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. 2017 Mar;38(1):53-62.
doi: 10.1080/0167482X.2016.1252910. Epub 2016 Nov 10.

Psychometric properties of stress and anxiety measures among nulliparous women

Carla M Bann  1 , Corette B Parker  2 , William A Grobman  3 , Marian Willinger  4 , Hyagriv N Simhan  5 , Deborah A Wing  6 , David M Haas  7 , Robert M Silver  8 , Samuel Parry  9 , George R Saade  10 , Ronald J Wapner  11 , Michal A Elovitz  9 , Emily S Miller  12 , Uma M Reddy  4 ; NuMoM2b study
Affiliations

Psychometric properties of stress and anxiety measures among nulliparous women

Carla M Bann et al. J Psychosom Obstet Gynaecol. 2017 Mar.

Abstract

Objective: To examine the psychometric properties of three measures, the perceived stress scale (PSS), pregnancy experience scale (PES), and state trait anxiety inventory (STAI), for assessing stress and anxiety during pregnancy among a large sample of nulliparous women.

Methods: The sample included 10,002 pregnant women participating in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nMoM2b). Internal consistency reliability was assessed with Cronbach's alpha and factorial validity with confirmatory factor analyses. Intraclass correlations (ICCs) were calculated to determine stability of PSS scales over time. Psychometric properties were examined for the overall sample, as well as subgroups based on maternal age, race/ethnicity and language.

Results: All three scales demonstrated good internal consistency reliability. Confirmatory factor analyses supported the factor structures of the PSS and the PES. However, a one-factor solution of the trait-anxiety subscale from the STAI did not fit well; a two-factor solution, splitting the items into factors based on direction of item wording (positive versus negative) provided a better fit. Scores on the PSS were generally stable over time (ICC = 0.60). Subgroup analyses revealed a few items that did not perform well on Spanish versions of the scales.

Conclusion: Overall, the scales performed well, suggesting they could be useful tools for identifying women experiencing high levels of stress and anxiety during pregnancy and allowing for the implementation of interventions to help reduce maternal stress and anxiety.

Keywords: Anxiety; parity; psychometrics; stress.

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Conflict of interest statement

DECLARATION OF INTEREST STATEMENT

The authors report no conflicts of interest. This study is supported by grant funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): U10 HD063036, RTI International; U10 HD063072, Case Western Reserve University; U10 HD063047, Columbia University; U10 HD063037, Indiana University; U10 HD063041, University of Pittsburgh; U10 HD063020, Northwestern University; U10 HD063046, University of California Irvine; U10 HD063048, University of Pennsylvania; and U10 HD063053, University of Utah.

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