How to Assess the Stress: An Exploration of the Importance of Perception for Prenatal Stress

• In Event: Stress Across the Transition to Parenthood

Abstract

The transition to parenthood is a time of great change for mothers. Although many feel joyful at the prospect of welcoming a new child, women can experience considerable stress during pregnancy. This stress can be associated with lasting negative outcomes for both mothers and children (Lautarescu et al., 2020; Obrochta et al., 2020). Although research has established clear associations between prenatal stress and child and maternal outcomes, measuring prenatal stress can be challenging because it is a multidimensional concept. The methods used to assess prenatal stress often ask women to report on the frequency with which they feel emotional symptoms, which can lead researchers and practitioners to use a definition of prenatal stress that does not adequately reflect the complexity of the construct. Existing measures do not typically take into consideration mothers’ perceptions of stressful experiences; rather, they assume that experiences are similarly stressful to everyone, despite individual differences. This study addresses gaps in our understanding of prenatal stress by exploring how the perception of stress aids in our understanding of the construct of prenatal stress. Measures were selected to reflect the most assessed domains of prenatal stress (i.e., pregnancy-specific anxiety, depression, and state-trait anxiety).

The sample is comprised of 337 pregnant women (80% Black, 20% White). The mean age of participants is 28.27 and the mean week of pregnancy is 22.31. Participants completed an online survey that included three rating scales: the Prenatal Distress Questionnaire (PDQ; Yali & Lobel, 1999), the Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987), and the State-Trait Anxiety Inventory (STAI; Spielberger et al., 1970). The scales were modified from their original format, which only asks about the frequency of each experience or event, to ask participants about both frequency and perceptions of how stressful each indicator is. Descriptive statistics, paired-sample t-tests, and correlations were conducted for each measure to examine whether frequency and perception were distinct but related markers of prenatal experiences. All analyses were conducted for the full sample and separately by race.

The mean total scores on all measures indicated mild to moderate concern. Correlations between the frequency and perception ratings of each measure varied, with the association being particularly strong for the PDQ and modest for the STAI and EPDS (See Table 1). Nevertheless, t-tests indicated in the full sample and in samples separated by race that mean frequency and mean perception were statistically different on each of the three measures of prenatal stress (See Table 2). For all samples, the average frequency was significantly lower than the average perception of stress on the PDQ and STAI, while frequency was significantly higher than perception on the EPDS. These significant mean differences support the hypothesis that the measurement of both frequency and perception of prenatal stress may provide important insight into understanding this construct. Prior to the conference, additional analyses will be conducted to explore construct invariance in each measure for Black and White women. These results will be discussed regarding the implications for practice and measurement.

Authors

• Erica Smolinski, University of Georgia
  Presenting Author

• Kristen L Bub, University of Georgia