The PSAS scales

Until recently, most tools used to measure anxiety after birth have been developed in general adult populations. This is problematic because they contain items which are inappropriate and do not contain items relevant to new mothers. In response to this, The Postpartum Specific Anxiety Scale - or P-SAS for short - was developed as a self-report measure for use in the first postpartum year. It examines the frequency of maternal and infant focused anxieties experienced by women over the previous week. These anxieties are grouped as Maternal Competence and Attachment Anxieties (for example concerns around self-efficacy, parenting, and the mother-infant relationship); Infant Safety and Welfare Anxieties (these are concerns about infant illnesses, accidents, and fatalities); Practical Infant Care Anxieties (for example concerns around feeding, sleeping, and general routine); and finally, Psychosocial Adjustment to Motherhood Anxieties (which are concerns regarding personal appearance, relationships and support, work, and finances). Responses are scored between 1 and 4, with higher scores indicating higher levels of anxiety. Alternative versions of the PSAS have been validated including a 16-item Research Short-Form and a 12-item Research Short-Form for use in health crises. The PSAS is also available for use in a number of different languages.

PSAS

The full 51-item version of the scale has been validated in mothers of infants up to 6 months of age. It features four subscales of maternal anxiety, which can be scored independently, consisting of Maternal Competence and Attachment Anxieties, Practical Infant Care Anxieties, Infant Safety and Welfare Anxieties, and Psychosocial Adjustment to Motherhood Anxieties. The scale has excellent reliability and validity.

PSAS-RSF

A 16-item research short form of the PSAS has been developed for use in mothers of infants up to 12 months of age. It retains the original four-factor structure of the PSAS, whilst reducing participant burden.

PSAS-RSF-C

A 12-item research short form of the PSAS has been developed and validated for use during global crises, to enable rapid response research, whilst reducing participant burden. It has been translated into five languages: Italian (PSAS-IT-RSF-C), French (PSAS-FR-RSF-C), Spanish (PSAS-ES-RSF-C), Chinese (PSAS-CN-RSF-C), and Dutch (PSAS-NL-RSF-C).

Training

The PSAS, and its derivatives, are designed to examine the frequency, and not severity, of anxieties specific to the postpartum period. The PSAS is not a diagnostic tool, nor is it to be used for screening purposes, at present. The PSAS, and its derivatives, include items about emotional distress, and anxieties related to the participant’s newborn infant. Therefore, we recommend the Administering Researcher should score the scale before the woman leaves the research setting to ensure the participant has not been excessively distressed when completing the scale. Administering Researchers must be vigilant about the level of risk and referrals should be made where appropriate to ensure the safety of both the mother and baby. As it reflects the woman’s experience of the last 7 days, the PSAS may be used on more than one occasion to track any changes in postpartum responses and their frequencies.

Licencing

The Postpartum Specific Anxiety Scale (PSAS) is provided subject to copyright licence terms. The PSAS and any approved derivatives are licensed by the creator (Vicky Fallon, University of Liverpool) under the Creative Commons Attribution-Non-Commercial-No Derivatives 4.0 International License (CC-BY-NC-ND 4.0). A commercial licence agreement is required to use the PSAS for any other purpose whatsoever, including commercially sponsored clinical trials.