Development of a Measure of Postpartum PTSD: The City Birth Trauma Scale

Background: About 3–4% of women in community samples suffer from childbirth-related posttraumatic stress disorder (PTSD). Surprisingly, the recently developed City Birth Trauma Scale (City BiTS) was the first diagnostic tool for childbirth-related PTSD covering DSM-5 criteria for PTSD. Since no questionnaire on childbirth-related PTSD is available in German, we aimed to validate a German translation of the City BiTS and to provide information on its psychometric properties.Methods: A community sample of 1,072 mothers completed an online survey, which included questions on sociodemographic and obstetric characteristics, the German version of the City BiTS, the Impact of Event Scale-Revised (IES-R), the PTSD Checklist for DSM-5 (PCL-5), Edinburgh Postnatal Depression Scale (EPDS), and the anxiety subscale of the Depression, Anxiety, and Stress Scale (DASS-Anxiety).Results: Exploratory factor analysis (EFA) on a random split-half sample confirmed the previously reported two-factorial structure of the City BiTS. The factors “Childbirth-related symptoms” and “General symptoms” explained about 53%, 52% of variance. Internal consistency was good to excellent for the subscales and the total scale (Cronbach's Alpha = 0.89−0.92). In a confirmatory factor analysis (CFA) in the holdout sample the two-factorial solution reached the best model fit out of three models. Correlation analyses showed convergent validity of the City BiTS (total scale and subscales) with the IES-R and PCL-5 and divergent validity with the EPDS and the DASS-Anxiety.Limitations: Data were acquired in a community sample and prevalence rates might not be representative for mothers of high-risk groups, e.g., after preterm birth.Conclusions: The German version of the City BiTS is the first German questionnaire which allows to assess symptoms of childbirth-related PTSD according to DSM-5 criteria. Besides an improvement in clinical routine it will help to make data on prevalence of childbirth-related PTSD internationally comparable. In addition, this work provides a basis to assess childbirth-related PTSD in studies conducted with a longitudinal study design or in high-risk samples.

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Assessment of posttraumatic stress disorder among women after childbirth using the City Birth Trauma Scale in Spain.

Psychological Trauma Theory Research Practice and Policy ◽

10.1037/tra0001007 ◽

2021 ◽

Author(s):

Rafael A. Caparros-Gonzalez ◽

Borja Romero-Gonzalez ◽

M. Isabel Peralta-Ramirez ◽

Susan Ayers ◽

Alejandro Galán-Paredes ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Birth Trauma ◽

The City

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Construct Validity and Psychometric Properties of the Hebrew Version of the City Birth Trauma Scale

Frontiers in Psychology ◽

10.3389/fpsyg.2018.01726 ◽

2018 ◽

Vol 9 ◽

Cited By ~ 3

Author(s):

Jonathan E. Handelzalts ◽

Ilana S. Hairston ◽

Adi Matatyahu

Keyword(s):

Construct Validity ◽

Psychometric Properties ◽

Birth Trauma ◽

Hebrew Version ◽

The City

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Development and Validation of a Measure of Birth-Related PTSD for Fathers and Birth Partners: The City Birth Trauma Scale (Partner Version)

Frontiers in Psychology ◽

10.3389/fpsyg.2021.596779 ◽

2021 ◽

Vol 12 ◽

Author(s):

Rebecca Webb ◽

Ann M. Smith ◽

Susan Ayers ◽

Daniel B. Wright ◽

Alexandra Thornton

Keyword(s):

Birth Trauma ◽

Post Traumatic Stress ◽

Good Reliability ◽

Duration Of Symptoms ◽

Self Blame ◽

Traumatic Birth ◽

Post Traumatic ◽

Relationship Breakdown ◽

Development And Validation ◽

The City

Research suggests that some fathers and birth partners can experience post-traumatic stress disorder (PTSD) after witnessing a traumatic birth. Birth-related PTSD may impact on many aspects of fathers’ and birth partners’ life, including relationship breakdown, self-blame and reducing plans for future children. Despite the potential impact on birth partners’ lives there is currently no measure of birth-related PTSD validated for use with birth partners. The current study therefore adapted the City Birth Trauma Scale for use with birth partners. The City Birth Trauma Scale (Partner version) is a 29-item questionnaire developed to measure birth-related PTSD according to DSM-5 criteria: stressor criteria (A), symptoms of re-experiencing (B), avoidance (C), negative cognitions and mood (D), and hyperarousal (E), as well as duration of symptoms (F), significant distress or impairment (G), and exclusion criteria or other causes (H). A sample of 301 fathers/birth partners was recruited online and completed measures of birth-related PTSD, bonding, and demographic details. Results showed the City Birth Trauma Scale (Partner version) had good reliability (α = 0.94) and psychometric and construct validity. The fathers/birth partners version has the same two-factor structure as the original scale: (1) general symptoms and (2) birth-related symptoms, which accounted for 51% of the variance. PTSD symptoms were associated with preterm birth and maternal and infant complications. Overall, the City Birth Trauma Scale (Partner version) provides a promising measure of PTSD following childbirth that can be used in research and clinical practice.

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