Psychometric properties of the European Portuguese version of the modified perinatal PTSD questionnaire (PPQ-II)

Childbirth-related posttraumatic stress symptoms (CB-PTSS) are prevalent and have pervasive consequences for the entire family. The development and validation of tools for screening CB-PTSS are deemed necessary to maximize prevention and intervention efforts. This study aims to examine the psychometric properties of the modified perinatal PTSD questionnaire (PPQ-II) in a sample of European Portuguese mothers. Four hundred and fifty-one women, from 1 to 18 months postpartum, participated in an online cross-sectional study that was conducted between February and March 2020. Participants completed the PPQ-II and the Depression Anxiety Stress Scales - 21 (DASS-21). Factor structure was estimated through an Exploratory (EFA; n = 229) and Confirmatory factor analysis (CFA; n = 222). Convergent and known-groups validity and internal consistency of the scale were also computed. The EFA suggested a 2-structure factor (Factor 1 "Arousal", containing 7 items; and Factor 2 "Avoidance and Intrusion", containing 4 items), accounting for 48.3% of the total variance of the scale. This factor structure was supported by the CFA, showing an adequate fit to the data. Convergent validity was shown by significant associations between the PPQ-II and DASS-21 subscales. Overall, the scale discriminated between at-risk and low-risk mothers. The McDonald' omega coefficients attested the high reliability of the PPQ-2 (ranging from 0.78 to 0.89). The PPQ-II is a valid and reliable instrument to routinely screen for CB-PTSS in perinatal health services. It also adds to prior studies demonstrating its cross-cultural validity.