Kristie Alcorn - Academia.edu (original) (raw)

Papers by Kristie Alcorn

Research paper thumbnail of Subjective Appraisal of Threat (Criterion A2) as a Predictor of Distress in Childbearing Women

Journal of Nervous & Mental Disease, 2014

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has removed criterion A2 fr... more Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has removed criterion A2 from the diagnosis of posttraumatic stress disorder. The current study aimed to assess the claim that criterion A2 has low use in predicting distress, while addressing the shortcomings of previous research looking at criteria A1 and A2. Data from a longitudinal, prospective study was used, with 933 women having been assessed at four time points both prebirth and postbirth. In our sample of women, model comparisons suggest that criterion A2 should be reintroduced into the diagnostic criteria as it provides a better indicator of who goes on to have problems after giving birth than criterion A1 on its own. There is also evidence that this subjective reaction to event confrontation (A2) should include anger, shame, and guilt.

Research paper thumbnail of Predicting posttraumatic stress disorder after childbirth

Midwifery, 2014

Objective: Around 50% of women report symptoms that indicate some aspect of their childbirth expe... more Objective: Around 50% of women report symptoms that indicate some aspect of their childbirth experience was "traumatic", and at least 3.1% meet diagnosis for PTSD 6 months post partum. Here we aimed to conduct a prospective longitudinal study and examine predictors of birth-related trauma-predictors that included a range of pre-event factors-as a first step in the creation of a screening questionnaire. Method: Of the 933 women who completed an assessment in their third trimester, 866 were followed-up at 4 to 6 week postpartum. Two canonical discriminant function analyses were conducted to ascertain factors associated with experiencing birth as traumatic and, of the women who found the birth traumatic, which factors were associated with those who developed PTSD. Results: A mix of 16 pre-birth predictor variables and event-specific predictor variables distinguished women who reported symptoms consistent with trauma from those who did not. Fourteen predictor variables distinguished women who went on to develop PTSD from those who did not. Conclusions: Anxiety sensitivity to possible birthing problems, breached birthing expectations, and severity of any actual birth problem, predicted those who found the birth traumatic. Prior trauma was the single most important predictive factor of PTSD. Evaluating the utility of brief, cost-effective, and accurate screening for women at risk of developing birth-related PTSD is suggested. The arrival of a new baby is typically an event that is associated with much anticipatory and experienced joy. However, despite low mortality rates in developed countries (World Health Organization, 2004) the birthing process can, for a few, also be accompanied by feelings of terror, fear for the mother's or baby's life and a sense of helplessness or lack of control (Geller, 2004; Soderquist, Wijma, & Wijma, 2002). While experiencing some anticipatory anxiety may almost be viewed as normative, there are some women whose actual birthing experience results in them meet diagnostic criteria for either partial or full PTSD. In a large Australian sample of pregnant women (Alcorn, O'Donovan, Patrick, Creedy, & Devilly, 2010), 3.6% met full PTSD criteria (diagnosed using the Posttraumatic Diagnostic Scale; Foa, Cashman, Jaycox, & Perry, 1997) 4 to 6 weeks postpartum. By 6 months, this figure had risen to 5.8%. Controlling for antenatal psychopathology (pre-existing trauma and clinically significant depression and anxiety) only reduced these rates to 1.2% and 3.1% respectively. These rates are comparable to other reports where the rates of PTSD following childbirth have ranged from 1% to 6% (Creedy, Shochet, & Horsfall, 2000; Ayers & Pickering, 2001). These numbers are also similar to the 12-month prevalence rate of PTSD after experiencing a potentially traumatic event. Creamer, Burgess, and McFarlane (2001) found the proportion of women who met criteria for PTSD following any trauma to be 2.9%. These prevalence rates are of concern as PTSD following childbirth is associated with significant problems in mother-infant attachment (Allen, 1998), partner relationships (Beck, 2004) and increased use of the healthcare system (Switzer, Dew, Thompson, Goycoolea, Derricott & Mullins, 1999). It is reasonable to propose that further investigation of factors that predict PTSD will inform and improve clinical practice. Several studies have made a significant contribution to the field already. Soderquist and colleagues

Research paper thumbnail of Variations Among Women: An Investigation Into the Nature of Birth Trauma

An anxiety disorder following childbirth that has received increased research attention is Posttr... more An anxiety disorder following childbirth that has received increased research attention is Posttraumatic Stress Disorder (PTSD). However, methodological and theoretical problems limit research findings. This thesis identifies these problems, and evaluates research on trauma in childbirth considering these concerns. A primary aim of this thesis was to examine the prevalence of traumatic births and PTSD and partial PTSD (i.e., subsyndromal PTSD) using a methodology that addressed previous limitations. Data were collected during the third trimester and 4 to 6 weeks, 3 months, and 6 months postpartum. Nine hundred and thirty three women completed the first study phase. Results revealed that 45.5% of women experienced a traumatic birth using the DSM-IV criteria for a traumatic event and that 1.2% had PTSD at 4 to 6 weeks and 3.1% had PTSD at 3 and 6 months postpartum respectively. The prevalence rates of partial PTSD ranged from 1.3% to 2.3% postpartum. Another primary aim was to investi...

Research paper thumbnail of Running head : PREDICTING POSTTRAUMATIC STRESS DISORDER Predicting Posttraumatic Stress Disorder after Childbirth

Objective: Around 50% of women report symptoms that indicate some aspect of their childbirth expe... more Objective: Around 50% of women report symptoms that indicate some aspect of their childbirth experience was “traumatic”, and at least 3.1% meet diagnosis for PTSD 6 months post partum. Here we aimed to conduct a prospective longitudinal study and examine predictors of birth‐related trauma – predictors that included a range of pre‐event factors – as a first step in the creation of a screening questionnaire. Method: Of the 933 women who completed an assessment in their third trimester, 866 were followed‐up at 4 to 6 week postpartum. Two canonical discriminant function analyses were conducted to ascertain factors associated with experiencing birth as traumatic and, of the women who found the birth traumatic, which factors were associated with those who developed PTSD. Results: A mix of 16 pre‐birth predictor variables and event‐specific predictor variables distinguished women who reported symptoms consistent with trauma from those who did not. Fourteen predictor variables distinguished...

Research paper thumbnail of Anxiety, depression and PTSD in an Australian birthing cohort

Research paper thumbnail of A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events

Psychological Medicine, 2010

BackgroundChildbirth has been linked to postpartum impairment. However, controversy exists regard... more BackgroundChildbirth has been linked to postpartum impairment. However, controversy exists regarding the onset and prevalence of post-traumatic stress disorder (PTSD) after childbirth, with seminal studies being limited by methodological issues. This longitudinal prospective study examined the prevalence of PTSD following childbirth in a large sample while controlling for pre-existing PTSD and affective symptomatology.MethodPregnant women in their third trimester were recruited over a 12-month period and interviewed to identify PTSD and anxiety and depressive symptoms during the last trimester of pregnancy, 4–6 weeks postpartum, 12 weeks postpartum and 24 weeks postpartum.ResultsOf the 1067 women approached, 933 were recruited into the study. In total, 866 (93%) were retained to 4–6 weeks, 826 (89%) were retained to 12 weeks and 776 (83%) were retained to 24 weeks. Results indicated that, uncontrolled, 3.6% of women met PTSD criteria at 4–6 weeks postpartum, 6.3% at 12 weeks postpar...

Research paper thumbnail of The authors reply: PTSD due to childbirth stands at between 3.1% (adjusted) and 5.8% (unadjusted)

Psychological Medicine, 2011

Research paper thumbnail of Subjective Appraisal of Threat (Criterion A2) as a Predictor of Distress in Childbearing Women

Journal of Nervous & Mental Disease, 2014

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has removed criterion A2 fr... more Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has removed criterion A2 from the diagnosis of posttraumatic stress disorder. The current study aimed to assess the claim that criterion A2 has low use in predicting distress, while addressing the shortcomings of previous research looking at criteria A1 and A2. Data from a longitudinal, prospective study was used, with 933 women having been assessed at four time points both prebirth and postbirth. In our sample of women, model comparisons suggest that criterion A2 should be reintroduced into the diagnostic criteria as it provides a better indicator of who goes on to have problems after giving birth than criterion A1 on its own. There is also evidence that this subjective reaction to event confrontation (A2) should include anger, shame, and guilt.

Research paper thumbnail of Predicting posttraumatic stress disorder after childbirth

Midwifery, 2014

Objective: Around 50% of women report symptoms that indicate some aspect of their childbirth expe... more Objective: Around 50% of women report symptoms that indicate some aspect of their childbirth experience was "traumatic", and at least 3.1% meet diagnosis for PTSD 6 months post partum. Here we aimed to conduct a prospective longitudinal study and examine predictors of birth-related trauma-predictors that included a range of pre-event factors-as a first step in the creation of a screening questionnaire. Method: Of the 933 women who completed an assessment in their third trimester, 866 were followed-up at 4 to 6 week postpartum. Two canonical discriminant function analyses were conducted to ascertain factors associated with experiencing birth as traumatic and, of the women who found the birth traumatic, which factors were associated with those who developed PTSD. Results: A mix of 16 pre-birth predictor variables and event-specific predictor variables distinguished women who reported symptoms consistent with trauma from those who did not. Fourteen predictor variables distinguished women who went on to develop PTSD from those who did not. Conclusions: Anxiety sensitivity to possible birthing problems, breached birthing expectations, and severity of any actual birth problem, predicted those who found the birth traumatic. Prior trauma was the single most important predictive factor of PTSD. Evaluating the utility of brief, cost-effective, and accurate screening for women at risk of developing birth-related PTSD is suggested. The arrival of a new baby is typically an event that is associated with much anticipatory and experienced joy. However, despite low mortality rates in developed countries (World Health Organization, 2004) the birthing process can, for a few, also be accompanied by feelings of terror, fear for the mother's or baby's life and a sense of helplessness or lack of control (Geller, 2004; Soderquist, Wijma, & Wijma, 2002). While experiencing some anticipatory anxiety may almost be viewed as normative, there are some women whose actual birthing experience results in them meet diagnostic criteria for either partial or full PTSD. In a large Australian sample of pregnant women (Alcorn, O'Donovan, Patrick, Creedy, & Devilly, 2010), 3.6% met full PTSD criteria (diagnosed using the Posttraumatic Diagnostic Scale; Foa, Cashman, Jaycox, & Perry, 1997) 4 to 6 weeks postpartum. By 6 months, this figure had risen to 5.8%. Controlling for antenatal psychopathology (pre-existing trauma and clinically significant depression and anxiety) only reduced these rates to 1.2% and 3.1% respectively. These rates are comparable to other reports where the rates of PTSD following childbirth have ranged from 1% to 6% (Creedy, Shochet, & Horsfall, 2000; Ayers & Pickering, 2001). These numbers are also similar to the 12-month prevalence rate of PTSD after experiencing a potentially traumatic event. Creamer, Burgess, and McFarlane (2001) found the proportion of women who met criteria for PTSD following any trauma to be 2.9%. These prevalence rates are of concern as PTSD following childbirth is associated with significant problems in mother-infant attachment (Allen, 1998), partner relationships (Beck, 2004) and increased use of the healthcare system (Switzer, Dew, Thompson, Goycoolea, Derricott & Mullins, 1999). It is reasonable to propose that further investigation of factors that predict PTSD will inform and improve clinical practice. Several studies have made a significant contribution to the field already. Soderquist and colleagues

Research paper thumbnail of Variations Among Women: An Investigation Into the Nature of Birth Trauma

An anxiety disorder following childbirth that has received increased research attention is Posttr... more An anxiety disorder following childbirth that has received increased research attention is Posttraumatic Stress Disorder (PTSD). However, methodological and theoretical problems limit research findings. This thesis identifies these problems, and evaluates research on trauma in childbirth considering these concerns. A primary aim of this thesis was to examine the prevalence of traumatic births and PTSD and partial PTSD (i.e., subsyndromal PTSD) using a methodology that addressed previous limitations. Data were collected during the third trimester and 4 to 6 weeks, 3 months, and 6 months postpartum. Nine hundred and thirty three women completed the first study phase. Results revealed that 45.5% of women experienced a traumatic birth using the DSM-IV criteria for a traumatic event and that 1.2% had PTSD at 4 to 6 weeks and 3.1% had PTSD at 3 and 6 months postpartum respectively. The prevalence rates of partial PTSD ranged from 1.3% to 2.3% postpartum. Another primary aim was to investi...

Research paper thumbnail of Running head : PREDICTING POSTTRAUMATIC STRESS DISORDER Predicting Posttraumatic Stress Disorder after Childbirth

Objective: Around 50% of women report symptoms that indicate some aspect of their childbirth expe... more Objective: Around 50% of women report symptoms that indicate some aspect of their childbirth experience was “traumatic”, and at least 3.1% meet diagnosis for PTSD 6 months post partum. Here we aimed to conduct a prospective longitudinal study and examine predictors of birth‐related trauma – predictors that included a range of pre‐event factors – as a first step in the creation of a screening questionnaire. Method: Of the 933 women who completed an assessment in their third trimester, 866 were followed‐up at 4 to 6 week postpartum. Two canonical discriminant function analyses were conducted to ascertain factors associated with experiencing birth as traumatic and, of the women who found the birth traumatic, which factors were associated with those who developed PTSD. Results: A mix of 16 pre‐birth predictor variables and event‐specific predictor variables distinguished women who reported symptoms consistent with trauma from those who did not. Fourteen predictor variables distinguished...

Research paper thumbnail of Anxiety, depression and PTSD in an Australian birthing cohort

Research paper thumbnail of A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events

Psychological Medicine, 2010

BackgroundChildbirth has been linked to postpartum impairment. However, controversy exists regard... more BackgroundChildbirth has been linked to postpartum impairment. However, controversy exists regarding the onset and prevalence of post-traumatic stress disorder (PTSD) after childbirth, with seminal studies being limited by methodological issues. This longitudinal prospective study examined the prevalence of PTSD following childbirth in a large sample while controlling for pre-existing PTSD and affective symptomatology.MethodPregnant women in their third trimester were recruited over a 12-month period and interviewed to identify PTSD and anxiety and depressive symptoms during the last trimester of pregnancy, 4–6 weeks postpartum, 12 weeks postpartum and 24 weeks postpartum.ResultsOf the 1067 women approached, 933 were recruited into the study. In total, 866 (93%) were retained to 4–6 weeks, 826 (89%) were retained to 12 weeks and 776 (83%) were retained to 24 weeks. Results indicated that, uncontrolled, 3.6% of women met PTSD criteria at 4–6 weeks postpartum, 6.3% at 12 weeks postpar...

Research paper thumbnail of The authors reply: PTSD due to childbirth stands at between 3.1% (adjusted) and 5.8% (unadjusted)

Psychological Medicine, 2011