City Research Online

Longitudinal trajectories of post-traumatic stress disorder (PTSD) after birth and associated risk factors

Dikmen-Yildiz, P., Ayers, S. & Phillips, L. (2018). Longitudinal trajectories of post-traumatic stress disorder (PTSD) after birth and associated risk factors. Journal of Affective Disorders, 229, pp. 377-385. doi: 10.1016/j.jad.2017.12.074

Abstract

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.

Publication Type: Article
Additional Information: © 2018 Elsevier B.V. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords: Post-traumatic stress disorder, Trajectories, Childbirth Risk factors, Resilience, Recovery
Departments: School of Health & Psychological Sciences > Midwifery & Radiography
School of Health & Psychological Sciences
SWORD Depositor:
[thumbnail of Running head Trajectories of birth-related PTSD.pdf]
Preview
Text - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (340kB) | Preview

Export

Add to AnyAdd to TwitterAdd to FacebookAdd to LinkedinAdd to PinterestAdd to Email

Downloads

Downloads per month over past year

View more statistics

Actions (login required)

Admin Login Admin Login