The Pregnancy Obsession-Compulsion-Personality Disorder Symptom Checklist

Abstract

Background: Up until now, very little research has been undertaken on the possible role of personality traits, such as perfectionism and obsessive compulsive personality disorder (OCPD), on pregnancy distress. This is possibly due to the fact that no appropriate instruments are available for use during pregnancy. The current study was undertaken to develop self-rating instruments for assessing symptoms of OCPD (including perfectionism) during gestation, and to evaluate the relationship between high scores on these scales and (recurrent) depression. Method: In a large unselected sample of 1095 pregnant women, the Clinical Perfectionism Scale was adapted and modified to fit into a 15-item perfectionism scale. At the same time, ten questions taken from the SCID OCPD structural interview were modified to fit into a separate self-rating scale. The sample was randomly split into two equal sub-samples: Group I was used for reliability and Explorative Factor Analysis (EFA), and Group II for Confirmative Factor Analysis (CFA). The Edinburgh Depression Scale (EDS), completed at 12, 22 and 32 weeks’ gestation was used to assess concurrent and discriminant validity. Results: A seven-item perfectionism (Eigenvalue: 3.6, 52% explained variance) and seven-item OCPD (Eigenvalue: 3, 40% explained variance) symptom check list retained good psychometric properties: Cronbach’s alpha of 0.85 and 0.78, respectively, and good CFA model fit: a CFI of 0.96, NFI of 0.95, TLI of 0.97, and RMSEA of 0.05, with a lower limit of 0.04; and CFI of 0.97, NFI of 0.97, TLI of 0.98, and RMSEA of 0.05 with a lower limit of 0.03, respectively. Both scales correlated significantly with EDS scores at different trimesters (r: 0.32-0.43). Significantly more often, women with high scores on these scales (defined as a score of >1 SD>mean) reported single and recurrent episodes of depression during gestation and a previous history of depression earlier in life. Conclusion: Self-rating scales that assess OCPD trait symptoms are able to detect women at risk for (recurrent) depression during pregnancy.