Introduction
Method
Participants
Mothers
Maternal characteristic | Value | Infant characteristic | Value |
---|---|---|---|
Maternal age (mean years ± SD) | 32.25 (22.94) | Infant age (mean weeks ± SD) | 13.02 (15.69) |
Ethnicity (N/%) | Birth order (N/%) | ||
White | 1935 (95.2) | 1st | 1221 (60.1) |
Pakistani | 4 (0.2) | 2nd | 644 (31.7) |
Black Caribbean | 3 (0.1) | 3rd | 128 (6.3) |
Bangladeshi | 5 (0.2) | 4th | 128 (6.3) |
Black African | 2 (0.1) | Timing of birth (N/%) | |
Chinese | 6 (0.3) | Premature (<37 weeks) | 137 (6.5) |
Indian | 14 (0.7) | Early term (>37 < 39 weeks) | 396 (19.4) |
Black other | 1 (0.0) | Full term (39 weeks) | 522 (25.7) |
Other | 56 (2.8) | Post term (>40 weeks) | 978 (48.1) |
Prefer not to say | 7 (0.3) | Multiple birth (N/%) | |
Marital status (N/%) | Yes | 23 (1.1) | |
Married | 1248 (61.4) | No | 2010 (98.9) |
Co-habiting | 741 (36.4) | Current feeding method (N/%) | |
Divorced | 2 (0.1) | Exclusively breastfeeding (100%) | 1056 (51.9) |
Widowed | 0 (0.0) | Predominantly breastmilk (over 80%) with a little formula milk (20%) | 175 (8.6) |
Separated | 4 (0.2) | Mainly breastmilk (50–80%) with some formula milk | 36 (1.8) |
Single | 38 (1.9) | A combination of both breastmilk (50%) and formula milk (50%) | 36 (1.8) |
Occupation (N/%) | Mainly formula milk (50–80%) with some breastmilk | 21 (1.0) | |
Managers, directors, senior officials | 247 (12.1) | Predominantly formula milk (over 80%) with a little breastmilk (20%) | 34 (1.7) |
Professionals | 874 (43.0) | Exclusively formula feeding (100%) | 675 (33.2) |
Associate professionals and technical | 59 (2.9) | ||
Administrative and secretarial | 297 (14.6) | ||
Skilled trade | 43 (2.1) | ||
Caring, leisure, and other service | 337 (16.6) | ||
Process, plant, and machine operatives | 4 (0.2) | ||
Elementary | 27 (1.3) | ||
Not in paid occupation | 145 (7.1) | ||
Education attainment (N/%) | |||
Postgraduate education | 500 (24.6) | ||
Undergraduate education | 899 (44.2) | ||
A-levels or college equivalent | 390 (19.2) | ||
GCSEs or secondary school equivalent | 168 (8.3) | ||
No qualifications | 24 (1.2) | ||
Other qualification | 52 (2.6) | ||
Current diagnosis of anxiety (N/%) | |||
Yes | 378 (18.6) | ||
No | 1642 (80.2) | ||
Prefer not to say | 13 (0.6) | ||
Current diagnosis of depression (N/%) | |||
Yes | 290 (14.3) | ||
No | 1734 (85.3) | ||
Prefer not to say | 9 (0.4) |
Expert panel
Design and procedure
Mothers
Expert panel
Measures
Demographic questions
Postpartum Specific Anxiety Scale (PSAS; Fallon et al. 2016)
Expert panel survey items
Ethics
Method of analysis
Principal component analysis (n = 672)
Confirmatory factor analyses (sample 2 n = 673; sample 3 n = 688)
Internal consistency
Results
Factor structure of the PSAS
Rotated components | ||||
---|---|---|---|---|
Scale Item | 1 | 2 | 3 | 4 |
Factor 1: Psychosocial adjustment to motherhood anxieties | ||||
I have worried more about completing household chores than before my baby was born | 0.70 | −0.02 | −0.14 | 0.14 |
I have felt resentment towards my partner | 0.68 | −0.13 | 0.04 | −0.03 |
I have been less able to concentrate on simple tasks than before my baby was born | 0.66 | 0.10 | −0.08 | 0.08 |
I have felt that I have had less control over my day than before my baby was born | 0.63 | 0.18 | −0.10 | −0.12 |
I have felt unable to juggle motherhood with other responsibilities | 0.61 | 0.06 | 0.01 | −0.09 |
I have worried that my partner finds me less attractive than before my baby was born | 0.61 | 0.00 | −0.13 | 0.22 |
I have felt isolated from family and friends | 0.60 | 0.01 | 0.09 | 0.13 |
I have worried more about my relationship with my partner than before my baby was born | 0.60 | −0.11 | 0.17 | 0.10 |
I have felt that I am not the parent I want to be | 0.59 | 0.17 | 0.20 | −0.13 |
I have felt tired even after a good amount of rest | 0.58 | 0.00 | −0.07 | 0.18 |
I have felt that I do not get enough support | 0.56 | −0.06 | 0.16 | 0.04 |
I have worried more about my relationship with my family than before my baby was born | 0.53 | −0.15 | 0.30 | 0.09 |
I have worried that I am not going to get enough sleep | 0.51 | 0.06 | 0.04 | −0.08 |
I have felt that other mothers are coping with their babies better than me | 0.51 | 0.42 | 0.14 | −0.14 |
I have felt that motherhood is much harder than expected | 0.50 | 0.14 | 0.18 | −0.15 |
I have worried more about my finances than before my baby was born | 0.46 | 0.02 | −0.13 | 0.30 |
I have worried more about my appearance than before my baby was born | 0.44 | 0.03 | −0.18 | 0.15 |
I have had difficulty sleeping even when I have had the chance to | 0.44 | 0.06 | 0.07 | 0.29 |
I have felt that I should not need help to look after my baby | 0.41 | 0.03 | 0.09 | 0.07 |
I have worried that other people think my parenting skills are inadequate | 0.41 | 0.27 | 0.22 | 0.01 |
I have worried more about my relationship with my friends than before my baby was born | 0.38 | −0.11 | 0.29 | 0.25 |
Factor 2: Practical infant care anxieties | ||||
I have worried about my baby’s milk intake | −0.05 | 0.71 | −0.08 | 0.16 |
I have worried about the way that I feed my baby | −0.04 | 0.66 | 0.03 | 0.06 |
I have worried about my baby’s weight | −0.25 | 0.65 | −0.04 | 0.25 |
I have worried about the length of time that my baby sleeps | 0.30 | 0.54 | −0.12 | −0.22 |
I have worried that my baby is less content than other babies | 0.17 | 0.53 | 0.15 | −0.09 |
I have worried about my baby’s health even after reassurance from others | 0.06 | 0.52 | 0.06 | 0.39 |
I have used the internet for reassurance about my baby’s health | 0.12 | 0.48 | −0.17 | 0.25 |
I have worried that my baby is not developing as quickly as other babies | 0.04 | 0.47 | 0.10 | 0.21 |
I have felt unconfident or incapable of meeting my baby’s basic care needs | 0.08 | 0.46 | 0.38 | −0.09 |
I have worried about being unable to settle my baby | 0.31 | 0.45 | 0.20 | −0.20 |
I have worried that my baby feels more content in someone else’s care | 0.13 | 0.37 | 0.24 | −0.08 |
I have worried about how I will cope with my baby when others are not around to support me | 0.30 | 0.35 | 0.19 | −0.14 |
I have worried about the bond I have with my baby | 0.31 | 0.35 | 0.28 | −0.11 |
I have worried about getting my baby into a routine | 0.16 | 0.34 | 0.27 | 0.04 |
I have worried about accidentally harming my baby | 0.25 | 0.28 | 0.13 | 0.16 |
Factor 3: Maternal competence and attachment anxieties | ||||
I have felt that my baby would be better cared for my someone else | −0.09 | −0.02 | 0.88 | 0.02 |
I have had negative thoughts about my relationship with my baby | 0.03 | 0.00 | 0.82 | −0.02 |
I have worried I will not know what to do when my baby cries | −0.02 | 0.14 | 0.67 | −0.03 |
I have worried that I will become too ill to care for my baby | 0.07 | −0.04 | 0.56 | 0.31 |
I have felt that when I do get help it is not beneficial | 0.28 | −0.03 | 0.46 | 0.26 |
I have worried that my baby is picking up on my anxieties | 0.34 | 0.12 | 0.44 | 0.14 |
Factor 4: Infant safety and welfare anxieties | ||||
I have repeatedly checked on my sleeping baby | 0.08 | 0.13 | −0.12 | 0.64 |
I have worried that my baby will stop breathing while sleeping | 0.03 | 0.14 | 0.11 | 0.64 |
I have felt frightened when my baby is not with me | 0.16 | 0.04 | 0.14 | 0.61 |
I have thought of ways to avoid exposing my baby to germs | −0.09 | 0.13 | 0.16 | 0.53 |
I have worried about my baby being accidentally harmed by someone or something else | 0.09 | −0.02 | 0.38 | 0.50 |
I have worried about leaving my baby in a childcare setting | 0.20 | 0.16 | −0.09 | 0.45 |
I have felt a greater need to do things in a certain way or order than before my baby was born | 0.23 | 0.03 | 0.19 | 0.39 |
I have worried about returning to work | 0.32 | 0.00 | −0.14 | 0.38 |
I have not taken part in an everyday activity with my baby because I fear they may come to harm | 0.17 | 0.21 | 0.24 | 0.24 |
% of variance explained | 17 | 10 | 9 | 8 |
McDonald’s ω | .90 | .85 | .78 | .88 |
Version 1 production: PSAS Working Group review
Version 2 production: statistical review
Expert panel
Version 3 production: face and content validity review
Version 4 production: qualitative review
Confirmation of factor structure for versions 1, 2, 3, and 4 (n = 673)
Version | ||||
---|---|---|---|---|
Scale item | 1 | 2 | 3 | 4 |
I have felt unable to juggle motherhood with my other responsibilities. | * | * | * | * |
I have worried more about my relationship with my family than before my baby was born. | * | |||
I have worried about accidentally harming my baby. | ||||
I have worried about how I will cope with my baby when others are not around to support me. | ||||
I have felt that I do not get enough support. | * | * | ||
I have been less able to concentrate on simple tasks than before my baby was born. | * | * | ||
I have felt that I should not need help to look after my baby. | ||||
I have felt frightened when my baby is not with me. | * | * | * | * |
I have worried I will not know what to do when my baby cries. | * | * | * | * |
I have worried more about my relationship with my partner than before my baby was born. | * | * | ||
I have worried that my baby feels more content in someone else’s care. | ||||
I have felt isolated from my family and friends. | * | * | ||
I have worried about my baby’s weight. | * | * | * | |
I have worried about getting my baby into a routine. | * | * | ||
I have worried that I will become too ill to care for my baby. | ||||
I have worried about my baby being accidentally harmed by someone or something. | * | * | * | |
I have felt unconfident or incapable of meeting my baby’s basic care needs. | ||||
I have worried about being unable to settle my baby. | ||||
I have felt a greater need to do things in a certain way or order than before my baby was born. | * | * | ||
I have had negative thoughts about my relationship with my baby. | * | * | * | * |
I have worried more about my relationship with my friends than before my baby was born. | * | |||
I have thought of ways to avoid exposing my baby to germs. | * | * | ||
I have worried that my baby is less content than other babies. | ||||
I have felt that other mothers are coping with their babies better than me. | ||||
I have felt that I am not the parent I want to be. | ||||
I have worried more about completing household chores than before my baby was born. | * | * | ||
I have not taken part in an everyday activity with my baby because I fear they may come to harm. | ||||
I have worried about my baby’s milk intake. | * | * | * | * |
I have felt that I have had less control over my day than before my baby was born. | * | * | * | * |
I have worried more about my finances than before my baby was born. | * | * | * | |
I have worried about my baby’s health even after reassurance from others. | ||||
I have felt that when I do get help it is not beneficial. | ||||
I have worried that my baby will stop breathing while sleeping. | * | * | * | * |
I have used the internet for reassurance about my baby’s health. | * | * | ||
I have worried about leaving my baby in a childcare setting. | * | |||
I have felt that my baby would be better cared for by someone else. | * | * | * | * |
I have worried that I am not going to get enough sleep. | * | * | * | * |
I have felt that motherhood is much harder than I expected. | ||||
I have worried that my baby is picking up on my anxieties. | * | * | * | |
I have worried about the bond that I have with my baby. | ||||
I have worried about the length of time that my baby sleeps. | * | * | ||
I have worried about returning to work. | ||||
I have worried more about my appearance than before my baby was born. | * | |||
I have had difficulty sleeping even when I have had the chance to. | * | * | ||
I have worried that other people think that my parenting skills are inadequate. | ||||
I have worried that my partner finds me less attractive than before my baby was born. | * | * | ||
I have worried that my baby is not developing as quickly as other babies. | * | * | ||
I have felt resentment towards my partner. | * | * | ||
I have worried about the way that I feed my baby. | * | * | * | |
I have repeatedly checked on my sleeping baby. | * | * | * | * |
I have felt tired even after a good amount of rest. | * | * |
Goodness of fit indices | Version 1 | Version 1** | Version 2 | Version 2* | Version 3 | Version 3* | Version 4 | Version 4** |
---|---|---|---|---|---|---|---|---|
CFI | .95 | .96 | .96 | .97 | .96 | .97 | .93 | .96 |
TLI | .94 | .95 | .95 | .96 | .95 | .96 | .91 | .95 |
RMSEA | 0.05 | 0.05 | 0.05 | 0.04 | 0.05 | 0.04 | 0.07 | 0.05 |
SRMR | 0.07 | 0.07 | 0.06 | 0.06 | 0.07 | 0.06 | 0.08 | 0.07 |
McDonald’s ω | .92 | – | .89 | – | .87 | – | .87 | – |
PSAS-RSF final version
Confirmation of factor structure for PSAS-RSF (n = 688; see Table 5)
Rotated components | ||||
---|---|---|---|---|
Scale item | 1 | 2 | 3 | 4 |
Factor 1: Psychosocial adjustment to motherhood | ||||
1. I have felt that I have had less control over my day than before my baby was born | 0.63 | 0.18 | −0.10 | −0.12 |
2. I have felt unable to juggle motherhood with other responsibilities | 0.61 | 0.06 | 0.01 | −0.09 |
3. I have worried that I am not going to get enough sleep | 0.51 | 0.06 | 0.04 | −0.08 |
4. I have worried more about my finances than before my baby was born | 0.46 | 0.02 | −0.13 | 0.30 |
Factor 2: practical infant care anxieties | ||||
5. I have worried about my baby’s milk intake | −0.05 | 0.71 | −0.08 | 0.16 |
6. I have worried about my baby’s weight | −0.25 | 0.65 | −0.04 | 0.25 |
7. I have worried about the length of time by baby sleeps | 0.30 | 0.54 | −0.12 | −0.22 |
8. I have worried about getting my baby into a routine | 0.16 | 0.34 | 0.27 | 0.04 |
Factor 3: maternal competence and attachment anxieties | ||||
9. I have felt that my baby would be better cared for my someone else | −0.09 | −0.02 | 0.88 | 0.02 |
10. I have had negative thoughts about my relationship with my baby | 0.03 | 0.00 | 0.82 | −0.02 |
11. I have worried I will not know what to do when my baby cries | −0.02 | 0.14 | 0.67 | −0.03 |
12. I have worried that my baby is picking up on my anxieties | 0.34 | 0.12 | 0.44 | 0.14 |
Factor 4: infant safety and welfare anxieties | ||||
13. I have repeatedly checked on my sleeping baby | 0.08 | 0.13 | −0.12 | 0.64 |
14. I have worried that my baby will stop breathing while sleeping | 0.03 | 0.14 | 0.11 | 0.64 |
15. I have felt frightened when my baby is not with me | 0.16 | 0.04 | 0.14 | 0.61 |
16. I have worried about my baby being accidentally harmed by someone or something else | 0.09 | −0.02 | 0.38 | 0.50 |
McDonald’s ω | 0.60 | 0.80 | 0.82 | 0.85 |