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The short version of the Postpartum Bonding Questionnaire: A cross-country psychometric study of mothers

Jarašiūnaitė-Fedosejeva, G., Radoš, S. N., Ayers, S. ORCID: 0000-0002-6153-2460 , Brekalo, M., Costa, R., Horsch, A., Ionio, C., Kalfon-Hakhmigari, M., Pinto, T. M., Rattaz, V., Riklikienė, O., Sigurðardóttir, V. L., Swift, E. M., Webb, R. ORCID: 0000-0002-8862-6491 & Handelzalts, J. E. (2026). The short version of the Postpartum Bonding Questionnaire: A cross-country psychometric study of mothers. Midwifery, 163, article number 105020. doi: 10.1016/j.midw.2026.105020

Abstract

Background: The Postpartum Bonding Questionnaire (PBQ) is widely used and considered a robust measure in terms of psychometric characteristics to assess difficulties in mother–infant bonding; however, the original 25-item version has yielded inconsistent factor solutions across studies and cultural contexts. Shorter versions may enhance feasibility for routine screening. Using multicountry data, the present study aimed to establish a short version of the PBQ that reflects the original structure and demonstrates adequate psychometric properties across countries. Methods: Data were collected from 1731 postpartum women across five European countries participating in the INTERSECT study. Participants completed the PBQ and the Edinburgh Postnatal Depression Scale at 6–12 weeks postpartum, with a subsample reassessed at 26 weeks postpartum (n = 352). Item reduction and factor structure were examined using exploratory and confirmatory factor analyses on split samples. Measurement invariance, internal consistency, test–retest reliability, and associations with depressive symptoms were assessed. Results: Analyses supported a unidimensional 10-item PBQ version with good model fit (RMSEA= .072; CFI=.973, TLI=.965, SRMR=.052), internal consistency (McDonald's ω=.82), and test–retest reliability (ICC=.73). This version showed a strong correlation with the original PBQ and demonstrated configural, metric, and scalar measurement invariance across countries. The short version was moderately associated with depressive symptoms. Conclusions: The findings support a brief, reliable PBQ version for assessing maternal bonding difficulties and suggest that variability in prior factor structures reflects differences in item stability rather than the absence of a coherent underlying construct.

Publication Type: Article
Additional Information: © 2026 The Authors. Published by Elsevier Ltd. This article is available under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed.
Publisher Keywords: Cross-cultural psychometrics, Infant, Mother, Postpartum bonding, Short version
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RG Gynecology and obstetrics
Departments: School of Health & Medical Sciences
School of Health & Medical Sciences > Department of Nursing & Midwifery
SWORD Depositor:
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