title: Posttraumatic stress disorder in new mothers: results from a two-stage U.S. national survey.
abstract: BACKGROUND
  Prevalence rates of women in community samples who screened positive for meeting the DSM-IV criteria for posttraumatic stress disorder after childbirth range from 1.7 to 9 percent. A positive screen indicates a high likelihood of this postpartum anxiety disorder. The objective of this analysis was to examine the results that focus on the posttraumatic stress disorder data obtained from a two-stage United States national survey conducted by Childbirth Connection: Listening to Mothers II (LTM II) and Listening to Mothers II Postpartum Survey (LTM II/PP).
  
  
  METHODS
  In the LTM II study, 1,373 women completed the survey online, and 200 mothers were interviewed by telephone. The same mothers were recontacted and asked to complete a second questionnaire 6 months later and of those, 859 women completed the online survey and 44 a telephone interview. Data obtained from three instruments are reported in this article: Posttraumatic Stress Disorder Symptom Scale-Self Report (PSS-SR), Postpartum Depression Screening Scale (PDSS), and the Patient Health Questionnaire-2 (PHQ-2).
  
  
  RESULTS
  Nine percent of the sample screened positive for meeting the diagnostic criteria of posttraumatic stress disorder after childbirth as determined by responses on the PSS-SR. A total of 18 percent of women scored above the cutoff score on the PSS-SR, which indicated that they were experiencing elevated levels of posttraumatic stress symptoms. The following variables were significantly related to elevated posttraumatic stress symptoms levels: low partner support, elevated postpartum depressive symptoms, more physical problems since birth, and less health-promoting behaviors. In addition, eight variables significantly differentiated women who had elevated posttraumatic stress symptom levels from those who did not: no private health insurance, unplanned pregnancy, pressure to have an induction and epidural analgesia, planned cesarean birth, not breastfeeding as long as wanted, not exclusively breastfeeding at 1 month, and consulting with a clinician about mental well-being since birth. A stepwise multiple regression revealed that two predictor variables significantly explained 55 percent of the variance in posttraumatic stress symptom scores: depressive symptom scores on the PHQ-2 and total number of physical symptoms women were experiencing at the time they completed the LTM II/PP survey.
  
  
  CONCLUSIONS
  In this two-stage national survey the high percentage of mothers who screened positive for meeting all the DSM-IV criteria for a posttraumatic stress disorder diagnosis is a sobering statistic.
authors: School of Nursing, University of Connecticut, Storrs, USA.
authors: Cheryl Tatano
authors: CT
authors: Beck
authors: Robert K
authors: RK
authors: Gable
authors: Carol
authors: C
authors: Sakala
authors: Eugene R
authors: ER
authors: Declercq
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000523:psychology / Q000706:statistics & numerical data; D019052:Depression, Postpartum / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D011247:Pregnancy; D011644:Puerperal Disorders / Q000175:diagnosis / Q000453:epidemiology*; D012044:Regression Analysis; D012307:Risk Factors; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D013315:Stress, Psychological; D014481:United States / Q000453:epidemiology; D055815:Young Adult