Sandra Nakić Radoš

Anxiety and anxiety sensitivity as predictors of fear of childbirth: different patterns for nulliparous and parous women

Abstract Objective: The demographic characteristics, maternal parity and personal traits of pregnant women have been frequently studied predictors of fear of childbirth (FOC). The aim of this study was to examine the role of demographic variables, expected pain level, trait anxiety and anxiety sensitivity in FOC among nulliparous and multiparous women in the last trimester of pregnancy. Method: Two-hundred pregnant women completed a booklet with questionnaires including the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), Anxiety Sensitivity Index (ASI), The State – Trait Anxiety Inventory (STAI) and questions on expected labor pain and demographics. Results: Results showed that FOC was higher amongst nulliparous women, but FOC level was not associated with other demographic variables. Different predictors were established in nulliparous and multiparous women. While higher intensity of expected labor pain and anxiety sensitivity (dimension physical concern) were significant predictors in both groups, trait anxiety was significant for the first-time mothers only. Conclusion: Amongst all women, anxiety sensitivity (physical concerns dimension) was identified as an important vulnerability factor for FOC. As such, the level of anxiety sensitivity, and any resulting fear or expectations of pain, should be assessed in expectant mothers by clinicians in prenatal settings. Furthermore, anxiety sensitivity should be an important target for psychological interventions aimed at managing FOC.

Personal growth in UK and Croatian women following childbirth: A preliminary study

Objective: The aim of this study was to examine growth in UK and Croatian women following childbirth and to identify correlates of personal growth after birth, specifically focusing on sociodemographic, obstetric and coping variables. Background: Childbirth is a significant and challenging life event for many women with the potential for both positive and negative psychological changes. Research is increasingly exploring growth in different cultures. No studies have explored growth in Croatian women following childbirth. Methods: UK (N = 193) and Croatian (N = 160) women who had given birth within the last two years completed online questionnaires measuring growth, depression, posttraumatic stress symptoms and coping strategies. Results: Approximately 44% and 35% of UK and Croatian women, respectively, reported a moderate level of growth after childbirth. Hierarchical multiple regression analyses showed that younger women in both countries reported more growth. In the UK sample, coping strategies were related to higher growth. In the Croatian sample, higher posttraumatic stress symptoms and the avoidant coping strategy of denial were associated with higher levels of growth. Conclusion: This study suggests that many women report positive changes as a result of their birth experience. Further research is needed to explore how cultural elements are manifested in the experience of growth.

Is the Predictability of New-Onset Postpartum Depression Better During Pregnancy or in the Early Postpartum Period? A Prospective Study in Croatian Women

The researchers’ aim was to examine whether it was better to predict new-onset postpartum depression (PPD) during pregnancy or immediately after childbirth. A prospective study conducted in Croatia followed women (N = 272) from the third trimester of pregnancy through the early postpartum period (within the first 3 postpartum days), to 6 weeks postpartum. Questionnaires on depression, anxiety, stress, coping, self-esteem, and social support were administered. Through regression analyses we showed that PPD symptoms could be equally predicted by variables from pregnancy (30.3%) and the early postpartum period (34.0%), with a small advantage of PPD prediction in the early postpartum period.

Are non-pregnant women afraid of childbirth? Prevalence and predictors of fear of childbirth in students

Abstract Introduction: Fear of childbirth (FOC) has been mostly studied in peripartum women; however, it can be present in non-pregnant young women, and the question is whether it occurs even before pregnancy planning. Objective: (1) to determine the prevalence of clinically significant FOC in non-pregnant female students, and (2) to investigate the role of anxiety sensitivity (AS), trait anxiety, childbirth pain expectancy, and sources of birth knowledge for FOC. Methods: Non-pregnant female students (N = 374) from different study programmes (health studies, social sciences and humanities, and biotechnical studies) participated in the study. They completed Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ, version A), The State–Trait Anxiety Inventory (STAI-T), Anxiety Sensitivity Index (ASI), the average expected labor pain, and sources of information about childbirth. Results: The results showed that 25.9% of students reported clinically significant FOC. FOC could be predicted by postponing pregnancy planning, the high expectancy of labor pain, high trait anxiety, and high physical dimension of AS. Students from health sciences reported a lower level of FOC, as opposed to social science and humanities’ students. Students reported receiving the most information about childbirth from family and the least from the professional books. Conclusions: Fear of childbirth is highly prevalent in the sample of young nulliparous women with one in four women reporting clinically significant fear. The higher levels of the FOC could be predicted, by AS, trait anxiety, expected labor pain, and sources of knowledge about the childbirth. Implications of the findings are discussed.

Anxiety During Pregnancy and Postpartum: Course, Predictors and Comorbidity with Postpartum Depression

SUMMARY – Previous findings on peripartum anxiety are inconsistent in respect to the prevalence and course of peripartum anxiety with comorbidity of depression. Our aim was threefold: (1) to examine the course of elevated anxiety during pregnancy, immediately after childbirth, and six weeks postpartum; (2) to establish comorbidity of postpartum anxiety and postpartum depression (PPD); and (3) to examine predictors of anxiety 6 weeks postpartum. A sample of women (N=272) who were below the cut-off score for clinical depression during pregnancy were assessed in the third trimester of pregnancy, then 2 days and 6 weeks postpartum. Questionnaires on anxiety, pregnancy specific distress, stress, coping styles, social support, and depression were administered at each assessment. Obstetric data were collected from the participants’ medical records. The estimated rate of high anxiety was 35% during pregnancy, 17% immediately after childbirth, and 20% six weeks postpartum, showing a decrease in anxiety levels after childbirth. Comorbidity of anxiety and PPD was 75%. Trait anxiety and early postpartum state anxiety are significant predictors of postpartum anxiety. Anxiety is a common peripartum psychological disturbance. Anxiety symptoms overlap with PPD, but not completely, indicating that screening for postpartum mental difficulties should include both depression and anxiety.

Functional hypothalamic amenorrhea and its psychological correlates: a controlled comparison

Abstract Objective: The goal of the study was to examine differences between adolescents and young women with functional hypothalamic amenorrhea (FHA) and control groups in personality traits, eating attitudes and behaviours, and perception of parental behaviour. Background: The FHA is stress-induced anovulation, both related to metabolic challenges, such as excessive exercise and malnutrition, and psychogenic challenges, such as perfectionism and poor coping strategies. Methods: Three groups of adolescents and young women participated in the study: the FHA group (N = 25), the organic anovulation group (N = 21) and the eumenorrheic group with regular menstrual cycle (N = 20). Questionnaires on multidimensional perfectionism, self-control methods, eating attitudes and behaviours and perception of parental behaviour were administered. A clinical interview (SCID) was conducted with each participant. Results: The FHA group had higher levels of perfectionism traits, i.e. higher levels of concerns over mistakes and personal standards, compared to control groups. The FHA group did not engage in disordered eating behaviours more often in comparison with control groups, but reported more prevalent history of anorexia nervosa. The FHA group did not differ from controls in perception of parental rejection, emotional warmth or overprotection. Conclusion: The findings suggest that FHA can be characterised by the subtle psychological differences in personality traits, so the patients need to be diagnosed carefully.