Testing a cognitive model to predict posttraumatic stress disorder following childbirth

Area of Science:

• Psychology
• Obstetrics
• Mental Health

Background:

• Approximately one-third of women experience childbirth as traumatic.
• Between 0.8% and 6.9% of women develop posttraumatic stress disorder (PTSD) after childbirth.
• The cognitive model of PTSD, while applicable to various traumas, requires specific consideration for childbirth due to its unique nature.

Purpose of the Study:

• To investigate if variables from the cognitive model of PTSD explain unique variance in postnatal PTSD symptoms.
• To assess the applicability of the cognitive model to childbirth trauma.
• To identify key cognitive predictors of PTSD following childbirth.

Main Methods:

• A cross-sectional online survey was administered to 157 women 1-12 months postpartum.
• Validated questionnaires assessed PTSD, depressive symptoms, childbirth experience, social support, trauma memory, peritraumatic processing, negative appraisals, and cognitive/behavioral strategies.
• Demographic, obstetric, and clinical risk factors were also collected.

Main Results:

• A PTSD screening suggested 5.7% of the sample met diagnostic criteria.
• Risk factors alone predicted 43% of PTSD symptom variance; cognitive-behavioral factors alone predicted 72.7%.
• A combined model explained 73.7% of PTSD symptom variance, with cognitive factors uniquely predicting 37.1%.

Conclusions:

• Variables from Ehlers and Clark's cognitive model significantly predict PTSD symptoms post-childbirth.
• The cognitive model is applicable and useful for understanding and treating PTSD following childbirth.
• Cognitive factors play a crucial role in the development and maintenance of PTSD after traumatic childbirth experiences.