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Turkish Adaptation and Psychometric Evaluation of the Tilburg Pregnancy Distress Scale-Revised in Three Independent
Meryem Kececi Oguzhanoglu1, Pelin Mutlu1, Kursat Oguzhanoglu1
1Department of Obstetrics and Gynecology, Haseki Training and Research Hospital, University of Health Sciences, 34265 Istanbul, Türkiye.
Background/Objectives: Pregnancy-specific distress is distinct from generic anxiety and depression and predicts adverse perinatal outcomes. This study adapted the 14-item Tilburg Pregnancy Distress Scale-Revised (TPDS-R), which assesses childbirth-related worries, pregnancy-related worries, and partner involvement, into Turkish and evaluated its measurement properties at three defined gestational stages. Methods: In this cross-sectional study, 450 pregnant women (150 each at 12, 22, and 32 gestational weeks) completed the Turkish TPDS-R and the Edinburgh Postnatal Depression Scale (EPDS). Adaptation followed an eight-stage procedure including expert panel review and pilot testing. Structural validity, reliability, measurement invariance, and convergent and known-groups validity were examined, with factor analyses estimated by robust diagonally weighted least squares in split-half samples. Results: Parallel analysis supported three factors. The three-factor model fitted adequately in the independent confirmatory half (CFI = 0.947) and the total sample (CFI = 0.962), although the TLI fell below the prespecified 0.90 criterion in all three gestational subgroups (0.877-0.899). Internal consistency was acceptable for the total scale (α = 0.70) but weak for pregnancy-related worries (α = 0.60); test-retest reliability was excellent (ICC = 0.94). Only configural invariance was supported. The total score correlated with the EPDS (r = 0.42), and primiparous women reported higher childbirth-related distress (d = 0.47). Pregnancy-related distress was lower in the later gestational groups. A 12-item version omitting items 3 and 10 fitted better but showed weaker external validity. Conclusions: The Turkish TPDS-R reproduces the original three-factor structure with excellent temporal stability, supporting dimensional assessment in research and clinical evaluation. Because measurement invariance was not established, between-group differences are descriptive. Criterion-validity studies and cut-off scores are needed before screening use.
Background/Objectives: Pregnancy-specific distress is distinct from generic anxiety and depression and predicts adverse perinatal outcomes. This study adapted the 14-item Tilburg Pregnancy Distress Scale-Revised (TPDS-R), which assesses childbirth-related worries, pregnancy-related worries, and partner involvement, into Turkish and evaluated its measurement properties at three defined gestational stages. Methods: In this cross-sectional study, 450 pregnant women (150 each at 12, 22, and 32 gestational weeks) completed the Turkish TPDS-R and the Edinburgh Postnatal Depression Scale (EPDS). Adaptation followed an eight-stage procedure including expert panel review and pilot testing. Structural validity, reliability, measurement invariance, and convergent and known-groups validity were examined, with factor analyses estimated by robust diagonally weighted least squares in split-half samples. Results: Parallel analysis supported three factors. The three-factor model fitted adequately in the independent confirmatory half (CFI = 0.947) and the total sample (CFI = 0.962), although the TLI fell below the prespecified 0.90 criterion in all three gestational subgroups (0.877-0.899). Internal consistency was acceptable for the total scale (α = 0.70) but weak for pregnancy-related worries (α = 0.60); test-retest reliability was excellent (ICC = 0.94). Only configural invariance was supported. The total score correlated with the EPDS (r = 0.42), and primiparous women reported higher childbirth-related distress (d = 0.47). Pregnancy-related distress was lower in the later gestational groups. A 12-item version omitting items 3 and 10 fitted better but showed weaker external validity. Conclusions: The Turkish TPDS-R reproduces the original three-factor structure with excellent temporal stability, supporting dimensional assessment in research and clinical evaluation. Because measurement invariance was not established, between-group differences are descriptive. Criterion-validity studies and cut-off scores are needed before screening use.
