Revision of the Postpartum Depression Predictors Inventory

doi:10.1111/j.1552-6909.2002.tb00061.x

Journal of Obstetric, Gynecologic & Neonatal Nursing

Volume 31, Issue 4, May 2002, Pages 394-402

https://doi.org/10.1111/j.1552-6909.2002.tb00061.x Get rights and content

Postpartum depression has been described as a thief that steals motherhood. Early recognition is one of the major challenges with this devastating mood disorder. This article describes a revised version of the Postpartum Depression Predictors Inventory (PDPI) based on the results of an updated meta-analysis. This revised inventory consists of 13 risk factors related to postpartum depression. Guide questions for each of the 13 predictors that clinicians can use during an interview process also are included. Included among these 13 predictors in the PDPI-Revised are four new risk factors: self-esteem, marital status, socioeconomic status, and unplanned/unwanted pregnancy. Ideally, this checklist should be completed each trimester to update a pregnant woman's risk status. After a woman gives birth, the PDPI-Revised should be used to continue to monitor her risk status because she can develop postpartum depression at any time during the 1st year after childbirth.

Section snippets

Screening Instruments

A review of the literature revealed that in addition to the PDPI, there were six instruments designed to identify women during the prenatal period who are at risk for developing postpartum depression. The earliest instrument was developed by Braverman and Roux (1978). Clinical intuition and current knowledge regarding psychopathology were used to create the items in their instrument. Braverman and Roux tested a preliminary 19-item, yes/no questionnaire with 120 Canadian women and identified the

Updated Meta-Analysis

Thirteen significant predictors of postpartum depression were identified (Beck, 2001). Each of these 13 risk factors in the updated meta-analysis found to have a significant relationship with postpartum depression is defined below.

PDPI-Revised

The PDPI-Revised consists of 13 risk factors found to be related to postpartum depression in Beck’s (2001) updated meta-analysis (see Table 2). All 13 relationships were found to be statistically significant. Guide questions for each predictor that clinicians can use during the interview process are also listed in Table 2. These guide questions are intended to assist health care providers in determining whether a risk factor is present in the woman being interviewed. The first 10 risk factors

REFERENCES (27)

L. Appleby et al.
Screening women for high risk of postnatal depression
Journal of Psychosomatic Research
(1994)
C.T. Beck
A checklist to identify women at risk for developing postpartum depression
Journal of Obstetric, Gynecologic, and Neonatal Nursing
(1998)
C.T. Beck
The effects of postpartum depression on child development: A meta-analysis
Archives of Psychiatric Nursing
(1998)
C.T. Beck
Postpartum depression: Stopping the thief that steals motherhood
AWHONN Lifelines
(1999)
J. Petrick
Postpartum depression: Identification of high-risk mothers
Journal of Obstetric, Gynecologic, and Neonatal Nursing
(1984)
R. Ramsay
Postnatal depression, Lancet
(1993)
M. Bagedahl-Strindlund et al.
Postnatal depression: A hidden illness
Acta Psychiatrica Scandinavica
(1998)
C.T. Beck
The effects of postpartum depression on maternal-infant interaction: A meta-analysis
Nursing Research
(1995)
C.T. Beck
A meta-analysis of predictors of postpartum depression
Nursing Research
(1996)
C.T. Beck
A meta-analysis of the relationship between postpartum depression and infant temperament
Nursing Research
(1996)

C.T. Beck

Predictors of postpartum depression: An update

Nursing Research

(2001)

D. Boyer

Predictions of postpartum depression

NAACOG's Clinical Issues in Perinatal and Women's Health Nursing

(1990)

D. Boyer et al.

Prediction of postpartum depressive symptoms in low income Black women

(1990)

Cited by (162)

For Whom and for How Long Does the “Be a Mom” Intervention Work? A Secondary Analysis of Data From a Randomized Controlled Trial Exploring the Mid-Term Efficacy and Moderators of Treatment Response
2024, Behavior Therapy
This study explored clinical and sociodemographic moderators of treatment response to “Be a Mom”, an internet-based cognitive behavioral therapy (iCBT) intervention, from baseline to postintervention, in women at high risk for postpartum depression (PPD). The study also assessed the stability of women’s treatment gains from baseline to 4-months postintervention (follow-up). This open-label randomized controlled trial (RCT) involved a sample of 1,053 postpartum Portuguese women identified as being at high risk for PPD (i.e., having a score of 5.5 or higher on the Postpartum Depression Predictors Inventory-Revised); participants were allocated to “Be a Mom” intervention group or a waiting-list control group, and completed self-report measures at baseline, postintervention, and a 4-month follow-up (554 women completed follow-up assessments). Depressive and anxiety symptoms were measured using the Edinburgh Postnatal Depression Scale and the anxiety subscale of the Hospital Anxiety and Depression Scale, and flourishing/positive mental health was assessed with the Mental Health Continuum. Regression models and linear mixed models were used to examine moderators of treatment and the mid-term efficacy of the “Be a Mom” intervention, respectively. The results revealed that treatment completion, higher depression scores at baseline, and higher income levels were linked to greater symptom reduction and positive mental health enhancement. Moreover, the efficacy of the “Be a Mom” intervention was supported at the 4-month follow-up. The “Be a Mom” intervention appears to be an effective iCBT tool for reducing psychological distress and enhancing positive mental health in women at risk for PPD, with therapeutic improvements maintained over a 4-month period.
Are women with traits of perfectionism more likely to develop perinatal depression? A systematic review and meta-analysis
2022, Journal of Affective Disorders
Women who present with a maladaptive form of the perfectionism trait may be vulnerable to perinatal depression (PND). The studies examining this association, though, differ in the specific time-points at which PND is measured, the tool/s used to assess PND and/or perfectionism, and the sample of women used; consequently, extant results reflecting this association can be difficult to integrate and interpret. This systematic review and meta-analysis seeks to clarify the association between PND and perfectionism by surveying literature on the relationship. Literature search strategies were developed using medical subject headings (MeSH) and text words related to PND and perfectionism. Nine electronic databases of published and unpublished literature were searched for relevant studies, which were selected for inclusion in this systematic review and meta-analysis if they contained data on female participants aged 18 or over and pregnant or who were within 12 months post-birth; additionally, studies were included if they contained quantitative reporting of depressive symptoms and trait perfectionism symptoms within the perinatal period (between pregnancy and up to 12 months post-birth). Ten publications were selected for inclusion based on independent review against the selection criteria by the authors. Eight of the 10 publications provided substantial correlational data and were analysed using meta-analytic techniques. All studies showed a significant positive relationship between measures of perfectionism and depression at various time points within the perinatal period (3^rd trimester to 12-months postpartum), including concurrently in pregnancy, concurrently in postpartum, and longitudinally between pregnancy and postpartum. Interestingly, however, moderation analyses identified that the relationship between perfectionism and PND in the 3^rd trimester may emerge only when a perinatal-specific, but not when a general, depression screening tool is used. These analyses also revealed that the strength of the relationship between perfectionism and PND may increase with length of time postpartum. The findings of this systematic review and meta-analysis, thus, suggest that medical professionals should consider perfectionism when formulating PND prevention strategies and assessing for PND using perinatal-specific screening tools.
Predicting postpartum depression by evaluating temperament during pregnancy
2021, Journal of Affective Disorders
: The purpose of this study was to investigate premorbid temperaments to predict postpartum depression in pregnant women with no previous psychiatric history and to clarify the correlation between postpartum depression and the factors included in the Postpartum Depression Predictors Inventory-Revised (PDPI-R) and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A)/Munich Personality Test (MPT).
: A total of 170 eligible pregnant women filled out both questionnaires, the first between the 8th and 23rd week of gestation, and the latter between the 34th and 38th week of gestation. Participants filled out The Edinburgh Postnatal Depression Scale (EPDS) one month postpartum to measure for postpartum depression symptoms. All participants delivered full-term healthy babies.
: Seventeen (10%) women met the criteria for postpartum depression with a score of 9 or higher on the EDPS. The factors significantly related to developing postpartum depression were schizoid and melancholic temperament on the TEMPS-A/MPT and marital dissatisfaction on the PDPI-R. The total score on the PDPI-R was significantly correlated with depressive, cyclothymic, irritable, and anxious temperaments on the TEMPS-A/MPT. A lack of social support on the PDPI-R was significantly correlated with depressive, irritable, and anxious temperaments on the TEMPS-A/MPT.
: The findings suggest that postpartum depression may be related to schizoid and melancholic temperaments and marital dissatisfaction. The hyperthymic temperament was identified as a significant predictor in preventing PPD. Careful observation during puerperium is recommended if a pregnant woman is likely to have these temperaments or psychological conditions. Temperament evaluation should be done during pregnancy as a form of postpartum depression screening.
The peripartum human brain: Current understanding and future perspectives
2020, Frontiers in Neuroendocrinology
The peripartum period offers a unique opportunity to improve our understanding of how dramatic fluctuations in endogenous ovarian hormones affect the human brain and behavior. This notwithstanding, peripartum depression remains an underdiagnosed and undertreated disorder. Here, we review recent neuroimaging findings with respect to the neuroplastic changes in the maternal brain during pregnancy and the postpartum period. We seek to provide an overview of multimodal neuroimaging designs of current peripartum depression models of hormone withdrawal, changes in monoaminergic signaling, and maladaptive neuroplasticity, which likely lead to the development of a condition that puts the lives of mother and infant at risk. We discuss the need to effectively integrate the available information on psychosocial and neurobiological risk factors contributing to individual vulnerability. Finally, we propose a systematic approach to neuroimaging the peripartum brain that acknowledges important co-morbidities and variation in disease onset.
“Social support and stressful life events: risk factors for antenatal depression in nulliparous and multiparous women”
2024, Women and Health
Cascading effects of partner relationship satisfaction on complete perinatal mental health: An exploratory serial mediation analysis
2024, Current Psychology

View all citing articles on Scopus

View full text

Article: Principles & PracticeRevision of the Postpartum Depression Predictors Inventory

Section snippets

Screening Instruments

Updated Meta-Analysis

PDPI-Revised

Journal of Psychosomatic Research

Journal of Obstetric, Gynecologic, and Neonatal Nursing

Archives of Psychiatric Nursing

AWHONN Lifelines

Journal of Obstetric, Gynecologic, and Neonatal Nursing

Postnatal depression, Lancet

Postnatal depression: A hidden illness

Acta Psychiatrica Scandinavica

The effects of postpartum depression on maternal-infant interaction: A meta-analysis

Nursing Research

A meta-analysis of predictors of postpartum depression

Nursing Research

A meta-analysis of the relationship between postpartum depression and infant temperament

Nursing Research

Predictors of postpartum depression: An update

Nursing Research

Predictions of postpartum depression

NAACOG's Clinical Issues in Perinatal and Women's Health Nursing

Prediction of postpartum depressive symptoms in low income Black women

Article: Principles & Practice
Revision of the Postpartum Depression Predictors Inventory