Cognitive Behavioural Therapy Versus Psychoeducation for Perinatal Anxiety

The PSWQ is a 16-item self-report measure that assesses the tendency to worry. Items are scored on a 5-point scale ranging from 1 ('not typical at all') to 5 ('very typical'), with higher scores reflecting greater pathological worry. A cut-off score of 62 or higher has been suggested for determining a probable GAD diagnosis. The PSWQ has demonstrated excellent internal consistency and validity across various populations and has been validated for use in perinatal samples.

The GAD-7 is a 7-item self-report measure that assesses anxiety symptom severity over a previous two-week period. Items are measured on a 4-point scale ranging from 0 ('not at all') to 3 ('nearly every day'). A cut-off score of 10 or higher with sensitivity of 89% and specificity of 82% has been suggested for detecting a probable diagnosis of Generalized Anxiety Disorder. The GAD-7 has also been validated for use in perinatal samples.

The EPDS is a 10-item self-report measure that assesses symptoms of depression during the perinatal period. Items are scored on a 4-point scale ranging from 0 to 3, with higher scores reflecting greater depressive symptomatology. The EPDS has demonstrated good sensitivity and specificity for a diagnosis of Major Depressive Disorder (MDD). Cut-off scores of 15 and 13 or higher have been suggested for detecting a probable diagnosis of MDD during pregnancy and the postpartum period, respectively.

The WBI-PR is adapted from the Worry Behaviours Inventory, which assesses the frequency of problematic behaviours associated with generalized anxiety disorder. The WBI-PR is a 10-item self-report measure that is designed to measure problematic GAD behaviours during the perinatal period. Items are measured on a 5-point Likert scale, ranging from 0 to 4 and includes two subscales: Avoidance and Safety Behaviours. In its initial validation, the WBI-PR demonstrated acceptable internal consistency and convergent and discriminant validity.

The IUS is a 27-item self-report questionnaire assessing one's beliefs and reactions to uncertainty. Items are scored on a 5-point scale ranging from 1 ('not at all characteristic of me') to 5 ('entirely characteristic of me'), with higher scores reflecting greater intolerance of uncertainty. The IUS has demonstrated excellent internal consistency and test-retest reliability in the general population, and excellent convergent validity with measures of worry and GAD in perinatal populations. A cut-off score of 64 of greater with sensitivity of 89% and specificity of 65% has been determined for detection of an anxiety disorder within the perinatal period.

The PSS is the most widely used psychological instrument for measuring the perception of stress. The PSS is a 10-item self-report measure designed to assess the degree to which situations in one's life are appraised as stressful. Items are scored on a 5-point scale ranging from 0 ('never) to 4 ('fairly often') with higher scores reflecting greater perceived stress. The PSS has demonstrated good psychometric properties.

The DERS is a 36-item self-report scale designed to assess difficulties with emotion regulation. The DERS contains six subscales that measure: non-acceptance goals, impulse, awareness, strategies, and clarity. Items are rated on a 5-point Likert scale, ranging from 1 (almost never, 0-10%) to 5 (almost always, 91-100%), with higher scores reflecting greater difficulties regulating emotions. The DERS has demonstrated good internal consistency (α=0.86) and test-retest reliability (0.74).

The ISI is a 7-item self-report questionnaire that assesses the nature, severity, and impact of insomnia. Items are scored on a 5-point Likert scale ranging from 0 ('no problem') to 4 ('very severe problem') with higher scores reflecting greater insomnia severity. Total scores between 0-7 indicate an absence of insomnia; scores between 8-14 suggest subthreshold insomnia; scores between 15-21 indicate moderate insomnia; and scores between 22-28 suggest severe insomnia. The ISI has demonstrated good psychometric properties.

The ASI-3 is an 18-item self-report measures that assesses anxiety sensitivity related to physical, cognitive and social concerns. Items are scored on a 5-point scale ranging from 0 ('very little') to 4 ('very much'), with higher scores reflecting greater anxiety sensitivity. The ASI-3 has demonstrated good reliability and validity.

The ADAS is a 7-item self-report scale assessing relationship satisfaction and adjustment in couples. Six of the items are scored on a 6-point Likert Scale, with higher scores reflecting greater relationship satisfaction. Item seven provides a global 'overall happiness' rating and is scored on 7- point Likert Scale ranging from 0 (extremely unhappy) to 6 (perfect). The ADAS has demonstrated good internal consistency, validity, and responsivity to change.

The SPS is a 24-item self-report scale that assesses perceived social support received within social relationships. Items are scored on a 4-point scale ranging from 1 (strongly disagree) to 4 (strongly agree), with higher scores indicating higher levels of perceived social support. The SPS has 6 subscales assessing dimensions of attachment, social integration, reassurance of worth, guidance, nurturance, and reliance.

The IIRS is a 13-item self-report measure designed to assess the extent to which a particular problem causes impairment in different aspects of one's life including health, diet, work, recreation, finances, social and romantic relationships, sex life, self- and religious-expression, and community/civic involvement. Items are scores on a 7-point scale ranging from 1 ('not very much') to 7 ('very much'), with higher scores reflecting greater intrusiveness. The IIRS has shown good reliability and validity.

The WHOQoL-BREF is a 26-item self-report measure that assesses quality of life across four domains, including physical health, psychological health, social relationships, and environment (WHOQoL group, 1998). Items are scored on a 5-point Likert scale ranging from 1 to 5, with higher scores indicating greater quality of life. The WHOQoLBREF has demonstrated good discriminant validity, content validity, internal consistency, and test-retest reliability.

The CSQ is an 8-item self-report scale designed to measure satisfaction with health services. Items are scored on a 4-point scale from 1 to 4, with higher scores indicating higher levels of satisfaction with services. This scale demonstrates good psychometric properties with high internal consistency (Cronbach's alpha ranging from 0.92 to 0.93). In terms of construct validity, tests of global improvement correlated with client satisfaction (r = 0.53).