Reliability and validity of the original and brief German version of the Maternal Antenatal Attachment Scale (MAAS): Longitudinal study findings

Abstract

Background: Maternal-foetal attachment (MFA) seems essential for adapting to motherhood and the healthy development of the child, with direct implications for clinical practice. It is often assessed using the Maternal Antenatal Attachment Scale (MAAS), which covers two dimensions: quality and intensity of attachment. However, studies including the MAAS presented missing or inadequate psychometric properties. Therefore, the current study aimed to investigate the reliability and validity of both the original and the recently introduced brief German version of the MAAS.

Materials and methods: Data from 184 pregnant women from a longitudinal study were used. Women (≥ 18 years old) were recruited between the 18th and 22nd weeks of gestation while waiting for routine prenatal diagnostic appointments. Participants answered the MAAS, together with other questionnaires measuring maternal mental health, self-esteem, and social support. For both versions of the MAAS (19 items vs. 13 items), item characteristics, confirmatory factor analysis, internal consistency, and test-retest reliability were calculated and compared. Moreover, associations between the brief German MAAS and theoretically related constructs were analysed using correlation coefficients.

Results: In this study, item analyses revealed better psychometric properties for the brief German MAAS than for the original MAAS, with a significant reduction in items with inadequate discriminatory power. The internal consistency (α ≥ .69) and test-retest reliability (ICC ≥ .62) were acceptable to good for both MAAS versions. With regard to structural validity, factor analysis of the German MAAS presented acceptable to good global model fit indices for the model with correlated factors (GFI > .90; RMSEA ≤ .08; SRMR < .10) in the current sample. In contrast, most global model fit indices of the original MAAS were not acceptable. The construct validity of the German MAAS was demonstrated on the basis of small-to-moderate correlations with a variety of constructs (e.g., measures of depression, anxiety, stress).

Conclusions: According to the present results, the brief German version of the MAAS represents a reliable and valid measurement instrument of MFA for use in clinical practice. Further studies examining possible cut-off values are needed to identify pregnant women with significant attachment difficulties who may benefit from additional support.