Skip to main content
Original Article

Childbirth and Posttraumatic Stress Responses

A Validation Study of The Dutch Impact of Event Scale – Revised

Published Online:https://doi.org/10.1027/1015-5759.22.4.259

Childbirth has been identified as a possible traumatic experience, leading to traumatic stress responses and even to the development of posttraumatic stress disorder (PTSD). The current study investigated the psychometric properties of the Dutch version of the Impact of Event Scale-Revised (IES-R) in a group of women who recently gave birth (N = 435). In addition, a comparison was made between the original IES and the IES-R. The scale showed high internal consistency (α = 0.88). Using confirmatory factor analysis no support was found for a three-factor structure of an intrusion, an avoidance, and a hyperarousal factor. Goodness of fit was only reasonable, even after fitting one intrusion item on the hyperarousal scale. The IES-R correlated significantly with scores on depression and anxiety self-rating scales, as well as with scores on a self-rating scale of posttraumatic stress disorder. Although the IES-R can be used for studying posttraumatic stress reactions in women who recently gave birth, the original IES proved to be a better instrument compared to the IES-R. It is concluded that adding the hyperarousal scale to the IES-R did not make the scale stronger.

References

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author. First citation in articleGoogle Scholar

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. First citation in articleGoogle Scholar

  • Arbuckle, J. (1997). AMOS user's guide. Chicago: Smallwaters. First citation in articleGoogle Scholar

  • Arntz, A. (1993). Dutch translation of the PSS-SR. Universiteit Maastricht, the Netherlands: Author. First citation in articleGoogle Scholar

  • Asukai, N. , Kato, H. , Kawamura, N. , Kim, Y. , Yamamoto, K. , Kishimoto, J. (2002). Reliability and validity of the Japanese-language version of the Impact of Event Scale-Revised (IES-R-J): Four studies of different traumatic events. Journal of Nervous and Mental Disease, 190, 175–182. First citation in articleCrossrefGoogle Scholar

  • Ayers, S. , Pickering, A.D. (2001). Do women get posttraumatic stress disorder as a result of childbirth? A prospective study of incidence. Birth, 28, 111–118. First citation in articleCrossrefGoogle Scholar

  • Becht, M.C. , Van Erp, C.F. , Teeuwisse, T.M. , Van Heck, G.L. , Van Son, M.J. , Pop, V.J. (2001). Measuring depression in women around menopausal age: Toward a validation of the Edinburgh Depression Scale. Journal of Affective Disorders, 63, 209–213. First citation in articleCrossrefGoogle Scholar

  • Brewin, C.R. , Holmes, E.A. (2003). Psychological theories of posttraumatic stress disorder. Clinical Psychology Review, 23, 339–376. First citation in articleCrossrefGoogle Scholar

  • Brom, D. , Kleber, R.J. (1985). De Schokverwerkingslijst. [Impact of Event Scale] Nederlands Tijdschrift voor de Psychologie, 40, 164–168. First citation in articleGoogle Scholar

  • Brom, D. , Kleber, R.J. , Witztum, E. (1992). The prevalence of posttraumatic psychopathology in the general and the clinical population. Israelian Journal of Psychiatry and Related Science, 28(4), 53–63. First citation in articleGoogle Scholar

  • Brunet, A. , St Hilaire, A. , Jehel, L. , & King, S. (2003). Validation of a French version of the Impact of Event Scale-Revised. Canadian Journal of Psychiatry, 48(1), 56–61. First citation in articleGoogle Scholar

  • Cox, J.L. , Chapman, G. , Murray, D. , Jones, P. (1996). Validation of the Edinburgh Postnatal Depression Scale (EPDS) in nonpostnatal women. Journal of Affective Disorders, 39, 185–189. First citation in articleCrossrefGoogle Scholar

  • Cox, J.L. , Holden, J.M. , Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786. First citation in articleCrossrefGoogle Scholar

  • Creamer, M. , Bell, R. , Failla, S. (2003). Psychometric properties of the Impact of Event Scale-Revised. Behaviour Research and Therapy, 41, 1489–1496. First citation in articleCrossrefGoogle Scholar

  • Creedy, D.K. , Shochet, I.M. , Horsfall, J. (2000). Childbirth and the development of acute trauma symptoms: Incidence and contributing factors. Birth, 27, 104–111. First citation in articleCrossrefGoogle Scholar

  • Czarnocka, J. , Slade, P. (2000). Prevalence and predictors of posttraumatic stress symptoms following childbirth. British Journal of Clinical Psychology, 39, 35–51. First citation in articleCrossrefGoogle Scholar

  • Foa, E.B. , Riggs, D.S. , Dancu, C.V. , Rothbaum, B.O. (1993). Reliability and validity of a brief instrument for assessing posttraumatic stress disorder. Journal of Traumatic Stress, 6, 459–473. First citation in articleCrossrefGoogle Scholar

  • Horowitz, M.J. (1976). Stress response syndromes. New York: Jason Aronson. First citation in articleGoogle Scholar

  • Horowitz, M.J. (1997). Stress response syndromes: PTSD, grief, and adjustment disorders (3rd ed.). Northvale, NJ: Jason Aronson. First citation in articleGoogle Scholar

  • Horowitz, M. , Wilner, N. , Alvarez, W. (1979). Impact of Event Scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209–218. First citation in articleCrossrefGoogle Scholar

  • Hox, J. (1999). Principes en toepassing van structurele modellen. [Principles and application of structural models] Kind en Adolescent, 20, 200–217. First citation in articleGoogle Scholar

  • Hu, L. , Bentler, P.M. (1999). Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55. First citation in articleCrossrefGoogle Scholar

  • Inamoto, E. , Ando, K. , Kageyama, T. , Okada, T. , Ishii, T. , Asukai, N. (2002). Traumatic experience and “avoidance” mechanism – from an community survey on violence against women. Journal of Mental Health, 48, 35–41. First citation in articleGoogle Scholar

  • Keogh, E. , Ayers, S. , Francis, H. (2002). Does anxiety sensitivity predict posttraumatic stress symptoms following childbirth? A preliminary report. Cognitive Behaviour Therapy, 31, 145–155. First citation in articleCrossrefGoogle Scholar

  • Kleber, R.J. , Brom, D. (1992). Coping with trauma: Theory, prevention, and treatment. Lisse, the Netherlands: Swets & Zeitlinger. First citation in articleGoogle Scholar

  • Kleber, R.J. , De Jong, E. (1998). Dutch version of the Impact of Event Scale – revised.Internal report. Utrecht: Department of Clinical Psychology, Utrecht University. First citation in articleGoogle Scholar

  • Kleber, R.J. , Figley, C.R. , Gersons, B.P.R. (Eds.). (1995). Beyond trauma: Cultural and societal dynamics. New York: Plenum. First citation in articleCrossrefGoogle Scholar

  • Lyons, S. (1998). A prospective study of posttraumatic stress symptoms 1 month following childbirth in a group of 42 first-time mothers. Journal of Reproductive and Infant Psychology, 16, 91–105. First citation in articleCrossrefGoogle Scholar

  • Marmar, C.R. , Weiss, D.S. , Metzler, T.J. , Ronfeldt, H.M. , Foreman, C. (1996). Stress responses of emergency services personnel to the Loma Prieta earthquake, Interstate 880 freeway collapse, and control traumatic incidents. Journal of Traumatic Stress, 9, 63–85. First citation in articleCrossrefGoogle Scholar

  • Olde, E. , Van der Hart, O. , Kleber, R.J. , Van Son, M.J.M. , Wijnen, A.A.H. , Pop, V.J. (2005). Peritraumatic dissociation and emotions as predictors of PTSD symptoms following childbirth. Journal of Trauma and Dissociation, 6, 125–142. First citation in articleCrossrefGoogle Scholar

  • Pfefferbaum, B. , Seale, T.W. , McDonald, N.B. , Brandt, E.N., Jr. , Rainwater, S.M. , Maynard, B.T. (2000). Posttraumatic stress 2 years after the Oklahoma City bombing in youths geographically distant from the explosion. Psychiatry, 63, 358–370. First citation in articleGoogle Scholar

  • Pop, V.J. , Komproe, I.H. , van Son, M.J. (1992). Characteristics of the Edinburgh Post Natal Depression Scale in The Netherlands. Journal of Affective Disorders, 26, 105–110. First citation in articleCrossrefGoogle Scholar

  • Saladin, M.E. , Drobes, D.J. , Coffey, S.F. , Dansky, B.S. , Brady, K.T. , Kilpatrick, D.G. (2003). PTSD symptom severity as a predictor of cue-elicited drug craving in victims of violent crime. Addictive Behaviors, 28, 1611–1629. First citation in articleCrossrefGoogle Scholar

  • Simeon, D. , Greenberg, J. , Knutelska, M. , Schmeidler, J. , Hollander, E. (2003). Peritraumatic reactions associated with the World Trade Center disaster. American Journal of Psychiatry, 160, 1702–1705. First citation in articleCrossrefGoogle Scholar

  • Soet, J.E. , Brack, G.A. , & Dilorio, C. (2003). Prevalence and predictors of women's experience of psychological trauma during childbirth. Birth, 30, 36–46. First citation in articleCrossrefGoogle Scholar

  • Spielberger, C.D. , Gorusch, R.L. , Lushene, R.E. (1970). Manual for the State-Trait Anxiety Inventory (self-evaluation questionnaire). Palo Alto, CA: Consulting Psychologists. First citation in articleGoogle Scholar

  • Turnbull, S.J. , Campbell, E.A. , Swann, I.J. (2001). Posttraumatic stress disorder symptoms following a head injury: Does amnesia for the event influence the development of symptoms? Brain Injury, 15, 775–785. First citation in articleCrossrefGoogle Scholar

  • Van der Ploeg, E. , Mooren, T.T. , Kleber, R.J. , van der Velden, P.G. , Brom, D. (2004). Construct validation of the Dutch version of the Impact of Event Scale. Psychological Assessment, 16, 16–26. First citation in articleCrossrefGoogle Scholar

  • Van der Ploeg, H.M. , Defares, P.B. , Spielberger, C.D. (1981). de-Beoordelings Vragenlijst. Een Nederlandse bewerking van de Spielberger State-Trait Anxiety Inventory (STAI). [Manual of the Zelf-Beoordelings Vragenijst. A Dutch version of the Spielberger State-Trait Anxiety Inventory (STAI)]. Lisse: Swets & Zeitlinger B.V First citation in articleGoogle Scholar

  • Weathers, F.W. , Litz, B.T. , Herman, D.S. , Huska, J.A. , Keane, T.M. (1993). The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Paper presented at the 9th Annual Conference of the ISTSS, San Antonio First citation in articleGoogle Scholar

  • Weiss, D.S. , Marmar, C.R. (1997). The Impact of Event Scale – Revised. In J.P. Wilson, T.M. Keane, (Eds.), Assessing psychological trauma and PTSD: A handbook for practitioners (pp. 399–411). New York: Guilford. First citation in articleGoogle Scholar

  • Weiss, D.S. , Marmar, C.R. , Metzler, T.J. , Ronfeldt, H.M. (1995). Predicting symptomatic distress in emergency services personnel. Journal of Consulting and Clinical Psychology, 63, 361–368. First citation in articleCrossrefGoogle Scholar

  • Wijma, K. , Soderquist, J. , Wijma, B. (1997). Posttraumatic stress disorder after childbirth: A cross-sectional study. Journal of Anxiety Disorders, 11, 587–597. First citation in articleCrossrefGoogle Scholar

  • Wu, K.K. , Chan, K.S. (2003). The development of the Chinese version of Impact of Event Scale – Revised (CIES-R). Social Psychiatry and Psychiatric Epidemiology, 38, 94–98. First citation in articleCrossrefGoogle Scholar

  • Yehuda, R. , McFarlane, A.C. (1995). Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis. American Journal of Psychiatry, 152, 1705–1713. First citation in articleCrossrefGoogle Scholar