523:psychology*; D010555:Personality Inventory; D011247:Pregnancy; D012307:Risk Factors; D050497:Stillbirth / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology*