Effects of the interaction between PTSD and ADHD symptoms on the level of reporting psychotic-like experiences: findings from a non-clinical population.

Objective: Psychotic-like experiences (PLEs) are increasingly being recognized as subclinical phenomena that might predict the development of various mental disorders that are not limited to the psychosis spectrum. Accumulating evidence suggests that attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) are highly comorbid mental disorders. However, their interactive effect on the occurrence of PLEs has not been investigated so far. Therefore, in the present study we aimed to investigate the effect of interaction between ADHD and PTSD symptoms on the level of psychotic-like experiences (PLEs) in the non-clinical sample. Methods: The study included 3,000 individuals aged 18-35 years with a negative history of psychiatric treatment. The symptoms of ADHD and PTSD were assessed using self-reports. Results: There was a significant association of the interaction between ADHD and PTSD with the level of reporting PLEs. This association remained significant after adjustment for age, gender, the level of education, the current vocational situation, lifetime history of problematic substance use, and depressive symptoms. Post-hoc tests demonstrated significantly higher levels of reporting PLEs in participants with positive screening for both ADHD and PTSD compared to other subgroups of participants. Also, individuals with positive screening for one vulnerability (either ADHD or PTSD) reported significantly higher levels of reporting PLEs compared to those with a negative screening for ADHD and PTSD. In turn, no significant differences between individuals reporting one vulnerability, i.e., between those with positive screening for ADHD and those with positive screening for PTSD, were observed. Conclusion: Findings from the present study imply that both PTSD and ADHD symptoms the interaction effect on the level of reporting PLEs that might be of importance for early intervention strategies. However, observed associations require replication in clinical samples.

Factors associated with fear of childbirth among Polish pregnant women.

The purpose of our study was to elucidate the association between obstetric and psychological factors and fear of childbirth (FOC) during the third trimester of pregnancy and to identify women at risk of severe FOC in Poland. An additional goal of the study was to verify the Polish version of the Wijma Delivery Expectancy Questionnaire (W-DEQ) and to establish its psychometric characteristics. Cross-sectional study with a total of 359 women recruited during routine visits to an antenatal clinic in Poland during the third trimester (≥ 27 weeks gestation). The survey included obstetric details (parity, obstetric history and preferred mode of delivery), and standardized psychological measures: the W-DEQ (fear of childbirth) and the EPDS (depressive symptoms). We demonstrated the satisfactory psychometric properties of the Polish version of the W-DEQ. Our findings confirm the one-factor structure found by the authors of the original version of the scale. A greater FOC was reported by women with unplanned pregnancies, women whose preferred mode of delivery was a cesarean section, and women who had previously undergone psychiatric treatment. The risk factors for severe FOC were depression, unplanned pregnancy or parity, and disagreement with the birth plan proposed by the obstetrician. The W-DEQ is a widely used, valid instrument for the assessment of FOC in pregnant women and can be used in Poland. Findings support the key role of obstetric and psychological variables in predicting fear of childbirth.