Factor Structure and Measurement and Structural Invariance of the Edinburgh Postnatal Depression Scale during the Perinatal Period among Japanese Women: What Is the Best Model?

The Edinburgh Postnatal Depression Scale (EPDS) is a widely used screening tool for perinatal depression. Its factor structure is still a debatable topic. Our study aimed to examine the factor structure and measurement invariances of the Japanese version of the EPDS from late pregnancy to early postpartum. A total of 633 women were followed with the EPDS at three times over the perinatal period: late pregnancy (n = 633), 5 days after childbirth (n = 445), and 1 month after childbirth (n = 392). We randomly divided the participants into two groups: one for exploratory factor analyses (EFAs) and another for confirmatory factor analyses (CFAs). The result of the EFAs indicated different factor models at each time point. Hence, CFAs were performed using the second sample set to compare different models including the ones previously reported. A 3-factor model consisting of depression (items 7, 9), anxiety (items 4, 5), and anhedonia (items 1, 2) (Kubota et al., 2018) was consistently stable during the whole perinatal period. Kubota's 3-factor model showed invariance across the perinatal period.

Factor structure of the Postpartum Bonding Questionnaire: Configural invariance and measurement invariance across postpartum time periods.

BACKGROUND: Despite the research and clinical significance of the Postpartum Bonding Questionnaire (PBQ), its psychometric properties have not been studied intensively. The goodness-of-fit of proposed factor models of the PBQ is poor. Configural and measurement invariance have never been reported. METHODS: As a secondary analysis of the previous paper (Ohashi et al., 2016), we analysed the PBQ data at 5 days and 1 month after childbirth among 247 mothers of a singleton. We created 9 parcels of PBQ items to perform confirmatory factor analysis (CFA). We also examined configural and measurement invariances of the PBQ factor structure between the two observation times. RESULTS: The CFI of the 3-factor model of the PBQ was .936 and .968 for 5 days and 1 month after childbirth, respectively. Configural, measurement (metric, scalar, and residual), and structural (factor variance and factor covariance) invariances were accepted. The mean of only 'anger and restrictedness' factor was scored higher at 1 month than 5 days after childbirth. CONCLUSION: The 3-factor model of the PBQ was good in its fit with the data as well as robust in its measurement between the two observation time periods.

Perinatal self-report of thoughts of self-harm, depressive symptoms, and personality traits: Prospective study of Japanese community women.

AIM: The aim of this study was to identify women with thoughts of self-harm preceded by suicidal ideation, during the perinatal period, on cluster analysis and to clarify their psychological correlates. METHODS: A secondary analysis was conducted using the data from a longitudinal study involving 18 obstetric clinics between 2011 and 2012 in Kumamoto Prefecture (Japan). Self-administered questionnaires including demographic data, Edinburgh Postnatal Depression Scale, Temperament and Character Inventory, and the Postnatal Bonding Questionnaire were distributed during the third trimester of pregnancy (wave 1), at 5 days (wave 2), and 1 month postpartum (wave 3). RESULTS: On cluster analysis using the data of participants who answered all observational points, the participants were divided into two groups: cluster 1, normal (n = 201); and cluster 2, thoughts of self-harm (n = 42). Low self-directedness, low cooperativeness, higher anxiety, depression, and lack of affection and anger and rejection towards the baby were associated with cluster 2. CONCLUSIONS: The finding that low self-directedness and low cooperativeness were related to the cluster 2 group suggests that immature personality traits may work as a predisposing factor mediating between anxiety, depression and thoughts of self-harm.

Factor Structure of the Conflict Tactics Scale 1.

BACKGROUND: The Conflict Tactics Scale 1 (CTS1) is a widely used self-report measure of abusive attitudes of parents towards children. The factor structure of the CTS1 still remains to be clarified. The aim of this study was to examine the factor structure of the Japanese version of the CTS1 for postpartum women in community settings. METHOD: The data in this study came from the Okayama and Kumamoto's study. These were part of a larger survey using longitudinal questionnaire studies conducted in Japan from 2001 to 2002 and in 2011, respectively. In both study sites, the participant mothers were asked to fill in the CTS1 one month after delivery when they attended for check-up at the out-patient clinic. RESULTS: A total of 1,150 questionnaires were collected, excluding the participants with missing values in the CTS1. Finally, 1,078 were included in the statistical analyses. Data of 1,078 women were divided into two parts. In the first halved sample (n=578), an exploratory factor analysis was conducted for the CTS1 items after exluding nine items with extremely low prevalence. It revealed 2-factor or 3-factor models. Then, we conducted a model comparison with the second halved sample (n=500), using confirmatory factor analysis. In terms of goodness-of-fit indeces, the 2-factor model was superior. Its subscales were Reasoning and Psycholosical Aggression. CONCLUSION: The 2-factor model of the CTS1 consisting of Reasoning and Psychological Aggression was superior to the 3-factor model. This is not inconsistent with the original authors' theoretical model.

Postpartum Bonding Disorder: Factor Structure, Validity, Reliability and a Model Comparison of the Postnatal Bonding Questionnaire in Japanese Mothers of Infants.

Negative attitudes of mothers towards their infant is conceptualized as postpartum bonding disorder, which leads to serious health problems in perinatal health care. However, its measurement still remains to be standardized. Our aim was to examine and confirm the psychometric properties of the Postnatal Bonding Questionnaire (PBQ) in Japanese mothers. We distributed a set of questionnaires to community mothers and studied 392 mothers who returned the questionnaires at 1 month after childbirth. Our model was compared with three other models derived from previous studies. In a randomly halved sample, an exploratory factor analysis yielded a three-factor structure: Anger and Restrictedness, Lack of Affection, and Rejection and Fear. This factor structure was cross-validated by a confirmatory factor analysis using the other halved sample. The three subscales showed satisfactory internal consistency. The three PBQ subscale scores were correlated with depression and psychological abuse scores. Their test-retest reliability between day 5 and 1 month after childbirth was measured by intraclass correlation coefficients between 0.76 and 0.83. The Akaike Information Criteria of our model was better than the original four-factor model of Brockington. The present study indicates that the PBQ is a reliable and valid measure of bonding difficulties of Japanese mothers with neonates.

Temperament, Character, and Depressive Symptoms during Pregnancy: A Study of a Japanese Population.

Background. To examine the effects of temperament and character domains on depression during pregnancy. Methods. We examined 601 pregnant women using a questionnaire that included the Edinburgh Postnatal Depression Scale (EPDS), the Temperament and Character Inventory (TCI), and demographic variables. Results. In a hierarchical regression analysis, severity of depression during pregnancy was predicted by the women's negative response towards the current pregnancy, low self-directedness, and high harm avoidance, persistence, and self-transcendence. Conclusion. Depression during pregnancy is predicted by personality traits as well as women's negative attitudes towards the current pregnancy.