Hyperarousal symptoms after traumatic and nontraumatic births

Ayers, Susan, Wright, Daniel B and Ford, Elizabeth (2015) Hyperarousal symptoms after traumatic and nontraumatic births. Journal of Reproductive and Infant Psychology, 33 (3). pp. 282-293. ISSN 0264-6838

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Abstract

Background: Measurement is critical in postnatal posttraumatic stress disorder (PTSD) because symptoms may be influenced by normal postnatal phenomena such as physiological changes and fatigue. Objective: This study examined: (1) whether hyperarousal symptoms differ between women who have traumatic or nontraumatic births; (2) whether the construct of hyperarousal is coherent in postnatal women; and (3) whether hyperarousal symptoms are useful for identifying women who have traumatic births or PTSD.

Methods: A survey of PTSD symptoms in 1,078 women recruited via the community or Internet who completed an online or paper questionnaire measuring childbirth-related PTSD symptoms between 1 and 36 months after birth. Women who had a traumatic birth as defined by DSM-IV criterion A (n = 458) were compared with women who did not have a traumatic birth (n = 591).

Results: A one-factor dimension of hyperarousal was identified that included all five hyperarousal items. Diagnostic criteria of two or more hyperarousal symptoms in the previous week were reported by 75.3% of women with traumatic birth and 50.5% of women with nontraumatic births. The difference in mean hyperarousal symptoms between groups was substantial at 0.76 of a standard deviation (Hedge’s g, CI = 0.64, 0.89). A larger difference was observed between women with and without diagnostic PTSD (g = 1.64, CI 1.46, 1.81). However, receiver operating characteristic analyses showed hyperarousal symptoms have poor specificity and alternative ways of calculating symptoms did not improve this. Comparison with other PTSD symptoms found re-experiencing symptoms were most accurate at identifying women with traumatic births.

Conclusions: Results suggest hyperarousal symptoms are associated with traumatic birth and are a coherent construct in postnatal women. However, they have poor specificity and should only be used as part of diagnostic criteria, not as a sole indicator.

Item Type: Article
Keywords: childbirth, emotional, postnatal care
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Brighton and Sussex Medical School > Primary Care and Public Health
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > R Medicine (General)
Depositing User: Jane Hale
Date Deposited: 20 Mar 2015 15:54
Last Modified: 06 Mar 2017 05:13
URI: http://sro.sussex.ac.uk/id/eprint/53362

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